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Member Highlight Interview: Patrick Stover, Ph.D.

Dr. Stover graduated from Saint Joseph’s University with a B.S. degree in Chemistry and was awarded the Molloy Chemistry Award at graduation. He received a Ph.D. degree in Biochemistry and Molecular Biophysics from the Medical College of Virginia and performed his postdoctoral studies in Nutritional Sciences at the University of California at Berkeley. Patrick Stover was elected into the National Academy of Sciences in 2016. In 2014, he was elected as a Fellow of the American Association for the Advancement of Science. He also he received the SUNY Chancellor’s Award for Excellence in Scholarship and Creative Activities and the Osborne and Mendel Award for outstanding recent basic research accomplishments in nutrition from the American Society for Nutrition.

In 2012, he received a MERIT award from NIH’s National Institute of Diabetes and Digestive and Kidney Diseases and in 1999, he received the E.R.L. Stokstad Award in Nutritional Biochemistry from the American Society for Nutritional Sciences. In 1996, Patrick Stover received the Presidential Early Career Award for Scientists and Engineers from President Clinton, the highest honor bestowed by the U.S. government on outstanding scientists and engineers beginning their independent careers, and he has been selected as an Outstanding Educator four times by Cornell Merrill Presidential Scholars. He also serves as Editor for the Annual Review of Nutrition.

How did you first get involved in nutritional biochemistry and research? What made you interested in the field of nutrition science?

I caught the research bug through an undergraduate research experience at Saint Joseph’s University. Dr. Nelson’s research group was funded by the Naval Air Development Center and focused on the design, synthesis and function of synthetic prostaglandin oligomers as anti-ischemic agents. Studying the role and biological function of small nutrients became my passion and drove my interest in metabolism and biochemistry. I then studied enzymology and folate metabolism for my doctoral research under the mentorship of Dr. Verne Schirch at the Medical College of Virginia. This experience naturally led to an interest in nutrition and my migration to the University of California at Berkeley, when I studied folate nutrition and metabolism in the research group of Dr. Barry Shane.

When and why did you first join ASN? What value does ASN continue to provide you?

I joined ASN much later than I should have. I had regularly attended Experimental Biology and participated in ASN programming since graduate school but was most active in ASBMB. I joined ASN in1999 shortly after I was tenured as an associate professor, initially due to my interest in graduate education. I joined the Graduate Nutrition Education Committee and rose to rank of chair when we published what I believe is still a very important resource for all nutrition graduate programs: J Nutr.2002 Apr;132(4):779-84. ASN became my academic and professional home over the years—where I see old and meet new colleagues and collaborators, where my students present their research findings, where I developed leadership skills, and where I give time and treasure back to the nutrition community.

What aspects of ASN membership have you found most useful, professionally for you, your faculty and students? What other aspects of your membership do you find useful as your career has progressed?

All science is now a “social” science—collaboration is critical to address most important research questions. No one can succeed in a vacuum. Understanding how to forge meaningful and constructive partnerships through collaboration is essential to success, and ASN offers numerous opportunities to bring scientists together in an environment that promotes the exchange of ideas. Importantly, ASN also actively promotes mentoring opportunities for students and junior scientists, which has been invaluable for my students.

What aspects of your research do you foresee being most important for ASN members?

My bias is that nutrition, in all its dimensions, behaves as a complex dynamic system, and system approaches are needed to provide solutions to the problems we seek to solve. Hence, many of my current collaborators are those expert in systems biology and computer science.

Can you tell us more about your new position and what you hope to accomplish?

Perhaps the greatest challenge of our time is harmonizing agriculture, food systems, human health and environmental health. This is essential to address skyrocketing diet-related health care costs, environmental deterioration, and to ensure sustainability of our agriculture systems. Texas, as a national leader in agricultural production, coupled with its Healthy Texas A&M AgriLife Extension initiative, will be a model for aligning healthy and profitable agriculture with healthy people and healthy environments. As Vice Chancellor and Dean of Agriculture and Life Sciences at Texas A&M University and System, I have the privilege of working with the talented faculty, academic staff, students, state-wide agencies and stakeholders to be a national model for excellence in meeting the one-health challenge through research, teaching, Extension and service.

Is there anything else you’d like to tell ASN members, especially students and postdocs?

For the students and trainees, do what you love and you’ll love what you do! Strive to become a world-class expert in your field and enjoy as many colleagues as you can. Share your ideas with others, and they will share openly with you. Give back to the community that has given so much to you…perhaps through the ASN Foundation!

 

The Stover research group investigates the chemical, biochemical, genetic and epigenetic mechanisms that underlie the relationships between one-carbon metabolism and human pathologies including neural tube defects, cardiovascular disease and cancer. Specific interests include the regulation of folate-mediated one-carbon metabolism and genome expression and stability, the molecular basis of the fetal origins hypothesis, development of mouse models to elucidate mechanisms of folate-related pathologies, and translational control of gene expression.

 

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National Nutrition Month

March is National Nutrition Month. The campaign promotes healthy eating habits and nutrition education, and it celebrates the people who promote these healthy habits. In 2018, the theme is “Go Further with Food”, highlighting that food decisions make an impact on your overall health.

Members of the American Society for Nutrition (ASN) are diverse. We study nutrition as a science, reporting on the physiological and biological aspects of foods and nutrients. We are also the nutrition educators and practitioners who get the latest nutrition science into the hands of those who need it: policymakers, dietitians, medical doctors, nurses and allied health professionals, and consumers. To celebrate National Nutrition Month and ASN’s impact on enhancing the knowledge of nutrition and quality of life, we will be highlighting some of our programs and activities that ultimately influence public health and how we can “go further with food.”

NUTRITION 2018 – American Society for Nutrition’s Annual Meeting

Nutrition 2018 LogoThis year ASN kicks off a new annual meeting that will focus on the multidisciplinary field of nutrition science. The meeting will bring together basic, translational, clinical, and population scientists and practitioners. The meeting will be held in Boston June 9-12 and registration is open now!

Some hot nutrition topics at the meeting:

  • Role of Anti-inflammatory Nutrition Strategies
  • Pediatric Nutrition
  • Nutrition and the Environment
  • Precision Nutrition
  • Science of Breastfeeding
  • Food Allergies

These are only a few topics that are included in the 4-day nutrition meeting. Our NUTRITION 2018 schedule is now open so please refer to it for the latest sessions.

Stay tuned for more news and a special membership offer for dietitians and nutritionists during National Nutrition Month.

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Member Highlight Interview: Richard Mattes, Ph.D.

Richard Mattes, MPH, PhD, RD

Interview with Richard Mattes, Ph.D., Distinguished Professor of Nutrition Science at Purdue University, Adjunct Associate Professor of Medicine at the Indiana University School of Medicine, Affiliated Scientist at the Monell Chemical Senses Center, and Vice-President Elect for the American Society for Nutrition.

Dr. Mattes received his Ph.D. in Human Nutrition from Cornell University and conducted post-doctoral studies at the Memorial Sloan-Kettering Cancer Center and the Monell Chemical Senses Center. He remained at Monell for 13 years progressing to full member. At Purdue University, Dr. Mattes is the Director of the Ingestive Behavior Research Center, and the Director of Purdue’s Public Health Graduate Program. He also holds numerous external responsibilities including Associate Editor for The American Journal of Clinical Nutrition. He is also secretary of the Rose Marie Pangborn Sensory Science Scholarship Fund. Richard Mattes has been the principal investigator on National Institutes of Health grants continuously since 1984, and has authored of over 265 publications.

 

1. How did you first get involved in nutritional biochemistry and research? What made you interested in the field of nutrition science?

My original plan was to pursue a career in public health. I selected nutrition as a focus because while diet-related disorders were widespread, a large proportion appeared solvable. It was a field where one could make a difference. Following completion of my public health training, I realized I needed a deeper understanding of nutrition science to be in a position to address the issues that now seemed much more complicated. My pivot to nutrition and sensory science stemmed from my work under Shiriki Kumanyika who was interested in sodium intake and hypertension at the time as well as a recommendation by a friend to attend an illuminating course taught by Bruce Halpern, a sensory scientist in the Psychology Department at Cornell. Understanding the drivers of food choice, such as sensory function, seemed to be a critical control point for moderating diet-related chronic diseases.

2. When and why did you first join ASN? What convinced you to join the organization

I joined the American Institute of Nutrition (AIN) in 1986, immediately following completion of my post-doctoral training, when I thought I had completed a sufficient body of work to be eligible for membership. I considered it an honor to be a member of a professional association that included many of the scientists publishing work that guided my thinking. It was also an important resource for me since I was at an institution with a mission to understand the mechanisms and functions of the chemical senses, not address nutrition problems. So, while I had wonderful colleagues, few had similar training to me or similar interests and as a young scientist, I needed more feedback from people knowledgeable in nutrition. The AIN was an invaluable resource.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

Membership benefits like access to all four ASN Journals have been, and continue to be the primary means for my keeping current with the advancing science.

4. What aspects of your research do you foresee being most important for ASN members?

My research has always been at the interface between nutrition, sensory, food and psychological sciences. I hope that it serves as a bridge to these other areas as they are integral to understanding food choice and how behavior influences physiology.

5. Can you tell us more about your current position and the research activities in which you are involved?

I currently have a split appointment. Sixty percent of my effort is devoted to building and administering a new public health graduate program. So, after over thirty years of basic and clinical research, I find myself back at my original professional aspiration. The other forty percent of my effort is as a traditional faculty member, though I do direct the Ingestive Behavior Research Center which provides a unique opportunity to train doctoral students in this area of specialization.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

My biggest concern stems from the decreasing funding base for nutrition research. Of course, it directly limits what science can be pursued, but more insidiously, I think it drives scientists to take more advocacy roles for their area of work and this corrodes the scientific process. It also requires more time and energy being spent writing grants with the consequence being less time to engage in professional activities (e.g., reviewing manuscripts, serving on professional committees) which further hampers progress.

7. Is there anything else you’d like to tell students and postdocs within ASN?

 Invoke the word “no” as seldom as possible. Many will argue the best advice is to maintain a laser focus on one’s area of study. Not having tried this approach I can’t speak to is success. My experience is that every opportunity I’ve pursued in some way, at some time, has proven to be worthwhile.

 

Dr. Mattes’ research focuses on the areas of hunger and satiety, regulation of food intake in humans, food preferences, human cephalic phase responses and the mechanisms and functions of taste, with the objective of understanding the neural, genetic, metabolic, hormonal, cognitive, cultural and especially sensory influences on human ingestive behavior, nutrient utilization and energy balance in healthy and clinical populations.

 

Intermittent fasting – healthy or hype?

As anyone in the nutrition field is aware, there are plenty of extreme dietary practices. Personally, I’ve heard about everything from the baby food diet to the Dukan diet to something about alkaline blood levels. Usually, these extreme dietary practices are met with an eye roll, knowing that these outrageous diets will last about as long as an avocado in it’s prime. But what if there was a dietary trend that promised long-term health benefits that focused not necessarily on what you eat, but when you eat?

Intermittent fasting is any period of voluntary food restriction. Protocols are varied and might include religious fasting, time restricted feeding (i.e. eating all calories within a short time window) or scheduled days of extreme caloric restriction (i.e. ≤ 25% of energy needs) followed by normal or high calorie days.

I am always skeptical of any diet or dietary pattern that claims to fix everything from obesity to cancer, but – bro-science aside – intermittent fasting is gaining a substantial amount of attention in research. A recent and thorough review in The Annual Review of Nutrition concluded that intermittent fasting might be a viable strategy to benefit overall human health, including improvements in biomarkers associated with chronic disease. Notably, however, most human research studies are limited by small sample sizes, lack of control groups, insufficient follow-up, and inclusion of normal weight or healthy individuals who are unlikely to respond to interventions.

The best diet for optimal health is one that is maintainable. A large (n=100) and long (1 year) study in metabolically healthy obese adults published last year found that drop-out was highest in the group randomized to alternate-day fasting. The long-term adherence to intermittent fasting and applicability to public health is therefore questionable.

Diet quantity and quality will always be paramount for the promotion of optimal health and healthy aging. For me, I couldn’t live without my morning matcha latte and eggs… but maybe breakfast isn’t the most important meal of the day, at least for habitual non-breakfast eaters.

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Prevention and Health Care Reform

The leading causes of death in the United States include heart disease, cancer, stroke, diabetes, and kidney disease (1). These conditions are strongly associated with poor diet, sedentary lifestyle, and excessive weight gain. Currently, 2 out of 3 Americans are either overweight or obese (2). As such, 75% of total healthcare costs are used for the treatment of these chronic conditions (3). Research continues to show that nutrition intervention can drastically improve one’s health and reduce the risk for many of these chronic diseases. Nutrition counseling by a registered dietitian nutritionist (RDN) can make a world of difference for chronic disease management, treatment, and prevention. Nutrition counseling that promotes lifestyle changes to include healthier diets and more physical activity have the potential to reduce incidence of type II diabetes by 34% (4), heart disease by 31%, and stroke by 20% (5). Utilizing these services can make a profound difference in the trajectory of health outcomes and healthcare costs for American’s. However, only 3% of all healthcare expenses are spent on preventive services (3). This is primarily due to a lack of coverage for these services by insurance companies. Medicare covers dietetic services only for patients who have diabetes or kidney disease. As such, patients who are prediabetic, obese, or have cardiovascular disease are not covered by Medicare to see a dietitian. Many people seek nutrition services and choose to pay out of pocket, recognizing the long term benefits these services provide. Yet, many individuals who need these services simply can’t afford to pay for them, costing around $118 an hour (6).

Under the Affordable Care Act (ACA), preventive services are covered more now than ever. The ACA mandated that insurance companies cover preventive services that were identified by the U.S. Preventive Services Task Force (USPSTF) (7). These services include “healthy diet and physical activity counseling” and “obesity screening and counseling (8).” Congress is currently proposing the American Health Care Act which threatens to discontinue the inclusion of these services. Such reform would be a step backwards in reducing the rates of chronic diseases and the rising healthcare costs. According to the Academy of Nutrition and Dietetics President Lucille Beseler, the American Healthcare Act will, “reverse advancements made in disease prevention and chronic care management (9).” With healthcare costs continuously on the rise, investing in prevention is a much-needed solution for our nation’s healthcare costs.

In addition to the inclusion of prevention services, the ACA also includes the Prevention and Public Health Fund. These funds are distributed to the states to be used for community specific programs, including prevention initiatives, surveillance, and research (10). Investing in these types of community programs can reduce healthcare costs. For every $1.00 spent, $6.60 in healthcare costs are saved over a five year period (3). The current healthcare reform proposal will repeal this fund, hurting the communities that have been benefiting from these public programs. The House of Representatives passed the American Health Care Act in May sending it to the Senate for deliberation. In June, the Senate released their revised version of the bill and titled it the Better Care Reconciliation Act. The Senate was unable to repeal the ACA by the September 30th deadline. In October, President Trump passed an Executive Order Promoting Healthcare Choices and Competition, which allows agencies to modify how they implement the ACA. As nutrition professionals, the implications of preventive services is extremely apparent, yet without proper support for these services we risk their exclusion from future healthcare reforms.

  1. FastStats. (2017). Available at: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. (Accessed: 15th December 2017)
  2. Overweight & Obesity Statistics | NIDDK. Available at: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity. (Accessed: 15th December 2017)
  3. Prevention and Public Health Fund. Available at: https://www.apha.org/topics-and-issues/health-reform/prevention-and-public-health-fund. (Accessed: 15th December 2017)
  4. The data are in: Eat right, reduce your risk of diabetes – Harvard Health Blog – Harvard Health Publishing. Available at: https://www.health.harvard.edu/blog/the-data-are-in-eat-right-avoid-diabetes-2017010510936. (Accessed: 15th December 2017)
  5. Guide to Insurance and Reimbursement – Today’s Dietitian Magazine. Available at: http://www.todaysdietitian.com/newarchives/0217p40.shtml. (Accessed: 15th December 2017)
  6. Preventing Heart Disease | The Nutrition Source | Harvard T.H. Chan School of Public Health. Available at: https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/preventing-cvd/. (Accessed: 15th December 2017)
  7. Health Care Reform and Preventive Services. www.eatrightpro.org Available at: https://www.eatrightpro.org/resource/payment/nutrition-services/health-care-reform/healthcare-reform-and-preventive-services. (Accessed: 15th December 2017)
  8. USPSTF A and B Recommendations – US Preventive Services Task Force. Available at: https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/. (Accessed: 15th December 2017)
  9. Academy of Nutrition and Dietetics Announces Opposition to American Health Care Act. www.eatrightpro.org Available at: http://www.eatrightpro.org/resource/media/press-releases/public-policy/academy-announces-opposition-american-health-care-act. (Accessed: 15th December 2017)
  10. Prevention and Public Health Fund | HHS.gov. Available at: https://www.hhs.gov/open/prevention/index.html. (Accessed: 15th December 2017)
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Member Highlight Interview: Sharon Donovan, Ph.D., R.D.

Interview with Sharon Donovan, Ph.D., R.D., Professor and Melissa M. Noel Endowed Chair in Nutrition and Health in the Division of Nutritional Sciences at the University of Illinois and Past President of the American Society for Nutrition.


Dr. Donovan received her Ph.D. in Nutrition from the University of California, Davis and completed a post-doctoral fellowship in Pediatric Endocrinology at Stanford University School of Medicine. She joined the University of Illinois, Urbana in 1991, where she became Professor in 2001 and in 2003 she was named the first recipient of the Melissa M. Noel Endowed Chair in Nutrition and Health. She served as Director of the Division of Nutritional Sciences Interdisciplinary Graduate Program from 1999-2009. Dr. Donovan served as President of the American Society for Nutrition for 2011-2012. She is also President-Elect of the International Society for Research on Human Milk and Lactation (ISRHML) and she continues to provide leadership and guidance in several committees and special initiatives for ASN. In October 2017, she was elected to National Academy of Medicine.

How did you first get involved in nutrition research? What made you interested in the field of nutrition science?

I was an undergraduate student at U.C. Davis majoring in Zoology, with the intention of going to veterinary school. In my junior year, I took a physiological chemistry course (basically nutritional biochemistry) taught by Richard Freedland—and I loved the course! Afterward, I took a nutrition course in the Department of Nutrition, where Bo Lönnerdal was a guest lecturer on the topic of pediatric nutrition—and I was hooked! I switched my major to nutrition science and started doing research in his laboratory and eventually was accepted into his laboratory for my doctoral degree.

When and why did you first join ASN? What convinced you to join the organization?

I joined the former AIN in 1984 as a graduate student in nutrition at U.C. Davis and attended my first FASEB meeting in 1985. I became a Full Member in 1989. I joined because the American Society for Nutrition is the top nutrition society for basic, translational and applied research in nutrition.

What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

ASN membership has been instrumental throughout my career. Early on, ASN provided a framework for disseminating my research through annual meetings and publications. Likewise, through ASN I was able to build a broad professional network of colleagues at other institutions in the U.S. and around the world. ASN also provided numerous leadership opportunities through the RIS groups, on the Executive Board as Councilor and Secretary and, eventually, as President of the Society. All of these activities have been very professionally fulfilling for me.

What aspects of your research do you foresee being most important for ASN members?

My laboratory conducts basic and translational research in the area of pediatric nutrition. During this phase of life, proper nutrition is of key importance for growth, development and long-term functional outcomes, such as cognition and immune response. A large focus in my lab is how early life events influence the composition and functional capacity of the gut microbiome. As we learn more about the microbiome and its relationship with many of the same diseases that have long been associated with dietary intake, it is clear that nutrition researchers should know more about this newly appreciated “organ”.

Can you tell us more about your current position and the research activities in which you are involved?

I am a Professor in the Department of Food Science and Human Nutrition and am affiliated with the Division of Nutritional Sciences and the Department of Pediatrics. Currently, my collaborators and I are investigating dietary approaches to improve the structural and functional development of the intestine and the brain, and the development of gut microbiome and the gut-brain-microbiome axis. In addition, I enjoy engaging with researchers in other fields to conduct transdisciplinary research focused on ways to prevent childhood obesity and picky eating behaviors and to reduce the severity of symptoms in children with autism.

What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

Obviously, research funding continues to be a challenge for researchers in all areas. However, given the importance of nutrition in health and chronic disease prevention, I believe that there are many opportunities for nutrition researchers for interdisciplinary collaborations, which can be very attractive for funding agencies. In my opinion, more research is needed in understanding the contribution of the individual to interactions with diet and other environmental factors. For example, what role are host genetics and epigenetics genetics playing in responses to diet? This has been a hot area of research for a decade, but has not been fully translated to clinical medicine. Similarly, we need to know a lot more about the host aspect of host-microbe interactions, if we are going to tease out the role that the microbiome plays in health and disease.

Is there anything else you’d like to tell ASN members, especially students and postdocs?

I encourage everyone to take the opportunity to get involved in ASN. There are opportunities to “dip your toe” in the water and see how you like it! The RIS’s and other membership engagement groups, such as the Student Interest Group and the Postdoc/Early Career Nutrition Interest Group are great places to get involved. Networking is critical, particularly at earlier stages of your career, and professional contacts made through networking can help open doors that lead to opportunities, including internships, postdocs and jobs. Later in your career, being known by your colleagues can help with getting letters of P&T or learning about new positions in industry.

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Fish oil and resistance training – effective for older adults?

Omega-3 fatty acids have been long touted for their cardiovascular benefits. But many research studies strongly suggest that these fatty acids exert improvements well beyond those related to heart health.

 

Omega-3 fatty acids and/or fish oil supplements (the latter being a rich source of omega-3s) have been administered to those with cancer, heart disease, rheumatoid arthritis, and psychiatric disorders (i.e. schizophrenia and major depressive disorder) with resultant improvements in disease-specific outcomes and body composition (read: more and/or better quality of muscle) (1, 2). The supplement also has essentially no side effects, aside from the occasional lingering fishy after-taste. It’s thought that these beneficial effects are due to omega-3’s inhibition of numerous pro-inflammatory pathways.

So is there a place for these supplements in healthy populations? Say, exercising older adults? This is exactly what Mariasole Da Boit and a group of colleagues investigated in a randomized, double-blind placebo controlled trial published in the American Journal of Clinical Nutrition earlier this year (3). Fifty men and women (age 70.6 ± 4.5) participated in a resistance exercise training program for lower limbs twice weekly for 18 weeks. All were randomized to 3g fish oil/day or placebo (3g safflower oil/day). In women, maximal isometric torque (static contraction) and muscle quality defined by torque per unit of muscle cross-sectional area improved more in the fish oil group, independent of muscle mass changes; no differences were observed in men. Plasma triglycerides decreased in both sexes, while maximal isokinetic torque (moving contraction), 4-minute walk test, chair-rise time, muscle size, and muscle fat did not differ. The authors speculate that omega-3 improves neuromuscular function and/or enhances the contractile properties of type II (fast-twitch) muscle fibers. Some findings suggest that older women do not increase muscle strength to the same degree as older men; thus women could undergo a more profound response to resistance training since there is a greater capacity for muscular improvement.

While this is only one study and the mechanisms behind the results are somewhat speculative, the results are promising. With forthcoming research, omega-3 fatty acid supplements might become an evidence-based recommendation for healthy community-dwelling older adults and many clinical populations.

  1. Lee S, Gura KM, Kim S, Arsenault DA, Bistrian BR, Puder M. Current clinical application of omega-6 and omega-3 fatty acids. Nutrition in Clinical Practice 2006; 21(4):323-41
  2. Murphy RA, Mourtzakis M, Chu QS, Baracos VE, Reiman T, Mazurak VC. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy. Cancer 2011;117(8):1775-82.
  3. Da Boit , Sibson R, Sivasubramaniam S, Meakin JR, Greig CA, Aspden RM, et al. Sex differences in the effect of fish-oil supplementation on the adaptiveresponse to resistance exercise training in older people: a randomized controlled trial. American Journal of Clinical Nutrition 2017; 105:151-8
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Does Breastfeeding Make You Smarter?

Does Breastfeeding Make You Smarter?

Good nutrition has been shown to help with survival, growth, mental development, health, and well-being across one’s lifespan. Unearthing precisely what to eat to help achieve maximal benefit has been the subject of many research studies and debates, especially regarding childhood nutrition starting at an early age.

Breastfeeding has been recognized for its ability to provide infants with essential nutrients to help with growth and development. Research has shown there are many benefits associated with breastfeeding, such as building a healthy gut microbiota and increasing the bond between mother and child. The child benefits from the nutrients found in breast milk, such as docosahexaenoic acid (DHA) and arachidonic acid, omega-3 and -6 fatty acids essential for cognitive development. Somewhere down the line the notion that breastfeeding can make your baby smarter has been perpetuated. However, this has not yet been proven.

Researchers from the University College Dublin in Ireland conducted a study to investigate the impact of breastfeeding on children’s cognitive development. Around 8,000 families from the Growing Up in Ireland longitudinal infant cohort were randomly selected to participate. Data was collected when the child was 9 months old, 3 years old, and 5 years old. Questionnaires were used to measure children’s cognitive abilities, expressive vocabulary, and problem behaviors, and breastfeeding data was collected as retrospective self-report from the mothers. Propensity score matching, instrument variables, and sibling pair models were used for the analysis. The “breastfed” and “never breastfed” groups were matched based on infant, mother, and family-level factors, such as birth weight and maternal age.

Children who were breastfed scored higher on the problem-solving scale. However, after adjusting for potential confounders, this result was found to be no longer significant. This means other factors, such as socioeconomic status, could better explain the variability here. Breastfed children had lower parent-rated hyperactivity compared with controls after the adjustment, but this effect was only seen at 3 years of age. This may mean that breastfeeding helps reduce hyperactivity in the short term, but this effect was not maintained. Although the researchers found no evidence to support that breastfeeding helps improve cognitive abilities, they did note that their study did not contradict any of the medical benefits of breastfeeding. Research on breastfeeding will continue to be done and hopefully we will see more positive findings emerge in this area. For now, the current World Health Organization recommendation for breastfeeding is to exclusively breastfeed for the first 6 months of a child’s life, if you are able.

 

References:

Girard L, Doyle O, Tremblay RE. Breastfeeding, Cognitive and Noncognitive Development in Early Childhood: A Population Study. Pediatrics. 2017;139(4):e20161848. doi:10.1542/peds.2016-1848

Meat Preparation and Carcinogens: Practical Recommendations

By Chris Radlicz

This past October, the International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), made headlines when they classified processed meat as a Group 1 carcinogen. This classification was based on “sufficient evidence in humans that the consumption of processed meats causes colorectal cancer”. Additionally, red meat has been classified as a Group 2A carcinogen due to “limited evidence that consumption of red meat causes cancer in humans and strong mechanistic evidence supporting a carcinogenic effect” [1]. These IARC statements advocating a limited intake of processed and red meats tend to be misconstrued by the public and many may take it to mean that all meat should be avoided. Besides the inherent benefits of protein and various micronutrients in meat, red meat is primarily trumpeted as the best source of heme-iron in the diet. With iron deficiency as the most common nutritional disorder in the world [2], limiting red meat may not be prudent advice. What, therefore, is unique to red meat and processed meats which explains their carcinogenic potential?

What gives meat a bad rap is not inherent in the animal muscle itself, but rather the preservatives added to meats and the cooking processes which meats undergo. So what can be done to mitigate and avoid the proposed cancerous effects of some meats? Below are some practical tips to be conscious of and implement when meat shopping and preparing meats so that consumers can take full advantage of the nourishment from meats while limiting any risk

  • 1. Cook with Moist Heat: The Journal of the American Dietetic Association in a 2010 article, showed that cooking with dry heat promoted a 10 to 100-fold increase in advanced glycation end products (AGEs). AGEs increase oxidative stress and inflammation, and have shown to be a player in the pathogenesis of many chronic diseases. Cooking with moist heat, at low temperatures, and shorter cooking times have all been shown to reduce AGE formation [3]. Cooking meat in stews and sauces at low temperatures for longer periods of time, typical of crock-pot style cooking, is an effective way to reduce formation of these questionable AGEs.
  • 2. Avoid Charring Meats: Cooking meat at high temperatures, typically on a grill or skillet, can lead to browning or charring. This browning is known to occur as a result of the Maillard reaction which has been shown to produce heterocyclic amines (HCAs), and polycyclic aromatic hydrocarbons (PAHs). PAHs form when fat from grilled meat is ignited, causing flames containing these PAHs, which can then adhere to the meat’s surface. HCAs are formed from amino acids, sugars, and creatine reacting at high temperatures. These chemicals have been shown to be mutagenic to DNA after consumption and digestion, leading to genetic instability and increased risk of cancer [4]. Cooking meats at higher temperatures and for long periods of time will lead to increased HCAs, while smoking and charring will result in more PAH formation. No Federal guidelines exist addressing PAH and HCA consumption, but these chemicals provide a mechanism as to meats carcinogenic capacity. With this in mind, the National Cancer Institute suggests that concerned individuals should turn meat over frequently when cooking, use a microwave first to shorten high temperature cooking time, remove charred portions of meat, and refrain from using gravy made from meat drippings as ways to reduce PAH and HCA exposure [5].
  • 3. Purchase Nitrate-Free and Uncured Meats: Nitrates and nitrites added as preservatives to meat have been shown to convert to activated N-nitroso compounds (nitrosamines and nitrosamides) in the gut, and are proposed to be carcinogenic due to their ability to cause DNA damage [6]. N-nitroso compound formation can also be increased with the intake of red meat, principally due to interactions with the heme-iron [7].
  • 4. Purchase Meat that isn’t Smoked: Smoked meats fall under the category of processed meats. Epidemiological studies, have shown a correlation between cancer of the intestinal tract and the frequency of dietary intake of smoked foods [8]. More convincingly, the smoking process forms N-nitroso compounds and inevitably contain high levels of PHAs.
  • 5. Purchase Antibiotic-Free Meat– Some antibiotics and pesticides in meats can react with nitrite to form nitrosamines in high quantities [9]. Additionally, there is much worry that the antibiotic use in agriculture is contributing to the growing prevalence of antibiotic resistance, and in a more minor capacity, to the obesity epidemic [10,11]

Bibliography

[1]       WHO | Q&A on the carcinogenicity of the consumption of red meat and processed meat

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Health Professionals Need More Nutrition Education. How Can We Deliver?

By Allison Dostal, PhD

It’s not a revelation that most Americans would benefit from increased nutrition education and guidance. Newly released data from the Centers for Disease Control and Prevention1 show that 64% of Americans are overweight or obese – a number that’s held steady over the past few decades – and that nearly 40% of us consume less than 1 serving of fruits or vegetables daily. $210 billion is spent annually on obesity-related disease2.

It is known, perhaps intuitively, that physicians trained in nutrition achieve improved health outcomes in patients with obesity-related conditions3. Numerous clinical guidelines recommend that physicians counsel their overweight and obese patients on diet, and yet, fewer than 25% feel that they received adequate training in doing so. As a result, only 1 in 8 medical visits includes a discussion of nutrition4,5. This disconnect in recommendations versus practice is a significant issue in medical education today, and the perennial discussion of how to improve the current state of nutrition education in the medical curriculum continues to increase in relevance in our nation’s obesity crisis.

The Problem

It is recommended that physicians-in-training receive 25 contact hours of nutrition education, including basic nutrition knowledge, assessment, nutrition intervention, and dietary treatment of disease. However, nutrition education in medical schools has continued to fall below this target – and it’s getting worse. A 2012 survey4 found that most medical schools fail to require the recommended amount of nutrition education, with less than 15% of schools providing the 25-hour minimum. The number of hours devoted to nutrition education has dropped substantially since 2004, while the number of schools with no required nutrition education has risen4.

Compounding this issue, many medical training programs provide only basic nutrition background, often buried within a biochemistry or physiology course. While it is undeniably important to highlight the specific actions of vitamins and minerals, this model fails to highlight real-world clinical application of nutrition. Even less time is devoted to developing patient counseling skills. Lastly, the U.S.’s health professional training systems do not provide expertise or incentives to deliver effective counseling on how to achieve and maintain a healthy weight, diet, and physical activity level. This leads to a divide in thinking – a “should” or “want to do” versus “need to” or “have time to do”, and a reduced sense of urgency about implementing changes.

Working Toward a Solution

In addition to a lack of monetary or standard-of-care incentive to increase knowledge dissemination, another primary reason for suboptimal nutrition education is lack of time. This exists both in the amount of time devoted to actual coursework within medical training and for development of a nutrition curriculum within a program. Fortunately, several groups have worked diligently to provide resources that alleviate these barriers. In contrast to many programs that are specific to a particular institution, Nutrition in Medicine6, is a web-based series for students and healthcare professionals, administered through the University of North Carolina at Chapel Hill’s Department of Nutrition. There are over 40 modules ranging from 15 to 60 minutes in length that offer basic nutrition knowledge as well as evidence-based instruction of clinical skills. In addition to providing biochemical, clinical, and epidemiological components and virtual case studies, NIM also offers nutrition tools like pocket notes, nutrient recommendations, quizzes, and YouTube video vignettes. Nearly 75% of U.S. medical schools take advantage of at least one NIM module, and the program has proven to be successful in providing 33% more nutrition education in schools that use NIM versus those that do not.

And the best part? It’s completely free.

Future Directions

Despite the advances made by NIM in improving the dissemination of nutrition knowledge in the medical curriculum, challenges remain. Martin Kohlmeier, NIM’s principal investigator, has acknowledged that building good nutrition education tools is expensive and time consuming, since materials need to be reviewed continuously and updated every 4-5 years. Supporting a web-based tool takes a significant amount of resources, and funding sources are difficult to consistently maintain.

Recently, this cause has been taken up by several prominent health and medicine-focused organizations. A new effort has been launched to teach medical students, physicians, and other allied health professionals how to discuss obesity treatment and prevention options with patients. This initiative is a collaboration between the Bipartisan Policy Center, the Health and Medicine Division of the National Academies of Sciences, the American College of Sports Medicine, and the Alliance for a Healthier Generation. The multi-year project, supported by the Robert Wood Johnson Foundation, will develop “core competencies for obesity prevention, management, and treatment for the health professional training pipeline and identify payment policies that will incentivize the delivery of this care”, as stated in their April 11th press release7. Their goals are for these competencies to be implemented in training programs across the full spectrum of health professionals, and to determine a strategy to reimburse effective counseling for maintaining a healthy weight, diet, and physical activity level. “Training health professionals without a concurrent strategy to reimburse this type of care will not lead to meaningful change. And offering payment without having trained professionals to provide the care also will not result in improve[d] patient care,” the group stated.

This working group, like those involved in the Nutrition in Medicine curriculum, acknowledges that systemic changes to improve nutrition education in medical training will require continuous commitment from a wide range of stakeholders. Details of this initiative have not yet been announced, but those of us involved in education and clinical care certainly look forward to seeing the first steps begin.

Are you a health care professional, student, or educator? What is your experience in teaching or learning nutrition and nutrition counseling skills? I welcome your comments and insight on this issue.

References

1.Nutrition, Physical Activity and Obesity Data, Trends and Maps web site. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity, Atlanta, GA, 2015. Available at http://www.cdc.gov/nccdphp/DNPAO/index.html.

2.Cawley J and Meyerhoefer C. The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics, 31(1): 219-230, 2012.

3.Rosen BS, Maddox PJ, Ray N. A position paper on how cost and quality reforms are changing healthcare in America: focus on nutrition. Journal of Parenteral and Enteral Nutrition 2013;37(6):796–801.

4.Adams, K.M., Kohlmeier, M., & Zeisel, S.H. Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey. Academic Medicine. 2010;85(9): 1537-1542.

5.Early KB, Adams KM, Kohlmeier M. Analysis of Nutrition Education in Osteopathic Medical Schools. Journal of Biomedical Education, vol. 2015, Article ID 376041, 6 pages, 2015. doi:10.1155/2015/376041

6.K. M.Adams, M.Kohlmeier, M. Powell, and S. H. Zeisel, “Nutrition in medicine: nutrition education for medical students and residents. Nutrition in Clinical Practice. 2010;25(5), 471–480. Available at: http://nutritioninmedicine.org/

7.Bipartisan Policy Center. New Effort Launch to Train Health Professionals in Nutrition and Physical Activity. http://bipartisanpolicy.org. 21 Mar. 2016.