Overview: Nutrient-nutrient interaction
The 2018 Spring Conference, hosted by the Scottish Section and held at the Royal College of Physicians and Surgeons in Glasgow, explored the interactions between nutrients and the consequences of these interactions on health and disease. Acknowledging that nutrient interaction is often overlooked, the conference focused on the competition between nutrients and how this affects function and bioavailability of dietary compounds, and considered the mechanisms of nutrient-nutrient interactions demonstrating their role in protection from disease and how this can inform diets for health and welfare.
Scientific Organisers, Dr Emily Combet and Dr Stuart Gray, University of Glasgow, welcomed 97 delegates to the conference from across the UK, Ireland, Europe, and as far away as Egypt, the Kingdom of Saudi Arabia and Thailand. Professor Julie Miller Jones, St. Catherine University, St Paul, USA, gave the first plenary lecture on a hotly debated topic, the avoidance of processed and ultra-processed foods. Professor Miller Jones highlighted the benefits of processing some foods, including palatability in case of grains, fortification to add nutrients, and to ensure year round availability by freezing or canning. She discussed public misconceptions around the benefits of food processing and emphasised that healthy (and unhealthy) diets can be constructed from foods with all levels of processing and that ‘processed’ should not become code for poor dietary patterns.
Dr Dora Pereira, University of Cambridge, UK, and Medical Research Unit, The Gambia, gave a talk on iron bioavailability, a topic of particular importance as iron deficiency anaemia is the leading form of micronutrient malnutrition globally. Dr Pereira also drew attention to iron deficiency as a protector against malaria and other co-infections, a protection which is lost through iron supplementation so antimalarial protection must be considered.
After symposium one, and a healthy lunch with plenty of discussion on the morning’s talks, the OC sessions took place. Naomi Fallon from the University of Central Lancashire was announced as the Student Competition winner for her electronic poster presentation comparing micronutrient intakes in adult females in the North-West of England following omnivorous, vegetarian and vegan diets. Congratulations to Naomi whose winning abstract will be published in Proceedings of the Nutrition Society early next year.
Symposium two followed the OCs focusing on nutrient interactions and their role in protecting against chronic disease. Professor Margaret Rayman, University of Surrey, UK, gave a comprehensive overview of the importance of iodine, in particular for pregnant women and those of child bearing age as deficiency can have detrimental effects on the child’s cognitive development. Professor Rayman then described the interactions between iodine, iron and selenium. Professor Craig Sale, Nottingham Trent University, UK, presented on bone health across the life span focusing on nutritional modulators of bone health. He said protein was particularly interesting as it can be both beneficial and detrimental to bone health, depending on the amount consumed, and the protein source and how it interacts with calcium and vitamin D.
Professor Donald McMillan, University of Glasgow, Scotland, gave a fascinating talk on the role of systemic inflammation and nutritional status. He opened his talk acknowledging Sir David Cuthbertson recognising his pioneering work on metabolic response to injury in the 1930s. Professor McMillan outlined the inflammatory response to trauma and presented evidence on plasma levels of some micronutrients, including vitamin C, D and E, dropping in response to trauma. The take home message from his talk was that practitioners must understand the systemic inflammatory response before measuring micronutrient status to avoid incorrectly diagnosing deficiency.
The second day was opened by Dr William Rees, Rowett Institute of Nutrition and Health, University of Aberdeen, Scotland, who gave the second plenary lecture on the interactions between nutrients in the maternal diet and the implications for the long-term health of the offspring. Dr Rees discussed the macro and micro nutrient interaction of the mother’s diet on the phenotype of offspring and the long-term health implications in relation to the Developmental Origins of Health and Disease.
Dr Marleen Lentjes, University of Cambridge, UK, discussed the balances between food and dietary supplements. Dr Lentjes began by outlining consumer confusion on what supplements are before showing data on UK and European supplement usage. Data from the latest National Diet and Nutrition Survey (NDNS) show that supplement use has increased across all age groups, except the elderly, with fish oil the most common supplement taken. Dr Lentjes said that with supplement use rising, particularly amongst those who have a healthy diet, are active and are a healthy weight (or the ‘worried well’ as she described them), consideration must be given to nutrient toxicity and health outcomes.
Dr Gareth Wallis, University of Birmingham gave the last lecture of the conference focused on carbohydrate-fat interactions during exercise. Dr Wallis provided evidence that meal ingestion acutely alters fuel selection exercise with fasted exercise having greater fat oxidation and carbohydrate intake before exercise supressing fat oxidation. Dr Wallis also confirmed that exercise before breakfast increases fat oxidisation over 24 hours highlighting the need to understand whether this has any long-term health benefits for body mass and cardiometabolic risk.
Bringing together lessons learnt in the previous days, Professor Julie Miller Jones, Dr Marleen Lentjes and Dr Gareth Wallis took part in the panel discussion taking questions from the audience. Questions led to a wide discussion on breakfast consumption generally, reaching vitamin D recommendations through fortification, public health messaging, and how working with industry to improve the nutritional quality of processed food could be an effective strategy to improve diets.
The Society would like to thank the Scottish Section for hosting the conference, in particular Scottish Section Secretary, Dr Spiridoula Athanasiadou, the Association for Nutrition for supporting the conference, and thank delegates for their valuable contributions during the discussions raising key questions and opening debate.