Due to the restrictions resulting from the COVID-19 pandemic, the Society’s annual Winter Conference, which usually takes place in London, was held as a virtual event on 8-9 December allowing the Society to continue welcoming speakers and delegates from all over the world. Despite ongoing restrictions and potential screen fatigue, 295 delegates from 17 countries across Europe, Africa, Asia, Russia and the United States, came together virtually to discuss the topic of micronutrient malnutrition across the life-course, sarcopenia and frailty. This was the highest number of delegates a Nutrition Society Winter Conference has ever seen.
The conference opened with a warm welcome from the Society’s president Professor Julie Lovegrove, and Professor Ailsa Welch, Scientific Programme Organiser, both highlighting the importance of micronutrient malnutrition as a global public health issue.
Whilst supplementation, fortification and biofortification can all deliver benefits, they are not without their limitations and finding a way to sustainably improve the quality of diets in the poorest regions is central to meet the UN Sustainable Development Goals. Professor Mairead Kiely, University College Cork, followed with a lecture on the risk factors and health impacts of vitamin D, iron and iodine deficiencies during pregnancy, highlighting the importance of maternal micronutrient status on neonatal outcomes particularly on lifelong health and wellbeing. Associate Professor Christophe Matthys, University of Leuven, focused on the risks of developing vitamin and mineral deficiencies after bariatric surgery as a result of the anatomical changes influencing nutrient digestion and absorption. During the lively panel discussion, the speakers responded to questions on the current COVID-19 pandemic and agreed that any effects of COVID-19 on micronutrient malnutrition would have strong links to socio-economic status. The disrupted movement of food and increasing food prices resulting from national lockdowns has meant many communities have lacked access to important sources of micronutrients.
Delegates were encouraged to get up and move during a short break before Professor Paul Kelly, Blizard Institute, BARTS School of Medicine, provided excellent insight into environmental enteropathy, a common variation (or adaptation) in the gut structure, that could be responsible for widespread micronutrient malnutrition due to a reduction in gut functional capacity, arguing that RNI’s for micronutrients may need rethinking.
The afternoon began with a dedicated timeslot to view the 52 posters with topics ranging from “The association of meat consumption with dementia” to “Dietary intakes in community dwelling adults during the COVID-19 outbreak”.
The last symposium of the day explored micronutrient nutrition in development, health and disease. Professor Philip Calder, University of Southampton, stressed the importance of a well-functioning immune system in protecting against infection highlighting that the immune system is highly complex, but micronutrients play a vital role in supporting its ability to function; vitamin D, zinc and selenium seem to have particularly ‘special’ roles. Professor Sian Robinson, Newcastle University, highlighted the importance of micronutrients in relation to mechanisms involved in the onset of sarcopenia but explained the current efforts to prevent and treat sarcopenia have been limited by the current lack of understanding of its pathophysiology. Using evidence from zebra fish studies, Professor Maret Traber, Oregon State University, identified mechanisms such as lipid peroxidation and mitochondrial damage to metabolic processed as possible causes of embryo mortality and increased miscarriage in populations with low vitamin E status. Day one ended with dedicated networking sessions allowing delegates to meet with the speakers, Society Trustees and Council Members and other delegates.
Wednesday began with the third symposium of the conference on ‘Ageing, frailty, sarcopenia, osteoporosis & micronutrients’. Dr Jeroen De Baaij, Radbound University Medical Center, began with a fascinating talk on the essential ion magnesium, focusing on the recently discovered hereditary mutations in magnesium channels that lead to hypomagnesaemia, as well as hypomagnesaemia resulting from certain drug uses such as diuretics and proton pump inhibitors. Professor Lisette de Groot, Wageningen University, then reviewed the evidence for the role of nutritional concerns in ageing-related disorders, highlighting that a healthful dietary pattern appears to be most relevant in old age, before Professor Jasminka Llich, Florida State University, discussed the complex syndrome osteosarcopenic adiposity highlighting its interactions with muscle bone and fat distribution and resulting interactions micronutrient status.
The final symposium of the conference focused on how to address the some of the issues discussed. Professor Ann Prentice, University of Cambridge, winner of the 2020 Widdowson Award, and Professor Hilary Powers, University of Sheffield, looked back to when the UK Dietary Reference Values (DRVs) for micronutrients were first published, and provided a summary of how recommendations are developed and implemented. Professor Prentice highlighted the relevance of sexual dimorphism on recommendations, noting they were originally set on a limited understanding of estimated requirements, but highlighting that the increased clinical data now available for sex, ethnicity and lifestyle factors may allow for more ‘personalised’ guidelines to be developed in future. Whilst consideration is being given to setting global DRVs, both speakers agreed during the panel discussion that setting reference values is complex and inaccuracies around validity of biomarkers, and uncertainty around environmental factors make personalised recommendations even more challenging.
A common theme throughout was the of importance of ensuring adequate micronutrient intake for health, being able to accurately identify deficiency and understand interactions between nutrients, drugs and the environment. It was agreed that better biomarkers are needed to better understand, and successfully address, the issues but dietary diversity remains crucial and provides some indication as to why areas of the world with low diet diversity experience higher micronutrient deficiency prevalence.
Thank you to Bimuno, Friesland Campina Institute, Nutritics, Nutrium, Oatly, Quorn and Yakult for their generous support, and to all delegates and speakers for their engagement and thoughtful questions throughout the conference and via social media using #NSWinter20 (a selection of which have been archived here).
Papers exploring the topics covered will be available in Proceedings of the Nutrition Society over the coming months.