A few weeks ago I was so happy to have a quick getaway from my Masters of Dietetics Studies in Brisbane, and head to Melbourne for the Australasian College of Nutritional and Environmental Medicine (ACNEM) Nutrition in Medicine Conference. A conference of which the audience was primarily medical doctors furthering their nutrition education, there were many times that I felt well out of my depth. However lots of note-taking, quick thinking and the fact that I recently completed my Advanced Nutrition Sciences subject left me feeling relatively balanced and as if I had a place there. I did manage to have a quiet chuckle to myself every time one of the sponsors/stall-holders asked me whether I prescribe their products. Some of them did seem to lose interest in me once they find out that not only am I not a doctor, but I am not yet a qualified dietitian.
Journalist and Channel 9 News Presenter Jayne Azzopardi was Master of Ceremonies and did a fantastic job, and is obviously a person who has a personal interest in nutrition and health She pointed out that medical doctors in Australia go through their entire degree without studying any kind of nutrition education and health science courses. Following Jayne in the Saturday opening plenary session was ACNEM President Associate Professor Eugen Molodysky, who reminded us that health care and prevention of disease are not synonymous. In order to reduce the burden of disease in Australia we need to recognize the importance of shifting the focus from tertiary hospital care to the domain of primary care, and associated levels of preventative health.
I was really interested to hear our Minister for Health, Hon Sussan Ley, talk about her own personal interest and experience in nutrition in medicine. Her father, now 97, approached nutrition as a ‘treatment’ well ahead of his time, and when diagnosed with Type 2 Diabetes Mellitus in his forties embraced the link between nutrition and health, and never looked back. She also discussed the need to fund primary care in order to keep people out of hospitals, and that prevention is “what we do to keep well, before we do what to do to keep better”.
The conference had three streams running concurrently: gastrointestinal, mental health, and heart, diabetes, and weight. In addition, there were scientific abstracts being presented during this time. I found it almost impossible to choose which talks to attend, as almost everything sounded interesting, and highly relevant to me. Here are some of my personal highlights:
• Professor John Funder spoke about the epidemic of obesity, and changing public perceptions. Once obesity is recognized as its own disease independent of other complications, and associated stigma issues are eliminated, people can essentially “get over it”, and treat it. He also spoke about how, in order to avoid childhood obesity and other disorders, you need to focus on the four years prior to the child’s third birthday. This period includes preconception, pregnancy, and the first three years of life, which is important as the child is developing preferences. Preconception and pregnancy are critical periods for causal components of childhood obesity, such as maternal diabetes, obesity, stress, and caloric and protein deficiency. The health professional community needs to revise guidelines for prospective parents about what best they can do to avoid obesity in children, as “the stage is set before the child can reach the fridge”.
Professor John Funder: The Epidemic of Obesity
• BDNF (Brain-derived neurotrophic factor): was a relatively new term to me and was mentioned by several speakers, seemingly being the next big ‘thing’. Professor Michael Berk, who spoke about depression being an inflammatory disease, described BDNF as a brain ‘fertiliser’: a protein that helps it grow. He said that depressed people have been observed to have less BDNF. Belinda Reynolds, whose topic was Inflamed Mood, Depleted Mind, also spoke about BDFR promoting survival and regeneration of certain neurons, and that levels are lower in people suffering from major depressive and other mental disorders. These two topics had many similarities, yet were also very different. They were two of my favourite talks however, as I have a personal interest in mental health. Belinda Reynolds (Practitioner Sales Consultant, Bioceuticals) spoke a lot about mental disorders, and even described that depression can be a significant risk factor for dementia in later life – it has been seen to precede memory decline. With inflammation being linked so heavily to depression, this association did not surprise me. Mrs Reynolds explained the self-perpetuating cycle of inflammation increasing reactive oxygen species, which increase mitochondrial distress, which increases inflammation all over again. Professor Berk (Depression is an inflammatory disease but where does the inflammation come from, and how can we change this?) also talked about the effect of anti-inflammatory drugs on depression, in that they can actually reduce depression symptoms and possibly are even as good as anti-depressants. This effect has been observed with aspirin, and even statins, which reduce markers of inflammation, but seem to also reduce the risk of developing depression.
• Epigenetics, and nutritional genomics were of course hot topics of discussion. It couldn’t be more evident that personalized nutrition is the future for dietitians in practice. Genetic testing can be so important for finding gene variants in metabolic pathways. This testing is crucial to identify any particular process that may require a kick-starter, and point us in the direction of which dietary cofactors may assist. This is the future, this is personalized nutrition. Associate Professor Cath Suter (Epigenetic inheritance and the legacy of parental obesity) was my favourite speaker with regards to this topic. So much research has been done about maternal nutrition and prenatal health, but A/Prof Suter’s most recent research has been around paternal obesity and its effect on the offspring’s phenotype. There is a link between this epigenetic inheritance and RNA in sperm – which appears to have some sort of affect on where the epigenetic tags are placed, and therefore which genes are ‘switched on or off’. I am not going to pretend that I understood everything that was being mentioned, but as A/Prof Suter said; “the rules of epigenetic inheritance are not well understood”.
The entire conference was a huge learning curve for me and such an excellent experience. I recently received the slides from all the lectures, and I’m sure it will take me some time to go through them again. That might be a job for the summer holidays.
Sophie Walsh, Master of Dietetics Student – University of Queensland.