International Summit on Medical Nutrition Education and Research

INTRODUCTION & FOUNDATION

The summit took place at the University of Cambridge, England earlier this summer covering a variety of topics from the focus on macronutrients to nutrition and workplace wellbeing. The sessions were designed to allow for debate and knowledge exchange, which led to very interesting discussions in the captive and diverse audience. 

Some key issues arose, listed below:

What are the priorities for nutrition research?

How are dietary guidelines reflecting current research?

How do we translate bonafide information with an evidence based framework to give people appropriate information and avoid myths and fads from being adopted as facts?

Some myth busting took place at the summit, the most interesting of which to me where:

  1. All calories are not created equal - calorie counting is not the most effective way to consider individuals' energy balance. 
  2. Fructose has a much higher thermic effect than glucose, making fruit a better source of sweetness to maintain a healthy weight.
  3. Homeostatic control of energy intake is overridden by the hedonic control activated by our taste receptors in response to the activation of our brain's 'reward centres'.
  4. The ratio of lean mass to fat mass is more important to body mass alone. 
  5. Resting energy expenditure levels vary greatly between people, especially obese and non-obese. We also need to consider genetic differences (for e.g. APOA2 variance).
  6. The majority of the human population does not posses the gain of function gene mutation for lactase persistence, which is a difference of just 1 bp, making their intestinal enterocytes unable to express lactase after weaning in infancy. This means that consuming milk and milk products into adulthood is not natural for a lot of the world's populations. 

Interestingly, the impact that exercise has on energy expenditure extends to beyond the time of exercise itself - post-workout burn is significant and adds to the beneficial effects of exercise.

The Glycaemic Index and fat consumption were also discussed, with the messaging surrounding both scrutinised. The GI is a useful tool for determining glucose content, however it does not take into account other sugars such as fructose and lactose, making it less useful for real food and complex meal measurement. 

Dietary fats are a hot topic of debate in the press and popular media at the moment, but what was clear from the summit is that it depends on the type and source of the fats we are referring to. Certainly, animal derived fats are not beneficial to health, whereas olive oil and other polyunsaturated fats have been proven to be beneficial (see Wang et al in JAMA

Whilst our resting metabolic rate undergoes small and slow variances throughout the lifecourse, we can boost our energy expenditure and increase our lean muscle mass through daily activities and exercise to maintain a healthy body weight. 

Daily Energy Expenditure

Speakers: Prof Sumantra Ray, NNedPro, Prof Luc Tappy, University of Lausanne, Prof Martin Kohlmeier, UNC School of Medicine & Public Health, Prof Caryl Nowson, Prof Daniele del Rio, University of Parma, Andre Laperrier and Dr Daniela Beltrame, Dr Rachel Pryke, Dr Minha Rajput-Ray.