Current knowledge on cancer and nutrition has benefited countries at all levels of economic development. However, those working in the field of cancer are often unfamiliar with the role of nutrition in the care of cancer patients and for those living with and beyond cancer. Equally, those working in nutrition are often not involved in the prevention and management of cancer. This lack of synergy across nutrition and cancer applies across multiple domains of research, education and practice, from both clinical and public health perspectives. The Task Force plans to foster a community of clinicians, oncologists, scientists, researchers, patients and the public to share knowledge, understanding and best practice, to jointly deliver high quality research; to build capability and capacity in the area of nutrition and cancer to foster excellence in research and practice and ensure continuity into the future; to raise awareness of the opportunities to improve prevention and care in people living with and beyond cancer through nutrition; and to provide a robust base for public policy to address the increasing burden of cancer.
The concept of sustainable diets, that is the connection between a healthy diet and a healthy planet, has become an imperative for addressing many on-going efforts and processes. Sustainable diets provides the entry point to clarify the importance of nutrition in sustainability efforts undertaken by many sectors, the most important of which are agriculture, environment and health. It is worth noting that the 1991 IUNS conference in Adelaide, Australia, had the theme, “Nutrition in a Sustainable Environment.” Subsequently, the IUNS paid little attention to the issue in its conferences and Task Forces (although the INFOODS TF did use environmental sustainability, sustainable diets, and biodiversity as themes in its International Food Data Conferences). An IUNS Task Force on sustainable diets will help bring about awareness and advocacy for the need to simultaneously address nutrition and environmental issues in ongoing processes including the Sustainable Development Goals, the Decade of Action on Nutrition, the Right to Food, the Decade of Biodiversity, the Aichi Targets, SIDS[1] Accelerated Modalities of Action (SAMOA) Pathway, the 10 Year Framework of Programs on Sustainable Consumption and Production, and more. A formal infrastructure provided by an IUNS Task Force will facilitate communication and coherence among the nutrition science community in their research, teaching and interactions; and between different sectors/disciplines where nutrition could/should be integrated into environmental sustainability issues.
To contribute to the development and standardisation of nutrition indicators and methodologies for characterising and promoting sustainable diets;
To provide a communication forum for multisectoral and multidisciplinary activities, including interactions with other relevant IUNS Task Forces;
To provide stable framework for the on-going organisation of the International Scientific Symposia on sustainable diets, and inclusion of sustainable diets sessions in other scientific conferences/symposia, including IUNS ICN and its regional conferences.
Task Force Members and Affiliations:
Namukolo Covic, IFPRI-Addis Ababa, Ethiopia
Sandro Dernini, Forum on Mediterranean Food Cultures, Italy
Kunchit Judprasong, Institute of Nutrition, Mahidol University,Thailand
Mark Lawrence, Deakin University, Australia
Jennie Macdiarmid, University of Aberdeen, Scotland
Farah Naja, American University of Beirut, Lebanon
Penina Vatucawaqa, National Food and Nutrition Centre, Fiji
Ex officio:
Harriet Kuhnlein, Chair of Indigenous Peoples’ Food Systems TF
Considerable controversy and confusion persists on what advice on dietary fat intake should be provided. This topic can have an important public health impact. The aims of this Task Force are: to systematically compile and review the existing evidence of health effects of dietary fat and fat quality, starting with a compilation and review of existing systematic reviews and guidelines, and extending where deemed necessary in a systematic review of recently published original data; to draft a position paper that summarizes the evidence and provides conclusions and recommendations, which should be published in the journal of IUNS (Ann Nutr Metab); and to communicate and disseminate findings to researchers, nutrition and health professionals, policy makers, and the public.
This Task Force was previously named ‘Risk and Benefits of Iron’, and is now changed to ‘Benefit-risk and cost effectiveness of micronutrient interventions’ to expand upon the work already done in the Task Force. They developed a model to quantify potential outcomes associated with an iron supplementation programme which along with economic analysis can potentially guide programme managers and policy makers when selecting between various health priorities and public health interventions. It is planned that the Task Force will extend their current model to other nutritional interventions.
Risk and Benefits of Iron Task Force (2013 – 2017)
Anaemia affects 496 million non-pregnant women, 32 million pregnant women and 273 million pre-school children worldwide, especially in low and middle-income settings. Approximately half of this burden has been considered amenable to restitution of iron stores, although this proportion is smaller in malaria endemic settings. Putative effects of iron deficiency anaemia in children include impairment in cognitive development, while in women iron deficiency anaemia is considered to cause fatigue, impaired exercise performance and reduced economic productivity. In pregnancy, anaemia is associated with reduced birthweight. Public health strategies to restitute iron stores include distribution of iron supplementation (including multiple micronutrient powders in pre-school children), and the World Health Organization recommends universal distribution of these interventions in settings where anaemia is prevalent. However, a critical recent concern has been the safety of iron supplementation to children living in settings where malaria and other infections are endemic, supported by large randomized controlled trials. Other risks, less commonly discussed, include the risk of fatal overdose from iron (especially in children), iron overload from chronic iron ingestion in individuals with a propensity to load iron, and potential impairments from iron on growth in children.
WHO guidelines recommend universal iron supplementation (or iron-containing micronutrient powders) where anaemia is prevalent. These guidelines are based on GRADE-based evaluations of evidence for pre-defined beneficial and harmful outcomes. However, these guidelines do not incorporate risk-benefit or economic analysis for these interventions. While economic analyses of iron supplementation programmes have been developed, these have not generally attempted to incorporate any assessment of the costs of potential harms associated with iron.
Formal assessment of the benefit-risk is required for implementation of new public health policies (for example, by NICE in the UK) and for licensing of new pharmaceuticals (for example, by the FDA in the US, TGA in Australia). Formal risk-benefit analysis can provide policy-makers and countries with a sophisticated quantification of the potential outcomes associated with an iron supplementation programme than is presently available within WHO guidelines. Together with economic analysis, this information can potentially guide programme managers and policy makers when selecting between various health priorities and public health interventions.
Taskforce Objectives
1. To evaluate the benefit-risk of iron supplementation as a public health intervention.
a. Sensitivities of assessments to age, intervention and context (e.g. malaria endemicity) will be incorporated.
b. If possible, an algorithm will be developed enabling re-evaluation of this assessment in different settings, with different interventions, or as evidence changes.
2. To undertake a health economic evaluation of iron supplementation as a public health intervention.
a. Sensitivities of assessments to age, intervention and context (e.g. malaria endemicity) will be incorporated.
b. If possible, an algorithm will be developed enabling re-evaluation of this assessment in different settings, with different interventions, or as evidence changes.
3. To identify the evidence gaps limiting benefit-risk and health economic analysis of iron supplementation interventions and make specific recommendations concerning the critical work needed.
The Risk and Benefits of Iron Task Force report for 2015 can be accessed here.
The Risk and Benefits of Iron Task Force Proposal can be accessed here.
The Task Force was formerly named ‘Gene-nutrient interactions: Knowledge to Action’ and reflects the growing interest in relating the risk or protection provided by dietary intake to the genetic predisposition of individuals, now made possible by the growth of modern genomic technologies. IUNS Council requested that the name be changed to ‘Precision Nutrition’ for the current period to better reflect the aims of the Task Force.
It is planned that this Task Force will continue the preparation of symposia and academic papers, work to develop an online course about Precision Nutrition, and prepare a document concerning Precision Nutrition based upon OMICS approaches.
Personalized nutrition is becoming a globally important area of research that complements knowledge and applications concerning public health nutrition. Indeed, the advances of nutrigenetics, transcriptomics, nutriepigenomics, metabolomics and systems biology are strongly contributing to pave the way to more focused nutrition in different healthy individuals and disease conditions. These views need to be coordinated with community and epidemiological approaches to safe and nutritionally optimal eating. In this context, IUNS has devoted a Task Force to cover such issues with the following aims: – To promote scientific exchanges in different conferences (e.g. FENS) and summer schools (e.g. University of Navarra, UNAV). – To strengthen links with existing consortia /societies concerning this field such as NUGO and the International Society for Nutrigenetics and Nutrigenomics. – To generate documents /modules for educational purposes.
The Gene-Nutrient Interactions: Knowledge to Action 2015 report is availablehere.
The programme for the 9th Congress of the International Society of Nutrigenetics and Nutrigenomics (2015) is available here.
The 2014 report for the Task Force: Gene-Nutrient interactions: Knowledge to action is available here.
A list of activities of the Gene-Nutrient Interactions Task Force in 2012 can be accessed here.
The agenda of the ‘Global health and individualised nutrition’ 2012 summer course supported by the Gene-nutrient interaction: Knowledge to action Task Force can be found here.
Establish three regional networks (south and southeast Asia; sub-Saharan Africa; Latin America) to coordinate technical expertise and develop capacity-building partnerships
Raise the profile of malnutrition among health policy makers and donor agencies and advocate for increased recognition of its importance in child survival
Work with partners to build capacity to prevent and treat malnutrition, especially in countries with high child mortality
Advocate for inclusion of malnutrition in medical and nursing curricula and for the WHO case-management guidelines to be implemented in all paediatric wards where severe malnutrition is found
Encourage health workers to undertake operational research to monitor and improve their performance and provide data for advocacy action
raise resources
publish and disseminate the findings and experiences.
This Task Force was previously named Traditional, Indigenous and Cultural Food and Nutrition and was chaired by Professor Harriet Kuhnlein and Dr T Longvah. The Task Force recently published a special issue of the journal Maternal and Child Health entitled ‘Indigenous Peoples’ Food Systems: Gender Roles, Biodiversity and Food Security’. The issue consists of eleven chapters and an introduction from Professor Anna Lartey (IUNS Past President) and Professor Catherine Geissler (IUNS Secretary General). This issue is available free online through Wiley. In the current Council period Harriet Kuhnlein and T. Longvah will continue their involvement as a steering committee and there is an expanded membership including Dr Gina Kennedy as the new Chair of the Task Force. The Task Force has shifted the emphasis to documenting diverse local food systems and promoting elements within them for improving nutrition and health in various ways including livelihood development of knowledge holders. They plan to conduct a meta-analysis of the benefits of these food systems drawing on international publications, prepare policy briefs for national governments, UN agencies and professional societies to better enable governments to meet SDG commitments, and prepare symposia for regional conferences.
To develop a capability approach to child growth, where growth is redefined as achieving a capability set. The different dimensions of healthy growth would then include, for example, not just physical growth, but other dimensions, such as access to shelter, care, and education (micro level). Moreover, the approach would take into account factors that facilitate the capabilities that underlie these functionings, such as the quality of the health care system and of the infrastructure (meso level); and the country’s nutrition transition stage, biological history, and political system (macro level).
To access the 2017 – 2021 Task Force proposal please click here.
To access the 2016-2017 Task Force report, please click here.
To access the 2015 – 2016 Task Force report, please click here.
To access the 2014-2015 Task Force report, please click here.
To access the 2013 – 2014 Task Force report, please click here.
