3RD INTERNATIONAL CONFERENCE ON The Science of … · clinical application of nutrition in medicine and healthcare ... Certificate of attendance and other CPD/CME ... Powerpoint presentations

Showcasing the latest scientific research and evidence-basedclinical application of nutrition in medicine and healthcare

www.nutritionmedicine.org.au

Sheraton on the Park, Sydney, Australia

3RD INTERNATIONAL CONFERENCE ON

The Science ofNutrition in Medicine and Healthcare

Friday 3 May – Sunday 5 May 2013

Diamond Sponsor:

Platinum Sponsor:

Media Sponsor:

Gold Sponsor:

Theme Sponsors:

Silver Sponsors:

Index

Conference information 11

Welcome 11Conference themes 11Who is attending 12Sessions 12Powerpoint presentations 12Audio of conference sessions 12The venue at a glance 13Exhibitor Game Board 13RACGP QI&CPD (Continuing Professional Development) 14Claiming RACGP points 14Certificate of attendance and other CPD/CME 14Scientific stream 15Poser viewing times 15Prizes and awards 15Student scholarships 15

Sponsors and supporting organisations 16

Sponsors 16Supporting academic organisations 24Supporting organisations 25

Guest Speakers & Facilitator 28

Dr Caroline West (Master of Ceremonies & Faciltator) 28Dr Norman Swan 29David Butt 30Christoper Stephen 30Prof Michael Boyer AM 30John Bertrand 31Gail O’Brien 31Prof Jeanette Ward 32

Invited speakers (alphabetical by family name) 33

Prof Leigh Ackland 33Prof Dennis M Bier 34Professor Henry Brodaty AO 35Prof Ashley Bush 36Prof Lynne Cobiac 37Prof Marc Cohen 38Dr Ron Ehrlich 39Prof Michael Fenech 40Prof Lynnette R Ferguson 42Dr Debbie Fewtrell 43Dr Terri Foran 44Dr Denise Furness 45Dr Dilip Ghosh 46Dr Ross Grant 47Prof Ken Ho 48Prof Peter Howe 50Dr Ray Kearney OAM 51Dr Lance Macaulay 52Prof Ralph Martins AO 53Dr Leila Masson 54A/Prof Eugen Molodysky OAM 55Dr Karen Murphy 56Prof V Prakash 57Dr James Read 59Belinda Reynolds 60

A/Prof Ken Sikaris 61Prof A. David Smith 62Prof Wayne Smith 64Dr Maarten Stapper 65Prof Con Stough 66Prof Mark L. Wahlqvist AO 67Dr Christabelle Yeoh 69

Scientific abstract presentations (alphabetical by family name) 70

Ali, Yassir 70Archer, Nicholas 71Beliak, Olga 72Camfield, David 73Clark, Erlidia 74Cosford, Robyn 75Coulson, Samantha 76De Bock, Martin 77Donohoe, Mark 78Ferguson, William 79Harnett, Joanna 80Karpouzis, Fay 81Lee, Sally 82Liberato, Selma 83Main, Penelope 84Mann, Neil 87Marx, Wolfgang 88Oates, Liza 89Omar, Syed Haris 90Palacios, Talia 91Pipingas, Andrew 92 Ried, Karin 93Rossi, Megan 94Rozman, Margaret 95Rucklidge, Julia 96 Sarris, Jerome 97Schloss, Janet 98Seubsman, Sam-ang 99Shrapnel, Bill 100Spedding, Simon 101Venn, Bernard 102Vitetta, Luis & Coulson, Samantha 103Yates, Lisa 104

Index (continued)

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Nutrition Care Pharmaceuticals was founded by Professor Ian Brighthope. His commitment to providing drug-free, inexpensive and effective health care products to people all over the world is the driving force of Nutrition Care Pharmaceuticals.

Nutrition Care’s purpose built, state of the art, manufacturing facility in Australia supplies vitamin, mineral and herbal medicines all over the world.

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Fitgenes combines the science of Nutrigenetics and Nutrigenomics with leading edge cloud-based technology to deliver a genome-based healthcare system for personalised Patient intervention programs.

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100% Personalised MedicineBecause everybody is different.

Kingsway Compounding is an integrated pharmacy specialised in making customised nutraceutical medications. Whether it’s vitamins, minerals, amino acids or pharmaceuticals, we can cre-ate a tailor made medication to suit you and your patient. Every patient is unique and requires an individual approach to their needs. Compounding allows you to decide the ingredients, strength, form and quantity of your patients’ personalised medi-cation. At Kingsway Compounding we will work withyou to achieve that goal.We may just have the solution you’ve been looking for ...

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40/9 Powells Road, Brookvale 2100P: 02 9939 8988F: 02 9939 7988E: [email protected]: www.kingswaycompounding.com.au

The best products,the best education,

the best service.

Metagenics is the Practitioner Only products division of Health World Limited – a leader in research and development of specialised nutritional supplements for Healthcare Practitioners.

Metagenics products are based on extensive scientific research and use only the highest quality raw materials at therapeutic doses and state of the art manufacturing processes to create the most effective products possible.

Sold only to Healthcare Practitioners to help support your business, Metagenics products are supported by technical assistance and literature as well as the most significant ongoing educational program available to Practitioners. Our clinically relevant seminars are presented at 47 locations throughout Australia and New Zealand three times a year.

Metagenics offers clinically effective product ranges for the most commonly presented symptoms you see in your clinic. Clinical tools have been designed to help support Practitioners and educate patients about these key nutritional products.

To find out more about how Metagenics helps people live happier healthier lives, or to book an appointment with an Area Sales Manager contact us on 1800 777 648 or go to www.metagenics.com.au.

www.metagenics.com.auMET3324 - 01/13

Laboratory Testing For Functional Medicine Practitioners Healthscope Functional Pathology offers a range of tests that investigate functional, biochemical, nutritional, metabolic and hormonal states of health. We are dedicated to the education and support of our practitioners Previously known as ARL Functional Pathology, we have delivered specialised medical laboratory testing services to Functional Medicine Practitioners and their patients to achieve and maintain optimal health. Healthscope Functional Pathology is a specialised business unit of Healthscope Limited, one of Australia’s largest healthcare companies. Our core business is to support the practice of Functional Medicine by providing the highest quality laboratory testing.

To find out more visit powerofmushrooms.com.au

A dramatic increase in published scientific research this century, both in Australia and internationally, revealed that mushrooms benefit human health.

Visit our booth to taste the Power of Mushrooms. The first 25 visitors who mention this ad will receive a free cookbook. Join the Mushroom Lovers Club and you will also go into the running for an apron and a cookbook.

Pick up our referenced booklet for health professionals. Or for more information, the CSIRO produces a biennial Mushroom and Health Report, www.mushroomsandhealth.com. You’ll find a summary of the nutrition and health benefits of the mushroom at www.powerofmushrooms.com.au

FREE cookbook

for first

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CLINICALLY PROVEN TREATMENT FOR ACUTE BRONCHITIS. New Kaloba® is a TGA-registered, plant-based medicine for acute bronchitis, that’s suitable for both adults and children over 2 years.*1-4 Kaloba®, may hasten recovery by helping to reduce acute bronchitis symptoms.1-5

*Children under the age of 6 years should only be treated with Blackmores Kaloba® after consultation with a doctor.References: 1. Kamin W et al. International Journal of Clinical Pharmacology & Therapeutics 2010;48:184-91. 2. Matthys H et al. Current Medical Research & Opinion 2007;23:323-31. 3. Chuchalin AG et al. Explore: The Journal of Science & Healing 2005;1:437-45. 4. Matthys H et al. Planta Medica 2008;74:686-92. 5. Matthys H et al. Phytomedicine 2003;10(4): 7-17

Conference Information

Science of Nutrition in Medicine and Healthcare | 3-5 May 2013 | Page 11 of 106

WelcomeThe Australasian College of Nutritional and Environmental Medicine (ACNEM) Inc, the Preventative Health Flagship of CSIRO, and the Nutrition Society of Australia (NSA) are proud to present the 3rd International Conference on the Science of Nutrition in Medicine and Healthcare, from 3-5 May 2013 at the Sheraton on the Park, Sydney, Australia.

This conference is a unique and world-class international meeting bringing together the medical, nutrition and scientific communities to explore the clinical application of the latest nutritional, genetic and genomic science and research.

The 2013 conference program will journey through early development and childhood, environmental impacts on human health, and age and lifestyle-related neurological decline, once again reflecting important areas in clinical practice and scientific research, focusing on identifiable and modifiable factors in illness and disease. Frontiers in nutritional genetics/genomics will also be presented in the popular pre-conference Nutrigenomics workshop.

Once again, world leaders in science, research and clinical application have been invited to explore the conference themes and their inter-relationship.

Dr Caroline West as Master of Ceremonies will guide us through the weekend and facilitate the plenary forum discus-sions each day.

We extend a warm welcome to what will be an informative, intellectually challenging and clinically important event.

A/Prof Eugen Molodysky, President, ACNEM Prof Michael Fenech, Research Group Leader, CSIRO A/Prof Barbara Meyer, President, NSA

Conference Themes• Nutrigenomics (pre-conference workshop)• Early development and childhood• Environmental impacts on human health• Age and lifestyle-related neurological decline• Scientific (abstracts) stream

Each theme will be addressed in the plenary sessions as well as in the concurrent (breakout) ‘workshop’ style sessions. You can attend any of the breakout sessions, depending on which speakers and topics you would like to hear. There is no need to decide which breakout sessions you want to attend until the day.



Who is attending?The conference has been designed to meet the needs and interests of the following groups of professionals:

• Medical Practitioners ◦ Specialists/Physicians ◦ General Practitioners ◦ Registrars

• Healthcare Professionals ◦ Nurses ◦ Psychologists ◦ Naturopaths ◦ Nutritionists ◦ Dieticians ◦ Other health professionals

• Scientists & Researchers

• Public health professionals

SessionsThere are five distinct sessions during the conference. Your name badge will show which sessions you have registered for. Please wear your name badge at all times as entry to the lecture rooms will be monitored to ensure sufficient seating for registered delegates. All sessions are held at the Sheraton on the Park, Sydney on Level 2.

• Pre‐conference Epigenetics & Nutrigenomics workshop 10am-5pm Friday 3 May

• Opening Plenary Session & Cocktail Reception 5pm-9pm Friday 3 May

• Conference Day 1 9am-6pm Saturday 4 May

• Conference Dinner 7pm-11pm Saturday 4 May

• Conference Day 2 9am-5pm Sunday 5 May

If you wish to attend a session you have not registered for, please see the conference staff at the registration desk.

Powerpoint presentationsSubject to agreement from the lecturers to make their presentation available, you will receive a PDF document of the Powerpoint presentation by email about a week after the conference. Our policy is to only provide copies of Powerpoint presentations in ‘slide notes’ format. Slide notes contain small images (3 or 6 images to a page) of the Powerpoint slides.

Audio of conference sessionsSubject to agreement from the lecturers to make their presentation available, an audio version of all sessions will be available approximately two weeks after the conference for an additional fee.



The venue at a glanceRegistration Level 2Pre. Conference Workshop Hyde Park RoomMain plenary sessions Grand Ballroom 1Concurrent (breakout) workshop sessions Grand Ballroom 1, Grand Ballroom 2, Hyde Park Room, Phillip 2Exhibition area, lunches, morning/afternoon tea Level 2 prefunction areaPoster presentations Level 2

Exhibitor Game BoardIn your conference delegate bag you will find an ‘Exhibitor Game Board’. We encourage you to visit the exhibition area of the conference, to view the products and services on display, to talk to the exhibitors and of course, to get your Exhibitor Game Board hole-punched by each exhibitor to go into the draw to win some great prizes! Once you have completed your game board, hand it in to the conference staff at registration desk by the end of lunch on Sunday.

Scienti�c Posters

Registration

PHILLIP 2PHILLIP 1

HYDE PARK ROOM

GRAND BALLROOM I

GRAND BALLROOM II



RACGP QI&CPD (Continuing Professional Development)This activity has been approved by the RACGP QI&CPD Program for the 2011-2013 Triennium (through ACNEM) as follows:

• Nutrigenomics pre‐conference workshop (10am‐5pm Friday 3 May) Activity Number 766561. “Nutrigenomics in Medicine 2013.” Active Learning Module. 40 Category 1 points.

• Main conference Day 1 (9am‐6pm Saturday 5 May) Activity Number 766562. “Applications of Nutrition in Medicine 2013 ‐ Day 1.” Active Learning Module. 40 Cat 1 points.

• Main conference Day 2 (9am‐5pm Sunday 6 May) Activity Number 766563. “Applications of Nutrition in Medicine 2013 ‐ Day 2.” 13 Category 2 points.

Claiming RACGP pointsIf you are attending the pre-conference workshop on Friday, and/or the main conference on Saturday, and wish to claim RACGP points, you must complete a predisposing activity, a reflective activity, and a feedback form for each day. These are requirements of Category 1 activities. If you are attending on Sunday, you will only need to complete a feedback form (Category 2 activity).

The pre-disposing and reflective activities for Friday and Saturday were emailed to all delegates prior to the conference. The feedback forms are included in your delegate bag. Please note that you are required to hand in your pre-disposing activities at registration, and to return your reflective activity within 4 weeks of the event.

Certificate of attendance and other CPD/CMEIf you wish to apply for CPD/CME points from your professional organisation, such as those shown below, please be aware that we can provide you with a certificate of attendance detailing the total content hours for each day you were registered for. However, the certificate does not indicate which lectures or workshops you attended. You should keep a copy of the conference program to be able to substantiate the lectures you attended in order to apply for CPD/CME points.

if you wish to receive an attendance certificate please advise the conference staff at the registration desk.

• Australian College of Rural and Remote Medicine (ACRRM) (application for PDP points pending at time of printing)

• Royal New Zealand College of General Practitioners (RNZCGP) (MOPS points for non‐accredited activities will apply)

• Royal Australian College of Physicians (RACP) • Royal Australian & New Zealand College of Psychiatrists (RAZNCP) • Australian Psychological Society (APS) • Dieticians Association of Australia (DAA) • Nutrition Society of Australia (NSA) • Australian Naturopathic Practitioners Association (ANPA) • National Herbalists Association of Australia (NHAA)

This is not an exhaustive list. Please enquire of your professional organisation whether CPD/CME points apply.



Scientific streamSubmissions were invited for oral or poster presentations that represent original and new, important or clinically rele-vant nutritional science, research, application or public health relating to one or more the themes of the conference.

Nearly 50 high quality abstracts were received. Successful applicants were offered the opportunity to present a short oral presentation (10 minutes + 2 minutes for questions) in the scientific stream of the concurrent sessions and/or a poster presentation.

Some abstracts have been selected to be presented in a plenary session (to the whole conference) to highlight the scientific abstract process. Abstracts are arranged alphabetically by presenting author’s family name in the latter half of this book.

Posters will be displayed on poster boards on the conference floor (see map) throughout the conference. Poster pre-senters are expected to stand beside their posters where possible during poster viewing times, but at least during the two formal poster sessions to answer questions from delegates.

Poster viewing times: Saturday 4th May

• 8am-9am • 11am-11.30am • 1.30pm-2.30pm (2pm-2.30 pm formal poster session + judging) • 4.30pm-5pm

Sunday 5 May• 8am-9am • 11am-11.30am • 1.30pm-2.30pm (2pm-2.30 pm formal poster session + judging)

Prizes and awardsThere will be a number of oral abstract and poster presentation prizes judged by the scientific committee and award-ed at the conference, including:

1. Best Abstract Presenter - for the best oral abstract presentation 2. Best Poster Presenter - for the best poster presentation 3. New Investigator Award – to a stand-out new researcher/scientist

Oral abstract and poster presenters up to the level of PhD candidate are eligible for the awards.

Student scholarshipsAs part of the Call for Abstracts, four student scholarships have been awarded to under-graduate and post-graduate students up to PhD candidate level. This demonstrates the commitment of the convenors to encourage and reward academic excellence in nutritional science, research and clinical application.

Scholarship winners are:• Erlidia Clark• Penelope Main• Janet Schloss• Liza Oates• Megan Rossi• Wolfgang Marx

Congratulations to all scholarship winners!

Sponsors and supporting organisationsWe greatly appreciate the financial and in-kind support of sponsors, exhibitors and supporting organisations, without which it would not be possible to hold a competitively-priced conference for delegates. Special thanks go to the following organisations for their support and assistance in presenting this special event.

We encourage you to visit the exhibition area of the conference, to view the products and services on display, to talk to the exhibitors and of course, to get your ‘Exhibitor Game Board’ hole-punched by each exhibitor to go into the draw to win some great prizes!

Diamond SponsorSwisse is an Australian company dedicated to making people healthier and happier through clinically proven natural health products and education. Established in the 1950s, Swisse offers an extensive range of market-leading formulas containing premium quality natural ingredients and based on decades of significant investment in cutting edge, independently verified scientific research.

The Swisse range of products includes Australia’s number one multivitamin and some of the fastest growing supplements in Australia.

www.swisse.com

Platinum SponsorBioCeuticals® is Australia’s leading provider of nutritional and therapeutic supplements. Renowned for manufacturing and delivering high quality integrative medicines to healthcare practitioners, BioCeuticals® aims to consistently raise the standards of natural-based therapies. With quality,

innovation and integrity as guiding principles, BioCeuticals® is at the forefront of ensuring complementary and alternative medicines (CAMs) become an integral part of the Australian allied healthcare industry.

The professional division of Blackmores, BioCeuticals® has a strong commitment to research, functional formulas and reliable practitioner support. Our supplements are recgnised by qualified healthcare practitioners as well as patients; a fact that reflects our reputation as a progressive force in integrative health.

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Media SponsorMedical Observeris a multi-award winning print and digital news, features and content provider targeted at medical professionals. With more than 20,000 readers nationally, Medical Observer provides a weekly printpublication, a comprehensive website offering and daily e-newsletters.

Both print and digital products offer a comprehensive range of content including latest news, commentary, myriad clinical resources and professional education as well as established links to the medical community.

Produced by highly trained health journalists and doctors, our bespoke clinical content and news keeps readers abreast of the latest developments in medicine plus practical tips in managing patients and conditions. Lifestyle content specifically aimed at health professionals is also an important element of the content mix. Part of the global health information provider UBM Medica, Medical Observer also delivers bespoke publications and online content to niche markets in health care including primary care nurses, among others.

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Sponsors and supporting organisations


Gold SponsorNutrition Care Pharmaceuticals was founded by Professor Ian Brighthope (former ACNEM president); as part of his commitment to providing drug-free, effective health care products to people all over the world. Nutrition Care’s purpose built, state of the art, manufacturing facility in Australia produces and supplies high-quality nutritional supplements, nutraceuticals and herbal medicines to practitioners in Australia and across the globe. The

plant is fully licensed by the Therapeutic Goods Administration and the products are approved for quality and safety. Nutrition Care Pharmaceuticals in cooperation with GeneCare, is now revolutionising Nutrigenomics - combining the knowledge of an individualised genetics profile with nutritional medicine to improve quality of life.

www.nutritioncare.com.au

Theme Sponsor for the pre‐conference Nutrigenomics workshopFitgenes is an Australian company delivering measurable and sustainable health and well-being outcomes with the world’s most advanced approach to Nutrigenomics. By applying its proprietary analytical tools and systems to match the most appropriate Nutrigenomic interventions with individual requirements, the Fitgenes program helps Eliminate the GuessworkTM

associated with managing patient health and well-being by offering a personalised, multi-disciplinary approach to designing targeted intervention programs for optimal health and well-being. In applying science, the Fitgenes program offers a four tiered approach to Healthy Living : Healthy AgingTM based on prevention, prediction, personalisation and participation.

www.fitgenes.com.au

Theme Sponsor for the Environmental impacts on human health streamThe Australian Nutrition Trust Fund supports activities that promote high quality human nutrition science.

Silver SponsorsAustralian Mushroom Growers: With a five-fold increase in consumption since 1980, mushrooms are now the third most valuable fresh produce item in the vegetable section. An explosion in published scientific research this century, both in Australia and internationally, reveal that mushrooms can improve human health. Mushrooms have attributes not found in fruits or vegetables as they reside in their own biological kingdom. Beyond its nutrient-richness, its bioactive compounds influence our immune function,

light-exposed mushrooms produce vitamin D, and there is much excitement around the antioxidant ergothioneine. The CSIRO produces a biennial Mushroom and Health Report.

www.powerofmushrooms.com.au

Healthscope Functional Pathology provides specialised medical laboratory testing services to Functional Medicine practitioners and their patients. Our goal is to assist Functional Medicine practitioners and their patients to achieve and maintain optimal health. Previously known as ARL

Functional Pathology, our tests provide essential information to assist the practioners in the diagnosis, treatment and management of patients seeking a holistic approach to health.

www.healthscopepathology.com.au




Silver Sponsors (continued)At Kingsway Compounding we make unique medications, in conjunction with the practitioner that are specific for your patients needs. The “art” of making unique personal medicines is called Compounding. Using a biomedical approach we specialise in compounding personalised vitamins, minerals,

amino acids, antioxidants, HRT and Chelation formulations and can reformulate conventional medicines to suit patient taste, dose, delivery route, form etc. In our specialised compounding premises, we use pharmaceutical grade raw materials from GMP approved manufacturers that comply with USP/BP/EP/JP specifications to produce high quality and efficacious compounded products. Talk to our professionally qualified staff for your patients individualised treatment needs, we may just have the solution you’ve been looking for… ‘Customized medicines for your individual needs’.

www.kingswaycompounding.com.au

Metagenics is the ‘practitioner only’ products division of Health World Limited – the Australian and New Zealand leader in research and development of specialised nutritional supplements for healthcare

professionals. To Metagenics, being the industry leader is about being the leader in the eyes of the practitioner – a position that can only be earned through consistent efforts to provide the most effective, highest quality products available, exciting innovations to the industry, consistent effective clinical results and the best service, support and education in our field. In short, Metagenics believes the industry leader should set the standards to which its competitors aspire. Metagenics – helping people live happier, healthier lives.

www.metagenics.com.au

Professional Compounding Chemists of Australia (PCCA) is licensed by the Therapeutic Goods Administration (TGA) to supply high quality ingredients to compounding pharmacies. PCCA is also endorsed by the Pharmacy Guild of Australia.

PCCA compounding pharmacies have access to clinical and technical support, an extensive formula database, and accredited training and continuing education. In addition, pharmacies displaying the PCCA Compounding Standards Program ‘tick’ logo have undergone a stringent auditing process to ensure their compliance with best practice pharmacy compounding standards and use of PCCA high quality ingredients. PCCA enables you to use compounded products with confidence.

www.pccarx.com.au

Bronze Sponsorsa2 Milk™ is pure dairy milk, completely natural, permeate and additive free, which is why it tastes so refreshing. Most dairy milk today contains 2 main types of beta-casein protein, A2 and A1, while originally all dairy cows produced milk containing only the A2 type of beta-casein protein. a2 Milk™ comes from cows specially selected to produce A2 beta-casein protein

rather than A1. Because a2 Milk™ is rich in A2 beta-casein protein, it may assist with your digestive wellbeing. There are over 100 scientific studies to support the A2 story.

www.a2australia.com.au


Bronze Sponsors (continued)The AustralAsian Academy of Anti-Ageing Medicine (A5M) is dedicated to the advancement of longevity science, medicine and technologies to detect, prevent and treat ageing-related disease and to promote the Practice of Integration for a Healthy Life.

The A5M is the recognised evidence-based educational service provider for the Anti-Ageing Industry throughout AustralAsia, with a comprehensive Education Program - including Fellowship & Certification Programs. Representing the interests of medical practitioners and healthcare professionals with particular interests in Anti-Ageing,

Preventative and Integrative Medicine, A5M is part of a global group headed by the member-based organisation, World Anti-Aging Academy of Medicine (WAAAM) and the American Academy of Anti-Aging Medicine (A4M).

www.a5m.net

Australian Custom Pharmaceuticals is Australia’s largest Compounding Pharmacy. Utilising ACP for your compounding needs ensures that your patients are getting exactly what they ordered first time, every time. Our ability to test all incoming raw materials as well as ongoing method analysis and final product analysis allows you to feel confident in prescribing

compounded medications and nutrients for your patients. This combined with our advanced recall system and constant refining of technology and formulations give us the edge. It’s called Compounding with Confidence. As the largest compounder in Australia, ACP can produce what your patients need. Call us on 1300 853 620.

www.acpharm.com

Bio Concepts is an Australian owned company, formulating and supplying innovative practitioner only supplements for over 25 years. Bio Concepts founder Henry Osiecki is a well renowned Australian Nutritionist and

educator and has published a number of text books on nutrition including his most recent text book, Cancer: The Importance of Clinical Nutrition.

Bio Concepts has established an indisputable reputation for unique product development and highly effective practitioner education. Offering brands including Orthoplex, Pure Innovation and Pure Oil Innovation, Bio Concepts vision is to consistently improve upon the science of clinical nutrition, so that we can be of more service to you and, most importantly, your patients.

www.bioconcepts.com.au

Biological Therapies was founded by present Managing Director and medical educator Dr Ian Dettman PhD, who has decades of experience in nutritional pharmaceutical formulation, together with a deep knowledge and understanding of the associated indications, usage and current medical literature which he uses to support practitioners.

The company is committed to excellence, innovation and the availability of extremely safe nutritional injectables and oral medicines.

Our TGA-licensed, GMP premises produce sterile AUST-R injectables and AUST-L orals, as well as a comprehensive range of extemporaneously made products for Australian and overseas leading-edge GPs – please request details of this range.

www.biologicaltherapies.com




Bronze Sponsors (continued)At Blackmores scientific and traditional evidence are combined to create high quality and clinically relevant products for effective and accessible

natural healthcare. With over 80 years experience Blackmores continues to set the standard in natural medicine with the launch of Blackmores Institute. Blackmores Institute has been established with the purpose of becoming a centre of excellence ininnovation, research and education. Collaborating with leading research institutes, hospitals and universities the Blackmores Institute provides research into the clinical applications of phytomedicines, nutrients and foods as well as exploring their modes of action. Join the Blackmores Institute for free updates on the latest developments in natural medicine at www.blackmoresinstitute.org. For information on Blackmores please go to: www.blackmores.com.au or call Blackmores Healthcare Professional Support on 1800 151 493.

www.blackmores.com.au

The Cell-Logic focus is on evidence-based Nutrigenomic products. The ability to significantly change the expression of clinically-relevant genes takes modern clinical practice to a whole new level. Cell-Logic is an acknowledged leader in this field.

Our flagship bioactive, EnduraCell® 100% Myrosinase-Active Broccoli Sprout powder is produced by our proprietary process to yield bioactive Sulforaphane, the most potent natural activator of cellular defences. EnduraCell® is available in powder orcapsules, as a single ingredient or in the formulation DefenCell®, combined with supporting nutrients and another bioactive GliSODin®, a potent nutrigenomic inducer of Superoxide dismutase. EnduraCell, DefenCell and GliSODin stand in a class of their own.

Founded by an experienced clinician, Cell-Logic offers clinicians superior technical support, backed by an active and ongoing research programme.

www.cell-logic.com

MedicalMine, Inc, is a Pleasanton, California-based software company founded to address the application of cloud-based technology to medicine, both to improve patient participation, and to enhance patient outcomes and productivity at medical practices. Its first product, patient portal ChARMtracker, has over 6,000 users worldwide. The second product,

ChARM EHR, is currently being used by small and medium sized medical practices worldwide.

www.charmehr.com

Diagnostic Insight is an Australian owned and managed company providing specialist pathology services. Our profiles include metabolic, nutritional and toxicant profiles. In addition, we provide microbiological assessment of faecal specimens, employing advanced molecular methods (DNA/PCR) of technology. We have strict specimen integrity and stability protocols;

therefore a key focus is on a patient support at each step of the testing procedure. This ensures efficient and timely dissemination of accurate and reliable results. In addition our company focus to provide cutting edge clinical and technical support to medical doctors and allied health professionals to ensure the best in patient care. We proudly support professional organisations involved in the education of Australian and Healthcare professionals.

www.diagnosticinsight.com.au


Bronze Sponsors (continued)Flordis Natural Medicines is an Australian company solely dedicated to bringing practitioners the very best natural medicines from around the world. Flordis provides best-evidenced natural health solutions which are backed by the latest modern medical science and knowledge about herbs and other natural medicines. Flordis specifically clinically proven products

are the exact products proven effective in clinical trials, they include: Iberogast® registered for the treatment of gastric and abdominal discomfort associated with functional and motility-conditioned gastrointestinal disturbances e.g. functional dyspepsia and Irritable Bowel Syndrome, Legalon® which helps to maintain and improve healthy liver function, Premular® for the relief of premenstrual syndrome and Femular® for the relief of menopausal symptoms as well as many others.

www.flordis.com.au

Genostics is an Australian molecular diagnostic, consulting, education and research provider, specialising in the field of Oncology. The Genostics tests use the most advanced molecular medicine techniques to:

• Utilise a select panel of biomarkers to detect, isolate and identify Circulating Tumour Cells (CTCs) as a means of early detection of a developing cancer (‘EDT’);

• Analyse an individual person’s cancer cell response to chemotherapy agents, monoclonal antibodies, hormones, botanicals and nutrients, to produce an individual profile of therapeutic choices (‘Comprehensive CTC Test’);

• Monitor disease progression and the effectiveness of a person’s cancer treatment by providing a CTC ‘count’ (‘CTC Count Test’).

These advances assist Health Practitioners to design effective, targeted, individual treatment options and predict which therapeutic agents may be most effective.

www.genostics.com.au

ImuPro is a worldwide company specialising in IgG food intolerance tests (type III, delayed onset food allergy). The ImuPro300 test is the most comprehensive IgG test available, pinpointing individual reactions to 271 different food allergens. As well as a detailed report of findings, we also provide a personalized recipe booklet, individual report booklet and patient’s

manual. We offer a supplementary histamine intolerance test.. ImuPro Aust and NZ also offers an advanced LipoScan cholesterol test which measures LDL and all its subfractions.

www.imupro.com.au

While Integria Healthcare is a new name in natural health, our successful portfolio of brands already enjoys the trust of practitioners in Australia and around the world. What makes us unique is not only the reputation of brands like MediHerb, Eagle, Nutrimedicine and MH Enhance but also the quality

focus of these brands. Integria Healthcare’s vision is to be a new leader in science-based natural healthcare through a unique combination of brands, intellectual property, manufacturing capability and distribution network in the natural healthcare business. Integria Healthcare is a truly diverse brand portfolio, each sharing in the vision of leadership in science based natural healthcare.

www.integria.com





Bronze Sponsors (continued)In the field of Nutritional and Natural medicines, InterClinical Laboratories is one of Australia’s foremost practitioner aligned companies. InterClinical Laboratories is the leading service provider of Hair Tissue Mineral Analysis (HTMA) Pathology in Australia and this service is regarded by many doctors,

naturopaths and nutritional therapists as one of the most valuable screening tools available in everyday and preventative health care. InterClinical Laboratories also offer a range of Nutritional and Herbal medicines for Practitioners and we pride ourselves on the purity of our formulations, ensuring each product is created from high quality, bio-available, easily digested ingredients.

www.interclinical.com.au

MyGene is an Australian genetic testing company, striving to bring useful and purposeful gene testing to patients via healthcare professionals. MyGene genetic tests allow healthcare professionals to make more informed and personalised healthcare decisions for their patients.

Genetic tests offered by MyGene cover the areas of nutrigenetics, pharmacogenetics and medical testing, as well as sport and exercise genetic testing. MyGene also has active R&D programs and collaborations in these four areas.

MyGene offers education and training to healthcare professionals to ensure they are best positioned to conduct tests and deliver results to their patients with confidence and purpose. To register to conduct MyGene genetic tests, or for more information, please visit our website.

www.mygene.com.au

Our goals at NutriPath are to: • Provide our clients with a comprehensive range of reliable and high quality laboratory testing. • Provide our clients with a dedicated and committed SERVICE through our friendly and attentive Customer Service Staff.

Through this focus our aim is not only to ensure the ongoing success of this testing laboratory, but concurrently to support your practices as one of our service providers so that we reflect a positive and professional experience for your patients. NutriPath testing panels are available to all healthcare professionals. NutriPath offers an extensive range of testing panels in the areas of Hormonal Assessments, GIT Assessments, Food Allergy Assessments as well as some testing in the areas of Nutritional and Metabolic Assessments. We envisage expanding the range of tests in the future to ensure the range remains comprehensive.

nutripath.com.au

Want finance for your practice, equipment, motor vehicle, investment property, cash flow or home? Medfin is an Australian leader in practice finance. For approved customers, we can lend up to 100% of the purchase price of your practice needs without requiring additional security. Medfin understands that your time is important so our experienced Relationship Managers are available by phone or make appointments at a time and

place that suits you. Want more information? Call your local Medfin Relationship Manager on 1300 361 122 or visit Medfin.com.au to request a quote.

www.medfin.com.au

Bronze Sponsors (continued)Research Nutrition is an Australian company which globally sources the highest quality nutritional supplements and functional testing services for healthcare practitioners to promote optimal ageing, improved clinical

efficacy and personalised test results. The successful combination of functional diagnostic testing with evidence-based supplementation represents a preventive approach to health management. This provides the practitioner a framework to understand the pathophysiology and not simply treat the end stage manifestations of the altered physiology.

Research Nutrition works with companies with solid integrity, dedicated to research and education. We provide practitioner training via personal meetings, seminars, webinars and educational programs. Our products and services support practitioners that adopt such a patient-centred, wellness approach in their practice. Visit www.researchnutrition.com.au/practitioner to learn more about how Research Nutrition can help improve your practice.

www.researchnutrition.com.au

The Rosehip Specialists™ is an Australian owned family business that is recognised for sourcing and producing the highest quality Rosehip products, bringing to market the world’s number 1 evidence-based Rosehip therapy, Rose-Hip Vital® with GOPO®, supported by 30 scientific papers

including 4 double blind placebo controlled clinical trials unique to Rose-Hip Vital®, with outstanding results.

The Rosehip Specialists™ are renowned for manufacturing using best practices, maintaining the integrity and efficacy of the vitamins and minerals for optimum health. With a dedication to research, The Rosehip Specialists™ are at the forefront of bringing the highest standard evidence-based Rosehip therapy to the Australian healthcare industry.

Rose-Hip Vital® with GOPO® is a rich source of natural vitamin C and a powerful antioxidant made from 100% natural Rosehip (Rosa Canina) which may help temporarily relieve the pain of Arthritis, Rheumatism and Osteoarthritis, may help increase joint mobility, relieve inflammation and joint swelling and improve sleep when affected by joint discomfort. Rose-Hip Vital® with GOPO® is acknowledged by leaders in Integrative Medicine as a product which delivers on efficacy with evidence-based integrity. 1800 851 888.

www.therosehipspecialists.com.au

Gift SponsorsLindt has been creating fine chocolates since 1845, with Lindt Excellence being our most premium range of Dark and Milk Block Chocolates deliver-ing an exceptional taste experience for all five senses. It is with the dedi-cation and passion of the Lindt Master Chocolatiers in combination with their choice of superior ingredients that makes Lindt Excellence a chocolate masterpiece.

www.lindt.com/au/

Research tells us that almonds are a healthy choice. Almonds contain “good” monounsaturated fat - also found in olive oil and avocados. Studies show that diets which replace saturated fat with monounsaturated fat, are beneficial for heart health. Almonds also contain phytosterols, which are plant compounds that help support heart health. Almonds are extremely

high in Vitamin E. Vitamin E is a powerful antioxidant, this means that it protects our cells from damage, helping to maintain a healthy heart and blood vessels. Vitamin E also works best in foods that contain some good dietary fat, like almonds, to help its absorption. Just a small handful of almonds (30g) provides over half your daily vitamin E requirements. Almonds really are a natural Vitamin E powerhouse!

www.australianalmonds.com.au





Supporting academic organisationsThe Clinical Nutrition Research Centre offers Australia’s foremost expertise in the design and conduct of human intervention trials to evaluate cardiovascular, metabolic, anti–inflammatory and mental health benefits

of functional nutrients, foods and nutraceuticals. The CNRC is a multi-institutional research collaboration aimed at consolidating existing research strengths, building partnerships with stakeholders, delivering translational research outcomes, and setting a benchmark for research excellence.

www.newcastle.edu.au/research-centre/cnrc/research.html

Nutrition has been an implicit feature of much of the research done in the Faculty of Medical and Health Sciences for many years, although it was only formally established as a discipline within the faculty in April 2000. Science and Health Science graduates may be interested in a research career, and

nutrition provides different possible avenues for this. Nutrition is the major contributor to the common diseases of New Zealanders – cardiovascular disease, cancers, diabetes, obesity.

Potential research projects span from basic molecular/genetic mechanistic studies through to epidemiology. The discipline has interactions with both industry and functional foods. It can also capture the opportunities that Auckland offers through its unique population mix and industry base. Health science professionals including doctors, pharmacists, nurses, sports scientists and public health experts may consider advanced/specialist or refresher training in nutrition.

www.fmhs.auckland.ac.nz/sms/nutrition

The Nutritional Physiology Research Centre is one of Australia’s leading research centres investigating the benefits of nutrition and exercise for cardio-metabolic health, cognitive performance and physical function in populations ranging from patients with chronic disease to elite athletes.

The Nutritional Physiology Research Centre conducts research funded by Government and industry in accordance with ICH-GCP guidelines, ensuring strict compliance with requirements of regulatory authorities for the quality of evidence to support health claims and registration of nutraceuticals. The Nutritional Physiology Research Centre is currently conducting a number of large scale intervention trials investigating the effects of various dietary, supplemental and exercise regimens on health, including effects of dairy protein on strength and muscle mass and effects of peanuts, dairy and legumes on cardio-metabolic health and cognitive performance.

www.unisa.edu.au/research/sansom-institute-for-health-research/research-at-the-sansom/research-concentrations/nutritional-physiology/

The Swinburne University Centre for Human Psychopharmacology conducts research into the effects of natural products, pharmaceuticals and illicit drugs on neurocognitive processes across the lifespan. We are the largest group in the world researching the cognitive and mood effects of natural products, nutritional supplements and other nutritional interventions. We conduct government and industry-funded trials, and investigator-initiated studies. We are currently conducting large scale clinical trials in the area

of cognition, depression, anxiety, stress and mood using standard and novel natural medicines and supplements derived from plants. Our trials involve cutting edge cognitive, biochemical and neuroimaging technologies including functional MRI and MEG. The centre also aims to educate the public and consumers on the effects of natural medicines and illicit drugs on the human brain, driving, mood and behaviour.

www.swinburne.edu.au/lss/chp/



Supporting academic organisations (continued)NatMed-Research Unit, Southern Cross Plant Science, Southern Cross University

http://www.scu.edu.au/schools/hahs/index.php/16

Centre for Integrative Clinical and Molecular Medicine, School of Medicine, University of Queensland

http://www2.som.uq.edu.au/som/Research/CICMM/Pages/default.aspx

Supporting organisationsThe Australian Disease Management Association (ADMA) is a not-for profit self-funded organisation that provides a forum for disease management services and promotes programs, which improve chronic condition outcomes and quality of life and reduce acute health care utilisation and costs.

ADMA was founded in 2004 with support from public and private health industry stakeholders to provide benefits and resources to its members to assist in the delivery of services, and to provide expert advice regarding chronic disease management in Australia.

www.adma.org.au

The Australasian Integrative Medicine Association (AIMA) is the peak medical body representing the doctors and other health care professionals who practce integrative medicine. Integrative medicine is a philosophy of healthcare with a focus on individual patient care and combining the best of conventional western medicines and evidence-based complementary medicines and therapies within current mainstream medical practice. AIMA is an independent not-for-profit organisation supported by its membership

and governed by a board of voluntary doctors and academic leaders in the field of integrative medicine.

www.aima.net.au

The Australian Lifestyle Medicine Association (ALMA) aims to improve knowledge and practical skills of healthcare practitioners in lifestyle behaviour change within Australia. Lifestyle medicine is a relatively new discipline, which bridges the gap between health promotion and conventional medicine. It involves a range of health professionals working

as a team. The roles and functions of ALMA include: Raise awareness of Lifestyle Medicine in the management & prevention of chronic disease; Improve knowledge/skills in lifestyle behaviour change; Encourage more practitioners to enter this field; Formulate interdisciplinary care for chronic disease; Facilitate education in this area; Foster research in this area; Have input into policy development at government levels.

www.lifestylemedicine.com.au



Supporting organisations (continued)The Australian Naturopathic Practitioners Association (ANPA) is the peak body representing highly qualified naturopaths across Australia. ANPA is a democratic association and was founded in 1975. ANPA proudly leads the profession representing excellence, leadership and integrity in Naturopathic health care. Naturopathic principles provide important foundation guides for patient care: the healing power of nature, first do no harm, finding the cause, prevention, education and always treating the whole person,

not only the disease. Our missions link to our vision and we encourage alliances with other health professionals supporting a patient-centred approach to care. For more information contact visit the ANPA website or phone 1800 422 885.

www.anpa.asn.au

The Australian Self Medication Industry association (ASMI) is the peak body representing companies involved in the manufacture and distribution of non-prescription consumer healthcare products in Australia. The Association also represents related businesses including advertising, public relations, legal, statistical and regulatory consultancy companies and individuals. Our purpose is to promote the best interests of our Members through negotiation, debate and cooperation with a wide range

of stakeholders in our own region and around the world. We also gather information from diverse sources and disseminate it to our Members to alert them to potential issues that may affect their product or its market.

www.asmi.com.au

Bio-Balance Health’s primary aim is to make available in Australia information on the use of a comprehensive biochemical assessment and advanced complementary nutritional treatment of a range of disorders such as benavioural disorders, ADD, ADHD, learning disorders and Autism as well as mental disorders such as schizophrenia, bipolar disorder and depression. Bio-Balance Health continues to promote, support and participate on a not-for-

profit basis in the establishment of facilities in Australia for comprehensive biochemical assessment and complementary nutritional treatment and to support the training of medical practitioners.

www.biobalance.org.au

The Gawler Foundation provides a range of internationally renowned healing cancer retreats and programs that embrace an integrated approach to health, healing and wellbeing that includes the body, emotions, mind and spirit. Our cancer retreats and healing programs work within an

integrative medical framework to provide access to the best possible instruction and support for the implementation of self-help techniques for people experiencing cancer, Multiple Sclerosis and other serious illnesses, and those seeking a preventative approach to health and wellbeing.

www.gawler.org



Supporting organisations (continued)Now more than ever, Australian children need well-trained Integrative health practitioners. The alarming statistics speak for themselves. Today Autism affects as many as 1 in 100 Australian children, ADHD 1 in 9, Asthma 1 in 4 and allergies 1 in 5. Asthma, Autism and ADHD have each more than doubled in Australian children in the past 20 years. MINDD Foundation

invites practitioners to help fast-track effective treatments to children during critical neuro-developmental periods. MINDD services include: Mindd TV; Special Diets, Biomedicine, Recovery Stories; Recipes from the Healthy Cells Cookbook; Integrative Practitioners across Australia; Books & DVDs.

www.mindd.org

Founded in 1920, the National Herbalists Association of Australia (NHAA) is the oldest natural therapies association in Australia, and the only national professional body of medical herbalists and naturopaths. Our mission is to serve and support their membership and promote and protect the profession and practice of herbal medicine and naturopathic practices. NHAA has always set the standard and been active at both the political level and at the coal face of clinical practice and education.

www.nhaa.org.au

Just a handful of nuts a day can help reduce your risk of heart disease and diabetes, help control cholesterol and manage weight. “Low fat” thinking is no longer best for health - replacing saturated fat with mono- and polyunsaturated fats such as those in nuts is. Nuts for Life is a health education program co-funded by the Australian Tree Nut Industry and through government matched funding for R&D activities through Horticulture Australia. Go Nuts for Life. Go Nuts for Health.

www.nutsforlife.com.au

A not-for-profit organisation, National Institute of Integrative Medicine (NIIM) brings together education and research in Integrative Medicine as well as in practice at the NIIM Clinic for complete healthcare. We provide the best scientific evidence-based, conventional and complementary medicine for the prevention and treatment of cancer, heart disease,

diabetes and other chronic illnesses. With the support of local and international partners, NIIM conducts research into emerging technologies, innovative therapies and treatments in Integrative Medicine, assessing their efficacy, toxicity and quality. Accredited education courses designed as self-paced, online programs are offered for practicing medical and allied healthcare professionals. NIIM empowers people to take control of their health!

www.niim.com.au

The Quest for Life Foundation provides a range of residential programs and services that encourage, empower and educate people living with cancer or other serious illnesses, or who are suffering from grief, stress or trauma and

for those who care for them. Quest for Life programs provide a proven, effective and holistic approach to creating physical, mental, emotional and spiritual health and resilience. Most people leave our programs with a deeper understanding of themselves and feeling confident in their ability to deal effectively with their challenges.

www.questforlife.com.au

Guest speakers and Facilitator


Master of Ceremonies & Facilitator

Dr Caroline West, MBBS

Dr Caroline West is one of Australia’s best known media doctors. Currently Dr Caroline is the health and fitness host of the TV series “Guide to the Good Life” (Network 7). Her past credits include Beyond Tomorrow (enjoyed by a global audience through the discovery channel) GoodMedicine, Beyond 2000, 60 minutes, Sex/Life, Living Longer, Everybody and George Negus Tonight.

Dr Caroline West works as a General Practitioner In Darlinghurst, Sydney and has a special interest in lifestyle medicine. Her areas of expertise include nutirition, healthy lifestyle behavioural changes, weight management, sleep, exercise, mental health and preventative medicine. Dr Caroline remains committed to the latest developments in lifestyle medicine believing that prevention is the key for better health. She is a leader in this field and

communicates the latest in medical advances not only to her patients but also to a broader audience through her work as a media doctor, health broadcaster, corporate speaker and consultant.

Dr Caroline West is currently the President of the Australian Lifestyle Medicine Association (ALMA). Around Australia she regularly presents workshops on Lifestyle Medicine and prevention. She is an adjunct professional fellow at Southern Cross University.

As a health journalist she has been a regular columnist for the Sun Herald, Good Medicine and ninemsn and Australian Doctor.

Dr Caroline’s sanity savers include surfboard riding, cycling and kayaking. She won the Gold medal in the marathon kayaking event in her age division at the 2009 World Masters Championship. Dr Caroline is also passionate about music. She has written music for multiple ABC records and artists from Anne Kirkpatrick to the Crosby Sisters.

Dr Caroline West holds a Bachelor of Medicine / Bachelor of Surgery from the University of NSW. On graduation she was awarded the prize for most outstanding achievement in community.

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Special guest speakersWe are honored to welcome seven special guests to the conference to speak about the intersection of their work with the themes of the conference.

Opening Plenary Session ‐ Friday 3 May

Dr Norman Swan, FRCP, DCH, MD (Hon Causa)

Dr Swan was born in Scotland, graduated in medicine from the University of Aberdeen and later obtained his postgraduate qualifications in Paediatrics.

The Health Report is the world’s longest running health show on radio or television, having started in 1985. It aims to provide the community with up to date information based on medical and health research so that ordinary people have access to high quality evidence to inform decisions about their health and wellbeing. Norman has been Australian Radio Producer of theYear, received a Gold Citation in the United Nations Media Peace Prizes, has won three Walkley National Awards for Australian journalism, including the prestigious Gold,

and Australia’s top prize for Science Journalism, the Michael Daly Award, twice.

In 2004 he was awarded the Medal of the Australian Academy of Science, an honour that had only been given three times and the Royal College of Physicians of Glasgow made him a Fellow. In 2006 he was given a Doctorate of Medicine Hon Causa by the University of Sydney during its medical school’s 150th anniversary. Norman was co host of the social affairs programme, Life Matters on ABC Radio National for five years and is frequently a guesthost on Late Night Live and Radio National’s news and current affairs Breakfast programme. He also edits his own newsletter, The Choice Health Reader, which is published in partnership with CHOICE. On television, in addition to Catalyst, Dr Swan hosted its predecessor, Quantum, and has been a reporter on Four Corners. He hosted Health Dimensions on ABC Television, and created, wrote and narrated a four part series on disease and civilisation, “Invisible Enemies”, made for Channel 4(UK) and SBS Television. This has been shown in twenty seven countries. He co-wrote and narrated “The Opposite Sex”, a four part series for ABC Television and recently he was medical host of The Biggest Loser on Channel 10.

Norman Swan has been the Australian correspondent for the Journal of the American Medical Association and the British MedicalJournal and consults for the World Health Organisation in Geneva. In late 2008 Norman co-chaired a global meeting of Health Ministers in West Africa whichpursued the goal of making health policy evidence-based and facilitated a follow up meeting in Singapore in October 2009.

More Informationhttp://www.abc.net.au/rn/healthreport/default.htm

“Science meets reality ‐ will nutritional science and health research deliver on its promises?”Promises (and excuses) are made all the time by health and medical researchers. ‘Fund us and we’ll find a better treatment for cancer’; ‘As a result of our findings we hope to have a treatment in the clinic within five to ten years’; ‘I know the evidence says ‘x’ but in my twenty years’ experience, the answer is definitely ‘y’; ‘It’s all very well to say that randomised clinical trials are the gold standard but we can’t get funding’. Increasingly frustrated consumers are talking about the twin valleys of death. The first valley is where results from basic research fail to make to across the divide to the next stage of development. The second valley of death is something hopeful which doesn’t get any further beyond, say a phase 1 trial. In this talk I’m going to argue there’s a mountain of death which isn’t being scaled in the first place because of misplaced priorities. Perhaps all too often researchers and clinicians are from Mars while consumers are on Venus. Is there a way we can all pull and more importantly push in the same direction so that safe and effective prevention and therapies are put into practice. I will also tread on some land mines on the way by suggesting that some physicians are creating great risk by using poor science and going on hunches and beliefs rather than evidence.

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Conference Day 1 ‐ Saturday 4 May

David Butt

Deputy Secretary of the Department of Health and AgeingDavid Butt is Deputy Secretary of the Commonwealth Department of Health and Ageing with responsibility for national primary health care reform, population health, and regulatory policy and governance. Prior to commencing in this position in August 2011, David spent three years as CEO of the Australian General Practice Network, the peak national body for Australia’s Divisions of General Practice and State Based Organisations. David also has worked as National CEO of Little Company of Mary Health Care (the Calvary group of public and private hospitals, aged care and home care services) and CEO of ACT Health and

Community Care, including two years as Chair of the Australian Health Ministers Advisory Council (AHMAC).

Christopher StephenChristopher Stephen is the founder of Computer Law Services Pty Ltd (CLS) which consolidated the statutes of the Commonwealth, NSW and Victoria, and developed the first hypertext legal database, the model for which has been widely adopted in legal publishing circles. After the sale of CLS, Mr Stephen’s sister developed MS and she was unable to read properly. She was given large type books and she could read these easily either. Mr Stephen eventually discovered she had an eye tracking problem that could be solved by reformatting the text in specific ways. He then founded ReadHowYouWant which changes the text, not the reader, to make reading and learning easier. Mr Stephen has degrees in Science (Maths and Physics), Economics and Law from Sydney University.

More Informationhttp://www.readhowyouwant.com/

Gala Conference Dinner ‐ Saturday 4 May

Prof Michael Boyer AM, Bsc(Hons), PhD

Michael Boyer has been Director of the Sydney Cancer Centre since 2007, and was formerly the Area Director of Cancer Services for Sydney South West Area Health Service. He is also a Clinical Professor, within the Central Clinical School of the University of Sydney. He is a medical oncologist with a major clinical interest in the treatment of lung cancer, mesothelioma, and head and neck cancers. He is actively involved in research, focusing on the testing of new anticancer drugs for the treatment of lung cancer.

Dr Boyer’s medical training took place at the University of Sydney and he trained as a medical oncologist at Royal Prince Alfred Hospital. He undertook further training in medical oncology

at the Princess Margaret Hospital in Toronto, Canada, and also obtained a PhD in cell biology from the University of Toronto. He has been a member of the senior staff of Royal Prince Alfred Hospital since 1993.

In addition to his clinical activities, he is also the inaugural chair of the Scientific Advisory Committee of the Australasian Lung Cancer Trials Group, a position he has held since 2004. He is the author of more than 100 scientific publications, and holds several competitive grants. In 2010 he was made a member of the Order of Australia (AM) for his work as an educator, a clinical trials researcher and for his involvement in the development of integrated care facilities for people suffering with cancer.

More Informationhttp://sydney.edu.au/medicine/people/academics/profiles/mboyer.php http://www.sydneycancer.com.au/About_us/Management_and_departments/Staff_directory/Staff_Profile.aspx?id=10737418246



Conference Day 2 ‐ Sunday 5 May

John BertrandA World Champion and Olympic bronze medalist, John represented Australia in five America’s Cups and two Olympic Games.

Not only is John an international sportsman, he is also both a businessman and philanthropist. Over a 30-year career, John has built successful businesses in the Marine, Property and Media Industries.

Australia conferred a Member of the Order of Australia (AM) on John in 1985, in 2008 he was named Melbournian of the Year and in 2011 he received Monash University’s Distinguished

Alumni Lifetime Achievement Award.

John holds a Mechanical Engineering degree from Monash University and a Master of Science from MIT in Boston.

Gail O’BrienGail O’Brien is a Director and Board Member of the Chris O’Brien Lifehouse at RPA. As the wife of the late Professor Chris O’Brien, Gail plays an instrumental role in supporting her husband’s vision for a world-class, fully integrated and comprehensive cancer care facility in Australia as the Chris O’Brien Lifehouse at RPA moves towards opening its doors in 2013.

Professor Chris O’Brien AO was a head and neck cancer surgeon known around the world for his work, when at the height of his career, he was diagnosed with a lethal and highly aggressive brain tumour which eventually claimed his life in June 2009. He was honoured in a State funeral for his role as a model surgeon, mentor and humanitarian. Since Chris’ passing,

Gail has immersed herself in working with the COB Lifehouse at RPA as the building work continues on the facility that is now her husband’s legacy. In addition to her experience with the COB Lifehouse, Gail originally trained as a physiotherapist and it was during this time where she first met Chris as a fellow graduate in the medical fraternity.

Throughout their time together, Gail practiced as a physiotherapist and went onto manage Chris’ busy surgical practice and the many fundraising initiatives held for head and neck cancer. Gail now uses her own experience and insights to address a wide range of corporate, industry and special interest groups about the new hope that lies ahead for the thousands of Australians each year who receive the news they have cancer. Gail will speak about her work and passion for integrated cancer care.

More Informationhttp://www.lifehouserpa.org.au/



Prof Jeanette Ward, MBBS, MHPEd, PhD, FAFPHM, FACHSM, FAICD

Jeanette Ward is a Fellow of the Australasian Faculty of Public Health Medicine (FAFPHM) and the Australian College of Health Service Managers (FACHSM). She has a longstanding commitment to rigorous science, not only as a recognized research leader but also as an experienced decision-maker who understands first-hand the value of sound evidence in planning and implementing effective health services. Jeanette is currently consulting in policy and strategy as Principal of Health Perspectives, having recently completed 12 months in Broken Hill (NSW) to gain remote management experience with the Royal Flying Doctors Service.

She maintains active national and international collaborations to enhance global capacity for evidence-based policy and practice, including peer-reviewed papers in 2011 in Lancet and the Medical Journal of Australia. Jeanette mentors emerging business and academic leaders in both private and public sectors. She serves as Non-Executive Director on several not-for-profit boards, earning Fellowship of the Australian Institute of Company Directors in 2010 (FAICD).

New collaborations or old contests: multidisciplinary healthcare and the newer professionsAs newer professions emerge as a consequence of the deepening of specialised knowledge in health and the increasing complexity of patients’ clinical needs, how might we better prepare all members of the clinical team to work effectively through training, information management and standards of practice? What can the newer professions do and how might patients themselves become more empowered to ensure the care they receive is integrated and effective?

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Prof Leigh Ackland, Bsc(Hons), PhD

Personal Chair, School of Life and Environmental Sciences. Acting Director, Centre for Cellular & Molecular Biology, Deakin University, Melbourne.

Prof Ackland has contributed to advances in the field of trace metals in human health and disease. Her research has provided insights into the homeostatic regulation of zinc and copper within the body and the cellular mechanisms underlying metal transport. She and her team have elucidated the molecular basis of inherited disorders of zinc andcopper transport. Prof Ackland is a member of the Australian Society for Medical Research and the Cancer Council Victoria, Medical and Scientific Committee. She on the editorial board of

several journals and has been a member of the organising committee of a number of international metal-related conferences.

Prof Ackland established the Chinese-Australian Consortium for Environmental and Human Health and the Chinese-Australian Joint Research Centre for Environmental Remediation and Health, to foster Australia-China research collaborations. Within Deakin University she has developed collaborative research programs with several Indian Universities. Prof Ackland was a founding member of TEMTIA, the Epithelial to Mesenchyme Transition International Association. In 2003, she received the Deakin University Vice Chancellor’s Service Recognition Award for research development.

More Informationhttp://www.deakin.edu.au/sebe/les/staff/acklandl/

Trace element deficiencies, in particular zinc, and molecular genomic aspects of zinc deficiencyTrace elements including iron, iodine, fluoride, copper, zinc, chromium, selenium, manganese and molybdenum are vital for normal physiological functions. Although required in small amounts, trace elements have key roles in numerous cellular processes. Deficiencies of trace elements, often caused by poor nutrition, can cause a wide range of pathologies. Zinc deficiency is a major risk factor for disease in the developing world. Zinc deficiency results in a diminished immune response, reduced healing and neurological disorders, and can be fatal in the newborn. Altered zinc homeostasis is a feature of some chronic diseases including diabetes and neurological disorders. Marginal zinc deficiency is difficult to detect due to the lack of a suitable test for body zinc status. While zinc deficiency is commonly caused by dietary factors, several inherited defects of zinc deficiency have been identified. Analysis of the genetic basis of these zinc deficiency disorders provides insights into the mechanisms underlying zinc homeostasis. We have investigated the molecular basis of zinc deficiency disorders to establish the role of cellular zinc transporters in maintaining zinc homeostasis.

Health effects of environmental heavy metal contamination and remediation strategiesEnvironmental pollution due to anthropological activities is a major global problem. Since the industrial revolution, the emission of heavy metals such as lead, copper, and zinc has contributed to the burden of disease. Heavy metal pollution can arise from industry, municipal sources and from agriculture. Heavy metals exert their toxic effects though interference with biological processes. Cadmium poisoning causes kidney disease and long-term exposure to this metal seen in itai itai disease, results in bone disorders. Mercury poisoning has arisen from consumption of contaminated fish and dental amalgams. Organic and inorganic mercury poisoning lead to neurological disorders as well as affecting a number of body systems. Exposure to lead, arsenic and copper are likewise associated with adverse systemic effects. In northern China, the contamination of food crops and subsequent toxic effects on populations was a consequence of wastewater irrigation of crops with industrial waste. In a collaborative project with China, we have been developing phytoremediation strategies to decontaminate heavy metal-contaminated soil.

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Invited speakers

Invited speakers


Prof Dennis M Bier, MD

Professor of Pediatrics and Director of the USDA Children’s Nutrition Research Center at Baylor College of Medicine, Texas. Attending Physician, Section of GI and Nutrition, Texas Children’s Hospital.

Dennis M. Bier, M.D., is Professor of Pediatrics and Director of the USDA Children’s Nutrition Research Center at Baylor College of Medicine. He is a Fellow of the American Society for Nutrition, a Fellow of the American Association for the Advancement of Science, a member of the Institute of Medicine of The National Academies of Science, and a member of the Board of The Academy of Nutrition and Dietetics Foundation. Dr. Bier serves as Editor-in-Chief

of The American Journal of Clinical Nutrition and Associate Editor of the Annual Review of Nutrition.

Previously, Dr. Bier was Chairman of the Food and Nutrition Board of the Institute of Medicine, President of the American Society for Nutrition (with Dr. Naomi Fukagawa), the American Society for Nutritional Sciences, and the American Society of Clinical Nutrition. He also served as member of the FDA Pediatric and Food Advisory Committees. Dr. Bier has authored more than 260 scientific publications and, for his research work, he has received the Nutrition Award from the American Academy of Pediatrics, the E.V. McCollum Award from the American Society for Nutrition, the Grace A. Goldsmith Award from the American College of Nutrition and The Jonathan Rhoads Award from the American Society for Enteral and Parenteral Nutrition.

More Informationhttp://www.bcm.edu/cnrc/faculty/bier2.htm

Nutrition during development as an agent in the cause of adult disease: from observation to mechanismMore than two decades ago, evidence from observational epidemiological studies began to accumulate that infants born at the low end of the normal range of birth weight as a result of inadequate maternal nutrition were at increased risk of developing selected chronic diseases in adult life, particularly coronary heart disease, hypertension, stroke, obesity, and type 2 diabetes. While these observations generated great public health interest worldwide, general acceptance by the laboratory-based scientific community was lukewarm because of the lack of plausible mechanisms for maternal environmental signals affecting fetal developmental pathways in ways that would be “remembered” in adult life. In other words, how did the adult cell know what it “ate” during fetal life? In part, the skepticism was a result of prevailing beliefs that the genome contained all the information necessary to orchestrate development, that these instructions were all already packaged in the fertilized egg and that offspring phenotype was the direct readout of genotype. Over the last decade, these beliefs have been modified by the realization that gene expression is modified by environmental epigenetic mechanisms. These mechanisms, of which gene silencing by methylation is the most prominent, both direct developmental pathways and permanently “mark” selected genes so that altered gene expression effects persist into adult life. Proof of principle experiments are now extensive and will be discussed. The implications of how maternal environments, including nutrition, may affect health outcomes in the next generation are both extraordinarily exciting and potentially frightening.

Evidence‐based clinical nutrition: under constructionThe Nobel Laureate, Werner Heisenberg, said “Since the measuring device has been constructed by the observer, we have to remember that what we observe is not nature in itself, but nature exposed to our method of questioning.” In perhaps no other science are divergent views of nature so readily apparent as they are in nutrition. Conclusions about nutrients drawn from observational studies have not routinely been confirmed in randomized interventional trials. Because the conditions for “proof” are the same throughout the sciences, these discrepancies erode the perceived domains of validity of nutritional theories and practices. Various legitimate reasons (the known-knowns, the known-unknowns, and the unknown-unknowns) for the differences will be discussed along with their effects on the level of evidence (confidence) one can assign to nutritional beliefs derived from them.

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Professor Henry Brodaty AO, MBBS (Syd), MD (UNSW), DSc (UNSW), FRACP, FRANZCP

Personal Chair, School of Life and Environmental Sciences. Acting Director, Centre for Cellular Professor Brodaty AO, is Director, Dementia Collaborative Research Centre- Assessment and Better Care; Co-Director, Centre for Healthy Brain Ageing; Scientia Professor of Ageing and Mental Health, University of New South Wales; and Consultant Psychogeriatrician and Head of the Memory Disorders Clinic, Prince of Wales Hospital.

He has served on several New South Wales and Commonwealth committees related to ageing and dementia. He is the past chairman of Alzheimer’s Disease International,

representing over 75 national Alzheimer Associations and past president of Alzheimer’s Australia and Alzheimer’s Australia (NSW); he is President-Elect of International Psychogeriatric Association. He has published over 400 papers and book chapters, is on the editorial board of several journals and has been the recipient of a number of awards.

Research Interests include: Dementia, particularly Alzheimer’s disease: mild cognitive impairment; psychiatric sequelae of stroke; detection and management of dementia by General Practitioners; the effects of dementia on family carers and on how best to help them; trials of new drugs for the treatment of Alzheimer’s disease; the causes and management of behavioural and psychiatric complications of dementia (BPSD); nursing homes; late life depression.

More Informationhttp://www.dementia.unsw.edu.au/index.php?option=com_dcrc&layout=staffmember&smid=33&Itemid=187

Life style factors to prevent ADI will review risk factors and preventative strategies for dementia, focussing on Alzheimer’s disease.

Possibly 50% of the population risk of Alzheimer’s disease can be attributed to potentially modifiable environmental and lifestyle factors including high blood pressure, obesity and high cholesterol in mid-life, diabetes (type II), high fat diets, head injury, lack of education, lack of exercise, depression, low birth weight for gestational age, social isolation and smaller head circumference. Epidemiological studies report protective effects for physical exercise, education, complex mental activity in mid-life, mental activities, fluids rich in anti-oxidants and polyphenols such as vegetables and fruit juice and wine, (green) tea, fish, anti-cholesterol drugs and hormone replacement therapy.

Evidence for prevention effectiveness has been mixed. Randomised controlled trials with hormone replacement therapy, anti-inflammatory drugs, vitamin E and Ginkgo biloba have proven ineffective. Beneficial effects have been demonstrated for physical exercise, computer cognitive training, and adherence to Mediterranean diet, though not all trials are positive. There is stronger evidence that attention to vascular risk factors may prevent vascular dementia. There is no evidence for any preventative strategy for other neurodegenerative dementias such as Lewy body disease or frontotemporal dementia. Avoidance of heavy alcohol use and use of protective head gear and seat belts will reduce risk of dementia secondary to head injury.

Conclusions: i) There is no absolute prevention against Alzheimer’s disease specifically or dementia in general. ii) Prevention often means postponement rather than elimination. iii) Preventative strategies may be more effective against vascular dementia. Independent replication is required before accepting reports. Iv) Recommended lifestyle changes are physically beneficial and not harmful. v) Public campaigns about the potential to delay onset of cognitive decline could focus on regular physical exercise, mental activity, blood pressure control, attention to diet and avoidance of obesity and type 2 diabetes.

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Invited speakers

Invited speakers


Prof Ashley Bush, MBBS, DPM, FRANZCP, PhD, FTSE

Head, Oxidation Biology (Neuropathology) Laboratory at Mental Health Research Institute (MHRI), University of Melbourne, Co-Director of biomarker development, Australian Imaging Biomarker Lifestyle Study (AIBL), Chief Scientific Officer, CRC for Mental Health. Lecturer in Psychiatry, Harvard Medical School. Adjunct Professor of Neuroscience, Cornell University.

Ashley I Bush heads the Oxidation Biology Laboratory at the Florey Institute, is Professor of Pathology, The University of Melbourne, co-director of biomarker development within the Australian Imaging Biomarker Lifestyle Study (AIBL), Chief Scientific Officer of the CRC for Mental Health, lecturer in psychiatry at Harvard Medical School and Adjunct Professor

of Neuroscience at Cornell University. He has received numerous awards including the Potamkin Prize and the Beeson Award. Professor Bush has authored over 250 publications, with >20,000 citations, 21 patents and founded 3 biotechnology companies. He discovered the interaction of beta-amyloid with zinc as a major factor in Alzheimer’s disease.

More Informationhttp://www.mhri.edu.au/professor-ashley-bush

Metals in Alzheimer’s disease and Parkinson’s diseaseAlzheimer’s disease (AD) and Parkinson’s disease (PD) are incurable and common neurodegenerative diseases that complicate aging. Experimental therapeutic approaches that focus on the protein aggregates that typify these disorders have been disappointing in clinical trials, suggesting that the neurodegeneration is not merely due to proteinopathy. In both diseases, there is a severe dysregulation of metal homeostasis in affected brain tissue, with iron and zinc elevation and copper depletion reported in cortex (AD) and nigra (PD). This is important because iron accumulation in particular causes oxidative damage, which characterizes both diseases. We have determined that the major proteins implicated the disorders have important functions in metal transport, and may be components of a novel metal regulatory system that fails in aging. The amyloid protein precursor facilitates the export of iron from neurons and prevents dietary iron overload from collecting within the brain. Presenilins foster the uptake of copper and zinc, and tau impacts on iron export by trafficking APP to the cell surface. Failure of the metal transport functions of these proteins may explain why metals collect within the protein aggregates that typify these disorders, and may contribute to neuronal dysfunction. Small molecules that correct the abnormalities of metal transport have been effective in animal models of these diseases, and are being tested in clinical trials.

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Prof Lynne Cobiac, BSc, PhD, MBA (Advanced)

Director, Preventative Health National Research Flagship, CSIRO

Professor Lynne Cobiac is the Director of the CSIRO Preventative Health Flagship which is delivering scientific outcomes that have a positive impact on the health of the Australian community.

As Director, Professor Cobiac is responsible for leading multidisciplinary teams from CSIRO and other leading research institutions, working across science boundaries to address the challenge of chronic disease. The flagship brings together science and technical staff with

skills in genomics and proteomics, biotechnology, bioinformatics and statistical data analysis, structural biology, information technology, psychology and food and nutritional sciences.

A background in nutritional biochemistry and research in the area of nutrition and consumer science, coupled with an Advanced Masters of Business Administration (MBA) and business management experience, have provided the foundation for Prof Cobiac’s role in driving national research objectives in preventative health.

Prof Cobiac is Chair of the Working Party for Food, Nutrition and Health Research, as part of the development of the National Food and Nutrition R&D, TT Strategy for the Primary Industries Standing Committee (PISC); a member of the SA Premier’s Science and Industry Council; and a Food Standards Australia and New Zealand (FSANZ) Fellow.

Recently, Professor Cobiac was the Deputy Chief for CSIRO’s Food and Nutritional Sciences and prior to this, she was the Associate Dean of Flinders Clinical and Molecular Medicine, a multidisciplinary cluster of over 120 academics and clinicians, as well as Director of the Flinders Obesity and Lifestyle Evaluation Project and Co-Director of the Physical Activity and Nutrition Observatory for SA Health, which conducts research and evaluation around healthy weight in South Australia.

More Informationhttp://www.csiro.au/en/Organisation-Structure/Flagships/Preventative-Health-Flagship/LynneCobiac.aspx

Obesity and its impact on healthy ageingThe older population is heterogeneous and higher numbers of older people are reportedly becoming obese. In Australia the 65-74 year olds have the highest prevalence rate (75%) of overweight and obesity compared to 38% of the 18-24 year olds. Obesity amongst baby boomers in a recent Australian survey is more than double the rate of their parents at the same age. This is impacting on the risk of chronic diseases as they have three times the rate of diabetes, and almost double the cholesterol levels compared to their parents’ cohorts. More extreme obesity (BMI >32-35) reduces life expectancy. Those with obesity have a 2-fold greater risk of reporting a disability associated with daily living and lose an estimated 2-4 years of disability-free life years, compared to normal weight groups. This phenomenon is potentially reversing the trend of morbidity compression in an ageing population.

Obesity is a risk factor for a number of chronic diseases that are also associated with ageing. One important proposed mechanism is that older age is a state of chronic inflammation and relative accumulation of fat, and the presence of obesity in the older age group may exacerbate that inflammation, with a potentially negative effect on healthy ageing. Obesity in mid-life can increase risk of chronic diseases in later life (eg through shorter telomeres) but its impact on those who have already entered older age is uncertain. There appears to be some commonality and complex networking between genes related to both ageing and to obesity such as those that regulate adipogenesis, lipolysis, inflammation and fatty acid oxidation. Diet and increased physical activity (our exposome) can differentially affect gene expression in older obese. Furthermore, the state of obesity itself is also heterogeneous. Thus we also need to understand the effects of being fit and fat, and body composition on healthy ageing in the older age group. Where body fat accumulates in the body appears to be important in terms of metabolic health; and varies according to age, gender and genetics. Fat from different body depots display varied responses to dietary challenges such as excess energy balance.

Although it appears that both ageing and obesity are important risk factors for chronic diseases, we have a long way to go before we can tease out cause, effect and complex interactions.

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Invited speakers

Invited speakers


Prof Marc Cohen, MBBS (Hons), PhD (TCM), PhD (Elec Eng), BMed Sci (Hons), FAMAC, FICAE

Professor Marc Cohen is a medical practitioner with degrees in western medicine, physiology and psychologicalmedicine along with PhDs in Chinese medicine and biomedical engineering. For over 2 decades he has been one of Australia’s foremost pioneers of complementary medicine and has made significant impacts on education, research, clinical practice and policy.

He is currently Professor of Complementary Medicine at RMIT University where he leads an online Master of Wellness Program and conducts research into various aspects of wellness

and complementary medicine. He is also a current Board Member and Past-President of the Australasian Integrative Medicine Association (President from 2000-2007) and a member of the RACGP-AIMA Joint Working party which has guided the RACGP curriculum on Integrative Medicine. Prof Cohen’s impact has been recognised by the media and he has received 4 consecutive RMIT Media Star Awards and the inaugural NICM Award for Leadership.

More Informationhttp://www.rmit.edu.au/staff/marc-cohen

Environmental toxins and evidence‐based clinical detoxificationIn addition to over consumption of sugar, fat, salt, alcohol and tobacco, the entire human population is now involuntarily exposed to a toxic cocktail of industrial chemicals found in our food, air, water, soil, breast milk, human tissue, and indoor and outdoor environments. While the full impact of xenobiotic chemicals on human health is unknown, it is clear that many chemicals biomagnify up the food chain and bioaccumulate over the lifespan; that there are critical periods of development putting children more at risk; that endocrine disrupting non-monotonic dose responses occur with exposure to chemical cocktails having synergistic effects; that exposure can lead to epigenetic and trangenerational effects; and that exposure is highly variable across populations and environmental justice is an important issue. This presentation reviews the ‘ten toxic truths’, which describes the current state of our knowledge of environmental toxins and reviews the current research literature on clinical detoxification.

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Dr Ron Ehrlich, B.D.S (Syd Uni) FACNEM (Dent)

Dr Ehrlich graduated in Dentistry from Sydney University in 1978. and is the founder of the Sydney Holistic Dental Centre. He has been in private practice in the Sydney CBD for 30 years. Over that time his focus has been on how oral health impacts on whole-body health. Ron has undertaken research at UNSW, written papers and articles, appeared on radio and TV, was a contributing author in “Complementary Therapies in Dentistry” (Nutrition chapter), Butterworth-Heineman Publishers 1998 and is a Fellow of the Australasian College of Nutritional and Environmental Medicine (ACNEM). He has presented at conferences and delivered his course, “Holistic Healthcare - a dental perspective” in the UK and Australia.

Dental Mercury Amalgam – an environmental & health issueWestern medicine is primarily focused on disease management. The ‘debate’ surrounding the widespread and historical use of mercury dental amalgam fillings in a human population is an interesting example of all that is wrong with that healthcare model.

The World Dental Federation (FDI) representing 190 dental associations around the world has recently agreed to join the United Nations’ Global Mercury Partnership, to eliminate mercury exposure in our global environment. The FDI recognises the need to take a ‘holistic approach’ as a profession, recognising the problem of mercury polluting the environment and entering the food chain, with all its associated potential health problems. However, the FDI still maintains that mercury amalgam is still the ‘material of choice’ and its partnership with the UN is a ‘win-win for the environment and the profession’.

A ‘holistic approach’ would or should focus on the person attached to the tooth rather than just the tooth. So why is the profession still so convinced the only safe place to place a mercury amalgam fillings is in a human being?

It is illegal to dispose of excess, strap mercury amalgam in the garbage, toilet or sink, yet it is still legal to place it in a human being.

In this presentation we will explore the environmental occupational and public health issues surrounding the use of dental mercury amalgam, still the ‘material of choice’ amongst 50-70% of the dental profession, in Australia, USA and the UK.

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Invited speakers

Invited speakers


Prof Michael Fenech, PhD

Research Group Leader, DNA Damage Diagnostics & Nutrigenomics; Stream Leader, Nutrigenomics, Lifestyle & Neurodegenerative Disease Prevention, P-Health Flagship, CSIRO Food and Nutritional Sciences, Adelaide.

Professor Michael Fenech is Research Group Leader, DNA Damage Diagnostics & Nutrigenomics; Stream Leader, Nutrigenomics, Lifestyle & Neurodegenerative Disease Prevention, P-Health Flagship, CSIRO Food and Nutritional Sciences, Adelaide. He is recognised internationally for his research in nutritional genomics and genetic toxicology and for developing the cytokinesis-block micronucleus (CBMN) assay which is now a gold

standard method used internationally to measure DNA damage in human cells in vitro and in vivo. The CBMN assay has been endorsed by the International Atomic Energy Agency and the OECD for in vivo radiation biodosimetry and in vitro testing of genotoxins respectively. His key goal is to determine the nutritional and environmental requirements for DNA damage prevention using in vitro systems, epidemiology and placebo-controlled human intervention trials.

In 2003-05, Dr Fenech proposed a novel disease prevention strategy based on personalised diagnosis and prevention of DNA damage by appropriate diet/life-style intervention, which has led to the Genome Health Clinic concept and its translation into practice (link). In 2003-2009 his laboratory further developed the CBMN assay into a ‘cytome’ assay consisting of six complementary biomarkers of DNA damage and cytotoxicity which is now published in Nature Protocols. He co-founded the ongoing HUMN and HUMN-XL projects on micronuclei in human populations (link) and is a member of the coordinating group for the Micronutrients Genomics Project (link) which he has been leading since July 2011.

His research is currently also focussed on the impact of nutrition on telomere length and function; he conceived and developed, together with other scientists in his group, a novel quantitative PCR method for measuring absolute telomere length. He was awarded the Flinders University’s Convocation Medal in 2007, the Alexander Hollaender Award (USA) in 2008 and the honorary titles of Adjunct Professor (University of South Australia) in 2009 and Visiting Professor (Taipei Medical University, Taiwan) in 2010 and Professorial Fellow (Flinders University) in 2011 for his leadership/contributions to environmental/public health sciences internationally. His 210 publications have been cited 9,000 times and his H-index is 48.

More Informationhttp://www.reach100.com.au/http://www.humn.org/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989004/

The exposome concept approach to disease prevention at the fundamental genome levelDamage to genome is the most fundamental pathology that causes developmental and degenerative disease. It is therefore important is to consider how new knowledge on the genomic causes of disease can be used to determine which public health strategies are likely to provide better outcomes for disease prevention and prolonged well-being. Current evidence indicates that nutrition plays an important role in prevention of genome pathology by providing the cofactors and molecules required for DNA synthesis, DNA repair and control of gene expression. However, loss of genome integrity with age is not only influenced by malnutrition but also exposure to environmental genotoxins, poor life-style choices and adverse psycho-social environments. A holistic approach that integrates knowledge of genetic susceptibility with all of the above risk factors is required to efficiently prevent loss of DNA integrity. A comprehensive public health policy aimed at improving genome health in populations should be implemented by increasing access to foods rich in genome-protective micronutrients, minimising exposure to environmental genotoxins and promotion of life-style habits and psycho-social environments associated with improved genome maintenance. A revised Hippocratic Oath is proposed to guide new education strategies required to train health professionals on how to deliver optimal public health outcomes at the fundamental genomic level.

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Prospects for personalised nutrition in neurodegenerative disease prevention The process of neural/brain development, function and regenerative potential is dependent on the supply and metabolism of micronutrients required for DNA replication and repair, for the synthesis of important structures such as the myelin sheath of neurons, for the metabolism and recycling of proteins and organelle integrity. Furthermore it has been recently shown that the nutritional requirements for neurodegenerative disease prevention is likely to be different depending on inherited gene mutations that predispose to accelerated ageing (e.g. mutations in the APOe, TOMM40, XPD and ATM genes) and mutations in genes required for uptake and metabolism of vitamins, such as vitamin B12 (e.g. mutations in MTR, MTRR), choline (e.g. mutations in PEMT, BHMT), folate (mutations in MTHFD1, MTHFR) and long-chain polyunsaturated fatty acids (e.g. mutations in FADS gene cluster), that are essential for neural development and maintenance. The presentation will provide an overview of the latest knowledge on this topic and prospects for nutrition advice for neurodegenerative disease prevention based on genotype.

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Invited speakers

Invited speakers


Prof Lynnette R Ferguson, DPhil (Oxon), DSc, QSO, FNZIFST

Programme leader, Nutrigenomics New Zealand, Director of Mutagen Testing, Auckland Cancer Society Research Centre (ACSRC) and Head of the Discipline of Nutrition at the University of Auckland, School of Medical Sciences, Auckland University.

Professor Ferguson is Programme leader, Nutrigenomics New Zealand, Director of Mutagen Testing, Auckland Cancer Society Research Centre (ACSRC) and Head of the Discipline of Nutrition at the University of Auckland. Lynn Ferguson obtained her D.Phil. from Oxford University, working on the subject of DNA damage, DNA repair and mutagenesis in yeast. After her return to New Zealand, she began working as part of the Auckland Cancer Society Research

Centre, using mutagenicity testing as a predictor of carcinogenesis, with particular focus on the New Zealand situation. In 2000, she took on a 50% role as Head of a new Discipline of Nutrition at The University of Auckland. In more recent years, she has considered the interplay between genes and diet in the development of chronic disease, with particular focus on Inflammatory Bowel Disease, a cancer-prone condition and also in prostate cancer. As programme leader for the multidisciplinary-multiorganisation, Nutrigenomics New Zealand, she is working with a range of others to bring nutrigenomics tools and potential to the New Zealand science scene.

She has supervised more than 30 students to the successful completion of B.Tech, MSc or PhD. Her laboratory regularly supervises 2-3 summer students each year. She is the author or co-author of more than 300 peer reviewed publications as chapters in books or articles in international journals. She serves as one of the managing Editors for Mutation Research: Fundamental and Molecular Mechanisms of Mutation, as well as on the Editorial Boards of several other major journals.

More Informationhttp://www.fmhs.auckland.ac.nz/sms/staffct/staff_details.aspx?staffID=4C464552303133

Gene‐lifestyle interactions in the development of chronic disease A genetic basis for chronic diseases, including cardiovascular disease risk (CVD) and obesity, is now well established. There is now good evidence that some of the key genes interact with certain nutrients and dietary patterns, and there is increasing evidence that other lifestyle choices are particularly important in the context of particular genes. As examples, individuals carrying certain ApoE genotypes have an increased sensitivity to the nature of fats in the diet, increasing their CVD risk. This can be partly overcome by not smoking and/or being physically active. Variants in FTO and MC4R are particularly susceptible to high fat/ high sugar diets, and again not smoking and high physical activity levels can help to overcome this. While the MTHFR genetic polymorphism has been associated with a higher than average folate requirement, individuals carrying the risk allele are particularly susceptible to excess alcohol consumption. All these factors must be taken into account when identifying individual susceptibility to chronic diseases.

References1. Gustavsson, J., Mehlig, K., Leander, K., Strandhagen, E., Björck, L., Thelle, D. S., Lissner, L., et al. (2012). Interaction of

apolipoprotein E genotype with smoking and physical inactivity on coronary heart disease risk in men and women. Atherosclerosis, 220(2), 486–92.

2. Zlatohlavek L, Vrablik M, Motykova E, Ceska R, Vasickova L, Dlouha D, Hubacek JA. FTO and MC4R gene variants determine BMI changes in children after intensive lifestyle intervention. Clin Biochem. 2013 Mar;46(4‐5):313‐6.

3. Nienaber‐Rousseau C, Pisa PT, Venter CS, Ellis SM, Kruger A, Moss SJ, Melse‐Boonstra A, Towers GW. Nutritional Genetics: The Case of Alcohol and the MTHFR C677T Polymorphism in Relation to Homocysteine in a Black South African Population. J Nutrigenet Nutrigenomics. 2013 Mar 27;6(2):61‐72.

Gene‐environment interactions in the early development of chronic disease A considerable emphasis is currently being placed on nutritional deficiencies leading to epigenetic mechanisms and thereby Small for Gestational Age (SGA) children. Theories such as the thrifty gene hypothesis inevitably associate such a phenotype with the likelihood of cross-over growth and the early development of obesity. In the ABC (Auckland Birthweight Collaborative) study, we have sampled around 300 SGA and compared their growth trajectory as compared with a comparable Average for Gestational age (AGA) children. We have identified several genes associated with the SGA background. Unexpectedly, at least out to 11 years of age, those children who showed a genetic susceptibility to SGA maintained a parallel growth pattern to the AGA children. They were particularly benefitted by diet and lifestyle interventions. It will be important to separate genetic from epigenetic events in subsequent studies.


Invited speakers

Dr Debbie Fewtrell, MB ChB, Dip Obs, FRNZCGP, FACNEM

Dr Debbie Fewtrell has an integrative medical practice specialising in the biomedical treatment of children with neurodevelopment disorders. She has attended Pfeiffer and DAN! (Defeat Autism Now) physician training and is a fellow of the Australasian College of Nutritional and Environmental Medicine. Debbie has a strong focus to inspire and educate parents and professionals in Australasia to use integrative biomedical approaches to improve the health and neurological function of children.

The Autism epidemic ‐ reality or over diagnosis? Translating research into effective clinical practiceShould we be concerned over the reports of escalating rates of autism spectrum disorders? How could there be an epidemic of a “genetic“disorder? Debbie will discuss research that sheds light on possible contributors to the rising ASD incidence and then explains how we can use this knowledge and translate it into effective treatment approaches.

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Invited speakers


Dr Terri Foran, MBBS (Syd), MClin Ed(UNSW), FAChSHM

Dr Terri Foran is a Sexual Health Physician and has a special interest in women?s health contraception, menopause issues and the management of sexually transmitted infections. She was, from1998 until 2004, the Medical Director of Family Planning NSW, and is now in private clinical practice in Darlinghurst. She also presently engaged in both clinical and research work at the Royal Hospital for Women in Sydney.

Dr Foran holds the position of Lecturer at the University of New South Wales in the School of Women’s and Children’s Health. She coordinates Phase 2 of their undergraduate medical program in women?s health as well as a number of modules in the Masters of Reproductive

Medicine and Masters of Women’s Health Medicine Programs offered by UNSW.

Dr Foran is currently the monthly Women’s Health columnist for Australian Doctor Magazine.

Beyond the silent spring‐ the potential effects of endocrine disrupting chemicals on sexual and reproductive healthWe live in a world awash with manufactured chemicals and substances, which were not present when our ancestors evolved many thousands of years ago. These chemicals increase the yields of the crops we rely on for food and are present in the clothes we wear, our cooking utensils, the cosmetics we apply and the apparatus that we use to deliver medical services. They have become so much a part of our world that we fail to even note their presence in so much of what we do. There is however a growing concern that some of these chemicals may affect the human endocrine system and therefore have a potential to impact on reproductive function and fertility. Scandinavian researchers for example have been investigating possible links between endocrine- disrupting chemicals (EDCs) in the environment and a perceived increase in male reproductive dysfunction over the past 60 years. Though more difficult to quantify, it has also been suggested that some female reproductive problems may also be secondary to exposure to these chemicals at critical stages of foetal development. Though at the present time all this remains hypothetical many governmental agencies, including those in Australia, are attempting to gather the data which will allow them to determine just which of these chemicals are safe and at what concentrations they are acceptable in our environment. This presentation seeks to review the current research and scientific evidence with regard to the effect of endocrine-disrupting chemicals in the world in which we live.

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Invited speakers

Dr Denise Furness, PhD BSc RNutr REP

Dr Denise Furness has been involved in pregnancy health research for 10 years. In 2001 Denise completed her Bachelor of Biological Science with Honours and began working in Genetics. Denise has always been passionate about nutrition and health and in 2003 began her PhD in nutrigenomics and late gestation pregnancy complications with CSIRO Human Nutrition. In 2007 Denise started her postdoctoral position with the University of Adelaide and started the Predicting Adverse Pregnancy Study (PAPO) study at the Women?s and Children?s hospital, South Australia. Denise worked with couples who had experienced a range of pregnancy complications including infertility, miscarriage preeclampsia and fetal growth restriction. Denise?s research focused on DNA damage, diet, genes and lifestyle

factors in both men and women in relation to pregnancy health and outcomes. Denise completed her postdoctoral position in December 2012 and is currently analysing the PAPO data for publications. Recently, Denise achieved her greatest accomplishment having her first baby. Denise is also a registered nutritionist with Nutrition Society of Australia and a registered exercise professional with Fitness Australia.

Personalised nutrition to optimise pregnancy health and fetal outcomesModern lifestyles including exposure to pollutants, poor diet and lack of exercise cause excess inflammation, oxidative stress and ultimately DNA damage. There is a growing body of literature providing evidence that these lifestyle changes are increasing our risk for infertility, miscarriage and late gestation pregnancy complications. Moreover, baseline DNA damage rises with age and couples in developed societies are delaying childbirth placing them at further risk. DNA damage can affect multiple physiological processes associated with pregnancy health, from early stages such as oocyte maturation and sperm quality through to late gestation processes involved in placental and fetal development. In addition, DNA repair capacity has been shown to be reduced in pregnant women making them more susceptible to environmental and endogenous toxins which may lead to disease. The maternal diet is one of the major environmental factors influencing fetal development, as maternal nutrition supports the high rates of cellular proliferation and DNA replication that take place during fetal life. In addition, maternal nutrition is a key factor in determining genomic stability in both mother and baby as it affects all relevant developmental pathways, including the activation or detoxification of chemicals preventing cell death and DNA damage. As we better understand the relationship between nutrition, the genome and the epigenome, the opportunity arises for clinical applications in optimising pregnancy health which may improve fetal outcomes.

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Invited speakers


Dr Dilip Ghosh, PhD, FACN

Consultant, Nutritional and Functional Foods, Nutriconnect, Sydney.

Dilip Ghosh received his PhD in biomedical science from the University of Calcutta, India. Previously, he held positions in Organon (India) Ltd., a division of Organon International, BV and AKZO-NOBEL, The Netherlands; HortResearch, New Zealand; USDA-ARS, HNRCA at Tufts University, Boston; The Smart Foods Centre, University of Wollongong, & Neptune Bio-Innovation Pty Ltd, Australia. He has been involved for a long time in drug development (both synthetic and natural) and functional food research and development both in academic and industry domains. He is a Fellow of American College of Nutrition and also on the

editorial board of several journals. Currently Dr Ghosh is professionally involved with Soho Flordis International, and Nutriconnect, Sydney, Australia. He is Honorary Ambassador, Global Harmonization Initiative (GHI).

Dr Ghosh has published more than 60 papers in peer-reviewed journals, numerous articles in food and nutrition magazines and books. His two recent books, “Biotechnology in functional foods and nutraceuticals”, and “Innovation in healthy and functional foods”, under the CRC Press banner, have created a strong impact in the functional foods and nutraceuticals domains. Dr Ghosh is currently editing another book, “Clinical perspective of functional foods and nutraceuticals”. Dr Ghosh is Review Editor, Frontiers in Nutrigenomics; Editorial board member, the American Journal of Advanced Food Science and Technology, USA; Innova Database, the Netherlands; Panacea E-Newsletter, India; Guest Columnist of NutraScope, India; Associate Editor & member, Toxicology Mechanisms and Methods, Taylor & Francis, USA (2006-2007).

More Informationhttp://www.nutriconnect.com.au/

Ethical, legal, and social issues in personalised nutrition: other side of the coinBackground: Personalised food and nutritional products derived from the Nutrigenomics, the application of high-throughput genomics tools in nutrition research, are now past its incubation phase. The poorly understood associations of diet and disease prevention in particular will likely be the single most important catalyst to its accelerated and continued growth. Whether the goal of matching foods to individual genotypes to improve the health of those individuals can be attained, and personalised nutrigenomic foods enter the world’s food markets, depends on numerous hurdles being overcome: some scientific in nature, some technical and others related to consumer, market or ethical issues.

Methods: Many of the drivers behind the trend in personalisation of nutrition are now known, including: changing demographic and social trends, increasing convincing clinical evidence for the efficacy of functional foods, consumer’s move from health-care to self-care, increased functional foods marketing and market penetration activity to raise consumer awareness, and greater acceptance of the role of functional foods in the diet by health professionals. Ethical issues aside, adding the highly personalised dimension of a genetic profile as a future driver of functionalised food development looks relatively straightforward. Public adoption of new technologies is an important determinant for their success.

Results & Conclusions: Future development in the field of nutrigenomics undoubtedly will place its seemingly huge potential in better perspective. From the scientific responsibility point of view, one hopes that the new perspectives to be gained and progress to be made in this field will be so managed as to take the public at large on board, if we are to avoid another nutrition education disaster of the GMO type and dimension.

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Invited speakers

Dr Ross Grant, BEd(Sc), MAppSc(Clin Chem), PhD(Pharm)

Lecturer, Dept of Pharmacology, School of Medical Sciences, UNSW; Chief Executive Officer, Australasian Research Institute at Sydney Adventist Hospital.

Dr Grant is a biochemical pharmacologist, with graduate degrees in both Clinical Biochemistry (UTS) and Pharmacology (UNSW). Dr Grant currently holds an academic position in the department of Pharmacology, Faculty of Medicine, University of NSW and is head of the Australasian Research Institute, at the Sydney Adventist Hospital. Over the past 10 years, Dr Grant has published a number of research papers on the impact of oxidative stress induced NAD+ depletion on health and brain cell survival.

His current research interests include; nutritional effects on adolescent vascular and neurobiological health and the effect of various lifestyle choices on the induction of oxidative stress (i.e. increased free radical activity) in the young and older population and its relationship to disease.

More Informationhttp://medicalsciences.med.unsw.edu.au/user/28145http://www.sah.org.au/australasian-research-institute

Oxidative stress in the human central nervous system: correlation with age and lipid fractionsOxidative Stress (OS) is a pathobiological process, often linked to inflammation that plays a central role in creating the cellular damage seen in many neurodegenerative diseases including Alzheimer ’s disease (AD). Though evidence for OS in damaged brain tissue is well established it is not yet clear when in the course of life OS begins in the central nervous system (CNS) or what factors initiate it. Age is a significant risk factor for development of the degenerative dementias and has also been shown to be a time of increased OS. Research from our group suggests potential for a marked increase in oxidative activity around the 5th -6th decade of life in peripheral tissue. Continuing work from our group is investigating whether this is also mirrored by a similar increase in OS and inflammation in the CNS. This presentation will discuss briefly the role of OS in the development of neurodegenerative diseases such as Alzheimer’s and present recent data in support of increased OS & inflammatory activity in the CNS and its relationship to some diet derived lipids and other elements.

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Invited speakers


Prof Ken Ho, MD, FRACP, FRCP (UK)

Professor of Medicine, University of Queensland; Chair Centres for Health Research, Princess Alexandra Hospital, Brisbane.

As the new Chair of Princess Alexandra Hospital Centres for Health Research, Professor Ken Ho is bringing a program of research from Sydney to develop hormonal and metabolic treatments for obesity and frailty.

Ken Ho graduated in medicine at the University of Sydney in 1975, undertook studies towards a Doctorate in Medicine at the Garvan Institute of Medical Research before pursuing

a post-doctoral fellowship at the University of Virginia. Before taking up his position in Brisbane, he was Chairman, Department of Endocrinology, St. Vincent’s Hospital, Head, Pituitary Research Unit, Garvan Institute of Medical Research, and Professor of Medicine, University of New South Wales, Sydney, Australia.

Ken’s major research interests are in pituitary disease and the understanding of how hormones control metabolism, body composition and function. His work is strongly translational closely integrating laboratory and clinical studies encompassing the study of gene expression, receptor regulation, cell signaling, hormone secretion and the quantification of energy and substrate metabolism.

He has held continued peer-reviewed funding, including support from the NHMRC for 20 years. He has been invited to speak at numerous international meetings including those of the US, the British, German and the International Endocrine Societies. He was awarded the 2008 Asia Oceania Medal and the 2000 Clinical Endocrinology Trust Professorship by the British Endocrine Society. He was awarded an honorary fellowship of the Royal College of Physicians, UK. He has participated in international consensus panels providing guidelines on the diagnosis and treatment of pituitary disease. He has published over 200 scientific papers, which include publications in the Lancet, Annals of Internal Medicine, New England Journal of Medicine, Journal of Clinical Investigation and Proceedings of the National Academy of Science.

He has served on the NHMRC Career Development Award Committee and the Grant Review Panel. He is a founding Member and past president of the International Growth Hormone Research Society, and past-president of the Endocrine Society of Australia. He is an executive member of the Specialist Medical Review Council, Department of Veterans Affairs.

More Informationhttp://www.tri.edu.au/index.php/about-tri/key-researchers

The promise of growth hormone: separating fact from fictionGH regulates lipid, protein and carbohydrate metabolism in the adult after the cessation of linear growth. GH deficiency in adults increases body fat mass, reduces lean mass, bone mass, organ size, strength and fitness, changes mimicking those of senescence. GH replacement normalises body composition, muscle strength, physical fitness in patients with organic GH deficiency. Thus GH is a powerful metabolic hormone controlling body composition and function

GH is produced throughout adult life but its secretion falls with increasing age. There is speculation that diminishing output of GH causes loss of muscle and bone mass and an a gain of fat mass with advancing years. This has led to claims that GH can be used as an anti-aging hormone to improve quality of life and longevity.

GH supplementation to the elderly reduces fat mass, increases lean mass, but does not improve physical or cognitive function. Frequent adverse effects including arthrlalgia, hyperinsulinaemia and hyperglycaemia are observed. There is emerging epidemiological evidence linking insulin and IGF-I status to increased cancer risk. In animals, longevity is prolonged rather than shortened in GH deficiency.

The value of GH supplementation in the elderly remains to be established in contrast to clear benefits of replacement in organic GH deficiency. The epidemiological link between IGF-I and the negative impact of GH on longevity in animals, call for caution in the use of GH in the elderly.

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Invited speakers

Fighting fat with fat: harnessing the power of brown adipose tissue in humansBrown adipose tissue (BAT) plays a key role in energy homeostasis and thermogenesis in animals, conferring protection against diet-induced obesity and hypothermia. The thermogenic property of BAT is arises from the action of uncoupling protein 1 (UCP1) which induces conversion of energy from mitochondrial oxidation to heat instead of to ATP. The traditional belief that BAT exists only in infants but not in adults has resulted in a paucity of interest in humans. However, the recent discovery of fat with high metabolic activity in adults by functional imaging utilizing Positron Emission Tomography (PET) brought about a resurgence in research interest on BAT. Regulatory PET-CT studies and direct histological examination of adipose tissues have demonstrated that BAT is present in most, if not all adult humans. BAT activity correlates positively with resting energy expenditure and negatively with age, body mass index and glucose status. These findings provide strong evidence for a significant regulatory role in energy metabolism. Human BAT tissue harbours inducible precursors that differentiate into UCP1-expressing adipocytes in-vitro. These recent discoveries represent a metabolic renaissance for human adipose biology, overturning previous belief that BAT had no relevance in adult humans. Identifying factors regulating the proliferation, differentiation and activation of BAT in humans offers an exciting and novel approach for the treatment of obesity.

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Invited speakers


Prof Peter Howe, PhD, MSc, BSc

Director, Clinical Nutrition Research Centre, University of Newcastle. Research Professor in Nutritional Physiology and Human Research Ethics Advisor, University of South Australia. Adjunct Professor in Physiology at the University of Adelaide.

Peter is Professor of Nutrition Research at both the University of Newcastle and University of South Australia and heads the newly formed cross-institutional Clinical Nutrition Research Centre. An authority on health benefits of omega-3 and other bioactive nutrients, Peter has built partnerships with the food industry to develop functional foods and has contributed to food regulatory policy in Australia. He established the Smart Foods Centre at Wollongong and

the Nutritional Physiology Research Centre in Adelaide. He is a Fellow of the Nutrition Society of Australia and Editor-in-Chief of Nutrients.

He has an extensive track record of multidisciplinary preclinical and clinicalresearch in nutrition, cardiovascular physiology, neuroscience and more recently mental health. Having 40 years of full time research experience inuniversity, CSIRO, hospital and pharmaceutical industry, he is considered an international authority on cardiovascular and metabolic health benefits of bioactive nutrients. Peter has published 200 papers with 4500 citations (H-index = 32).

His research goal is the scientific substantiation and promotion of health benefits of functional foods and nutraceuticals through collaborative partnerships with industry.

More Informationhttp://www.newcastle.edu.au//staff/research-profile/Peter_Howe/

Vasoactive nutrients for ageing hearts and mindsIncreasing evidence links cardiovascular disease with cognitive decline and depression and it appears that endothelial dysfunction may be a primary pathogenic link. Flow mediated dilatation, a surrogate measure of endothelial function which is impaired in obesity and metabolic syndrome, is inversely related to cognitive performance. Certain nutrients can improve flow mediated dilatation following ingestion. We have observed sustained improvements with regular consumption of marine omega-3 fatty acids, cocoa flavanols, isoflavones and resveratrol and postulate that these vasoactive nutrients may deliver not only cardiovascular but also mental health benefits. We have shown improvements in mood and/or cognition following chronic supplementation with soy isoflavones and omega-3 and we are now using transcranial Doppler ultrasound to explore the link between cognitive effects of nutrients and endothelial function in cerebral arteries. This new approach is enabling us to identify nutrients with the potential to sustain mental health in an ageing population and to optimize both mood and cognitive performance under demanding conditions, such as extreme duress or prolonged fatigue.

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Dr Ray Kearney OAM, PhD

Ray Kearney is Associate Professor in the Department of Infectious Diseases and Immunology, Department of Medicine, Central Clinical School, University of Sydney. He was Head of the Department from 1993-2000. He has had advisory roles on numerous committees, giving expertise in areas of infectious diseases, occupational health and safety protection as well as in public health and health-risk management. He has appeared as an Expert Witness in seven NSW Parliamentary Inquiries dealing with health impacts of air pollution.

Ray is a member of several professional scientific/medical research organisations. He is a recipient of many Community Awards including, “Leadership”, “Citizen of the Year”,

“Outstanding Service to Youth” and a Centenary Medal (2003) awarded by former Prime Minister John Howard. He was among the NSW State Finalists for the Australian of the Year Award 2005. On Australia Day, 2007, Ray was awarded a Medal of the Order of Australia (OAM) for his voluntary contributions to public health, his campaigning for cleaner alternative fuels as well as his landmark contributions in conservation. After over 40 years in academia, Ray retired from the University of Sydney 31 December, 2006 and retains full academic entitlements and part-time teaching commitments.

The health impacts of fossil fuel pollutionArticle 12 of the International Covenant on Economic, Social and Cultural Rights in 1966 guarantees the “right of everyone to the enjoyment of the highest attainable standard of health”. Article 12.2 (b) comprises e.g., “the prevention and reduction of the population’s exposure to harmful substances such as radiation and harmful chemicals or other detrimental environmental conditions that directly or indirectly impact upon human health”.

In June, 2012, the WHO declared diesel fumes to be a proven Level-1 human carcinogen. http://www.iarc.fr/en/mediacentre/pr/2012/pdfs/pr213_E.pdf

In Sydney, some 1400 people die from air pollution annually i.e., exceeding traffic fatalities. Total air-pollution health costs in Sydney exceed $9 billion annually.

Exhaust pollution including coarse, fine and ultra-fine particles, gaseous irritants, and polycyclic aromatic hydrocarbons (PAH’s) either alone or in combination, are known to be associated with, for example:

• inflammatory lung diseases e.g., asthma, bronchitis and alveolitis • increased cardio-vascular disease• risk for exercise-induced heart damage • increased risk of blood clotting • 1/5 lung cancer deaths (USA) and accelerated tumour growth • symptoms of anaemia e.g., tiredness, headaches, fatigue and shortness of breath.• low birth weight and small head circumference of neonate. • intra-uterine growth retardation (for each 10 nanogram PAH’s /M3 increase) • certain leukaemias e.g., from exposure to benzene.• loss in productivity, absenteeism from work and school.• lung under-development for age 10 – 18 years

There is no enforceable STANDARD for carcinogenic Particulate Matter (PM) of 2.5µm or less (PM2.5). PM10 do not measure emissions from motor vehicles. Numbers and surface area are more important than weight. Oil and car industries have hamstrung attempts by state and federal legislators to make laws that address such threats/hazards.

Such disregard and contempt for human rights could not have resulted without the cowardice, laziness, apathy, and blind obedience of well‐meaning but unengaged spectators.

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Invited speakers

Invited speakers


Dr Lance Macaulay, Bsc, PhD

Theme Leader, Brain Health, Preventative Health Flagship, CSIRO, CMSE, Parkville, Melbourne.

Dr Macaulay has over 30 years’ experience in cell biology and biochemistry, specifically signal transduction, insulin action and metabolic regulation.

After completing a PhD in Biochemistry in 1981 at Monash University, Dr Macaulay spent four years at the University of Pennsylvania, followed by Department of Medicine at the University of Melbourne prior to joining CSIRO in 1990 carrying out research aimed at

delineating insulin signalling pathways, insulin action and metabolic regulation.

Since joining CSIRO in 1990, Dr Macaulay developed structure/function-based approaches to assessing insulin receptoraction, glucose transport and metabolic health. His recent studies have focused on understanding mechanisms that control age onset diseases such as type IIdiabetes and Alzheimer’s disease, particularly those mediated by AMP-activated protein kinase axis, as it and its substrates represent targets for the treatment of obesity, type II diabetes vascular disease and dementia. Some of his research has been published in high impact journals such as Science, Diabetes, PNAS, J.Biol. Chem., Mol. Cell. Biol., Molecular Psychiatry and Lancet Neurology.

He was a past Theme Leader of Obesity 2009-2010 and currently of Brain Health since 2010 within CSIRO’s Preventative Health Flagship. He sits on the on the management teams of the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL) that aims to improve understanding of the causes anddiagnosis of Alzheimer’s disease(www.aibl.csiro.au), as well as the START stroke consortium studying acute stroke therapy, its prevention and its impact (www.start.csiro.au) and University of Melbourne Obesity consortium.

Dr Macaulay has published over 65 peer reviewed publications and is a co-author of The Diabetes Diet and LifestylePlan (Penguin Pub). He has Honorary Fellow appointments in the University of Melbourne Department of Medicine, Royal Melbourne Hospital and at St Vincent’s Hospital. He has served on the Editorial Board of the international Journals, Endocrinology and Frontiers in Biosciences.

More Informationhttp://www.csiro.au/en/Organisation-Structure/Divisions/CMSE/Biosciences/LanceMacaulay.aspx

Can metabolomic biomarker profiles help predict susceptibility to Alzheimer disease and inform intervention?Neurodegenerative diseases are becoming a major global challenge due to our ageing population. The cost of dementia is over $600 Billion worldwide and predicted to double by 2030 without improvement in treatment or prevention. There is some hope on the horizon that advances in prevention can be made now that we have some understanding of the natural history of progression to Alzheimer’s disease that accounts for up to 70% of dementia in Ageing (Villemagne et al2013). The Australian Imaging, Biomarkers and Lifestyle longitudinal study of ageing (AIBL) (www.aibl.csiro.au) has shown that disease progression is slow, starting mid to late life, and progressing over 20years when there is significant brain damage and clinical disease develops. This slow rate of progression provides great opportunity to intervene through lifestyle changes as well as drugs if detected early. The AIBL study, as well as others like it internationally, such as ADNI, are providing important rate of change data tracking progression to disease that will enable the efficacy of lifestyle and drug interventions to be tracked. Genetic information may also inform strategies. For example the APOE ε4 genotype increases risk of disease shifting disease onset earlier in age. This presentation will highlight some of the biomarkers that can be used as well as review some of the evidence suggesting lifestyle intervention may be useful in delaying the progression to Alzheimer’s disease.

References:

1. Villemagne, VL, Burnham, S, Bourgeat, P, Brown, B, Ellis, KA, Salvado, O, Macaulay, SL, Martins, R, Maruff, P, Ames, D, Rowe, CC and Masters, CL for the Australian Imaging Biomarkers and Lifestyle Research Group The natural history of sporadic Alzheimer’s disease: dynamics of Aβ amyloid deposition, neurodegeneration and cognitive decline Lancet Neurology 2013. Published online Mar 8 http://dx.doi.org/10.1016/S1474-4422(13)70044-9

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Prof Ralph Martins AO, Bsc(Hons), PhD, CitWA, MAICD

Foundation Chair Ageing and Alzheimer’s Disease, Edith Cowan University, WA.

Ralph Martins is a leading expert in Alzheimer’s disease, whose career spanning 27 years, has resulted in 200+ publications in mid to high impact journals. He leads the AIBL diagnostic and biomarkers programme to investigate the effectiveness of early dietary and exercise intervention and treatments. He has built a research team currently comprising 50+ research staff and postgraduate students, who are working to understand the cause(s) of AD. His research has led to the identification of 3 novel drug candidates, attracting Federal funding and the interest of key commercial partners. He established the McCusker Foundation for

Alzheimer’s Disease Research in 2000 and in 2004 was appointed to the inaugural Chair in Ageing & Alzheimer’s at ECU. He is the winner of a number of awards, including 2010 WA Australian of the Year, 2011 WA Citizen of the Year Professions Award and in 2013 was appointed to Officer (AO) General Division of the Australia Day Honours. Martins is the board member of 3 research foundations, and several committees for national research organisations. He holds Adj. Professorships at the Thomas Jefferson University, University of Western Australia and Curtin University of Technology. His research is world renowned and is considered an international expert in his field.

More Informationhttp://www.ecu.edu.au/schools/medical-sciences/staff/profiles/professors/professor-ralph-martins-ao

Early Diagnosis and Prevention of Alzheimer’s Disease: The Australian Imaging Biomarkers and Lifestyle Study of AgeingCurrently there are over 300,000 Australians diagnosed with dementia and this figure is predicted to rise to over 1 million by 2050. Alzheimer’s disease (AD) is the major form of dementia and to date there has been no effective treatment. It is thought that once symptoms appear considerable neuronal loss has occurred for any treatment to be effective. Thus early diagnosis is critical in order to develop effective therapies.

The Australian Imaging Biomarkers and Lifestyle (AIBL) study of ageing involves following a cohort of 1100 Australians recruited from Melbourne and Perth which are assessed at 18 month intervals for blood and brain biomarkers and cognitive function as well as investigating the role of life style factors on influencing the risk of AD. The AIBL study was thus undertaken to develop early diagnostic tests for AD and identify lifestyle factors that played a role in AD risk.

This presentation will demonstrate that PET PiB Amyloid imaging of the brain identifies preclinical AD as early as 20 years before the onset of symptoms thereby providing a therapeutic window for effective intervention. Furthermore, PiB PET Amyloid imaging demonstrates that 50% of healthy APOE e4 carriers are positive for Beta Amyloid deposition as opposed to only 20% of healthy non-APOE4 carriers. These findings together with animal studies are consistent with the notion that APOE e4 is associated with poor clearance of Beta Amyloid. In order to develop population based screening approaches, blood biomarkers were investigated and a panel have been identified that show promise for diagnosing AD individuals but these findings need validation in other cohorts to determine whether they are specific for AD or just markers for neurodegeneration. Another approach that is being investigated in the AIBL cohort is Beta Amyloid deposition in the retina using Curcumin to visualize Beta Amyloid deposits.

Both Diet and Physical Activity will be discussed for their role in modulating risk of AD. Increased physical activity is associated with better cognition, bigger hippocampi and reduced cerebral Beta Amyloid deposition and this effect is APOE genotype dependant. Adherence to the Mediterranean diet is strongly associated with reduced cerebral Beta Amyloid deposition but this effect is compromised by negative lifestyle factors such as smoking.

In conclusion the AIBL longitudinal study of ageing is an invaluable national resource for developing much needed early diagnostic tools and prevention programs to effectively combat the looming AD epidemic.

Rainey-Smith, S, Brown, B, Gardener, S, Taddei, K, Ellis, KA, Macaulay, SL, Ames, D, Rowe, CC, Masters, CL and the Australian Imaging Biomarkers and Lifestyle Research Group.

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Invited speakers

Invited speakers


Dr Leila Masson, MD, MPH, FRACP, FAAP, DTMH, IBCLC

Consultant Paediatrician, Auckland.

Dr Leila Masson is an integrative paediatrician who combines allopathic medicine with a nutritional and biomedical approach to help her patients attain optimal health. She received her medical doctorate from the Free University of Berlin and did her paediatric specialist training at the University of California at San Francisco. She received her Master in Public Health from Harvard University and her Diploma in Tropical Medicine from the London School of Hygiene and Tropical Medicine. Leila has worked in the US and Europe and volunteered for 2 years setting up a clinic in Pakistan, before moving to New Zealand, where

she has lived and worked for the last 12 years. Leila has a busy practice in Auckland, specialising in a holistic approach to children’s health problems, including allergies, asthma, behaviour problems, autism spectrum disorders and ADHD. She will give a review of the recent literature on nutritional and environmental causes and discuss nutritional interventions for developmental and behavioural problems, including autism spectrum disorders and autism.

More Informationhttp://www.leilamasson.com/

Review of breastfeeding medicine and formula feeding with a focus on childhood development and immune disorders such as eczema and asthmaA comprehensive review of the literature on the most fundamental of all preventive health measures: breastfeeding. There are countless risks associated with not breastfeeding, such as increased infections and allergies, SIDS in childhood, but also longer-term elevated blood pressure and diabetes risk for that child in later life.

Breastfeeding sets the stage for life-long health. Additionally women who do not breastfeed their children have an increased risk of several cancers, osteoporosis, rheumatoid arthritis, metabolic syndrome and type 2 diabetes.

Formula feeding not only exposes the child to a lack of the nutritional and developmental factors in breast milk, but also toxins, plasticizers (BPA) and contamination in artificial infant milk.

This lecture will give you an overview of the risks of not breastfeeding and discuss the associated costs to society.

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A/Prof Eugen Molodysky, MBBS, DRACOG, PhD, OAM

Prof Eugen Molodysky is Clinical Associate Professor at Sydney University in the Sydney Medical School. He is recognised widely as a leader in primary health care. His commitment and contribution over three decades extend across clinical practice, research and teaching, to advocating on behalf of his profession. Professor Molodysky has been recognised for his research into the prevention of cervical cancer with the award of his PhD in 2000.

He has held and holds key positions in clinical governance in a number of organisations across the vertical spectrum of medical education and training - University of Sydney, University of Notre Dame, GP Synergy (previously SIGPET), RACGP, ESDGP and ESML. In the

field of teaching, in 2003, he was central to introducing clinical teacher training at Sydney University which is now being trialed for teacher training for Stage 3 medical students.

In the field of nutritional medicine, Professor Molodysky has been an advocate of putting nutrition into medicine, presenting to national and international audiences since the early 1990s. He has been a member of ACNEM since its beginning in 1982, and a member of AIMA since its beginning in 1992. Professor Molodysky is currently Vice President of ACNEM.

Professor Molodysky has also been committed and contributed to community engagement and leadership, and broader service to the profession and community. He was appointed to the Medical board of NSW in 2006 and in 2008 was recognised with a Medal of the Order of Australia “for services to medical education, particularly in the areas of general practice, through clinical teaching, curriculum and professional development and research into cervical cancer prevention”.

More Informationhttp://sydney.edu.au/medicine/people/academics/profiles/eugene.php

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Invited speakers

Invited speakers


Dr Karen Murphy, BAppSc (Hons), PhD, RNutr

NHMRC (Senior) Industry Research Fellow, Nutritional Physiology Research Centre, University of South Australia, Adelaide.

Dr Murphy is an NHMRC Industry Research Fellow with a background in nutritional biochemistry. The primary goal of her research is to understand and scientifically substantiate the impact of healthy foods (dairy foods, tea, lean meat), bioactive nutrients (flavonoids, antioxidants) and dietary patterns (Mediterranean diet, higher protein diets) on cardiometabolic health and cognitive performance through randomised controlled dietary intervention trials. She has extensive experience in clinical trials, particularly assessment of

dietary intake, body composition, cardiovascular health and more recently cognitive performance and psychological wellbeing. She is currently leading an NHMRC funded dietary intervention trial investigating the effect of a Mediterranean dietary pattern on cognitive performance and endothelial function in elderly Australians.

Dr Murphy is currently President of the Australasian American Oil Chemists Society, Honorary Treasurer of the Nutrition Society of Australia and a recipient of the prestigious South Australian Young Tall Poppy Science Award (2009).

More Informationhttp://people.unisa.edu.au/Karen.Murphy

Mediterranean diet: a healthy diet for the heart and mind? The traditional Mediterranean diet originated from Crete, Greece and is characterised by the consumption of fruits, vegetables, legumes, nuts, and low fat dairy food, small amounts of red meat, poultry, fish, olive oil and red wine. It delivers important nutrients such as antioxidants, vitamins, minerals, omega-3 fatty acids, monounsaturated fat and fibre and a range of bioactive components such as flavonoids, sterols and carotenoids. In the Seven Countries Study, the Mediterranean diet (MedDiet) was associated with a lower incidence of coronary heart disease and similarly reduced cardiac death in the Lyon Heart Study. These findings are further supported by a large prospective cohort study in an Australian (n=40,470) population which showed greater adherence to a MedDiet is associated with reduced total mortality and mortality from cardiovascular disease.

More recently the MedDiet has been associated with improvements in cognitive function, reduced risk of Alzheimer’s disease (AD) and dementia. In fact a large prospective study (133,626 subjects and 783 cases), a high adherence to a MedDiet was associated with a reduced incidence of Parkinson’s disease and AD (RR 0.87 [95%CI 0.80-0.96] P=0.004 with no heterogeneity among the studies I2=0% P=0.5). This was further supported by a number of prospective studies which have shown that adherence to a MedDiet, as calculated from food frequency questionnaires, is associated with improved cognitive function or reduced risk of cognitive impairment. We have recently calculated Australian’s have medium level of adherence to a MedDiet and found relationships between plant food intake and self-reported measure of cognition. It is thought the MedDiet elicits health benefits through a number of pathways including anti-inflammatory, anti-oxidative, modulation of neurotransmitters and through improved endothelial function and cerebral blood flow. It is vital to understand the mechanisms associated with a MedDiet to use a targeted dietary approach for prevention or management of disease and further research is required using randomised dietary intervention trials as well as assessing mechanisms of benefits.

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Prof V Prakash, PhD, MSc, BSc, FRSC, FIFT, FIAFoST, FIAS, FNAAS, FINAE

Distinguished Scientist of CSIR-India, Mysore. Director of Research, Innovation and Development, Center of Excellence of Nutraceuticals and Nutritionals at JSS-MVP, Mysore, India. Task Force Chairman on Nutraceuticals, International Union of Nutritional Sciences.

Dr. Prakash is currently the Distinguished Scientist of CSIR India. He has contributed enormously in the area of Nutrition, Proteins, Social Programmes of Child Feeding such as mid-day meals and its value addition. His contribution in the field of enzymes in the field of application to pre-digestive food such as energy food and the impact that it can make to the child nutrition is phenomenal. He is a Fellow of most of the academies and globally

renowned for his 45 years of contribution in the area of Food Science, Food Technology, Nutrition and Nutraceuticals, from the larger perspective of Health and Wellness and Management.

He is very well known in the area of Food Safety and Regulations for the past three decades and has brought in the element of Science-based Food Safety and its Regulations. He has more than 50 major awards to his credit and is recognised by many Academia and Universities as a Visiting Professor. He has more than 200 papers, 50 patents and more than 500 keynote, Chief Guest addresses in National and International Seminars and Conferences.

More Informationhttp://www.sdmimd.ac.in/als/pdfs/prakash.pdf

Epidemiology and traditional foods and nutrition: how does one tap that knowledge for reverse nutritional genomics?Modern science has shown with the synthesis of vitamin B12 that a large number of nutrients especially vitamins and minerals with a base of proteins, carbohydrates and fats are absolutely essential for the healthy growth of a child all the way to an adult and to an aged person. In this process the food based approach of nutrition is very important and apart from treatment of certain severe acute malnutrition (SAM) through clinical approach and tablets and other vital medicines to combat the critical cases. But a majority of the population on many occasions tread in the borderline that the food based approach especially based on the traditional knowledge and the epidemiology behind it perhaps is rather less untapped in today’s world of molecular knowledge. This is where data and analysis of certain genomic patterns may give a clue to the long term usage of certain foods which may be preventing certain diseases on the one hand and enhancing the nutritional status and bioavailability of the major nutrients and micronutrients on the other hand. This is where the treasure of “reverse nutrition” learning from epidemiology is very vital and therefore it is important for us to address this issue and discuss it in the workshop the importance of generation to generation information and use it for global wellness through a holistic approach.

The role of bioactives, nutritionals and nutraceuticals in combating environmental impact on health and wellnessThe role of human beings in changing the balance of the environment everyday is no exaggeration and as a matter of fact is accepted as truth! In such a situation with an increasing carbon footprint for every event and the atmosphere becoming polluted with chemicals, heavy metals, pollutants and even to a large extent unknown molecules some of which have never been seen by the human being have all become a common influx into the body whether one likes it or not. How does one fight this environmental impact, not only just global warming but the “toxicant warming” in the body is a challenge to the environmental scientist on the one hand and food and nutrition scientist on the other hand along with the molecular biologists. The role that nutraceutials play today a word which emerged from bioactive components from plant and marine sources which in synergy with the clinical intervention (may not be in all the cases) where nutrition and pharmacy decided that the word nutraceuticals can be one source for challenging this problem in environment. It is in this context that one has to remember that the base nutrition is very critical and nutraceuticals comes over and above it, as well as the pyramid of a holistic approach in nutrition. Perhaps it is indicative of a large amount of consumption of fruits and vegetables in many traditional countries like India and China, the herbals and more importantly how the combination of macro-nutrition to micro-nutrients is clubbed into nutraceuticals for a better health and wellness. It is vital that today from the genomic point of view a large amount of nutraceutical based data have evolved to show that certain molecules are important to not only prevent diseases but also sustain and improve the quality of life of the malnourished and recovering patients. It brings to mind the


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example of glucosamine, the well-known prescription as a dietary supplement for knee joint pain which is suppose to relieve the pain. But today the same glucosamine is also being prescribed along with the herbals and many other molecules to bring better effectiveness. In this area it is also vital to look very closely at the claims and many a time “over claims” dominate and need to be carefully examined for a safe and dependable nutraceuticals for the population. Therefore in combating the not so desired molecules which get into the body to flush it with defined molecules based on science to protect, prevent and ensure a better health for the population, this is an important mandate. One of the latest approaches with genomics is that it is important that we address this very openly and provide scientific support wherever it is needed even in many cases using some of the traditional knowledge, but it is important that we should not forget the generation to generation, use of these herbals. To distill that knowledge for relieving ailment on the one hand and prevent and extend the quality of life on the other hand have to go together. So much to do and so much to work on is lined for a “Team Global” approach and it is vital we target this issue as one of the top issues in the current scenario of Global networking in this Conference.

Translational nutrition and the need for capacity building and leadership to reach out the knowledge of nutrition to the unreachable – the role of Global Nutrition Security (GNS)There is an onset of networking of many of the public, private and nongovernmental organisations and self help groups addressing the issues of public nutrition through public policies. This is a very common scenario in most of the developing countries. The complexity is the number of people who are afflicted with malnutrition and at the same time a large number of programs that are in place, demands the need for trained, skilled and knowledgeable persons to spread this knowledge and also to implement the schemes effectively through managerial skills. It is in this area of translational nutrition where one has to take the power and knowledge of nutrition to the needy not just once in a single village, but through a cascading effect in several thousands of villages and even in slums in cities and often even the richest of the rich may be suffering from anemia! Therefore the moment we say translational nutrition it does not just derive itself into rural or economically poor populations. It is indeed spread across populations and we have to have that leadership and synergise with the capacity building programs which are directed towards this problem especially when we have solutions on hand. But on the other hand the CSR in industry also requires that capacity building and leadership to reach out the scientific knowledge to the masters. In this case, nutrition and to a certain extent nutraceuticlas and even a fundamental point like a balanced diet and healthy eating becomes all a matter of “information revolution” through appropriate leadership and that requires urgent attention. It is here one also has to address the food and nutrition security in many countries. It is not how much food one eats that is talked about but what food is eaten that is more important and also how it is distributed. The need for such a capacity building is the demand of the day and needs to be streamlined and organised, if we want the science that has been struggling out all these years to reach the right corner and ward off malnutrition, it has to become a very important agenda both from the point of medical knowledge, nutritional knowledge as well as food science knowledge, it must drive into policy matters for the benefit of population and cut across regions, especially to disperse this knowledge for addressing the issues with a clear mandate of science, technology and appropriate, adaptable and affordable technologies of scale up for Global Nutrition Security (GNS).

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Dr James Read, MBBS (Uni Syd), FRACGP, FACNEM, Grad Dip Rural GP, Dip RANZCOG, JCCA accredited GP Anaesthetist

Dr James Read is a GP specialising in both Nutritional/Environmental Medicine and Rural and Remote/Indigenous health. He is currently working between outback Western Queensland and the Kimberley in Western Australia as a GP anaesthetist whilst completing his Master of Public Health (Nutrition). He has previously worked in full time Nutritional Medicine practice in Singapore where he focussed on Chronic Fatigue, Obesity, ADHD and Mental Health problems. He has previously worked as a Bariatric Physician providing both medical and nutritional input for obese patients having weight loss surgery.

His has taught Nutritional and Environmental Medicine in Australia, New Zealand, Singapore, Malaysia and India. He is currently the Vice President of ACNEM. Dr Read?s passion is the integration of a holistic approach into all medical consultations where lifestyle, nutritional and environmental are routinely considered and managed.

Respiratory disease and the environment including food additives, diet and air pollutionThis presentation is an exploration of environmental contributors to both acute and chronic respiratory disease. This presentation will review environmental contributors to asthma, lung cancer, chronic obstructive airways disease restrictive lung disease and pulmonary infections.

In particular the presentation will focus on both ambient outdoor and indoor air pollution and occupational exposure to emissions particularly diesel. Briefly the influence of nutrition on expression of these diseases will also be explored

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Belinda Reynolds, BSc Nut & Diet(Hon)

Belinda Reynolds graduated with an Honours Degree in Nutrition and Dietetics in 2003. She has been involved in the complementary medicine industry for nearly 14 years - 9 of these working for FIT-BioCeuticals as a Practitioner Consultant, Team Leader, Presenter, Educator and Writer, with an involvement in Marketing and Product Development. Outside of this Belinda has spent time in hospitals and lectured at the Australasian College of Natural Therapies.

Belinda’s greatest passion is assisting practitioners in developing their knowledge by presenting new research in the area of integrative medicine. Now a mother of two, pre- and

post-natal, infant and child health have evolved as subjects particularly close to her heart.

New perspectives for pre‐ and postnatal probiotic therapyProbiotic therapy for immune-related disease is a growing area of interest, and for good reason. Science continues to confirm the link between dysbiosis and defective immunomodulatory mechanisms, while probiotics prove their benefit as a means of associated disease prevention.

In recent years, probiotic use for preventing pregnancy-related ailments and childhood disease has demonstrated its value. It is understood that maternal dysbiosis can contribute to compromised microbial balance in her offspring. The result is an increased risk of complaints including atopy and blood glucose imbalance.

Furthermore, revolutionary findings have revealed a pathway of probiotic translocation from the maternal gut to the fetal environment, to the lactation glands and into breast milk. It is via this pathway that maternal probiotic therapy can maximise offspring inoculation during the antenatal and postnatal periods (if breastfeeding). Clinical trials investigating this suggest infant atopy risk-reduction, growth pattern regulation, heightened immunity to infection and attenuation of inflammatory-related disease risk (e.g. mood disorders, metabolic syndrome).

Of particular interest are studies validating the success of Lactobacilli in eradication of infections frequently non-responsive to antibiotic treatment. Research from the University of Madrid analysed the anti-pathogenic functions of Lactobacilli isolated from the breast milk of healthy women. Cultured supplements of these probiotics were taken by women suffering infectious lactational mastitis. Results were fascinating, revealing the probiotic therapy as a more effective treatment than antibiotics.

These combined findings confirm that good pregnancy and infant health relies on sound maternal microbial balance throughout pregnancy and lactation. This lecture will discuss the results and implications of the above trials, and cover how best to implement these new findings to optimise the wellbeing of your pregnant patients and their children.

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A/Prof Ken Sikaris, MBBS, FRCPA, BSc(Hons), FAACB

Director of Chemical Pathology, Executive Director, Melbourne Pathology

A graduate of the University of Melbourne, Dr Sikaris trained at the Royal Melbourne, Queen Victoria, and Prince Henry’s Heidelberg Repatriation Hospitals. He obtained fellowships from the Royal College of Pathologists of Australasia and the Australasian Association of Clinical Biochemists in 1992 and 1997 respectively. Dr Sikaris was Director of Chemical Pathology at St Vincent’s Hospital in Melbourne between 1993 and 1996. A NATA-accredited laboratory assessor, Dr Sikaris specialises in Prostate Specific Antigen, cholesterol and quality assurance and is currently a member of the International Federation of Clinical Chemistry Committee

on Reference Intervals and decision Limits. His expertise is highly sought and he has presented extensively at national and international symposiums. Dr Sikaris is an Associate Professor of the Department of Pathology at Melbourne. He joined Melbourne Pathology in 2003 and has recently been appointed as Clinical Support Services Director with Sonic Healthcare.

More Informationhttp://www.mps.com.au/about-us/pathologists/pr-list/dr-ken-sikaris.aspx

Clinical biochemistry as a witness to the impact of environment on childhood developmentAll parents hope to give their children a good start to life. However they often receive conflicting messages such as being ‘sunsmart’ versus getting enough sunlight for growing bones or encouraging fruit and low GI foods versus avoiding fructose. While children are not little adults and they have the special needs of growth and development, the behaviours established in childhood can continue to adulthood. Unfortunately overly worried parents often look to health professionals for evidence of their children’s health and pathology laboratories need to be constantly improving and reviewing their understanding of what results are consistent with healthy childhood and what results are suggestive of declining health. Laboratories will often err on the side of high specificity in order to save the family the stress of the false positive result. Furthermore, the younger the child, the more important it is to minimise the trauma of phlebotomy unless important investigations are indicated. However a true family GP will be monitoring the health of the family and providing advice and guidance whenever it is indicated. By the time a young woman presents with polycystic ovary syndrome, metabolic changes may be established and require relatively urgent intervention to avoid the progressive risk of gestational diabetes or diabetes in later womanhood. Even if parents and clinicians aren’t certain about the ideal lifestyle, the least we can do is protect them from the harmful risks that have impacted on the preceeding generation.

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Prof A. David Smith, DPhil, FMedSci

Professor Emeritus of Pharmacology, University of Oxford. Founding Director, Oxford Project to Investigate Memory and Ageing (OPTIMA). Honorary Assoc. Director MRC Anatomical Neuropharmacology Unit, Oxford.

Prof A. David Smith is Professor Emeritus of Pharmacology at the University of Oxford. He has spent his entire academic career in the University of Oxford, graduating from Christ Church in Biochemistry in 1963 from where he joined the Department of Pharmacology to carry out research for a D.Phil. He was Chair and Head of Pharmacology from 1984-2005 and in 1985 the Medical Research Council established a new Unit (Anatomical Neuropharmacology)

associated with the Department of Pharmacology with Professor Smith as Honorary Director. In 1988 he co-founded the Oxford Project to Investigate Memory and Aging (OPTIMA). He was Deputy-Head of the newly established Division of Medical Sciences at Oxford from 2000-2005. He has honorary doctorates from the Universities of Szeged and Lund and is a member of the Hungarian and Norwegian Academies of Science. In 2000 he was elected Fellow of the Academy of Medical Sciences, UK. After retiring from his University positions in 2005, he continued his research on Alzheimer’s disease. His main current interests are in identifying modifiable risk factors for dementia and for obesity and in the role of nutrition in brain health.

More Informationhttp://www.medsci.ox.ac.uk/optimahttp://mrcanu.pharm.ox.ac.uk/

Modification of disease progression in early stages of Alzheimer’s disease by B vitamins: results of the Vitacog trialProgressive atrophy of specific brain regions occurs in Alzheimer’s disease (AD). Elevated plasma homocysteine is associated with brain atrophy and is a risk factor for cognitive decline and AD. Plasma homocysteine concentrations can be lowered by taking B vitamins. VITACOG was a 2-year randomized clinical trial involving 271 elderly (>70 y) with Mild Cognitive Impairment. High-dose B-vitamin treatment (daily: 0.8 mg folic acid, 0.5 mg vitamin B12, 20mg vitamin B6) lowered homocysteine by 30%, and significantly slowed mean whole-brain atrophy by 30%. The reduction in the rate of atrophy was dependent upon baseline homocysteine; those with levels ≥13 µmol/L showed a 53% slowing of atrophy.1 Cognitive assessments showed that B-vitamin treatment stabilized executive function over 2 years relative to placebo. In several other cognitive tests (MMSE, episodic and semantic memory) the B-vitamins slowed cognitive decline only in those with baseline homocysteine above the median (≥11 µmol/L). An actual improvement in clinical status (Clinical Dementia Rating) was found in those in the active treatment group whose homocysteine was ≥13 µmol/L.2

Voxel-based morphometry to study different regions of the brain showed that B-vitamins reduced by up to 7-fold the rate of atrophy specifically in those grey matter regions known to be vulnerable to the AD process, including the medial temporal lobe. This markedly beneficial effect was confined to participants with homocysteine above the median. Using Bayesian network analysis, we showed the following causal chain of events: B-vitamins lower homocysteine, which directly leads to a decrease in grey matter atrophy, thereby slowing cognitive decline.3 Our results show that B-vitamin supplementation can slow the atrophy of specific brain regions that are a key component of the disease process in AD. Thus, it is possible to modify the disease process early in AD.

References:

1. Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, et al. Homocysteine‐lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment. A randomized controlled trial. PLoS ONE. 2010; 5: e12244.

2. de Jager CA, Oulhaj A, Jacoby R, Refsum H, Smith AD. Cognitive and clinical outcomes of homocysteine‐lowering B‐vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry. 2012; 27: 592‐600.

3. Douaud G, Refsum H, De Jager CA, Jacoby R, Nichols T, Smith SM, et al. Preventing Alzheimer’s disease‐related grey matter atrophy by B vitamin treatment. PNAS. 2013; in press.

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What is the desirable blood level of Vitamin B12 to protect the brain?Cobalamin (vitamin B12) is crucial for brain function, as shown by the profound neurological and neuropsychiatric deficits that can occur in pernicious anaemia. In the general population, it is not always easy to detect effects of low plasma cobalamin concentrations on cognitive function. This is the consequence of at least two factors: first, that measurement of plasma cobalamin itself is not a good marker for the tissue status and that functional markers like methylmalonic acid and holotranscobalamin are better1. Second, that the context in which low cobalamin status occurs may be an important factor in determining its relation to cognition. Among the contexts that influence the association with cognition are: folate status and intake2; depression3; genetic polymorphisms such as the e4 allele of ApoE4.; and plasma total homocysteine concentration.

The traditional cut-off value for cobalamin deficiency of 148 pmol/L was originally defined in relation to haematological signs, but it has become clear that harmful consequences for the nervous system can occur at concentrations considerably above this level. Some outcomes that may be associated with ‘low-normal’ cobalamin levels, i.e., concentrations above 148 pmol/L, are: neural tube defects; cognitive impairment in elderly; Alzheimer’s disease; damage to white matter; brain atrophy; depression; autonomic dysfunction5. These findings raise the question: what is the desirable blood level of cobalamin to protect the brain? Should we be aiming for a higher cut-off value to define possible cobalamin insufficiency, below which treatment should be considered?

References:

1. Smith AD, Refsum H. Vitamin B‐12 and cognition in the elderly. Am J Clin Nutr. 2009; 89(suppl.): 707S‐11S.2. Morris MS, Selhub J, Jacques PF. Vitamin B‐12 and folate status in relation to decline in scores on the Mini‐Mental State

Examination in the Framingham Heart Study. J Am Geriatr Soc. 2012; 60: 1457‐64.3. Garrod MG, Green R, Allen LH, Mungas DM, Jagust WJ, Haan MN, et al. Fraction of total plasma vitamin B12 bound to

transcobalamin correlates with cognitive function in elderly Latinos with depressive symptoms. Clin Chem. 2008; 54: 1210‐7.4. Vogiatzoglou A, Smith AD, Nurk E, Drevon CA, Ueland PM, Vollset SE, et al. Cognitive function in an elderly population:

Interaction between vitamin B12 status, depression, and apolipoprotein E E4: The Hordaland Homocysteine Study. Psychosom Med. 2012; 75: 20‐9.

5. Smith AD, Refsum H. Do we need to reconsider the desirable blood level of vitamin B12? J Intern Med. 2012; 271: 179‐82.

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Prof Wayne Smith, BMath, BMed, MPH, PhD, FAFPHM

Director, Environmental Health Branch, NSW Health.

Professor Wayne Smith is the director of the Environmental Health Branch, NSW Health, Conjoint Professor of Epidemiology at the University of Newcastle and an Honorary Professor of the School of Public Health, University of Sydney. His research is broad ranging, including respiratory, nutritional, ophthalmic, environmental and genetic epidemiology.

He has held more than 40 peer-reviewed grants and published 180 peer-reviewed papers. He is also involved in a range in a range of air pollution and health research and currently

represents NSW health on a range of interjurisdictional national committees, including the National Environmental Health Committee - enHealth. He is currently on three NHMRC expert working groups and represents all State and Commonwealth Health departments on the National Environmental Protection Measures (NEPM) working group.

More Informationhttp://swahs.elcom.com.au/CHIP/Leaders-Forums/Leaders-Forum-Members/Professor-Wayne-Smith/default.aspx

Endocrine Disrupting Chemicals (EDCS): how the chemical environment influences health Certain chemicals, known as endocrine disruptors, can mimic hormones or interfere with the function of the body’s hormones. Endocrine disruptors, which usually mimic estrogen, are found in many of the everyday products we use, including: some plastic bottles and containers, food can liners, detergents, flame retardants, toys, cosmetics, and pesticides.

These compounds are of particular concern because they can alter the critical hormonal balances required for proper health and development.

Endocrine disrupting chemicals (EDCs) affect endocrine function by: binding to and activating hormone receptors (mimicking natural hormone action); or binding to and NOT activating hormone receptors (blocking natural hormone action), affecting the concentration of natural hormones by interfering with the synthesis, transport, metabolism and elimination of hormones.

The most clear-cut examples of environmental endocrine disruption is with exposure of gastropods (snails and slugs) to very low concentration molluscicides, leading to irreversible sexual abnormalities in females. Human health effects from low-dose exposure are mostly hypothesised; but clear evidence of sexual effects and transplacental carcinogenic effect of diethylstilbestrol at high doses (used to prevent miscarriages)

Proven human health effects include prescribed Diethylstilbestrol associated with vaginal cancers of affected foetuses, reproductive tract abnormalities and subfertility/infertilty. Potential human health effects include reproductive effects, neurological development, neuroendocrine function, behaviour (as a result from thyroid and neurotransmitter altered function), metabolic disruption and obesity, among a long list of other conditions.

Policy and regulatory issues are discussed, and issues in conducting and interpreting research on EDCs are considered.

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Dr Maarten Stapper, BAgSc AgEng, PhD, FAIAST

Director, BioLogic AgFood

Dr Stapper began a career in agricultural science forty years ago, has international experiences on four continents and is a former senior scientist with CSIRO. Employing a holistic approach, he is an expert across a wide spectrum of agricultural areas in research, development and extension. He was elected Fellow of the Australian Institute for Agricultural Science and Technology.

From personal experiences, Dr Stapper found low external input agriculture to be most sustainable for producers, consumers and landscape. His focus is on agroecological farming systems that help farmers improve the profitability of their operations by harnessing the power of natural soil processes with practices creating healthy soils while reducing heavy reliance on synthetic fertilisers and chemicals.

Required practices not just create healthy soils but also improve qualities of food and landscape. It makes plants, animals and land more resilient in a variable climate, and utilises natural resources for increased productivity ? and is thus ecosystem based and generates biodiverse landscapes.

Maarten featured in ABC TV’s Australian Story “Back to Earth” in 2009 about his road into biological farming systems and disconnect with official science world. He questioned GM and wanted to continue research towards low-input sustainable farming.

More Informationhttp://www.drmaartenstapper.com.au/ http://www.biologicagfood.com.au/

Higher nutrient density with agroecological farmingWorldwide industrial farming practices are degrading soils and bringing about dependency on the use of more synthetic fertilisers and chemicals, which increase chemical contamination of foods and the environment. Their continuous use affects the health of humans and soils. It decimates the abundance and diversity of soil-microbes which greatly lowers the nutrient density of food. Synthetics in food are also increasingly associated with chronic diseases.

Soils are the foundation of life on Earth. Through degradation and urbanisation we are losing one percent of the world’s arable land per annum. Most attention in the news and science focus on issues of human health, food security, biodiversity and climate change, usually without their direct connections to soil health and associated food quality.

Healthy soils and healthy humans are both dependent on an abundance and diversity of beneficial microbes. Producers’ soil awareness and consumers’ healthy food demand are now leading more to farming practices that use far less synthetic fertilizers and chemicals, or none (ie. organic). Such agroecological, low-external input farming improves food quality, soil health, landscape biodiversity and farm profitability. Associated soil carbon sequestration, reduction in GHG emissions and increased soil water retention help slow global warming.

Agroecological farming is still being treated as ‘alternative’ and receives little R&D as it works against vested interests. It has, however, received science-based endorsements in several UN agency reports as the way to feed the increasing world population. This without a need for Genetically Modified (GM) food whose long-term safety hasn’t been proven.

Consumers, supported by nutritionists, are driving the process of change. An important skill consumers, gardeners and farmers do need to (re)develop and use is the capacity to be biosensitive, that is, to trust nature and to be in tune with, sensitive to, and respectful of the processes of life.

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Prof Con Stough, BSc (Hons), PhD (Adel)

Professor of Cognitive Neuroscience, Swinburne University of Technology. Co-Director, Swinburne Centre for Human Psychopharmacology with Prof Andrew Scholey. Director, National Institute of Complementary Medicine Collaborative Centre for the study of herbal and natural medicines for neurocognition, Melbourne.

Prof Con Stough is Professor of Cognitive Neurosciences at the Swinburne Centre for Psychopharmacology and Professor of Psychology at Swinburne University. The Centre for Psychopharmacology has 20 full time research staff and 20 research students and is a leading research and teaching institute in cognitive neuroscience. He has an extensive track record in

research and consulting and has published more than 120 peer-reviewed international expert papers in the area of psychological assessment, biological psychology and psychopharmacology. He has also attracted more than 12 million dollars in research grants over the last 10 years fromNational and International government and Industry sources. Professor Stough is on the advisory panel for the International Society for Intelligence Research and editorial board for the journal Intelligence and is an invited member of the Neuroscience panel for the World Economic Forum. He has reviewed scientific papers for more than 50 different scientific journals.

Professor Stough is a leading researcher in the area of natural drugs, cognition, mood and the brain. He co-founded the Herbal and Nutraceutical Research Unit at Swinburne University and is past Director of the National Institute of Complementary Medicine (NICM) collaborative research centre in neurocognition and herbal medicines which was part of the Centre for Human Psychopharmacology from 2007-2011. The focus of this unit has been to study the efficacy of cognitive enhancing natural drugs. He has key publications and grants with several natural substances such as Ginkgo Biloba, Bacopa Monniera, DHA and fish oils, St John’s Wort, Pycnogenol, multi vitamins, rye grass, pine needle extract and patented combinations ofsmart drugs amongst many others. More recent work has been in large pharmacological trials for the prevention of cognitive and brain aging and supplementary treatments for abnormal aging such as Alzheimer’s Dementia.

Professor Stough is also a consultant for many Australian companies and has had more than 200 media interviews, Prof Stough appeared on the Channel 9 “National IQ test”, Australia’s highest rating television program. He has also developed commercial companies (e.g, Genos.com.au) and partnerships (e.g., with CDR Pty Ltd). In other areas of research Prof Stough has conducted work in the area of illicit drugs and driving with Vicroads and Vicpolice and in the area of emotional intelligence in schools.

More Informationhttp://www.swinburne.edu.au/lss/staff/view.php?who=cstough

Improving cognitive functioning in the elderly with chronic nutraceutical based treatmentsWith Australia’s increasingly ageing population, interventions capable of ameliorating age-related neurocognitive change are becoming vital areas of research. In addition to pharmacological interventions, nutritional supplements may provide a safe and alternative way for maintaining optimal health, including brain health. Unlike pharmaceutical cognitive enhancers, there are several putative neutraceuticals that may be able to improve cognitive and neurological function if taken chronically. Evidence from studies conducted in our own centre indicate the efficacy of a specific extract of Bacopa (Keenmind) and an extract of French Maritime Pine Bark (Pycnogenol) after 3 months of chronic administration on a range of cognitive variables in the elderly. With these preliminary results in mind we developed a 4 arm 12-month chronic placebo controlled RCT in which Keenmind, Pycnogenol and a specially formulated Nutraceutical is administered to 600 elderly participants. Variables assessed include cognitive batteries, inflammatory, anti-oxidant and other biochemical measures, telomere length and genetic markers, neuroimaging and cardiovascular endpoints. In this talk I describe this study and report on the preliminary baseline results from the first 100 participants.

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Prof Mark L. Wahlqvist AO, BMedSc, MBBS, MD, FRACP, FAIFST, FACN, FAFPHM, FTSE

Emeritus Professor, Monash University; Visiting Prof, Centre for Health Policy Research and Development, National Health Research Institutes; Visiting Prof, Food and Nutritional Science, Zhejiang University; Honorary/Adjunct Prof, Epidemiology & Preventive Medicine, Faculty of Medicine, Monash University.

Mark L. Wahlqvist was educated at Westbourne Park Primary School and Unley High School in Adelaide and at Adelaide and Uppsala Universities in Australia and Sweden, respectively. He is a Consultant Physician and has held chairs in Human Nutrition, Medicine, Epidemiology

& Preventive Medicine at Melbourne’s Deakin and Monash Universities and been Chair of Internal Medicine at Prince Henry’s Hospital, then the Monash Medical Centre, in Melbourne.

He was President of the International Union of Nutritional Sciences from 2001 to 2005. He was a member of the Melbourne group which drew up the inaugural constitution of the ANF, the Australian Nutrition Foundation. During his time as National Chair of the ANF (1995-2001), its re-badging as Nutrition Australia was realized. Nutrition Australia became the secretariat for FANO (the Federation of Australian Nutrition Organizations). He played a key role as Foundation Chair of the WMCACA (Weight Management Code Administration Council of Australia) for some 15 years and was a Board member of ANZFA, the Australian and New Zealand Food Authority (now FSANZ) and Foundation Chair of the Food Safety Council of Victoria. He chaired the Australian Academy of Science National Nutrition Committee (2002-2006).

He is currently Director of the APHNC (Asia Pacific Health & Nutrition Centre) at the MAI (Monash Asia Institute) and an Honorary Professor in the Faculty of Medicine at Monash University, Editor-in-Chief of the Asia Pacific Journal of Clinical Nutrition, a Principal Investigator at the National Health Research Institute (NHRI) and Professor of Public Health at the National Defense Medical Centre in Taiwan, and Honorary Professor of Food & Nutrition Science of Zhejiang University, Hangzhou, China.

Nutrition and neuroprotectionFew would disagree that the way we eat affects our brain function, but the extent to which it does so, at what stages of life this matters, what happens if the brain is not well-nourished and does the brain have different nutritional needs to other organs and systems like the heart and the immune system, have been open questions. Most importantly, what is the optimal diet for brain health?

In brief, nutrition and our brain health are already being determined even before we are conceived, in the uterus, with breast feeding, childhood and into old age. It is a life-long consideration. The brain is the most metabolically active organ in the body and requires a wide range of factors from food, but primed by physical, mental and social activity in healthy environments which stimulate our senses, especially touch, smell, sight and sound. Energy (Calorie) regulation seems particularly important for how we feel (hunger, satiety and mood) and even the microorganisms in our gut may influence our brain function.

The mind, mood, cognition, movement, inter-personal relationships and social discourse all require a healthy brain and for it to be well-nourished.

Some foods and food factors have received much attention in regard to brain health. These include fish because of its omega-3 fatty acids, iodine and vitamin D, fruits (especially berries) and culinary herbs because of their coloured phytonutrients, and certain micronutrients like iron, zinc and iodine because of specific functions. But dietary patterns like those around the Mediterranean, in Scandinavia and Japan may be a more health-integrative way of neuroprotection (brain protection) as long as essential nutrients like iodine are present in sufficient quantities; for many adequate vitamin D is difficult to obtain from food alone and sunlight exposure is necessary for the nervous system to meet its vitamin D needs. The safety, especially the contamination of our foods, is a growing concern for brain health, already evident in children exposed to such factors as the endocrine disruptors known as bisphenols. Indirectly, the nutritional status of many tissues like the cardiovascular system, body fat and the gut along with processes like inflammation and immunity also play a major role in the integrity of the nervous system.

The brain may be damaged in various ways, but chief among them are a loss of blood supply or haemorrhage with TIAs (transient ischaemic attacks) or stroke, neurodegeneration (with dementia or Parkinson’s disease) and affective

Invited speakers


disorders (principally depression).Nutritional factors are involved in each of these.

Brain health is necessary for active and long lives and is dependent on the way and what we eat- whether together and if characterised by safe, diverse, sustainable and affordable foods. Unfortunately, the most socio-economically and environmentally disadvantaged are those often at greatest risk of nutritionally-related brain disorders.

The clinical practice of food securityHealth care involves nutritional care since food is basic to life and its acquisition, preparation and consumption entwined with being human - we are the only species that cooks for each other and eating together is healthful. The food system as a whole relates to our entire health status (well-being, absence of disease and survival) in various ways. The ability to acknowledge and assess this by way of a food security diagnosis is a step beyond current clinical nutrition practice, whether by general or specialist practitioner and at all care levels. The new imperative to do so derives from the conjunction of climate change, inadequate family planning and over-population, rapid ageing, a dysfunctional global financial system and increased natural disaster frequency and severity. Clinicians will increasingly encounter new health patterns and crises, many with nutritional vulnerability as a contributor and the need for nutritional intervention as part of their management.

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Scientific abstract presentations

Dr Christabelle Yeoh, MBBS (London), MRCP (UK), MSc (Nutrition)

Dr Yeoh graduated from medicine at the University of London and obtained her membership with the Royal College of Physicians (UK). She has a Masters degree in Nutrition from King’s College London and worked as a clinician in the field of Nutritional and Environmental Medicine at Breakspear Medical Group in Hertfordshire, UK. She is a member of the American and British Academies of Environmental Medicine.

She is now in Australia and is involved in helping to develop postgraduate training for the Australian College of Nutritional and Environmental Medicine. She is on the medical advisory board for the MINDD foundation which is involved in family and preventative healthcare, a

great need driven by the unprecedented rise of atopic, neurodevelopmental and behavioral disorders occurring in children all over the world.

Environmental influences in childhood: Conception to kindyAre future generations in jeopardy? Scientific understanding of epigenetics and the study of environmental factors in health and disease have gained great strides over the past decade. With more and more evidence coming out that the environment is what dictates the expression of disease, we are being forced to enact the precautionary principle when taking care of our families and children. Ignorance of the problems in our environment is no longer acceptable and complacency in taking action puts present and future generations at increasing risk of environmental illnesses. In this talk, we review the information that can be given to parents and families in order to educate as many individuals as possible. Given the evidence that is increasingly available in this area of preventative medicine, it is the health care giver’s responsibility to raise awareness of environmental impacts on health.

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Scientific abstract presentations (poster)

FREE RADICAL SCAVENGING ACTIVITY AND TOTAL PHENOLIC COMPOUNDS OF THREE MALAYSIAN MEDICINAL PLANTS, AQUILARIA MALACCENSIS, ARDISIA CRENATA AND DICRANOPTERIS LINEARIS Ali, Yassir Mohammed 1, Kadir, Arifah Abdul 1, Ismail, Amin 2, Othman, Fauziah 2

1 Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia2 Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia

Introduction: Much attention was given to the usage of natural antioxidants to prevent oxidative damage caused by free radicals in human’s body1. Aquilaria malaccensis (A. malaccensis), Ardisia crenata (A. crenata) and Dicranopteris linearis (D. linearis) are three popular medicinal plants used in Malaysia. Despite the extensive use of these plants, there are insufficient studies for their antioxidants activity. Therefore, this study was undertaken to evaluate the free radical scavenging activity of these plants and their total phenolic compounds (TPC).

Materials/Methods: The ABTS and DPPH assays were used to determine the free radical scavenging activity of methanolic extracts of the plants’ leaves2. While, TPC of the extracts was determined by Folin_Ciocalteu method3.

Discussion: All tested extracts immediately reacted and quenched ABTS and DPPH free radicals at all concentrations (10-320 µg/mL) with dose and time dependence. Total antioxidant capacity (TAC) against ABTS free radical of A. malaccensis extract (32.09 ± 0.6%) was significantly more effective than A. crenata extract (15.9 ± 1.6%) and D. linearis extract (9.9 ± 1.9%), and comparable to ascorbic acid (33.8 ± 0.8%). Meanwhile, DPPH assay revealed significantly a higher TAC of A. malaccensis extract (17.9 ± 4.1%) than ascorbic acid, A. crenata extract and D. linearis extract (8.8 ± 1.8%, 6.1 ± 0.5% and 4.1 ± 1%, respectively). Recent studies demonstrated a positive correlation between antioxidant activity of the plant extracts with the content of their TPC4,5. In this study, the TPC of A. malaccensis extract was significantly higher than A. crenata and D. linearis extracts which may explain its higher TAC in ABTS and DPPH assays.

Conclusions: The results of this study reveal potent antioxidant and free radical scavenging activity of A. malaccensis extract higher than ascorbic acid which may serve as a new natural antioxidant and as a possible food supplement or in pharmaceutical applications.

References

1. Waters, D. D., Alderman, E. L., Hsia, J., Howard, B. V., Cobb, F. R., Rogers, W. J., et al. (2002). Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: A randomized controlled trial. Journal of Agricultural and Food Chemistry, 288(19), 2432‐2440.

2. Kim, Y. J., Lee, K. W., & Lee, H. J. (2004). Total antioxidant capacity of arginine‐conjugated linoleic acid (CLA) complex. Journal of Agricultural and Food Chemistry, 52(3), 439‐444.

3. Ikram, E. H. K., Eng, K. H., Jalil, A. M. M., Ismail, A., Idris, S., Azlan, A., & Mokhtar, R. A. M. (2009). Antioxidant capacity and total phenolic content of Malaysian underutilized fruits. Journal of food composition and analysis, 22(5), 388‐393.

4. Anokwuru, C. P., Esiaba, I., Ajibaye, O., & Ayobami O. Adesuyi, A. O. (2011). Polyphenolic Content and Antioxidant Activity of Hibiscus sabdariffa Calyx. Research Journal of Medicinal Plant, 5(5) 557‐566.

5. Diankov, S., Karsheva, M., & Hinkov, I. (2011). Extraction of natural antioxidants from lemon peels. Kinetics and antioxidant capacity. Journal of the University of Chemical Technology and Metallurgy,46(3), 315‐319.

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SWEET TASTE, DIET ANDTASTE GENE EXPRESSION IN OBESITY Archer, N.S.1, Shaw, J.1, Cochet, M.1, Gilbert, H.2, Taylor, P.2, Oytam, Y.1, Duesing, K.1, Hannan, G.N.1, Delahunty, C.2

1 CSIRO Animal, Food and Health Sciences, CSIRO, Sydney, Australia2 CSIRO Animal, Food and Health Sciences, CSIRO, Adelaide, Australia

Introduction: Taste tissues express specialised receptors which sense the nutrient profile of foods, resulting in hormonal and neuronal signals that modulate intake and satiety. Differences in taste sensitivity occur between individuals, and have also been reported to differ between lean and obese people1-4. Because taste is fundamental to food preference and eating behaviour, altered taste function may contribute to the onset and persistence of obesity. The aim of this study was to analyse the association between sweet taste, diet, and expression of sweet taste genes in lean and obese individuals.

Methods: A total of 49 female volunteers, 25 lean (BMI<25) and 24 obese (BMI>30), aged 18-55 years were recruited for the study (CSIRO HREC11/02). All participants were non-smokers, currently not dieting and free of chronic diseases. Anthropometric (weight, height, BMI, waist circumference), fungiform papillae count and sensory perception (sweet taste detection threshold, supra-threshold intensity and preference) were collected. Participants also completed a 4-day weighed food diary to measure macro- and micro-nutrient intake. Taste associated genes were assessed using Taqman assays of RNA extracted from blood.

Discussion: There was a trend towards a higher sweet taste threshold, altered perceived sweetness intensity, and a significant preference for sweet tasting food in the obese group, consistent with previous studies identifying taste differences between obese and lean individuals1,2. No significant relationship was observed between fungiform papillae density and BMI or sweet taste perception. Associations between sweet taste, diet and gene expression of sweet taste receptors (TAS1R2 and TAS1R3) and associated messenger molecules (GNAT3, PLCβ2, ITPR3) will be presented.

Conclusion: This study supports the hypothesis that taste perception differs between lean and obese individuals, and that reduced taste sensitivity may result in over consumption of food due to altered taste signals, and therefore, contribute to the onset and persistence of obesity.

References

1. Ettinger, L., Duizer, L. & Caldwell, T. (2012) Body Fat, Sweetness Sensitivity, and Preference: Determining the Relationship. Canadian Journal of Dietetic Practice and Research, 73 (1): 45‐48.

2. Overberg, J., Hummel, T., Krude, H. & Wiegand, S. (2012) Differences in taste sensitivity between obese and non‐obese children and adolescents. Archives of Disease in Childhood, 97 (12): 1048‐1052.

3. Stewart, J.E., Feinle‐Bisset, C., Golding, M., Delahunty, C., Clifton, P.M. & Keast, R.S.J. (2010) Oral sensitivity to fatty acids, food consumption and BMI in human subjects. British Journal of Nutrition, 104 (1): 145‐152.

4. Pepino, M.Y., Finkbeiner, S., Beauchamp, G.K. & Mennella, J.A. (2010) Obese Women Have Lower Monosodium Glutamate Taste Sensitivity and Prefer Higher Concentrations Than Do Normal‐weight Women. Obesity, 18 (5): 959‐965.

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ADDRESSING ROOT CAUSE IN NON‐HODGKIN’S LYMPHOMA (NHL): CASE STUDY Beliak O

Olgarithm, Sydney

Introduction: The aetiology of non-Hodgkin’s lymphoma is mostly unknown. Some correlation has been found with such environmental issues as industrial pollution, pesticides and solvents1. Viral infections and low immunity may also play a role. This paper presents a case of a patient with stage III large B Cell Non-Hodgkin’s lymphoma who chose to address probable root causes instead of following conventional treatment protocol.

Methods: The patient was diagnosed by core lymph node biopsy. His health condition was assessed with pathology tests, CT and Gallium scans and physical examination. Identified abnormalities were compared to problems often caused by chronic infections and environmental and nutritional issues. Probable lymphoma causes were mapped to other health issues and their causes. The patient went through anti-parasitic herbal treatment and followed a detoxification regime. He had his kidney stone removed thus improving kidney function. The patient changed his diet to mostly organic non processed food and followed supplementation protocol.

Results and Discussion: The patient went into a long remission. A second biopsy of the initially enlarged lymph node was performed 9 months after the diagnosis. The biopsy revealed some reactive changes and fibrosis but no sign of lymphoma. The first biopsy from the same lymph node was re-examined and confirmed the initial diagnosis of diffuse large B cell lymphoma.

Conclusion: Improving detoxification function, stimulating lymph flow with herbs, improving intestinal health with low allergy diet and probiotics, supporting mitochondrial respiration with supplements could provide selective advantage to normal cells and ultimately reverse pathological processes. Further research in this direction may lead to a new comprehensive approach to personalised cancer treatment.

References:

1. Zakerinia M, Namdari M, Amirghofran S. The relationship between exposure to pesticides and the occurrence of lymphoid neoplasm. Iranian Red Crescent Medical Journal. 2012;14(6):337‐344

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DIETARY PHOSPHOLIPIDS AND THE TREATMENT OF AGE‐RELATED COGNITIVE DECLINECamfield DA1 & Scholey AB1.

1Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia.

Introduction/Background: Phospholipids are vital building blocks for cellular membranes in the human brain. These compounds are essential for the biosynthesis and release of numerous neurotransmitters within the central nervous system, together with receptor density/activity and neuroplasticity. Human clinical trials using a variety of phospholipids have provided preliminary evidence to suggest that common phospholipids such as phosphatidylserine and phosphatidylcholine may be effective agents for ameliorating symptoms of age-related cognitive decline.

Methods/Materials: The current placebo-controlled randomised trial will investigate the efficacy of a novel milk protein concentrate, rich in bioactive phospho- and sphingolipids, in the treatment of age-associated memory impairment in elderly participants. The phospholipid treatment will be administered as a 6-month chronic intervention in 100+ participants, with Rey’s Verbal Learning Test (RVLT) as the primary endpoint for cognitive function. Additional secondary outcomes will include computerized cognitive testing, mood measures, cardiovascular measures, blood biomarkers of oxidative stress, glucoregulation and inflammation, together with brain imaging including functional MRI and magnetic encephalography.

Conclusions: The project will provide state of the art insights into the efficacy of high-dose phospholipid treatment for the amelioration of cognitive declines in the elderly.

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CHILD UNDERNUTRITION AND EXTREME WEATHER EVENT FLOOD EXPOSURE IN THE PHILIPPINES: THE 2009 TROPICAL STORM KETSANA/ TYPHOON PARMA EXPERIENCEClark, E.1; Banwell, C.1; Lokuge, K.1; Friel, S.1; Zoleta-Nantes, D.2; Neeman, T.3

1 National Centre of Epidemiology and Population Health2 Crawford School Resource Management of the Asia Pacific3 Statistical Consulting Unit, Australian National University, Australia

Background: Nutrition research has focused on the prevalence of malnutrition in Filipino children with little available evidence on its causes and the role of climate-related hazards in undernutrition. The objective of the study is to understand the relationship between climate change-induced extreme typhoon-related flood exposures and undernutrition in children aged 0-85 months in the Philippines.

Method: A cross-sectional study of child nutritional status was carried out in 13 flood-affected villages of District IV Laguna Province, 18-24 months after the 2009 extreme typhoon events with consequent floods. Face-to-face interviews with mothers and physical examinations were conducted on 946 children in the flooded villages. The association between flood exposure and malnutrition indicators was assessed by univariate, bivariate and multivariate logistic regression analyses.

Results: The prevalence of underweight in children was 27.3% while underweight was 36.7%. Significant variables associated with underweight include child age, gender, number of siblings, and maternal employment in the last 12 months, radio exposure, and water source. Birth order, number of siblings, mother’s education, water source, toilet and geographical location of village were significant factors for child stunting. Further analyses found that a younger age, higher educational level of mothers and higher wealth quintile were protective for underweight while for stunting, the level of education of mothers was protective. Overall, flood level and duration had a negative impact on both stunting and wasting. The highest impact on both wasting and stunting was seen in the first week of flood. The longer the flood duration (> 4 weeks), increased negative impact follows.

Conclusion: Exposure to floods is associated with both short and long-term child undernutrition. Younger children seem to have more protection. Long-term malnutrition prevention programs should be implemented in flood-prone areas to offset poor nutritional outcomes in future.

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IMMUNE CROSS‐REACTIONS AND METABOLIC ACIDOSIS IN CHILDREN WITH AUTISMCosford R.E

Northern Beaches Care Centre Narrabeen NSW, Australia;

Conjoint Lecturer, School of Biological Sciences, University of Newcastle, Australia

Introduction: Autism is a neurodevelopmental disorder of increasing frequency, incidence up to 1 in 54 boys in certain areas. Aetiology is unclear, and neurological abnormalities in structure and function are well documented. Gastrointestinal symptoms are common iand gastritis, duodenitis and deficiency of disacharidase enzymes have been demonstrated.1 Autoantibodies to neuronal tissues have also been identified in these children,2 as have cross-reacting antibodies to microbial and food antigens.3

Methods: Retrospective analysis was performed on clinical records of 36 children with DSM4 diagnosed autism, confirmed at a tertiary level, taken prior to intervention. Blood was drawn for serum electrolytes and streptococcal antibodies, and a faecal aerobic microbial analysis performed. Results were compared to laboratory norms.

Discussion: Raised streptococcal antibodies, often with no history of streptococcal disease, and raised anion gaps and reduced serum bicarbonate levels were detected at levels of significance. Faecal microbial analysis indicated consistent overgrowth of enterococcal and streptococcal species, with reduction in E coli species. Subsequent analyses have demonstrated the streptococcus to be predominantly of the oral microflora type.Streptococcus and enterococcus ferment glucose to D-lactate. It is theorised that this overgrowth of enterococcal and streptococcal species produced excessive D-lactate, which combined with other mitochondrial defects in autism, contributed to the metabolic acidosis as manifested in raised anion gaps and reduced serum bicarbonate seen.4 It is further theorized that this overgrowth is a consequence of the passage of oral streptococci to the duodenum, causing enzyme disruption and inflammation, and hence the colon.It is further hypothesised that abnormal antibody formation to the streptococcus may be cross-reacting with neuronal tissue, similar to as in PANDAS.5

Conclusion: This retrospective pilot study indicates that colonic overgrowth with streptococcal and enterococcal species is common in children with autism and may be contributing to the symptomatology.

References

1. J Pediatr. Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT.1999 Nov;135(5):559‐63.Gastrointestinal abnormalities in children with autistic disorder.

2. Pediatr Neurol. Singh VK, Warren R, Averett R, Ghaziuddin M.1997 Jul;17(1):88‐90.Circulating autoantibodies to neuronal and glial filament proteins in autism.

3. Vojdani A, Pangborn JB, Vojdani E, Cooper EL. Int J Immunopathol Pharmacol. 2003 Sep‐Dec;16(3):189‐99.Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism.

4. Petersen C. Nutr Clin Pract. 2005 Dec;20(6):634‐45.D‐lactic acidosis.

5. J.Murphy TK, Kurlan R, Leckman J Child Adolesc Psychopharmacol. 2010 Aug;20(4):317‐31.The immunobiology of Tourette’s disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders: a way forward

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THE ROLE OF GUT MICROBIOTA IN NON‐ALCOHOLIC FATTY LIVER DISEASE (NAFLD): THE EFFICACY OF A MULTI‐STRAIN PROBIOTIC IN OBESE ADOLESCENTSCoulson S1, Palacios T1, Butt H2, Leong G3, Dahiya R3, Vitetta L.1

1 School of Medicine, Centre for Integrative Clinical and Molecular Medicine, Translational Research Institute, The University of Queensland; 2 Bioscreen at Bio21 Molecular Science & Biotechnology Institute, Melbourne;

3 School of Medicine, Obesity Research Centre, Institute for Molecular Bioscience, The University of Queensland, Australia

Aim: To investigate the efficacy of a multi-strain probiotic in obese adolescents presenting with metabolic syndrome (MetS) and NAFLD in relation to lipid accumulation in hepatocytes, liver enzymes, insulin resistance (IR) gastrointestinal (GI) permeability and serum lipid profiles.

Introduction: NAFLD is an important disease developing in children and adolescents; the prevalence of which parallels that with the increasing pandemic of obesity and metabolic syndrome (MetS) in this cohort.1 IR plays a key role in both MetS and NAFLD. Evidence suggests a role for GI microbiota and their metabolites in the aetiology of NAFLD, with gut derived endotoxaemia involved in the development of IR and small bowel bacterial overgrowth correlated to NAFLD.2 The liver is the first organ to come into contact with bacterial antigens from the gut, thought to result from increased GI permeability.

Methodology: A double-blind, randomised, placebo controlled study will enrol 50 obese adolescents (male and female, aged 10-16 years) with MetS and randomise them to an evidence-based formulated multi-strain probiotic or placebo for 6 months duration with a 3 month follow-up. Outcome measures will include but not limited to magnetic resonance spectroscopy confirmed NAFLD in adolescents presenting with elevated ALT levels at baseline, IR (oral glucose tolerance test with insulin measurements), fetuin A/α2HS-glycoprotein ,fat mass (DEXA), liver enzymes, GI permeability (lactulose mannitol urinary test), serum cholesterol and triglycerides, serum adiponectin, inflammatory markers and cytokines, blood pressure and faecal microbial analysis to determine GI microbiota profiles before and after intervention.

Discussion: Evidence strongly suggests that the composition of the GI microflora may vary in association with obesity and its metabolic symptoms.3 The GI tract exhibits multi-directional communication with target organs including the liver, and given that obesity is characterised by various metabolic disorders such as NAFLD, it substantiates the importance of GI microbiota in such chronic diseases.4 A small number of clinical trials have previously investigated efficacy of probiotics in treating obese individuals with NAFLD, with decreased levels of liver enzymes typically reported.5

References

1. Alisi A, Nobili V. Non‐alcoholic fatty liver disease in children now: Lifestyle changes and pharmacological treatments. Nutrition 2012;28:722‐26.

2. Abu‐Shanab A, Quigley EM. The role of the gut microbiota in non‐alcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2010;7:691‐701

3. Brown K, DeCoffe D, Molcan E, Gibson DL. Diet‐Induced Dysbiosis of the Intestinal Microbiota and the Effects on Immunity and Disease. Nutrients 2012;4:1095‐1119.

4. Sanz Y, Santacruz A, Gauffin P. Gut microbiota in obesity and metabolic disorders. Proceed Nutr Soc 2010;69:434–441

5. Vajro P, Mandato C, Licenziati MR, et al. Effects of Lactobacillus rhamnosus strain GG in pediatric obesity‐related liver disease. J Pediatr Gastroenterol Nutr 2011;52:740‐3.

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OLIVE (OLEA EUROPAEA L.) LEAF POLYPHENOLS IMPROVE INSULIN SENSITIVITY IN MIDDLE‐AGED OVERWEIGHT MEN: A RANDOMIZED, PLACEBO‐CONTROLLED, CROSSOVER TRIALde Bock Martin1, Derraik Jose G B1, Brennan Christine M1, Biggs Janene B1, Morgan Philip E2, Hodgkinson Steven C1, Hofman Paul L1,3, Cutfield Wayne S Cutfield1,3*

1 Liggins Institute, University of Auckland, Auckland, New Zealand2 Heart Research Institute, University of Sydney, Sydney, Australia3 National Centre for Growth and Development (NRCGD), University of Auckland, Auckland, New Zealand

Background: Olive plant leaves (Olea europaea L.) have been used for centuries in folk medicine to treat diabetes, with very limited data examining the effects of olive polyphenols on glucose homeostasis in humans.

Objective: To assess the effects of supplementation with olive leaf polyphenols (51.1 mg oleuropein, 9.7 mg hydroxytyrosol per day) on insulin action and cardiovascular risk factors in middle-aged overweight men.

Design: Randomized, double-blinded, placebo-controlled, crossover trial in New Zealand. 46 participants (aged 46.4 ± 5.5 years and BMI 28.0 ± 2.0 kg/m2) were randomized to receive capsules with olive leaf extract (OLE) or placebo for 12 weeks, crossing over to other treatment after a 6-week washout. Primary outcome was insulin sensitivity (Matsuda method). Secondary outcomes included glucose and insulin profiles, cytokines, lipid profile, body composition, 24-hour ambulatory blood pressure, and carotid intima-media thickness.

Results: Treatment evaluations were performed on intention-to-treat. All participants took >96% of prescribed capsules. OLE supplementation was associated with a 15% improvement in insulin sensitivity (p=0.024) compared to placebo. There was also a 28% improvement in pancreatic β-cell responsiveness (p=0.013). OLE supplementation also led to increased fasting interleukin-6 (p=0.014), IGFBP-1 (p=0.024), and IGFBP-2 (p=0.015) concentrations. There were however, no effects on interleukin-8, TNF-α, ultra-sensitive CRP, lipid profile, ambulatory blood pressure, body composition, carotid intima media thickness, or liver function.

Conclusions: Supplementation with olive leaf polyphenols for 12 weeks significantly improved insulin sensitivity and pancreatic β-cell secretory capacity in overweight middle-aged men at risk of developing the metabolic syndrome. The observed effect in this population was comparable to mainstream therapeutics (such as metformin).

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EVOLUTIONARY MEDICINE PROVIDES A CONCEPTUAL FRAMEWORK FOR COMPLEMENTARY MEDICINE IN SUSTAINABLE GLOBAL HEALTHCAREDonohoe MJ

Contributing Medical Editor, Blackmores Institute Sydney

Background: Western scientific medicine has transformed disease and trauma management through a successful mechanistic model based on diagnosis and intervention. The immediate gains for the treated individual (i.e survival and recovery) needs to be weighed against harms that are:

• delayed or trans-generational (e.g. diethylstilbestrol causing cancer); • unanticipated (e.g. thalidomide causing birth limb defects);• a consequence of over-use or misuse (e.g. antibiotics causing bacterial resistance);• subtle but important defects with long-term use (e.g. antihypertensives & zinc deficiency1); &• unsustainable or inequitably distributed (e.g. costs, patents)

The dominant current medical model lacks a foundation in evolutionary biology, including undergraduate education2. Evolutionary fitness has become divorced from biological fitness for humans. The focus has been on the pathological process and hostile microbes rather than host health and resilience. The metaphor of “war” on perceived enemies of health (cancer, obesity, HIV/AIDS) has failed to achieve its goals3,4.

Evolutionary Medicine, a subset of Evolutionary Biology, is a potent alternative framework through which to view disease, and provides new ways of conceptualising health and disease and promises new, potentially sustainable treatment approaches that have much in common with traditional and complementary medicine.

An in-depth example of Pelargonium sidoides extract (EPs 7630) is presented for treatment of sinusitis and bronchitis. It has almost no direct antibacterial or antiviral action, yet multiple RCTs have shown it to halve the duration and severity of both conditions.

The multiple mechanisms of action of this herbal extract include:“defensin” release from neutrophils, cytoprotection against virus-induced cell destruction, inhibition of bacterial epithelial adhesion, stimulation of ciliary beat frequency, upregulation of NO synthase.

The author proposes a return to physics, chemistry and evolutionary biology as a way of achieving sustainable host improvement, and identifies research methodologies to assess Complementary Medicine approaches in the Evolutionary Medicine framework.

References:

1. Braun LA, Rosenfeldt F. Pharmaco‐nutrient interactions – a systematic review of zinc and antihypertensive therapy. Int J Clin Pract. 2012 Dec 26. doi: 10.1111/ijcp.12040. [Epub ahead of print]

2. Antolin, M. F., Jenkins, K. P., Bergstrom, C. T., Crespi, B. J., De, S., Hancock, A., Hanley, K. A., Meagher, T. R., Moreno‐Estrada, A., Nesse, R. M., Omenn, G. S. and Stearns, S. C. (2012), Evolution and medicine in undergraduate education: a prescription for all biology students. Evolution, 66: 1991–2006. doi: 10.1111/j.1558‐5646.2011.01552.x

3. Gluckman PD, Hanson M, Zimmet P, Forrester T. Losing the war against obesity: the need for a developmental perspective. Sci Transl Med. 2011;3:93cm19

4. Greenwald P. A favorable view: progress in cancer prevention and screening. Recent Results Cancer Res. 2007;174:3‐17

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CAN OBESITY BE RELATED TO MATERNAL DIET IN PREGNANCY? A CASE STUDY AND DISCUSSION OF EPIGENETIC AND TRANS‐GENERATIONAL CONTRIBUTIONS TO THE OBESITY EPIDEMICFerguson, Dr. W. MBChB, BHB, Dip Obs, FRNZCGP.

Kumeu Medical Centre, Auckland, New Zealand.

Quality of maternal diet in pregnancy may be paramount to the health of subsequent generations. Maternal physiology and biochemistry, and anything that influences it, can potentially be transfused via epigenetic mechanisms into lifelong patterns of gene expression, and consequent risk for subsequent metabolic disease.1,2 It now appears, from both animal and human studies, that the macronutrients in a pregnant woman’s diet can influence the incidence of obesity in the later life of her offspring.3,4

This paper will present the outcome of a 23 year case study. The study followed the three offspring of a patient who stringently controlled her diet during pregnancy with regard to its protein and carbohydrate components. In her first pregnancy the patient consumed a relatively high carbohydrate diet, and in the subsequent two pregnancies a relatively lower carbohydrate and higher protein intake. One of her offspring was to develop unexplained obesity in her teens, despite sharing the same diet, lifestyle, environment, and genome with her siblings.

There is evidence of epigenetic influence relevant to obesity across a range of molecular targets related to adipose tissue development, carbohydrate and fatty acid metabolism, insulin receptor function, glucocorticoid receptor function, and hypothalamic function. With regard to obesity the carbohydrate-protein axis seems to be an important modulator of this process; however the limited research to date on the relative role of protein and carbohydrate in programming adult obesity via epigenetic mechanisms seems to be pointing in two opposite directions.

Definitive human studies to answer this question may be impossible to perform for ethical reasons, let alone the difficulties of achieving rigorous compliance with a specific dietary pattern throughout pregnancy. Before recommendations can be made, more research is needed into the apparent conundrum of high versus low carbohydrate and high versus low protein in the maternal diet as inducers of subsequent obesity in humans. This unique case history concerning an obese patient and her family demonstrates a pattern that could be consistent with the emerging research

References:

1. Gluckman PD., Hanson MA., Cooper. C., Mechanisms of Disease: Effect of in utero and early‐life conditions on adult health and disease. The New England Journal of Medicine 359(1):61‐73, 2008; doi: 10.1056/NEJMra0708473

2. Godfrey KM., Lillycrop KA., Burdge G C., Gluckman P D., & Hanson MA. Epigenetic Mechanisms and the Mismatch Concept of the Developmental Origins of Health and Disease. Paediatr Res 61(5):5R‐10R, 2007; doi: 10.1203/pdr.0b013e318045bedb

3. Lillycrop KA, Burdge GC. Epigenetic changes in early life and future risk of obesity. International Journal of Obesity 35:72‐83, 2011; doi: 10.1038/ijo.2010.122

4. Taylor PD, Poston L. Developmental programming of obesity in mammals. Exp Physiol 92(2):287‐98, 2007; doi: 10.1113/expphysiol.2005.032854

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THE INTESTINAL MICROBIAL ECOLOGY OF PATIENTS WITH CD AND POTENTIAL EARLY CHILDHOOD AETIOLOGICAL FACTORSHarnett J, Gruner T, Myers S, Rolfe M

School of Health and Human Sciences, Southern Cross University Lismore New South Wales Australia

Background: Coeliac disease (CD) is a complex interplay between host genetics, immune system and diet affecting an estimated 1% of the Australian population. Approximately 30% of the general population carry the human lymphocyte antigen (HLA) genotyping for CD, however not all HLA DQ2 or DQ8 positive individuals will develop CD in response to gluten ingestion. This suggests an additional aetiological factor in triggering the aberrant immune response observed in CD. The microbial cells of the human microbiome supersede the number of cells of the human genome by a factor of 10. The majority of these microbial cells reside in the intestinal tract. The ability of the immune system to co-evolve with the microbiota during postnatal life allows the host and microbiota to coexist in a mutually beneficial relationship. Failure to achieve or maintain equilibrium between a host and its microbiota has negative consequences for both intestinal and systemic health.

Methods and Materials: The luminal contents of 45 patients with treated CD were compared to 28 non-Coeliac individuals employing polymerase chain reaction DNA methodology. Data regarding childhood influences on the intestinal microbiome was also obtained from the CD group (birth method, feeding practices and antibiotic use) and compared to the general Australian population.

Results: Significantly higher numbers of Bifidobacteria (p=0.005), Prevotella (p=0.003) and Clostrida sp. (p=0.003) and an overall higher number of total predominant bacteria (p=0.001) were observed in the Coeliac group. In addition, Candida sp and Saccharomyces sp. were detected in 33% of the CD group and none of the non-coeliac controls (p=.000). CD individuals had a shorter duration of breastfeeding and a higher frequency of use of antibiotics in early infancy than the general population (p=<0.05).

Conclusion: The differences observed in the intestinal microbiome of patients with CD and the early infancy factors influencing the intestinal microbiome warrant further investigation.

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NUTRITIONAL MANAGEMENT FOR ATTENTION-DEFICIT/HYPERACTIVITY DISORDERFay Karpouzis BSc, Grad DC, DO, MSc (Hons)

Increasing prevalence rates of pediatric and adolescent attention-deficit/hyperactivity disorder (ADHD), concerns over the safety and efficacy of psychostimulants, and fears about long-term use of psychostimulants have led many parents to seek alternative therapies for their children. Numerous environmental factors have been suspected of influencing ADHD. Over the last few decades, there has been an increasing awareness of the importance of nutrition and the potential role it has on influencing ADHD and ADHD symptomatology.

This article focuses on nutrition, dietary modifications, and nutraceuticals, which are the most commonly used complementary and alternative medicine (CAM) therapies for the management of pediatric and adolescent ADHD. The aim is to present a narrative literature review for dietary modifications and nutritional supplementation for pediatric and adolescent ADHD.

Searches were made in full-text English language articles from 2000 to February 2012

in the PubMed Central, Medline, Cochrane Library, Psych INFO, Scopus, and CINAHL databases. The review revealed a full range of research strategies, but this article concentrates on randomized controlled trials, observational studies, longitudinal studies, epidemiological studies, surveys, qualitative reviews, narrative reviews, systematic reviews, and meta-analyses. The literature reveals a mixture of results in respect to dietary modifications and nutritional supplementation for children and adolescents with ADHD; however, the future of nutritional research appears promising.

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CUMULATIVE HISTAMINE IN PSYCHOSIS AND SPRING MANIA, SUM OF INSIDIOUS POLLEN, FOOD ALLERGY AND/OR PATHOGENIC PARASITESLee KS1

1 unaffiliated, Perth, Australia

Introduction: Histamine is well-documented as having a role in psychosis, especially in early literature, and both antipsychotic and antidepressant medications have antihistamine effects, however the source is not routinely identified during psychiatric hospital admissions. Testing is inexpensive and could simplify and personalise treatment options.

Background: Histamine generating pathogenic parasites and a springtime tendency were identified as repeating physical patterns in an individual with a history of psychosis requiring hospitalisation on five separate occasions over an eighteen year period.

Methods: Extensive literature review, a multidisciplinary approach, blood and stool tests, immunology services, data interrogation and interpretation were used to develop a theory of cumulative histamine in psychosis suitable for practical application in a hospital environment.

Results: Initial IgE following the fifth episode was high (328 kIU/L, ref range <20). Stool testing revealed the parasite Blastocystis sp. Immunology using blood radioallergosorbent test (RAST) methods showed ‘very high’ grass pollen mix allergies (28.80 kIU/L) without other obvious symptoms, and ‘high’ tree and weed pollen mixes (7.01 and 9.06 kIU/L respectively). Extensive RAST testing for food allergens showed ‘high’ allergies to all grains, nuts and some fruit and vegetables. Back testing from previous admission data showed eosinophilia (eosinophils above 0.45 nL) on two earlier admissions (0.5 and 0.74 nL respectively) where data were available indicating an allergic response and/or parasitosis at the time of psychosis.

Conclusion: Investigative medicine including detailed physical assessment and attention in evaluating blood results on admission may lead to more personalised treatment options, reduce trauma and help demystify these types of psychosis/seasonal mania through inexpensively identifying physical sources of cumulative histamine.

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EFFECTS OF PROTEIN ENERGY SUPPLEMENTATION DURING PREGNANCY ON FETAL GROWTH: A REVIEW OF THE LITERATURE FOCUSING ON CONTEXTUAL FACTORSLiberato, SC1, Singh, G1,2, Mulholland, K1,3

1 Menzies School of Health Research, Charles Darwin University, Darwin, Australia, 2 Northern Territory Medical Program, Flinders University, Adelaide, Australia 3 Departments of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK.

Background: a major problem throughout the developing world is low birth weight (LBW) which is influenced by maternal diet during pregnancy. The outcomes for the infants are worse when fetal growth restriction (FGR) rather than prematurity. The aim of this review was to describe the studies examining the effects of protein energy supplementation during pregnancy on fetal growth focusing on the contextual differences.

Methods: Relevant published articles were identified through systematic electronic searches of the PubMed, Science Direct database and EBSCO database and the examination of the bibliographies of retrieved articles. Data of effectiveness and practical aspects of protein energy supplementation during pregnancy were extracted and compiled.

Results: Positive outcomes in infants and women cannot be expected if the supplementation is not needed. Therefore it is essential to correctly select women who will benefit from dietary intervention programs during pregnancy. However, there is currently no consensus on the most effective method of identifying these women. The content of protein in the supplements considering total diet is also an important determinant of fetal growth. Balanced protein energy supplementation (containing up to 20% of energy as protein) given to pregnant women with energy or protein deficit appears to improve fetal growth and increases birth weights. Supplements with excess protein provided to women with a diet already containing adequate protein may conversely impair fetal growth. There is also no consensus on the best time to start supplementation.

Conclusions: Balanced protein energy supplementation given to pregnant women with energy or protein deficit appears to improve fetal growth and increases birth weights. Strong quality studies examining adequate criteria to screen women who would benefit from supplementation, time to start supplementation and type of supplements are warranted.

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DNA DAMAGE AND AUTISMMain PAE1,2, King C1, Thomas P2, Angley M1, Esterman A1, Young R3 and Fenech MF2.

1 University of South Australia2 CSIRO Food and Nutritional Sciences3 Flinders University of South Australia

Background: Abnormal plasma levels of metabolites in the folate-dependent methionine and glutathione metabolism pathways have been reported in children with autistic disorder compared to age-matched controls. Cytogenetic alterations in peripheral blood lymphocytes and/or buccal cells have been reported in a range of neurologic conditions. It was hypothesised that children with autistic disorder may have increased levels of DNA damage compared to their non-autistic siblings or community controls.

Method: DNA damage bio-markers as measured by the cytokinesis blocked micronucleus assay and plasma levels of B vitamins and homocysteine were measured in 35 children with autistic disorder, 27 non-autistic siblings and 25 age and gender matched community controls and linked with psychometric measures.

Results: There was no significant difference in DNA damage bio-markers between children with autism, their non-autistic siblings and community controls suggesting that autistic disorder is not associated with a genetic susceptibility towards DNA damage induced by endogenous toxins and/or poor nutrition or lifestyle.

Lymphocyte proliferation ex vivo was significantly reduced in children with autism and their siblings compared to community controls suggesting that autism is associated with impaired cellular proliferation which in turn was correlated with folate status. Plasma riboflavin was found to be significantly increased in cases and siblings which may reflect either a defect in cellular uptake of riboflavin or increased dietary intake or both. There was no association between either reduced cellular proliferation or increased plasma riboflavin and autism severity.

Conclusions: Unlike some neurologic disorders, there appears to be no link between DNA damage and autistic disorder. The role of riboflavin in the aetiology of autism requires further investigation.

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IS THERE A LINK BETWEEN MATERNAL FOLATE INTAKE OR FOLATE METABOLISM GENES AND THE RISK OF AUTISM? A SYSTEMATIC REVIEWMain PAE1,2

1 Sansom Institute of Health Research, University of South Australia, Adelaide, Australia 2 Food and Nutritional Sciences, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia

Introduction: Autism is a heterogeneous neurodevelopmental condition characterised by impairments in reciprocal social interaction and communication. The underlying brain injury leading to autism has been difficult to identify.

The induction of autism by thalidomide exposure suggests that it originates from an injury at the time of closure of the neural tube. As the prevalence of autism diagnosis increased around the same time as the introduction of recommendations for periconceptual folate supplementation, it was hypothesised that there may be a link between periconceptual folate supplementation and increased risk of developing autism. The aim of our systematic review aims to examine the evidence for such an association.

Method: A systematic literature review conducted of studies examining periconceptual folate intake and/or genes of folate pathways in autism spectrum disorders was conducted in 2009 and updated in May 2012.

Results: Of the eighteen papers obtained, three papers hypothesised a link between periconceptual folate intake and autism, fourteen included genetic data pertaining to folate metabolism and two reported findings for risk of periconceptional folate intake and risk of autism. The latter provided evidence that mothers of children with autism were significantly less likely than those of typically developing children to have taken prenatal vitamins in the three months before pregnancy or one month after conception. Risk of the child developing autism was strongest for mothers and children with MTHFR 677 C>T variant genotypes. (MTHFR is a key enzyme involved in folate metabolism. The enzyme only has 30% activity in people who have a double mutation at MTHFR 677 C<T).

Conclusions: Evidence for the involvement of periconceptional folate intake and folate metabolism genes in autism spectrum disorders is sufficiently consistent to warrant further investigation in order to determine the significance in relation to clinical outcomes.

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NECROSIS IS INCREASED IN LYMPHOBLASTOID CELL LINES FROM CHILDREN WITH AUTISM COMPARED TO THEIR NON‐AUTISTIC SIBLINGS UNDER CONDITIONS OF OXIDATIVE AND NITROSATIVE STRESSMain Penelope AE1,2, Thomas Philip2, Esterman Adrian3 and Fenech Michael F2

1 Sansom Institute of Health Research, University of South Australia, Adelaide, Australia 2 Commonwealth Scientific and Industrial Research Organisation, Animal, Food and Health Sciences, Adelaide, Australia3 School of Nursing and Midwifery, University of South Australia, Adelaide SA

Introduction: Autism spectrum disorders are a heterogeneous group of neurodevelopmental conditions characterised by impairments in reciprocal social interaction, communication and stereotyped behaviours. As increased DNA damage events have been observed in a range of other neurological disorders, it was hypothesised they would be elevated in lymphoblastoid cell lines (LCL) obtained from children with autism compared to their non-autistic siblings.

Method: Six case-sibling pairs of LCL from children with autistic disorder and their non-autistic siblings were obtained from the Autism Genetic Resource Exchange (AGRE) and cultured in standard RPMI-1640 tissue culture medium. Cells were exposed to medium containing either: 0, 25, 50, 100 and 200 µM hydrogen peroxide (an oxidative stressor) or 0, 5, 10, 20 and 40 µM s-nitroprusside (a nitric oxide producer) for 1 hour. Following exposure, the cells were microscopically scored for DNA damage, cytostasis and cytotoxicity biomarkers as measured using the cytokinesis block micronucleus cytome assay.

Results: Necrosis was significantly increased in cases relative to controls when exposed to oxidative and nitrosative stress (p=0.001 and 0.01 respectively). Nuclear division index was significantly lower in LCL from children with autistic disorder than their non-autistic siblings when exposed to hydrogen peroxide (p=0.016) but there was no difference in apoptosis, micronucleus frequency, nucleoplasmic bridges or nuclear buds. Exposure to s-nitroprusside significantly increased the number of micronuclei in non-autistic siblings compared to cases (p=0.003), however, other DNA damage biomarkers, apoptosis and nuclear division did not differ significantly between groups.

Conclusion: The findings of this study show i) that LCLs from children with autism are more sensitive to necrosis under conditions of oxidative and nitrosative stress than their non-autistic siblings, and ii) refutes the hypothesis that children with autistic disorder are abnormally susceptible to DNA damage.

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THE ROLE OF DIET IN LIFESTYLE DISEASES: A STUDY OF ACNE AND DIET IN TEENAGERSMann NJ

School of Applied Sciences, RMIT University, Melbourne, Australia.

Background: With the advent of agriculture and subsequent development of food processing techniques, the human diet has changed significantly in composition from the food intake patterns that our ancestors experienced over several million years of evolutionary development1. These relatively recent changes in food types and form are proposed to be the underlying cause of many modern lifestyle diseases2. In the case of acne vulgaris for instance it has been reported that occurrence is only detected in hunter-gather societies once a western diet is adopted3. Chronic glycaemic elevation by continuous consumption of refined carbohydrate foods leading to hyperinsulinemia has been implicated in acne pathophysiology4. Low glycaemic load (LGL) diets typical of unacculturated societies may play a dual role in the prevention of hyperinsulinemia by decreasing circulating insulin levels directly and improving insulin sensitivity.

Aim: To compare the effect of a LGL diet with high glycemic load habitual diets on the severity of acne symptoms and endocrine variables associated with insulin resistance.

Materials and methods: 43 male acne sufferers were randomized to either a LGL diet or control diet for a period of 12-weeks and facial acne was assessed every four weeks by a dermatology specialist masked to group identity. Venous blood was collected at baseline and 12-weeks for assessments of insulin sensitivity, testosterone, sex hormone binding globulin, free androgen index (FAI), dehydroepiandrosterone sulfate (DHEA-S), insulin-like growth factor (IGF)-I and IGF-binding proteins.

Results: A significantly greater percentage reduction in total lesion count was observed in the LGL group compared with the control group as well as reductions in FAI, and an increase in IGFBP-1 and insulin sensitivity, when compared to the control group5.

Conclusion: This suggests that a LGL diet may reduce skin androgenic activity and oppose the growth promoting effects of IGF-I by increasing levels of its binding protein, IGFBP-1.

References:

1. Eaton SB, Eaton SB 3rd, Konner MJ (1997). Paleolithic nutrition revisited: a twelve‐year retrospective on its nature and implications. Eur J Clin Nutr, 51(4): 207‐16.

2. Cordain L, Eaton SB, Brand‐Miller J, Mann NJ, Sebastian A, Lindeberg S and O’Keefe JA (2005). Origins and evolution of the Western diet: Health implications for the 21st century. Am J Clin Nutr, 81: 341‐354.

3. Schaefer O (1971). When the Eskimo comes to town. Nutr Today, 6: 8‐16.

4. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton B, Brand‐Miller B. (2002). Acne Vulgaris ‐ A disease of Western civilization. Arch Dermatol, 138:1584‐1590.

5. Smith R, Mann NJ, Braue, A, Mäkeläinen H and Varigos G (2007). A low glycemic load diet improves symptoms in acne vulgaris patients. A randomized controlled trial. Am J of Clin Nutr, 86: 107‐115.

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IS GINGER SUPPLEMENTATION EFFECTIVE IN AMELIORATING CHEMOTHERAPY‐INDUCED NAUSEA AND VOMITING? Marx,W.1,2 Ried, K.2 Sali, A.2 Teleni, L.3 McCarthy, A.4 Vitetta, L.5 McKavanagh, D.6 Thomson, D.7 Isenring, E.1,3

1 Centre for Dietetics Research, University of Queensland, Brisbane, Australia.2 National Institute of Integrative Medicine, Melbourne, Australia.3 Department of Nutrition and Dietetics, Princess Alexandra Hospital, Queensland Health, Brisbane, Australia.4 School of Nursing, Queensland University of Technology and Cancer Services Southern Clinical Network, Queensland Health, Brisbane, Australia.5 School of Medicine, Centre for Integrative Clinical and Molecular Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia. 6 Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia. 7 The Cancer Collaborative Group, Princess Alexandra Hospital, Brisbane, Australia.

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common side-effect of cytotoxic treatment. It continues to affect a significant proportion of patients despite the widespread use of anti-emetic medication. In folk-medicine, ginger (Zingiber officinale) has been used to prevent and treat nausea in many cultures for thousands of years. To determine the potential use of ginger as a prophylactic or treatment of CINV, a systematic literature review was conducted.

Methods: The studies reviewed were comprised of randomised controlled trials or cross-over trials that investigated the anti-CINV effect of ginger as the sole intervention in chemotherapy patients.

Discussion: Seven studies met the inclusion criteria. Of the seven RCTs published to date five reported favourable results. Of these, three studies found ginger reduced either acute nausea only or both acute and delayed nausea and vomiting when combined with the standard anti-CINV treatment1-3. The two remaining studies found ginger reduced either acute or delayed nausea and vomiting equal to metoclopramide4,5. However, limitations such as the use of unstandardized ginger extracts and the lack of control for anticipatory nausea, were identified within the literature which reduce the clinical significance of these findings.

Conclusion: In conclusion, while there exists multiple supportive studies for its use, the considerable limitations in the methodology employed in some studies present genuine uncertainty about its efficacy in the chemotherapy setting and future trials are therefore required to resolve these uncertainties. This review provides recommendations for future research which have been incorporated into a RCT that we are currently conducting. In particular, issues regarding the inconsistent use of rigorous blinding procedures, patient screening, validated tools to assess CINV, and standardised ginger preparations have been addressed in our trial and should be considered for future research in this area. Until these trials have been conducted, professional opinion will be required when choosing ginger as a treatment option.

References:

1. Panahi Y, Saadat A, Sahebkar A, Hashemian F, Taghikhani M, Abolhasani E. Effect of Ginger on Acute and Delayed Chemotherapy‐Induced Nausea and Vomiting: A Pilot, Randomized, Open‐Label Clinical Trial. Integr Cancer Ther. Feb 7 2012.

2. Pillai AK, Sharma KK, Gupta YK, Bakhshi S. Anti‐emetic effect of ginger powder versus placebo as an add‐on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatr Blood Cancer. Feb 2011;56(2):234‐238.

3. Ryan JL, Heckler CE, Roscoe JA, et al. Ginger (Zingiber officinale) reduces acute chemotherapy‐induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. Aug 5 2011.

4. Manusirivithaya S, Sripramote M, Tangjitgamol S, et al. Antiemetic effect of ginger in gynecologic oncology patients receiving cisplatin. Int J Gynecol Cancer. Nov‐Dec 2004;14(6):1063‐1069.

5. Sontakke S, Thawani V, Naik MS. Ginger as an antiemetic in nausea and vomiting induced by chemotherapy: A randomized, cross‐over, double blind study. Indian J. Pharmacol. 2003;35(1):5.

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WHAT’S IN MY WEE? REDUCING URINARY PESTICIDES USING AN ORGANIC DIETOates L1, Cohen M1, Braun L2

1 School of Health Science (Wellness Group), RMIT University, Melbourne, Australia2 Centre of Ethics in Medicine and Society, Department of Medicine, Monash University; Pharmacy Department, The Alfred Hospital, Melbourne, Australia

Organophosphate pesticides are widely used in food production and have been associated with negative effects on human health1,2. Sales of organic food are on the increase with consumers believing that organic food is healthier to eat than conventionally grown food because it contains fewer pesticide residues3. While studies have confirmed that organic diets reduce pesticide exposure in children, exposure in adults is likely to be different as children are more highly exposed to pesticides because of their body weight and less efficient metabolism4,5. We conducted a prospective, crossover study to assess organophosphate exposure in a group of thirteen Australian adults following a seven day period on a largely organic diet compared to seven days on a largely conventional diet. Participants kept food diaries to ensure that a minimum of 80% of their food servings were organic or conventional during each phase. Urinary levels of six dialkylphosphate metabolites were analysed in first-morning voids collected on day 8 of each phase using GC-MS/MS. Limits of detection were 0.11-0.51 μg/L and results were creatinine corrected to account for the effects of urine dilution or concentration in spot samples. The mean total DAP results in the conventional phase were around nine times higher than in the organic phase (M=.294 and .032 respectively, p=.013). For total dimethyl DAPs there was more than a 23-fold difference (M=.252 and .011 respectively, p=.005). Although the mean total diethyl DAP levels were around double in the conventional compared to the organic phase (M=.042 and .021 respectively), the difference was not statistically significant. The most frequently detected metabolites were DMTP and DEP. Overall the consumption of organic food resulted in a statistically significant reduction in dimethyl DAPs and thus reduced exposure to organophosphate pesticides. However, future large scale studies are required to confirm these results and determine their clinical relevance.

References:

1. Ross SM, McManus IC, Harrison V, Mason O. Neurobehavioral problems following low‐level exposure to organophosphate pesticides: a systematic and meta‐analytic review. Critical Reviews in Toxicology 2013;43(1):21‐44.

2. Sanborn M, Bassil K, Vakil C, Kerr K, Ragan K. 2012 Systematic Review of Pesticide Human Health Effects: Ontario College of General Physicians, 2012: <http://www.beyondpesticides.org/lawn/activist/documents/2012‐systematic‐review‐of‐pesticide.pdf>.

3. Oates L, Cohen M, Braun L. Characteristics and consumption patterns of Australian organic consumers. Journal of the Science of Food and Agriculture 2012;92(14):2782‐7.

4. Curl C, Fenske R, Elgethun K. Organophosphorus pesticide exposure of urban and suburban preschool children with organic and conventional diets. Environ Health Perspect 2003;111(3):377‐82.

5. Lu C, Toepel K, Irish R, Fenske RA, Barr DB, Bravo R. Organic diets significantly lower children’s dietary exposure to organophosphorus pesticides. Environ Health Perspect 2006;114(2):260‐3.

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IN VITRO NEUROPROTECTIVE POTENTIAL OF OLIVE BIOPHENOLSOmar S H1,2, Scott CJ1,2, Hamlin A1, Obied HK1,2

1 School of Biomedical Sciences, Faculty of Sciences and 2E.H. Graham Centre for Agricultural Innovation, Charles \ Sturt University, Wagga Wagga, Australia

Olive (Olea europaea) fruit, leaves and extra virgin oil serve as good sources of biophenols and show versatile pharmacological activities, largely attributed to their antioxidant and free radical-scavenging activity1. However, the antioxidant mechanism alone cannot explain the diversity and potency of biophenols in combating diseases and maintaining health. Growing body of evidence from epidemiological, animal and clinical studies suggests that these compounds may maintain the integrity of the nervous system and protect neurons from assaults. Hence, they can play a pivotal role in prevention and treatment of neurodegenerative disorders such as Alzheimer’s Disease (AD) and Parkinson’s disease (PD). To address this, we investigated the effect of these biophenols on the activity of key enzymes implicated in these disorders; acetylcholine esterase and tyrosinase enzymes. Inhibition of acetylcholinesterase increases acetyl choline levels, an important neurotransmitter for learning and memory, and is one of the key mechanisms of treating AD. Tyrosinase can contribute to dopamine neurotoxicity and neurodegeneration associated with PD and the tyrosine phosphorylation of tau protein in AD2. Acetylcholinesterase and tyrosinase were incubated in presence of their substrates with varying concentrations of olive biophenols (oleuropein, caffeic acid, hydroxytyrosol, verbascoside and quercetin), or commercial olive extracts; and the reactions were monitored spectrophotometrically to calculate IC50. Quercetin (IC50: 63.3 μM), luteolin (IC50: 113.33 μM) along with 4 different olive commercial extracts all showed marked inhibition of acetylcholinestrase activity. On the other hand, only quercetin (IC50:9.42 μM) showed dose-dependent inhibition of tyrosinase activity. Olive biophenols and olive extracts showed marked binding to copper in tyrosinase and behaved as substrates for the enzyme. Flavonoid showed higher activity than the non-flavonoid compounds. Moreover, olive extracts showed good inhibition potency against acetylcholinesterase. Quercetin, rutin or olive extracts might have therapeutic potential for the treatment of AD.

References:

1. Hassan K. Obied, Paul D. Prenzler, Syed H. Omar et al. Chapter Six ‐ Pharmacology of Olive Biophenols. In: James CF (Eds.) Advances in Molecular Toxicology. 2012; volume 6. pp 195‐242: Elsevier.

2. Bhaskar, K., Hobbs, G. A., Yen, S. H., & Lee, G. (2010). Tyrosine phosphorylation of tau accompanies disease progression in transgenic mouse models of tauopathy. Neuropathol Appl Neurobiol, 36(6), 462‐477.

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GUT MICROBIOTA AND METABOLIC SYNDROME: HOW A MULTI‐STRAIN PROBIOTIC MAY INFLUENCE BIOMARKERS IN OBESE ADOLESCENTSPalacios T1, Coulson S1, Butt H2, Leong G3, Dahiya R3, Vitetta L.1

1 School of Medicine, Centre for Integrative Clinical and Molecular Medicine, Translational Research Institute, The University of Queensland2 Bioscreen at Bio21 Molecular Science & Biotechnology Institute, Melbourne3 School of Medicine, Obesity Research Centre, Institute for Molecular Bioscience, The University of Queensland, Australia

Aim: To investigate the therapeutic role of a multi-strain probiotic formula with lifestyle intervention on biological markers related with inflammation and metabolic syndrome (MetS) in obese adolescents.

Introduction: The gastrointestinal tract (GIT) microbiota is gaining significant research interest in relation to obesity-related disorders in an attempt to better understand the aetiology of these diseases. Recent findings suggest that the GIT microbiota may promote metabolic diseases by energy harvesting which promotes absorption, energy extraction and adipocyte fatty acid storage1; and over–consumption of calories that then may trigger GIT pro-inflammatory bacterial activity with a propensity toward the development of obesity and insulin resistance2. There are a limited number of epidemiological investigations of the GIT microbiome in relation to paediatric obesity and only one clinical study assessing efficacy of a single-strain probiotic on biochemical and inflammatory markers associated with MetS in adolescents. However, no significant outcomes of the probiotic intervention were found3. The efficacy of a multi-strain probiotic preparation containing evidence-based bacterial species in relation to obesity has not yet been conducted in adolescents with MetS.

Methodology: A randomised, double-blind, placebo-controlled study will recruit 50 obese adolescents (male and female, 10-16 years) diagnosed with MetS. They will be randomised to a novel multi-strain probiotic or placebo for 6 months with 3 months follow-up, with both groups receiving standard care (lifestyle and nutritional advice). Outcome measures will include but not exclusive to oral glucose tolerance test with insulin, fat mass (DEXA), serum lipids, adiponectin, inflammatory cytokines and markers, sex hormones, GIT permeability, faecal microbial profiles and short chain fatty acids.

Discussion: Research suggests that intentional manipulation of GIT microbial profiles may be useful for regulating inflammation and energy balance in obese individuals4. This could be achieved through the introduction of lifestyle modifications that are aimed to improve symptoms related to MetS in children and adolescents with the adjuvant use of a multi–strain probiotic supplement, using evidenced-based bacterial strains.

References

1. Backhed F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage. PNAS 2004; 101:15718‐15723.

2. Ding S, Lund PK. Role of intestinal inflammation as an early event in obesity and insulin resistance. Curr Opin Clin Nutr 2011;14:328–333.

3. Gøbel RJ, Larsen N, Jakobsen M, Mølgaard C, Michaelsen KF. Probiotics to obese adolescents; RCT examining the effects on inflammation and metabolic syndrome. Journal of Pediatric Gastroenterology and Nutrition 2012; 55: 673–678.

4. Ley RE, Bäckhed F, Turnbaugh P, et al. Obesity alters gut microbial ecology. PNAS 2005;102(31):11070‐11075.

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ALGAL‐DERIVED LONG CHAIN OMEGA‐3 FATTY ACIDS: BIOAVAILABILITY AND EFFECTS ON BRAIN AND HEALTHPipingas, A.

Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia

Population studies have shown that diets rich in EPA and DHA derived from fish are associated with reduced risk of cardiovascular disease and mental disorders1. A large number of clinical trials have also been conducted to investigate the effects of supplementation with EPA and DHA derived from fish oil on cardiovascular and cognitive functioning. These studies vary greatly in experimental methodologies including dosage, the ratio of EPA and DHA, duration of supplementation, the sample studied and the blood assays and endpoints assessed. Overall these findings have been positive for cardiovascular health with the Australian Heart Foundation making specific recommendations for regular inclusion of fish and fish oil supplements in the diet. With regard to mental health, the findings have been varied with more positive findings in children, effects on depression and mental disorders and in more vulnerable groups. The more recent application of neuroimaging methodologies has also provided the potential for more direct and more sensitive indicators of brain functional changes following supplementation with different fish oil diets2.

There is a smaller but rapidly growing literature assessing the effects of algal-derived long chain omega-3s. These are sourced from various species of microalgae and have been used to fortify foods such as infant formulas and they provide an alternative source of omega-3s for vegetarian and vegan diets.

The presentation will include a brief overview of studies examining the bioavailability of algal-derived omega-3s in relation to eating fish and supplementing with fish oils. There have also been a number of clinical trials investigating effects on triglyceride levels and cardiovascular functioning3, as well as cognitive functioning across the lifespan with a focus in childhood cognition and behaviour4 as well as age-related cognitive decline5.

The studies reviewed indicate that algal-derived long chain omega-3 supplements provide similar bioavailability profiles to fish and fish oil supplements and have the potential for similar health outcomes.

References:

1. Hibbeln et al. (2006). Healthy intakes of n‐3 and n‐6 fatty acids: estimations considering worldwide diversity. American Journal of Clinical Nutrition. 83(suppl) 1483S‐93S.

2. Bauer et al. (2011).Omega‐3 fatty acids modifiy human cortical visual processing: A double‐blind cross‐over study. Plos ONE. 6(12) e28214

3. Ryan et al. (2009). Clinical overview of algal‐Docosahexaenoic acid: Effects on Triglyceride levels and other cardiovascular factors. American Journal of Therapautics. 16; 183‐192

4. McNamara et al. (2012). Docosahexanoic acid supplementation increases prefrontal cortex activation during sustained attention in healthy boys: a placebo‐controlled, dose‐ranging, functional magnetic resonance imaging study. American Journal of Clinical Nutrition. 91:1060‐7.

5. Yurko‐Mauro et al. (2010). Beneficial effects of Docohexaenoic acid on cognition in age‐related cognitive decline. Alzheimer’s and Dementia. Nov 6(6): 456‐64

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AGED GARLIC EXTRACT LOWERS BLOOD PRESSURE IN HYPERTENSIVES: A DOSE RESPONSE TRIALRied K1,2,Frank O2, Stocks N2

1 National Institute of Integrative Medicine, Melbourne, Victoria, Australia2 Discipline of General Practice, The University of Adelaide, South Australia

Background: Hypertension affects about 30% of adults worldwide1,2. Garlic has blood pressure lowering properties and the mechanism of action is biologically plausible3,4. Our trial assessed the effect, dose-response, tolerability and acceptability of different doses of aged garlic extract as an adjunct treatment to existing antihypertensive medication in patients with uncontrolled hypertension.

Methods: A total of 79 general practice patients with uncontrolled systolic hypertension participated in a double-blind randomised placebo-controlled dose-response trial of 12 weeks. Participants were allocated to one of three garlic groups with either of one, two, or four capsules daily of aged garlic extract (240/480/960 mg containing 0.6/1.2/2.4 mg of S-allylcysteine) or placebo. Blood pressure was assessed at 4, 8 and 12 weeks and compared with baseline using a mixed model approach. Tolerability was monitored throughout the trial and acceptability was assessed at 12 weeks by questionnaire.

Discussion: Systolic blood pressure was significantly reduced by -11.8±5.4 mm Hg on average in the garlic-2-capsule group over 12 weeks compared with placebo (p=0.006), and reached borderline significant reduction in the garlic-4-group at 8 weeks (-7.4±4.1 mm Hg, p=0.07). Changes in systolic blood pressure in the garlic-1-capsule group and diastolic blood pressure were not significantly different to placebo. Tolerability, compliance, and acceptability were high in all garlic groups (93%) and highest in the groups taking one or two capsules daily.

Conclusions: Our trial suggests aged garlic extract to be an effective and tolerable treatment in uncontrolled hypertension, and may be considered as a safe adjunct treatment to conventional antihypertensive therapy5.

References

1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217‐23.

2. Martiniuk AL, Lee CM, Lawes CM, et al. Hypertension: its prevalence and population‐attributable fraction for mortality from cardiovascular disease in the Asia‐Pacific region. J Hypertens 2007;25:73‐9.

3. Al‐Qattan KK, Thomson M, Al‐Mutawa’a S, Al‐Hajeri D, Drobiova H, Ali M. Nitric oxide mediates the blood‐pressure lowering effect of garlic in the rat two‐kidney, one‐clip model of hypertension. J Nutr 2006;136:774S‐6S.

4. Benavides GA, Squadrito GL, Mills RW, et al. Hydrogen sulfide mediates the vasoactivity of garlic. Proc Natl Acad Sci U S A 2007;104:17977‐82.

5. Ried K, Frank OR, Stocks NP. Aged garlic extract reduces blood pressure in hypertensives: a dose‐response trial. Eur J Clin Nutr 2012, Epub 21 Nov.

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SYNBIOTICS: AN EMERGING TREATMENT FOR KIDNEY DISEASE?Rossi, M1, 2, 3, Klein, K4, Johnson, DW1, 3, Campbell, KL1, 2, 3

1 The University of Queensland, School of Medicine, Brisbane, Australia2 Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia3 Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia4 Queensland Clinical Trials & Biostatistics Centre, School of Population Health, University of Queensland, Brisbane, Australia

Objective: This systematic literature review assessed the effectiveness of pre-, pro- and synbiotics on reducing two protein-bound uremic toxins, p-cresyl sulphate (PCS) and indoxyl sulphate (IS).

Methods: Studies were included if they reported serum, urinary or fecal PCS and/or IS (or their precursors) as outcome measures in pre-, pro- or synbiotic interventions with more than one day duration, in English language and in human adults. Quality was determined using the GRADE approach. Intervention subgroups were assessed for differences in outcomes using meta analysis.

Results: 19 met the inclusion criteria, 14 in healthy adults and five in the haemodialysis population. Eight studies investigated prebiotics, six probiotics, one synbiotics, one both pre- and probiotics separately and three studies trialled all three interventions. The quality of the studies ranged from moderate to very low. From the 19 studies, 12 were included in the meta analyses with all four meta analyses reporting statistically significant reduction in IS and PCS with pre- and probiotic therapy.

Conclusion: This investigation demonstrates pre-, pro- and synbiotics hold great potential in lowering PCS and IS production in the chronic kidney disease (CKD) population, which may potentially translate into benefits to clinical outcome, such as reduction in cardiovascular markers and CKD progression. Unfortunately, there are a number of confounders that hinder the evaluation of this treatment. This highlighted the need for tight monitoring of dietary intake as well as appropriate selection of probiotic strains and prebiotic varieties. The increasing prevalence of CKD4 coupled with high mortality and morbidity rates5 and treatment costs presents a compelling and urgent need for further investigation into a cost effective nutrition-based treatment such as pre- and probiotics.

References:

1. Evenepoel, P., et al., Uremic toxins originating from colonic microbial metabolism. Kidney International, 2009. 76(S114): p. 12‐19.

2. Meijers, B.K.I. and P. Evenepoel, The gut‐kidney axis: indoxyl sulfate, p‐cresyl sulphate and CKD progression. Nephrology Dialysis Transplantation, 2011. 26(3): p. 759‐761.

3. Schepers, E., G. Glorieux, and R. Vanholder, The Gut: The Forgotten Organ in Uremia? Blood Purification, 2010. 29(2): p. 130‐136.

4. Excell L, McDonald S. (2008). Australian and New Zealand Dialysis and Transplant Registry Annual Report. ANZDATA. Retrieved March 20, 2011, from http://www.anzdata.org.au/anzdata/AnzdataReport/31stReport/Ch01StockandFlow.pdf

5. Li SQ, Cass A, Cunningham J. (2003). Cause of death in patients with end‐stage renal disease: assessing concordance of death certificates with registry reports. Aust N Z J Public Health, 27(4), 419‐424.

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INTERPRETATION AND PRACTICAL APPLICATION OF THE NEW AUSTRALIAN DIETARY GUIDELINES FOR EARLY CHILDHOOD SERVICESRozman M1, Watkins J1, Kempler J1

1 Nutrition Australia Victorian Division, Carlton, Victoria 3053, Australia

Supporting children’s nutrition needs in early childhood is crucial to long term health outcomes. To address this, the Healthy Together Victoria – Healthy Eating Advisory Service (HEAS) was established as part of the Victorian Healthy Together Communities strategy, to provide healthy eating advice for early childhood services, primary and secondary schools, hospitals and workplaces. One component of the HEAS includes supporting staff in long day care services to provide food and drink consistent with the nutrition needs of children. This is also an accreditation requirement of the National Quality Standard for early childhood services.

Since the release of the revised Australian Dietary Guidelines1 (draft 2011), current menu planning guidelines have not been available to support staff providing food for long day care services. To fill this gap, the HEAS has developed Menu planning guidelines for long day care2, which are consistent with the revised Australian Dietary Guidelines1 and the Australian Guide to Healthy Eating3..

A review of Australian literature and current programs targeting food provision in long day care was undertaken. The findings support the provision of at least half of children’s daily nutrition needs at morning and afternoon tea and lunch. The HEAS’s Menu planning guidelines3 reflect this and provide a framework for staff to create menus that are nutritionally sound, and promote food variety and cultural diversity.

Applying the Australian Dietary Guidelines was not easy. Challenges have included interpreting appropriate serving sizes for children and the practicalities associated with the amount of food required to meet children’s needs.

References:

1. Australian Dietary Guidelines (draft), National Health and Medical Research Council, 2011, www.eatforhealth.gov.au

2. Menu planning guidelines for long day care, Healthy Eating Advisory Service, Department of Health, State Government of Victoria, 2013, www.vheas.vic.gov.au

3. Australian Guide to Healthy Eating (draft), National Health and Medical Research Council, 2011, www.eatforhealth.gov.au

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A DOUBLE‐BLIND, RANDOMIZED, PLACEBO CONTROLLED TRIAL OF EFFICACY AND SAFETY OF MICRONUTRIENTS FOR THE TREATMENT OF ATTENTION‐DEFICIT/HYPERACTIVITY DISORDER (ADHD) IN ADULTSRucklidge, J. J.1, Frampton, C. M.2, Gorman, B.1, Boggis, A.3

1 Department of Psychology, University of Canterbury, Christchurch, NZ2 Department of Psychological Medicine, University of Otago, Christchurch, NZ 3 Canterbury District Health Board, Christchurch, NZ

Introduction: The role of nutrition in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient even though nutrients work synergistically. This study investigated the efficacy and safety of a micronutrient formula, consisting mainly of a broad-spectrum of minerals and vitamins, in the treatment of adults with ADHD.

Method: Eighty adults with ADHD were diagnosed with standardized instruments. A randomized double-blind placebo-controlled trial assigned participants to either micronutrients (n=42) or placebo (n=38) for eight weeks. Primary outcomes were the Conners Adult ADHD Rating Scale (CAARS) self, observer and clinician scores; clinical global impression (CGI); and Montgomery-Asberg Depression Rating Scale (MADRS).

Results: Intent-to-treat analyses showed significant between-group differences favouring the micronutrient treatment (p<0.05) for CAARS DSM-IV Total Symptom subscales on self-ratings (mean difference in change (Δ) -6.7, 95% confidence interval (CI) -11.7 to -1.7, p=0.009) and observer ratings (Δ=-5.1, CI-9.7 to -0.6, p=0.026), but not clinician scores (Δ=-2.1, 95% CI -6.2 to 2.1, p=0.23). However, clinicians’ CGI ratings favoured active treatment over placebo (Δ=-0.71, 95% CI -0.16 to -1.27, p=0.012): “Much” or “very much” improvement was seen in 48% (20/42) on micronutrients versus 21% (8/38) on placebo (OR=3.4; 95% CI 1.3-9.2). No group differences were observed on the MADRS (Δ =-2.66, 95% CI -5.64 to 0.31, p=0.078), but baseline ratings were low; for those who entered the trial moderately to severely depressed, there was significantly greater change in active versus placebo (Δ =4.35, 95% CI .380 to 13.450, p=0.039). There were no differences between groups in adverse event rates. The active group had significantly higher prolactin levels, vitamin D, B12 and folate than placebo at endpoint.

Conclusions: This study provides evidence of efficacy that broad-spectrum vitamin and minerals, without omega fatty acids, treat ADHD symptoms in adults, including normalization of hyperactivity/impulsivity ratings.

Trial registration: www.anzctr.org.au:ACTRN12609000308291

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NUTRIENT SUPPLEMENTATION FOR IMPROVING MOODSarris, J1,2, Schweitzer, I1, Mischoulon, D3

1 The University of Melbourne, Department of Psychiatry, Melbourne, Australia 2 Swinburne University of Technology, Centre for Human Psychopharmacology, Melbourne, Australia3 Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA

Nutritional supplements have a potential role in the treatment of affective disorders (mood and anxiety disorders),1 either as monotherapies or adjunctive applications with pharmacotherapies. As current treatments are manifestly inadequate for affective disorders,2,3 treatments to improve response is urgently needed. Specifically, this presentation highlights some of the latest research, unveiling the latest cutting-edge studies using nutraceuticals for treating affective disorders. Specially, the presentation will discuss current data supporting the use of several nutraceuticals for treatment of unipolar and bipolar depression, and for OCD. Novel studies currently underway are also outlined:

1. N-acetyl cysteine vs placebo vs. a nutraceutical combination which modulates mitochondrial function for bipolar disorder (a multi-centre NHMRC/CRC project: double-blind RCT)

2. S-adenosyl methionine vs. placebo vs. a nutraceutical “super pill” combination of SAMe, 5-HTP, EPA, Zinc, and folinic acid to improve the therapeutic effect of SSRI antidepressants in major depression (NHMRC project: double-blind RCT)

3. N-acetyl cysteine in the treatment of OCD (pilot double-bind RCT).

References 1. Sarris J, Kavanagh DJ, Byrne G. Adjuvant use of nutritional and herbal medicines with antidepressants, mood stabilizers and

benzodiazepines. J Psychiatr Res. Jan 2010;44(1):32‐41.

2. Warden D, Rush AJ, Trivedi MH, Fava M, Wisniewski SR. The STAR*D Project results: a comprehensive review of findings. Current psychiatry reports. Dec 2007;9(6):449‐459.

3. Thase ME. STEP‐BD and bipolar depression: what have we learned? Current psychiatry reports. Dec 2007;9(6):497‐503.

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B VITAMIN STATUS IN CANCER PATIENTS ADMINISTERED CHEMOTHERAPY.Schloss J1, Colosmio M1,2, Linnane AW1, Masci P1, Vitetta L1

1 The University of Queensland, School of Medicine, Centre for Integrative Clinical and Molecular Medicine at the Translational Research Institute Princess Alexandra Hospital2 Medical Oncology Group of Australia, Clinical Oncology Society of Australia, Queensland Clinical Oncology Group, Brisbane, Australia 4000

Introduction: Chemotherapy is one arm of mainstream medicine’s treatment options for patients diagnosed with a malignancy1. Nutritional status and deficiencies that may arise from the impact of chemotherapeutic agents are still poorly understood. Temporary deficits of certain nutrients (e.g. Vitamin B122) may play a role in the development and exacerbation of chemotherapy side effects. Correcting nutrient deficiencies may provide a protective role in reducing chemotherapy induced / specific side effects for cancer patients administered chemotherapy.

Methodolgy: The purpose of this trial was to assess the absorption and status of B group vitamins with selected chemotherapy agents compared to healthy volunteers. Six cancer patients and six healthy volunteers underwent a 72–hr assessment. The study subjects were divided into 3 groups. Namely, the healthy volunteers comprised the control group to ascertain that the selected B vitamin supplement could be absorbed over the study period. The cancer patients were randomised to receive either a B vitamin supplement or placebo during chemotherapy administration thereby to ascertain the primary outcome could a B vitamin supplement prevent nutrient deficiency or assist in correcting the B vitamin status during chemotherapy treatment. Blood samples were collected at baseline (before chemotherapy treatment was begun), at 24–hr and 72–hr. The B vitamins analysed included vitamin B1, B2, B6, folate and vitamin B12.

Discussion: It was hypothesised that a decrease in B vitamin status by specific chemotherapeutic agents e.g. paclitaxel, vincristine could occur after chemotherapy administration.

Conclusion: This probing clinical study demonstrated that healthy volunteers absorbed the selected B vitamins better than the subjects diagnosed with cancer. Moreover, the cancer group of patients had mixed results with a general trend to a decreased B vitamin status over the 24–hr period. Therefore patients undergoing chemotherapy may experience micronutrient deficiencies predisposing them to side effects e.g. CIPN, fatigue and poor memory.

References

1. Goodman LS, Wintrobe MM, Dameshek W, Goodman MJ, Gilman A, mclennan MT. “Landmark article Sept. 21, 1946: Nitrogen mustard therapy. Use of methyl‐bis(beta‐chloroethyl)amine hydrochloride and tris(beta‐chloroethyl)amine hydrochloride for Hodgkin’s disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. “ 1984, JAMA 251 (17): 2255–61.

2. Vu T, Amin J, Ramos M, Flener V et al. (1993). “New assay for the rapid determination of plasma holotranscobalamin II levels: Preliminary evaluation in cancer patients.” American Journal of Hematology 42(2): 202‐211.

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OBESITY AND TYPE II DIABETES RISKS AMONG AGE AND URBANIZING GROUPS: FINDINGS FROM A LARGE NATIONAL COHORT IN THAILAND Seubsman, S1, Sleigh, A2, and the Thai Cohort Study Team3.

1 School of Human Ecology, Sukhothai Thammathirat Open University,Nonthaburi, Thailand.2 National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia.3 Thai Cohort Study Team (Thailand: Jaruwan Chokhanapitak, Chaiyun Churwong, Suttanit Hounthasarn, Suwanee Khamman, Daoruang Pundee, Suttinan Pangsap, Tippawan Prapamontol, Janya Puengson, Yodyiam Sangrattanakul,Boonchai Somboonsook, Nintita Sripaiboonkij, Pathumvadee Somsamai, Duangkae Vilainerun and Wanee Wimonwattanaphan; Australia: Chris Bain, Emily Banks, Cathy Banwell, Bruce Caldwell, Gordon Carmichael,Tarie Dellora, Jane Dixon, Sharon Friel, David Harley, Matthew Kelly, Tord Kjellstrom, Lynette Lim, Anthony McMichael, Tanya Mark, Lyndall Strazdins, and Vasoontara Yiengprugsawan.)

Background: Obesity is a significant risk factor for diabetes and other noncommunicable diseases dominated causes of death in Thailand since 19991. It is important to study risk determinants and magnitude so informed policy making can be benefited.

Methods: Analysed Thai Cohort Study longitudinal health and nutritional status data (2005-2009) collected from 60,569 adult representatives from all geographical areas in Thailand. Health outcome prevalence and odd ratios were performed by using SPSS program.

Results: Age was a significant predictor of obesity and type 2 diabetes (T2DM). Adjusted odd ratio (AOR) for obesity in 2005 (2009) were 1.79 (1.55 ) for 41-50 years old and 2.13 (1.85) for >=51 years old respectively (p<0.001). AOR for T2DM in 2005(2009) were 5.91(4.05) for 41-50 years old and 15.40(10.12) for >=51 years old respectively (p<0.001). Obese cohorts had higher T2DM risk than nonobese, AOR 3.96 and 3.33 in 2005 and 2009 respectively (p<0.001).Living in urban area posed obesity risks, AOR 1.11 and 1.12 in 2005 and 2009 respectively (p<0.001). T2DM risk was also associated with urban life in 2009, AOR1.30 (p=0.03). From 2005-2009, urbanization among cohorts grew from 51.2% to 56%. Insufficient physical activity (<150 minutes per week) rose from 54.5% to 61%. Insufficient fruit/vegetables consumption (<5 serves per day) similarly grew from 52.6% to 58.6%. Obesity prevalence increased from 16.4% to 21.7%. T2DM rose from 368 cases (0.6%) to 930 cases (1.5%). Even though over 60% of cohort in 2009 had sufficient physical activities and nearly the same had sufficient fruits/vegetables consumption, obesity and T2DM rising trend persisted.

Conclusion: Age and urbanization posed significant obesity and T2DM risks to aging cohorts. Targeted group approach is recommended for strategic prevention and control.

References:

1. Porapakkham Y, Rao C, Pattaraarchchai J, et al. Estimated causes of death in Thailand, 2005: implications for health policy. Popul Health Metr 2010; 8: 14.

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THE SUGAR CONTENT OF A FOOD IS A POOR MEASURE OF ITS NUTRITIONAL QUALITYShrapnel BS

Shrapnel Nutrition Consulting Pty Ltd, Sydney, Australia

Limiting intake of added sugars is recommended in dietary guidelines and the sugar content of foods has been suggested as a criterion for assessing the nutritional quality of foods in front-of-pack food labelling systems. However, the scientific rationale for these recommendations is quite weak. All fermentable carbohydrates increase the incidence of dental caries in susceptible individuals. High sugar intake may be associated with ‘nutrient dilution’ if nutrient-rich foods are displaced. The potential of sugar to contribute to high glycaemic load and to the energy density of foods may be relevant to the current obesity epidemic. Two studies were conducted. In the first1, a new model for assessing the nutritional quality of carbohydrate-rich foods, employing nutrient density and glycaemic index, was developed. In the second study2 a systematic survey of Australian breakfast cereals was conducted and analysed to determine relationships between total sugars and energy density and between total sugars and glycaemic index. The model showed considerable capacity to discriminate between the nutritional quality of carbohydrate-rich foods. Although the ranking of foods was generally consistent with dietary guidelines recommendations, sugar content was a minor discriminator of nutritional quality. Foods with added sugar appeared in the lowest and highest quality categories, and higher and lower sugar versions of similar foods appeared in the same quality categories. Although some commonly recommended, low sugar cereal foods, such as rice, fell in the lowest quality category most sugar-sweetened breakfast cereals were rated higher due to higher nutrient density. In the systematic survey, total sugar content was not related to either glycaemic index or energy density in all breakfast cereals or a sub-set of ready-to-eat cereals. It is concluded that the sugar content of carbohydrate-rich foods is a poor measure of nutritional quality. Assessments of nutritional quality should be based on nutritionally meaningful measures.

References:

1. Shrapnel B, Noakes M. Discriminating between carbohydrate‐rich foods: A model based on nutrient density and glycaemic index. Nutr & Diet 2012; 69: 152–158

2. Shrapnel B. Amount of sugar in Australian breakfast cereals is not associated with energy density or glycaemic index: results of a systematic survey. Nutr & Diet 2013 (accepted for publication)

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VITAMIN D AND CHRONIC DISEASES: WHY IS THERE SO MUCH CONFUSION?Spedding S1, Morris H1, Scragg R2, Vanlint S3, Thompson R1, Buckley J1

1 Division of Health Science, University of South Australia, Adelaide, Australia2 School of Population Health, University of Auckland, Auckland, New Zealand3 Discipline of General Practice, University of Adelaide, Adelaide, Australia

Introduction: Guidelines and consensus statements about vitamin D and non-skeletal disorders disagree about how to define vitamin D deficiency and the efficacy of vitamin D supplementation1.

Background: As different physiological systems have a different dose-response profile for vitamin D, then different vitamin D levels are required for managing different chronic diseases.

This has been overlooked in designing studies. These design flaws lead to null RCTs and conflicting meta-analyses2.

Methods: A multi-disciplinary group examined the literature for vitamin D and chronic non-skeletal disease:• To find the minimum serum level required to correct deficiency for different disorders. • To examine the effect on guidelines of studies that did not meet this requirement of a minimum serum level, yet

still claimed to assess the efficacy of vitamin D supplementation.

Results: Many studies were flawed with low baseline levels and doses of vitamin D such that the intervention could not alter vitamin D status nor produced any change in the outcome.

Furthermore, rather than finding a single serum concentration that applies to all disorders, we found that different serum vitamin D concentrations are required for preventing different diseases: osteoporosis and fractures 50 nmol/L, premature mortality is 75 nmol/L3, diabetes 80 nmol/L, and cardiovascular disease 80 nmol/L, falls 95 nmol/L, cancer 100 nmol/L4, and for treating depression 75 nmol/L5.

Discussion: Design flaws are common in RCTs of vitamin D and different serum levels are required to manage different diseases.

Conclusions: So vitamin D deficiency is not a singular concept but varies with the physiology of that disease. Design flaws in RCTs produce conflicting meta-analyses, the current impasse in vitamin D research and confusion in clinical practice. Only RCTs without these flaws will allow research to translate into policy and practice.

References:

1. Scragg R. Do we need to take calcium with vitamin D supplements to prevent falls, fractures, and death? Curr Opin Clin Nutr Metab Care. 2012;15(6):614‐24.

2. Heaney R. P. Vitamin D — Baseline Status and Effective Dose. N Engl J Med. 2012; 367:77–78

3. Ford ES, Zhao G, Tsai J, Li C. Vitamin D and all‐cause mortality among adults in USA: findings from the National Health and Nutrition Examination Survey Linked Mortality Study. Int J Epidemiol. 2011;40(4):998‐1005

4. Garland C, Gorham ED, Mohr SB, Garland FC. Vitamin D for Cancer Prevention: Global Perspective. Ann Epidemiol. 2009;19(7):468‐83

5. Vieth R, Kimball S, Hu A, Walfish P. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J. 2004;3:1‐10

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CONTINUOUS GLUCOSE MONITORING IN PEOPLE WITH TYPE 2 DIABETES CONSUMING FOODS CHOSEN ON THE BASIS OF GLYCAEMIC INDEXVenn BJ, Tekinkaya H.

University of Otago, Department of Human Nutrition, Dunedin, New Zealand

Large increases in blood glucose concentration after eating a meal (postprandial hyperglycaemia), as opposed to fasting or pre-meal blood glucose concentration, is an independent risk factor for cardiovascular events in people with type 2 diabetes1. Diabetics are recommended to consume foods with low glycaemic index (GI). Some high GI foods produce a rapid rise in blood glucose concentration followed by a sharp decline, whereas low GI foods result in a more gradual rise and fall. This is the pattern seen when individual foods are tested under standardised laboratory conditions. It is unknown whether these same patterns of glucose response are seen when the individual foods are combined into meals and consumed in an everyday setting in which food consumption and activity are less strictly controlled. We recruited type 2 diabetics and fitted each with a continuous glucose monitoring device (Medtronic iPro2). We also provided participants with breakfast, lunch and dinner meals based on GI whilst recording 24 hour interstitial glucose concentrations for two days on each treatment in a randomised crossover design. Main outcomes will be comparisons of postprandial and 24 hour glycaemia. Recruitment will be completed mid January 2013 and the data analysed thereafter in preparation for presentation at the Nutrition in Medicine Conference.

References:

1. Cavalot F, Petrelli A, Traversa M et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab 2006;91:813‐9.

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A PHASE II RANDOMISED DOUBLE–BLIND PLACEBO–CONTROLLED CLINICAL TRIAL INVESTIGATING THE EFFICACY AND SAFETY OF A HERBAL MEDICINE PREPARATION FOR THE MANAGEMENT OF SYMPTOMS OF BENIGN PROSTATIC HYPERTROPHYVitetta L.1, Coulson S1, Rao A2 , Steels E2

1 The University of Queensland, School of Medicine, Centre for Integrative Clinical and Molecular Medicine, Brisbane, QLD 4102.2 Applied Science and Nutrition Pty Ltd P.O. Box 68 New Farm QLD Australia 4005

Background: Over the last two decades there has been a strong interest in the use of herbal medicine extracts to treat Benign Prostate Hyperplasia (BPH). In Europe, particularly Germany, Austria, Italy and France, phytotherapy is often the first line treatment administered for the management of symptoms of BPH1. The aim of this clinical trial was to evaluate the efficacy and safety of ProstateEZE Max, an orally dosed herbal preparation containing Cucurbita pepo, Epilobium parviflorum, lycopene, Pygeum Africanum and Serenoa repens in the management of symptoms of medically diagnosed BPH.

Materials/Methods: This was a 3-month phase II randomized double-blind placebo controlled clinical trial, conducted on 57 otherwise healthy males aged 40 to 80 years that presented with medically diagnosed BPH. The primary outcome measure was the International Prostate Specific Score (IPSS) measured at baseline, 1, 2 and 3 months. The secondary outcomes were the specific questions of the IPSS and day–time and night–time urinary frequency.

Discussion: There was a significant reduction in IPSS total score in the active group (36%, p< 0.05) over 3 months, compared to the placebo group (8%). The day–time urinary frequency in the active group showed a significant reduction (7.0 to 5.9 times per day, p<0.03) compared to baseline. The night-time frequency was also reduced significantly in the active group (2.9 to 1.8, p<0.004). There was no significant reduction in the day–time or night-time frequency in the placebo group. Based on the knowledge of the active constituents and on the individual extracts, it is likely that there are interactive mechanisms of action underlying the therapeutic effect of the herbal medicine preparation.

Conclusion: The herbal preparation (ProstateEZE Max) was shown to be well tolerated and have a significant positive effect on physical symptoms of BPH when taken over 3 months, a clinically significant outcome in otherwise healthy men.

References:

1. Wilt TJ, Ishani A, Rutks I, MacDonald R. Phytotherapy for benign prostatic hyperplasia. Public Health and Nutrition 2000; 3(4A): 459‐72.

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NUTS FOR WEIGHT MANAGEMENTYates LG

Nuts for Life, Sydney Australia

Around 61% of Australian adults are overweight or obese (68% of males and 55% of females)1. For many years weight loss diets were synonymous with low fat diets at the expense of healthy fat foods such as nuts. This presentation provides an overview of the scientific evidence examining the effects of nuts on weight management. Epidemiological evidence indicates either no association between nut consumption and Body Mass Index2 or a lower risk of weight gain in those with a higher frequency of nut consumption2-4. Mechanisms of action may include: satiety effects due to the presence of protein, fibre and fats (nut oils have also been shown to increase satiety hormone release in the intestine), increased energy expenditure digesting nuts and inefficient fat absorption resulting in increased fat excretion5. Nuts cause a low glycemic index effect when mixed with foods rich in carbohydrate and have been shown to reduce insulin levels in some studies which may help explain nuts’ positive effects on weight. Those on weight management diets that include nuts have better compliance and greater weight loss success due to greater palatability and enjoyment. The NHMRC has indicated that 65-110g of nuts per day does not lead to weight gain6. The inclusion of at least 30g or a handful of nuts every day in a weight management diet in place of unhealthy snacks is warranted.

References:

1. Australian Institute of Health & Welfare. Australia’s Health 2010. Determinants: Keys to Prevention pg 114. AIHW 2010. ISBN978 1 74249 0021.

2. Bes‐Rastrollo M, et al. Nut consumption and weight gain in a Mediterranean cohort: The SUN study. Obesity (Silver Spring) 2007;15(1):107‐16.

3. Bes‐Rastrollo M, et al. Prospective study of nut consumption, long‐term weight change, and obesity risk in women. Am J Clin Nutr 2009;89(6):1913‐9.

4. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long‐term weight gain in women and men. N Engl J Med. 2011 Jun 23;364(25):2392‐404.

5. Mattes RD The energetics of nut consumption. Asia Pac J Clin Nutr. 2008;17 Suppl 1:337‐9.

6. NHMRC. Australian Dietary Guidelines incorporating Australian Guide to Healthy Eating. Draft for public consultation Dec 2011.

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3RD INTERNATIONAL CONFERENCE ON The Science of … · clinical application of nutrition in medicine and healthcare ... Certificate of attendance and other CPD/CME ... Powerpoint presentations