Welcome to the Interactive Programme of MNF 2023

Over the last years, food systems have been shocked by multiple crises. Climate change, the COVID-19 pandemic, and the war in Ukraine are affecting access to, and prices of, food globally. Inequities within food systems restrict access to healthy diets exacerbating inequalities in diet, nutrition and health. As a result, food insecurity and young children with wasting have risen, foodborne diseases and the risk of zoonotic diseases are increasing, and unhealthy diets and malnutrition are among the main causes of disease and death.Mitigation, adaptation, and resilience are mechanisms that people, animals and the planet use to overcome the challenges posed by crises. However, these systems are managed and addressed individually, without recognizing their interconnections. More and more, it is becoming clear that integrated multisystemic responses across sectors are needed to address the root causes of malnutrition in all its forms. The One Health approach is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, plants, animals and ecosystems. It recognizes that the health of all are closely linked and inter-dependent. This session critically examines how the One Health approach can be implemented to improve micronutrient nutrition resilience.

The biofortification of staple crops through selective plant breeding, agronomic management, or genetic engineering is a complementary and sustainable intervention to prevent micronutrient deficiencies, particularly of vitamin A, iron and zinc. Based on two decades of multidisciplinary proof of concept research significant progress in scaling has been achieved in high burden countries. The first systematic review and meta-analysis of its efficacy will be presented. This session will also include research on crop combinations and additional micronutrients.

This session will provide an overview of some of the larger, longitudinal studies of human milk composition. The Mothers, Infants and Lactation Quality (MILQ) study is developing Reference Values for many constituents of human milk, including micronutrients. While the Reference Values are not yet finalized, the study has provided many lessons for the design of future lactation studies, which will be shared in this session as well as a separate Learning Opportunity. The ongoing International Milk Composition Consortium (IMiC) was established in 2020 to link data analysts with maternal-child health and milk composition scientists. Samples were collected from studies in 4 countries with the aim of linking milk composition to infant growth.

Results from new trials of intravenous (IV) iron for treatment of anemia will be presented. Consideration is given to feasibility in low resource settings, and application of formative research to understand concerns and barriers to applying IV iron interventions.

This session will bring together experts from the fields of nutrition and cognition to explore our current understanding on how micronutrients can both support cognitive development (in fetal life, infancy and early childhood), promote cognitive ‘health’ (in adolescence) and help prevent the cognitive decline associated with ageing.

Although micronutrient intervention programmes are heavily focussed on improving maternal status during pregnancy, there is increasing interest in the value of programmes starting before conception as well as those that extend into lactation. This session will review current knowledge on the efficacy of delivering micronutrients to women at different perinatal stages.

Iodized salt programs for the prevention of iodine deficiency have been remarkably successful. However, complacency is a challenge, and programs in several countries have faltered. Gaps in iodine intake still exist between geographic areas and population groups within countries. Whether targeted iodine strategies for pregnancy are needed is unclear. New approaches for assessing iodine status that provide improved precision and granularity are now available. This session will address current and future challenges for attaining optimal iodine nutrition and strategies to achieve equity in iodine nutrition. The efficacy of iodine supplementation in pregnant women will be discussed and multicenter studies evaluating new approaches for more sensitive iodine status monitoring will be presented.

Because micronutrients play an important role in many metabolic pathways, it is not surprising that micronutrient status is incereasingly linked to non-commicable diseases. However this is a relatively new area of research. Recent discoveries include NCDs affected by zinc, vitamin D, and selenium status.

This session will describe the latest and most relevant information from randomized controlled trials, systematic reviews, and meta-analyses. Subject areas include examining the effect of multiple micronutrient supplementation, lipid nutrient supplements and their effects on maternal and child nutrition; determining ideal thresholds for micronutrient deficiencies and dose responses; understanding the risk of excess from concurrent multiple population interventions and how to maintain complementary supplementation programs; and understanding how micronutrient status may affect immunity, with the gut microbiome as a potential modifier of immune response.

Increasing the density of minerals and vitamins in food staples offers a means to increase mineral and vitamin intakes at no extra cost to poor consumers. Transgenic plant development and agronomic approaches are discussed. Maintaining high productivity/yields and farmer profits is a key element to these approaches.

Accelerated climate change shocks impact the capacity of food systems worldwide to nourish populations, with a disproportionate impact on the nutrition resilience of the most vulnerable populations, specifically women and children. While this poses challenges for yields and nutrient density of crops, leading to higher food price and reduced micronutrient status, there are also opportunities for transformative adaptations of food systems for a positive impact on environment, health and micronutrition. Which transformations are ready to be scaled-up, what lessons can the global North learn from the global South, and what are the actions for which we shall hold governments, farmers, food industry, academics and consumers accountable?

This session will shed light on often-overlooked micronutrients of public health concern, with a focus on thiamine, vitamin D, riboflavin, and vitamin B6.