Title : Advancing Physical Activity : Opportunities in Challenging Environment

Organized by : ILSI

Schedule : Tuesday, August 6, 2019. 15.30-17.00

Room : Manado

Speaker 1 :  Dr Yuying Wang

Profile :  Dr. Wang is a research fellow at Chinese Center for Disease Control and Prevention and ILSI Focal Point in China. He obtained his doctoral degree in Nutritional Epidemiology from Chinese Center for Disease Control and Prevention in 2004, and he is a visiting scholar at UC Davis during 2015-2016. Dr. Wang’s research focus on assessment and intervention of early child nutrition, promotion of physical activity and Exercise is medicine in China. He also participated in the development of Chinese Physical Activity Guidelines which will be issued this year.

Abstract :

Advancing Physical Activities in China – Challenges, Opportunities and Programs Impact

Non-communicable diseases (NCDs) have become the major killer and burden in China, about 86% of total deaths caused by NCDs in 2012. As one of healthy lifestyle, physical activity has significant health benefits and contributes to prevent NCDs. Several studies in China showed that physical activity can reduce the incidence of diabetes, hypertension, major cardiovascular disease and cancer. However, only about 20% of adults (aged 20-69 years old) can reached the adequate amount of 150 min of moderate physical activity per week in 2014, and only 13.1% of children and adolescents (aged 9-17 years old) were physically active in 2016. National and local authorities have adopted actions or policies in a range of sectors to promote and facilitate physical activity. In 2004, “Happy 10 Minutes” was piloted to promote physical activity for primary schools in Beijing. After this, China CDC expanded the pilot nationally and it was widely recognized. This project also became one of the components in the Action on Healthy Living for all Nationals in 2011.Exercise is Medicine was one part of National Exercise Plan (2016-2020). A new Physical Activity Guidelines for Chinese will be jointly issued by National Health Committee and General Administration of Sport in 2019. Promotion of physical activity can contribute to Healthy China 2030.

Speaker 2 :  Dr Jason Lee

Profile : Jason Lee is an Associate Professor in Yong Loo Lin School of Medicine at the National University of Singapore. Jason obtained his first degree (Sports and Exercise Science – 1st Class Honours) from Loughborough University, UK. Following the award of G V Sibley Memorial Prize, he stayed on to complete a PhD in Exercise Physiology under sponsorship from the UK Overseas Research Scholarship and Faculty Studentship. Jason is a Fellow of the American College of Sports Medicine. He serves in various national and international panels related to human performance and safety. Jason’s main research interests are in fluid balance, thermoregulation and mitigation strategies for improving human performance. A key outcome of his research is the formulation of a holistic heat management system. Jason recently completed his 12-year tenure at the DSO National Laboratories by directing the Human Performance Programme in his final appointment. He chairs the Scientific Committee on Thermal Factors at the International Commission on Occupational Health.

Abstract :

Heat Stress on Physical Activity – the Dos and Don’ts of Hydration

Physical activities have shown to markedly improve human health and wellbeing. Environmental heat stress however often discourages or curtails outdoor activities through behavioural thermoregulation. This effect could potentially be made worse with global warming coupled with urbanization. In order to optimise exercise tolerance in the heat, various strategies are employed to alter heat strain such as maximising aerobic fitness, heat acclimatisation, pre-exercise cooling and fluid ingestion. Specific to fluid ingestion, the recommended volume to ingest before and after exercise is widely accepted. There are however differing views regarding fluid replacement during exercise. Severe under or over hydration has ill effects and therefore there is a need to drink correctly. Optimising the cooling effect from hydration solution by manipulating drink temperature and thermal capacity can enhance exercise tolerance especially in the heat. This presentation will cover key considerations in hydration to optimise physical activity levels.

Speaker 3 : Dr Stuart Phillips

Profile : Stuart Phillips obtained a Ph.D. from the University of Waterloo in Human Physiology in 1995. He joined McMaster University in 1998 and is currently a full Professor in the Department of Kinesiology and School of Medicine. He is Tier 1 Canada Research Chair in Skeletal Muscle Health. He is also the Director of the McMaster Centre for Nutrition, Exercise, and Health
Research and the Physical Activity Centre of Excellence. His research is focused on the
impact of nutrition and exercise on human protein turnover, specifically in skeletal muscle.
He is also dedicated to understanding how exercise and dietary protein impact body
composition, strength, and function in aging.
Dr. Phillips has authored more than 185 original research papers and 75 reviews and given more than 200 invited presentations. He has mentored 17 Ph.D. and 22 M.Sc. students and more than 110 undergraduate thesis students. He is a 5-time nominee and a 3-time winner of McMaster Student Union’s Outstanding Teaching Award. He was also the inaugural recipient of the Canadian Society for Exercise Physiology’s Mentorship award. In 2018 he was named by Clarivate as a highly cited researcher being in the top 1% of all cited researchers in nutritional sciences.
Dr. Phillips is a fellow of the American College of Sports Medicine, the American College of Nutrition, and the Canadian Academy of Health Science.

Abstract :

Dietary Protein in Support of Adaptation to Exercise: Finding the Signal in the Noise

Athletes engage in vigorous training that places stress on physiological systems requiring nutritional support for optimal recovery. Of paramount importance when optimizing recovery nutrition are rehydration and refueling. However, in this presentation I will highlight the benefits for dietary protein intake over and above requirements set out in various countries at 0.8-1.0 g/kg body mass (BM)/d for training adaptation, manipulating body composition and hypertrophy in athletes. To facilitate the remodeling of protein-containing structures, which are turning over rapidly due to their training volumes, athletes with the goal of weight maintenance or weight gain should aim for protein intakes of 1.6 g/kg BM/d. Protein intakes at this level would not necessarily require an overemphasis on protein-containing foods, but there may be advantages to the consumption of higher quality proteins. I will also highlight that optimal protein intakes may need to exceed 1.6 g/kg BM/d for athletes who are restricting energy intake and attempting to minimize loss of lean tissue. I will discuss the underpinning rationale for weight loss in athletes, explaining changes in metabolic pathways that occur in response to energy restriction when manipulating protein intake and training. I will offer some practical advice on protein intakes that warrant consideration in allowing an optimal adaptive response for track and field athletes seeking to train effectively and to lose fat mass while energy restricted with minimal (or no) loss of lean BM.


Title : Experience in Management of Diabetes Mellitus: Challenges and Opportunities in Asia

Organized by : ILSI

Schedule : Tuesday, August 6, 2019. 17.00-18.00

Room : Jakarta B

Speaker 1 : Dr Cecilia Acuin, IRRI, Philippines

Profile : Dr Cecilia Acuin has recently been appointed as Senior Scientist, lead for Human Nutrition, at the International Rice Research Institute (IRRI), Philippines. Before joining IRRI, she was the Chief Science Research Specialist, Nutritional Assessment & Monitoring Division and Chair, Institutional Ethics Committee at the Food & Nutrition Research Institute (FNRI), Department of Science & Technology, Philippines. In this position she was responsible for the conduct of the Philippine National Nutrition Surveys, and oversaw nutrition research projects of three Sections: the Nutritional Assessment Section, the Nutritional Statistics and Informatics Section, and the Nutritional Interventions, Evaluation and Policy Section. Her research interests are in the areas of maternal and child health and nutrition, food security, food and health systems and operations research, and risk factors of non-communicable diseases.

Dr. Acuin’s involvement in multi-country research initiatives includes the following among many others: as a Member of the International Union of Nutritional Sciences Committee on Nutrition and Anthropology; and as a Consultant and Vice-Chair of the WPRO Regional Advisory Committee on Health Research in the WHO Western Pacific Region. In the Philippines, Dr. Acuin has been the Co-Chair of the Philippine National Health Research System, Research Utilization Committee; Head of the Secretariat of the Universal Health Care (UHC) Study Group; Consultant in various capacities of USAID, UNICEF, World Bank, etc., as well as for academic institutions and local organizations such as the Zuellig Family Foundation among others. She obtained her Ph.D. in Nutrition with minors in Nutritional Epidemiology and Risk Communication from Cornell University, USA

Abstract :

The Potentials of Rice in The Dietary Management of Diabetes

The World Health Organization (WHO) estimates that of the 8.5% diabetics globally, about half are in Asian regions (SEARO & WPRO). Asia’s vulnerability to diabetes comes from multiple factors – lifestyle changes, urbanization, ageing, etc; in addition, growing evidence points to the contributions of phenotypic changes from an adverse uterine environment. As diet plays a key role in several of these factors, to what extent might rice be part of the equation – and is this towards the problem side or the solution side?

About 90% of the world’s rice is grown and consumed in Asia, with Asia prospering even as it is benefiting the most from the rice science that feeds the continent’s billions. About a decade ago, however, studies emerged associating white rice intake with the increasing rates of diabetes, obesity and metabolic syndrome particularly among Asian populations. Because of the quantities of white rice that Asians consume, this was contributing significantly to the glycemic load of their diets, relative to other food sources, and was impacting especially on increased diabetes risk.

Recent ecological data, however, points to a declining trend in rice intakes throughout most of Asia, alongside rising diabetes and obesity rates.  More comprehensive studies from China, India, and Singapore provide a better understanding of the rice-diabetes relationship – of rice when part of a diet rather than as a single food item, inclusion of its quality and nutrient attributes, consideration of co-factors such as smoking, alcohol intake and physical activity – that emphasize lifestyle, rather than diet alone, as THE factor for pinpointing the problem and developing solutions.  

Interventions ranging from harnessing omics technologies in identifying niche-specific rice varieties, to behavior change that replaces white with brown rice, are proving to be effective as Asians continue to include rice as part of healthier food choices and a more diverse diet.

Speaker 2 : Dr Barakatun-Nisak Mohd Yusof

Profile :  Dr Barakatun Nisak Bt Mohd Yusof is an Associate Professor and a practising dietitian in the Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM). She currently holds a position of Dietetics Program Coordinator and a member of the Research Centre in Nutrition and Non-Communicable Chronic Diseases (NNCD).

Dr Nisak received her PhD in Dietetics from Universiti Kebangsaan Malaysia before completing the Postdoctoral Research Fellowship at Joslin Diabetes Centre, Harvard Medical School in the field of Diabetes Nutrition.

Broadly, her research aims to improve metabolic control and quality of life in those with type 2 diabetes, women with gestational diabetes and obese individuals. Within this framework, she shared her experience with Ministry of Health, industrial partnership and professional associations in developing diabetes nutrition-related guidelines such as “Clinical Practice Guidelines for Adults with Type 2 Diabetes” and “Diabetes in Pregnancy”. Recent honors include a Fundamental Research Grant Scheme Awards from Ministry of Education Malaysia to identify the ‘Nutritype’ signatures for the prevention of diabetes in women with previous GDM.

Abstract :

A Low Glycemic Index Diet in The Management of Gestational Diabetes Mellitus: The Malaysian Experience

Excessive postprandial hyperglycemia during pregnancy has been associated with substantial adverse health outcomes for women with gestational diabetes mellitus (GDM). Use of low glycemic index (GI) diet may be beneficial in the management of GDM. This randomized controlled study investigated the effects of low GI diet on glycemic-related parameters and dietary intake in women with GDM. A total of 40 participants managed with diet only were randomized to either low GI diet (Low GI; n=20) or carbohydrate exchange (CE; n=20) dietary plan. The 2 groups were similar at baseline. At 4 weeks, fructosamine decreased significantly from baseline in the both groups (p< 0.05). Low GI group had significantly better reduction in 1-hour post-breakfast glucose levels (6.7 ± 1.0 mmol/l) compared to the CCE group (7.6 ± 1.5 mmol/l). Similarly, low GI meal resulted in significantly lower capillary blood glucose levels at 30, 60, and 120 mins in comparison to high GI meal (p< 0.05). Low GI group had significantly higher dietary calcium (p< 0.05) and tended to have a higher dietary fiber intake (p=0.05) than the CE group. Dietary GI in the LGI group was significantly lower by 7 units versus the CE group (p< 0.05). This study shows that Low GI and CE produced similar improvement in overall glycemic control. Furthermore, those following a low GI diet may have additional benefits from lowering 1-hour post-breakfast blood glucose levels, increasing calcium and fiber intake. However, these results warrant further evaluation for longer duration during pregnancy.

Speaker 3 : Ms Martelena Purba

Profile : Dr Martalena Purba is a Registered Dietitian trained in Indonesia and Australia both in Community Nutrition and Clinical Nutrition during her undergraduate and post graduate studies. She spent most of her works with out-patients & in-patients at Dr Sardjito Hospital, a Teaching Hospital for Gadjah Mada University. Medical Nutrition and Diet therapy (MNT) for non-communicable diseases such as diabetes, cancer, and chronic kidney disease are her current interests. Giving health education to the patients and their families as well as teaching medical and  dietetic students during their under-graduate and post-graduate study are her daily activities. In addition, research collaboration either in clinical and community setting regarding non-communicable diseases particulalarly in diabetes is also her main interest.

Abstract : 

Nutrition Counseling and Plant Based Diet in the Management of Diabetes

Backround/Aims: The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based eating patterns combined with exercise have been found to improve diabetes control and reduce the need for medication in intervention trials. Dietary choices are a key driver of insulin resistance, especially in an obese and more sedentary population. Increases in consumption of calorie-dense foods, including fast foods, meats & other animal fats, highly refined grains & sugar-sweetened beverages, are thought to play a critical role in the rising rates diabetes worldwide. Multiple potential mechanisms underlie the benefits of a plant-based diet as typical of traditional Indonesian eating habits  in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron. Result from our study in Jogjakarta shows that duration of the disease and type of occupation did not affect eating compliance in diabetic patients. Nevertheless, it was found that family support affected eating compliance (RP= 1,723 and p= 0,025) as well as eating schedule (RP = 2,151 and p= 0,02) among T2DM in Jogjakarta hospital. This finding suggest that a regular nutrition education are very important to increase macronutrients and micronutrient intake of diabetic patients.


Title : Updates on Nutrition and Cognition

Organized by : ILSI

Schedule : Wednesday, August 7, 2019. 09.30-11.00

Room : Manado

Speaker 1 :  Dr Naoki Saji

Profile : Naoki Saji, M.D., Ph.D. is a neurologist and a gerontologist, and currently Vice Director in the Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Japan. He received a Ph.D. in the geriatric medicine and internal medicine from the Kobe University Graduate School of Medicine, Japan under the supervision of Prof. Koichi Yokono. After he received the doctorate, he studied stroke medicine and worked as a Lecturer and an Associate Professor in the Department of Stroke Medicine, Kawasaki Medical School, Japan. For this reason, Dr. Saji studies the interrelationship between cerebrovascular diseases and cognitive dysfunction. His research interests include the common risk factors for stroke and dementia such as arterial stiffness, atrial fibrillation, cerebral small vessel diseases, and gut microbiome. Dr. Saji is also a fellow member of the Japan Stroke Society.

Abstract : 

Relationship Between The Gut Microbiome and Dementia: A Cross-sectional Study Conducted in Japan

Background: Dysregulation of the gut microbiome is associated with several life-threatening conditions and thus might represent a useful target for the prevention of dementia. However, the relationship between the gut microbial population and dementia has not yet been fully clarified.
Methods: We recruited outpatients visiting our memory clinic to participate in this study. Information on patient demographics, risk factors, and activities of daily living was collected, and cognitive function was assessed using neuropsychological tests and brain magnetic resonance imaging scans. Faecal samples were obtained, and the gut microbiome was assessed by terminal restriction fragment length polymorphism (T- RFLP) analysis, one of the most well-established and reliable 16S ribosomal RNA- based methods for classifying gut microbiota. Patients were divided into two groups, demented and non-demented. Multivariable logistic regression models were used to identify the variables independently associated with dementia.
Results: We analysed 128 eligible patients (female: 59%, mean age: 74.2 years). The T- RFLP analysis revealed differences in the composition of the gut microbiome: the number of Bacteroides (enterotype I) was lower and the number of ‘other’ bacteria (enterotype III) was higher in demented than non-demented patients. Multivariable analyses showed that the populations of enterotype I and enterotype III bacteria were strongly associated with dementia, independent of the traditional dementia biomarkers.
Conclusions: We have shown that components of the gut microbiome, in particular Bacteroides and ‘other’ bacteria, are independently associated with dementia. Further studies are needed to determine the mechanism underlying this association.

Speaker 2 : Dr Wen-Harn Pan

Profile : Dr. Wen-Harn Pan obtained her PhD from Division of Nutritional Sciences, Cornell University in 1983. During the period of 1983 to1986, she received her NHLBI post- doctoral training in cardiovascular epidemiology, statistics, and nutrition at the Department of Preventive Medicine, Northwestern University, Chicago. She is currently a distinguished Professor in the Institute of Biomedical Sciences, Academia Sinica, Taiwan.
Dr. Pan has established a community-based cardiovascular cohort study in Chu-Dong and Putze since 1989 and led the Nutrition and Health Survey in Taiwan since 1992. Dr. Pan has more than 300 publications and currently engages in food-disease
metabolomics research, dietary therapy for geriatric diseases and worksite health body promotion programs.
She obtained Outstanding Research Award from Taiwan Society of Nutrition in 2004, Lifetime Achievement Award from Asia Pacific Society of Clinical Nutrition in 2010, and Outstanding Contributions in Science &amp; Technology Award of Executive Yuan (equivalent to State Department), Taiwan in 2015.

Abstract : 

Taiwanese Eating Approach (TEA) associated with cognitive function in elderlies

Dietary pattern or eating approach studies have been limited to a few types such as Mediterranean diet and DASH diet. Asian dietary patterns have not been widely studied and understood with the exception of Japanese diet. Using data collected from Nutrition and Health Survey in Taiwan, we carried out data mining endeavor and discovered that a plant-based diet featured with phytonutrient-rich foods (vegetables and fruits) and drinks (tea) and multiple types of non-red protein foods was inversely associated with mild cognitive impairment. Some of these features (tea and fish) were also shown to associate with lower risk of dementia development. This finding calls for more research in various ethnic and regional diets including the Asia- Pacific region in order to contribute to in-depth understanding, prevention, and management strategy of dementia.

Speaker 3 : Dr Elizabeth Leah Prado

Profile : Dr Elizabeth Leah Prado is an assistant professor of Program in International and Community Nutrition, at Department of Nutrition, University of California Davis.  

Dr. Prado’s research focuses on nutrition, health, and environmental influences on brain development and evaluating randomized controlled interventions to support children to achieve their developmental potential. Through her research projects, Dr Prado has developed expertise in developmental and cognitive assessment in contexts in which standardized tests do not exist. She has been invited to speak to various audiences and participated in a working group convened by the Bill & Melinda Gates Foundation to develop recommendations for their grantees for neurodevelopmental measurement tools. Dr Prado co-authored the World Bank’s Child Development Assessment Toolkit, published in 2017. She is also a member of the World Health Organization consultative group to develop global early child development indicators. She is currently leading the neurodevelopmental assessments for a project in Malawi, which is the first project to use automated eye-tracking to measure infant cognition as an outcome of a randomized trial in a low- or middle-income country.

Dr Prado received her BA/MS in Lingustics from Georgetown University, and her PhD in Psychology from Lancaster University.

Abstract :

Nutrition and Cognitive Development in Children: Impact on Adulthood

Animal models have demonstrated the importance of adequate nutrition for the neurodevelopmental processes that occur rapidly during pregnancy and infancy, such as neuron proliferation and myelination. However, several factors influence whether nutrient deficiencies during this period cause long-term cognitive deficits in human populations, including the child’s interaction with the environment, the timing and  degree of nutrient deficiency, and the possibility of recovery. Certain types of nutritional deficiency are clearly associated with long-term impairment in brain development, including severe acute malnutrition, chronic undernutrition, iron deficiency, and iodine deficiency. While strategies such as salt iodization and micronutrient powders have been shown to improve these conditions, direct evidence of their impact on brain development is scarce. Other strategies also require further research, including maternal and infant supplementation with iron and other micronutrients, essential fatty acids, and fortified food supplements during pregnancy and infancy.