MICA: Creating an open access knowledge hub of nutritional biomarkers for use in global health settings

Lead Research Organisation: King's College London

Abstract

Malnutrition, from either under- or over-nutrition, directly affects one in three people globally making malnutrition, together with diet, by far the biggest risk factors for the global burden of disease. Widespread undernutrition and micronutrient deficiencies lead to poor child growth, impaired mental development and reduced adult labour productivity, while a
transition towards a more 'westernised' diet is associated with rising rates of obesity and diet related non-communicable diseases. This under- and over-nutrition often coexists to create a 'double-burden' of malnutrition-related health consequences and, with rapid urbanization and the associated nutrition transition, this double burden is most predominant
in many low- and middle-income countries (LMICs).
To advance understanding of links between diet, nutrition and health in LMICs and to develop and evaluate evidencebased programmes and policies, detailed understanding of nutritional status is required. Existing, community-based studies and surveys from LMIC settings often lack detailed data on individual and population-level nutritional status to inform on
policy. Data from critical population categories (e.g. infants, children, adolescents, pregnant and lactation women) are often limited to anthropometry and easy-to-assay parameters (e.g. haemoglobin) or single micronutrients (e.g. vitamin A, iodine).
This leads to a knowledge gap to describe the nutritional vulnerabilities in these population groups and hence inform on the design of novel interventions.
Modern methods to measure nutritional status have moved away from single nutrient assays requiring relatively large aliquots of blood, access to sample storage facilities, and sophisticated equipment towards 'multiplex' approaches where groups of analytes can be measured in small volumes or on more appropriate matrices, such as dried blood spots. A
critical barrier to applying these novel methodologies in LMIC contexts is a lack of easy to access information on their availability and utility and a lack of technical support for the required platforms.
In response to this global need, the aim of this application is to bring together expertise in nutritional biomarkers, to create a freely available, online resource (a 'knowledge hub') to support the accurate and detailed assessment of nutritional status in
populations from low- and middle-income countries (LMICs). Through a network of academic and industry experts, we will also identify research gaps, where existing methodologies are not practical for implementation in low resource settings or
for use in large, population based research in LMICs. The knowledge hub created will enable and support all nutrition and health related research activities in LMICs contributing towards a greater depth of knowledge on the nutritional status of populations in these settings. The longer-term vision of this work is to establish centres of excellence in nutritional assessment methodologies in LMIC settings. Supported by a network of academic, technical and industry experts, these centres will support academic and programmatic research in LMICs, enabling a more comprehensive understanding of the relationship between diet, nutrition and health. Further, where research gaps are identified, we will work with academic and industry partners to develop novel assays to meet the research needs for nutrition and health research globally.

Technical Summary

Malnutrition, in all its forms, directly affects one in three people globally making malnutrition, together with diet, by far the biggest risk factors for the global burden of disease. This is especially acute in many low- and middle-income countries (LMICs) where under- and over-nutrition often coexist, creating a dual-burden of disease within the same setting. To advance understanding of links between diet, nutrition and health in LMICs and to develop and evaluate evidence-based programmes, detailed understanding of nutritional status is required. Existing, community-based studies and surveys from LMIC settings often lack detailed data on individual and population-level nutritional status to inform on policy. This leads to
a knowledge gap to describe the nutritional vulnerabilities in these population groups and hence inform on the design of novel interventions.
Modern methods to measure nutritional status have moved away from single nutrient assays requiring large sample volumes and sophisticated equipment towards 'multiplex' approaches where groups of analytes can be measured in small volumes or on more appropriate matrices, such as dried blood spots. A critical barrier to applying these novel methodologies in LMIC contexts is a lack of easy to access information on their availability and utility and a lack of technical support for the required platforms.Through this application, we aim to bring together expertise in nutritional biomarkers, to create a freely available, online resource to support the accurate and detailed assessment of nutritional status in populations from LMICs. This work will pave the way for the development of centres of excellence in nutritional assessment methodologies in LMIC settings.
Supported by a network of academic, technical and industry experts, these centres will support academic and programmatic research, enabling a more comprehensive understanding of the relationship between diet, nutrition and health.

Publications

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Bourassa MW (2020) Antenatal multiple micronutrient supplementation: call to action for change in recommendation. in Annals of the New York Academy of Sciences

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Gomes F (2020) Setting research priorities on multiple micronutrient supplementation in pregnancy. in Annals of the New York Academy of Sciences

 
Description "Data in Nutrition" invited article in Sight & Life Magazine 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The OpeN-Global team were invited to publish an article on "Data in Nutrition" which includes the promotion of the the OpeN-Global website, an online resource to support the collection of micronutrient status data (p56-53/ Vol 33(1), 2019).
Year(s) Of Engagement Activity 2019
URL https://open-global.kcl.ac.uk/
 
Description Abstract: Micronutrient Forum (abstract accepted for presentation) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Target product proles for a micronutrient assessment tool and associated blood collection device for use in population health surveys: An expert consensus. Emily Smith, Dr Sophie Moore et al
Year(s) Of Engagement Activity 2020
URL https://conference.micronutrientforum.org/
 
Description Creating Global Health Science forum at KCL 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Together with a colleague at KCL, Sophie Moore initiated the 'Global Health Science Cafe' a forum for networking/sharing of scientific ideas across global health with the Department of Women and Children's Health at KCL.
Year(s) Of Engagement Activity 2018
 
Description Greenman Festival 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Focus on nutritional biomarkers and future health. Public engagement activity, August 16-20.
Year(s) Of Engagement Activity 2018
 
Description IAEA conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact International symposium on Understanding the Double Burden of Malnutrition for Effective Interventions. IAEA, Vienna. 10-13 December 2018."

"I attended this conference with two aims: 1) to listen, learn from, and participate in discussions surrounding the double burden of malnutrition (DBM) as it effects Global Health; and 2) to network and perform extensive outreach to raise awareness of our current project in Global Health, OpeN-Global. The main peer/stakeholder group of interest would be at this meeting, and hence it was an important opportunity to capture and raise interest.
To achieve this, I purchased a tablet that could be hand-held, on which I could demonstrate the website live to peers.

Outcomes:
This event was very successful in raising awareness of OpeN-Global within the Global Health nutrition peer group. It also led to an increase in stakeholder involvement (with IAEA and Sight and Life), and an invitation to submit an article on the OpeN-Global website to the forthcoming Sight and Life magazine, which has a very large audience within Global Health."
Year(s) Of Engagement Activity 2018
URL https://www.iaea.org/events/understanding-the-double-burden-of-malnutrition-symposium-2018
 
Description OpeN-Global Launch Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact London, May 2018. Partner meeting with ~35 international partners from academia, science and industry to launch the OpeN-Global project.
Year(s) Of Engagement Activity 2018
URL https://open-global.kcl.ac.uk
 
Description OpeN-Global website live launch - Drs Moore & Farebrother 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This activity is the online launch of the OpeN-Global website, that was live streamed to an international audience.

OpeN-Global is an online knowledge resource that brings open-access information and technical support on nutrition biomarkers to nutrition researchers and other nutrition stakeholders globally.

The website was launched officially online with a launch event on 27 Feb 2019.
Year(s) Of Engagement Activity 2018,2019
URL https://open-global.kcl.ac.uk
 
Description Participation in Gates funded meeting on assessment of micronutrients, Oakland, March 2019 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Formal Advisory Committee meeting sponsored by the Micronutrient Forum and Bill & Melinda Gates Foundation, to contribute to projects relating to the broad topic on 'Determining optimal blood processing and handling parameters for micronutrient assessment'
Year(s) Of Engagement Activity 2019
 
Description RSTMH conference - Dr Jessica Farebrother 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Royal Society of Tropical Medicine and Hygiene. Annual Meeting: Intersections of Neglected Tropical Diseases with non-communicable diseases and the sustainable development goals. London, September 2018"

Though a nutrition scientist, I am also a pharmacist with global health experience and am keen to retain and develop my knowledge at this interface. The meeting subject allowed me to deepen my understanding of NTDs and also get research ideas for future across this intersection with NCDs and the role of nutrition in both. Attendance at this conference and networking with the RSTMH peer group also has extended my network.
Year(s) Of Engagement Activity 2018
URL https://rstmh.org/events/rstmh-annual-meeting
 
Description Steering group for King's Global Health Institute 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The King's Global Health Institute was formally launched in 2018. I represent the School of Life Course Sciences and Department of Women and Children's Health as a member of the KGHI Steering group.
Year(s) Of Engagement Activity 2018,2019
URL https://www.kcl.ac.uk/kghi
 
Description Transforming Nutrition Science for Better Health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact A Joint Wellcome Trust - WHO consultation [15-17th October 2018]. Invited participant.
Year(s) Of Engagement Activity 2018