Under the heading “Nutrition Monitoring – experiences from NHANES”, Alanna Moshfegh, long-standing head of the Food Surveys Research Group at the US Department of Agriculture’s Human Nutrition Research Center, presented the US National Health and Nutrition Examination Survey, known by the abbreviation NHANES. The first NHANES survey was conducted in 1971; since 1999, 5,000 people have been surveyed annually. Every other year, the results are published online. Dr Marga Ocké from the National Institute for Public Health and the Environment in the Netherlands followed up with a presentation on the situation in Europe entitled “Developments and perspectives in European nutrition surveys”. Due to varying dietary habits and the differences in the studies carried out within Europe, harmonisation efforts have long been underway to make results more comparable. German experience with national nutrition monitoring was described by Dr Carolin Krems from MRI’s Nutritional Behaviour Institute in her lecture “Experiences from the German National Nutrition Monitoring”. She paid particular attention to NVS II (National Nutrition Study II) and the NEMONIT Study.
After this overview of the topic as a whole, the challenges and developments in planning studies was the first focus of attention: Internationally, a drop in the willingness to participate in studies has been observed, which means that the so-called response rate drops. One of the points considered by Dr Bärbel-Maria Kurth from the point of view of health monitoring in Germany (Title: New challenges for population based Health Examination Surveys) was how to increase people’s willingness to take part in monitoring. Drawing on the example of the recently completed Portuguese nutrition survey, project coordinator Carla Lopes’ contribution entitled
“Experiences from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016” discussed the specific challenges they had had to face and how they dealt with them.
Developments in the technical field and new nutritional survey methods were the subject of the second focus area. In her lecture “New devices to assess diet – applicable for nutrition monitoring?”, Professor Janet Cade, leader of the Nutritional Epidemiology Group at the University of Leeds, UK, gave an overview of new options for recording food intake such as devices for measuring swallowing and/or hand-to-mouth movements or cameras for capturing the eating process. She particularly emphasised online surveys of participants which are gaining in acceptance. When checking accuracy, known as validation, comparisons between online and interview-based surveys deliver similar results. In the future, access to and acceptance of online surveys will be ever less of a hurdle, according to the conference participants. Against the backdrop of the highly dynamic food market, one of the challenges is, however, to maintain the efforts required to capture the foodstuffs and nutritional data used in the survey methods.
The question as to whether the use of metabolomics could help to identify biomarkers for food intake was addressed by Professor Sabine Kulling from MRI’s Institute for the Safety and Quality of Fruit and Vegetables in her presentation with the title “Exploring dietary intake markers – chances and limitations of metabolomics”. In the last few years, MRI has established an analytical platform for metabolic analytics which are now also used in intervention and cohort studies to identify dietary intake markers. It became clear that various factors significantly influence the complex metabolite profile of foodstuffs, which must be taken into account when searching for markers. So far, no fewer than approx. 150 metabolites have been described as potential biomarkers for the intake of certain foodstuffs, but only a few of them have already been validated, which is a complicated and challenging undertaking. Various examples were cited illustrating that individual metabolites are often not specific enough or robust enough to reliably indicate the intake of a certain foodstuff; in the future, it will probably be necessary to resort to a combination of at least two metabolites.
In spite of all the challenges, it is considered worth pursuing these developments: In five to ten years’ time, Kulling predicts, validated and thus very reliable dietary intake biomarkers will be available for certain foodstuffs or food groups. Quantitative statements depend on the sample material that is available from studies and therefore requires additional research. The scientist is in no doubt that these markers will not replace the traditional methods of registering food intake, but they could become a valuable addition.
Pride of place in another thematic block was given to harmonisation: In order to carry out European nutrition monitoring in a harmonised fashion, a good research infrastructure is necessary. One step along this path are joint recommendations on conducting national studies.
Dr Davide Arcella from the European Food Safety Authority (EFSA) reported on the authority’s harmonisation efforts which aim to facilitate European-level access to comparable consumption data from national studies for risk assessment. In his presentation entitled “EU Menu – experiences and perspectives”, he gave an overview of the current recommendations on items like recruiting, survey methodology and the financial support available from EFSA for national nutrition surveys. Harmonising food consumption databases is also a major issue as they are the basis for evaluating dietary intake in consumption surveys. In his lecture, Mark Roe from the Quadrum Institute Biosciences, Norwich, UK, thus reported on the status of development of “European food composition databases – experiences and perspectives”, highlighting in particular the implementation of standards initiated by EuroFIR in the harmonisation and quality assurance of food composition data. In this context, software solutions that manage nutrition data and allow it to be accessed online play a crucial role.
The spotlight in the final thematic block was directed on the issue of dealing with the increasing amounts of data (Big Data) and the challenges this poses. On the one hand, it is a challenge to extract any sort of useful information from the huge mass of data available; on the other, the collection of data and how it is handled is also a cause for concern. At the Max Rubner Conference 2017, these tensions were also considered from a philosophical and legal point of view in order to respond appropriately to the situation of society as a whole. Professor for Ethics in Information Technologies at the University of Hamburg, Judith Simon, spoke on “Big Data – ethical, epistemological and political considerations”, including the uneven distribution of opportunities for accessing and using the data and the concomitant asymmetry of power. A new empiricism is growing in the context of Big Data in which analysis is not theory driven, rather, the data speak for themselves. The necessary evaluation of the data originally generated gets lost in the process. Consequently, the question about the quality of the data for Big Data analysis has to be asked. For Judith Simon, legislative options, agreements with industry on rules of behaviour, predefined controls in the interest of those concerned and much more intensive training are the four pillars that should accompany future developments.
During his lecture on “Research data – legal perspective on public and private interest”, Steffen Augsberg, Professor of Public Law at the University of Giessen and Member of the German Ethics Council, made it clear that whilst data protection is based on a fundamental right, he doubted whether there was such a thing as a ‘right of ownership’ to data. On the basis of the EU General Data Protection Regulation, which will become the legal basis for data protection for the Member States of the European Union in May 2018, he discussed the extended rights of those concerned as well as transparency obligations and the issue of consent. He closed his presentation with the announcement that the Ethics Council will be issuing a statement on this topic at the end of the year.
Rounding off this thematic block, Paul Burton, Professor of Data Science from the Institute of Health and Society at Newcastle University, introduced the DataSHIELD project to illustrate how the data from several studies can be jointly evaluated without ever leaving the original server. The principle whereby the evaluations are sent from a central computer to the respective data servers, rather than the other way around, means that the data needed for the analysis remain with the data owner and can neither be copied, screen-dumped nor even seen as individual values.
At the close of the conference, Professor Ingrid Hoffmann, head of MRI’s Institute of Nutritional Behaviour, invited the participants to gather at standing tables to share their visions on the themes of the conference and potentially launch collaborations or new initiatives.
One result of their lively participation was the wish to intensify cooperation and exchange and even establish a regular European meeting on all the facets of Nutrition Monitoring. Whether the conference and the final block with its invitation to participate really will kick-start new initiatives and ideas is something the coming years will reveal.