1. INTRODUCTION

The Centre of Excellence for Nutrition (CEN) was established in 2008, when the nutritionists and dietitians, previously part of the Africa Unit for Trans-disciplinary Health Research (AUTHeR), were given the opportunity to focus on nutrition in their research. This focus is determined by the prevailing nutritional problems in South Africa, the rest of Africa and also globally. The vision of the group, to contribute through all their activities to the sustainable improvement of nutritional status of individuals, families and society, is supported by their main aim to provide scientific evidence for the solutions of nutritional problems through high quality research.  During 2008 and 2009, the major strategic objectives of the group were:

• Firstly, to consolidate the good research done while part of AUTHeR, with a more explicit focus on nutrition. To improve the quality, depth, and understanding of the underlying mechanisms of their observations, the group decided to expand their molecular work, including more genetic research to support the clinical and epidemiological (public health nutrition) research, being unique in their scope from “molecules to society”

• Secondly, the group realised that they will have to position themselves as the leading nutrition research group in Africa and international role players in nutrition. The challenge was to promote the group as leaders in nutrition research and training, both nationally and internationally, through dissemination of the outputs and outcomes of all their activities;

• Thirdly, the group decided to be more supportive, relevant and involved in national and international nutrition activities as consultants and advocates, contributing with this “service delivery” role to their social responsibility;

• Fourthly,  the group accepted the challenge of further  “internal” capacity building, by improving the academic and NRF profiles (research skills, competencies and internationalization) of the members of the group. The stated goals were to increase post-doctoral fellows and postgraduate students, as well as expanding and improving laboratory infrastructure, creating an environment for research in which it would be possible to reach our goals.

The objectives of this annual report are firstly to evaluate how well we have progressed on the path of reaching the above-mentioned major strategic objectives (section 1); secondly, to submit the strategic plan for 2010 – 2012 (section 2); thirdly to summarise the administrative profile and outputs for 2009 (section 3); fourthly to discuss the financial profile for 2009 (section 4); and lastly, to apply for the 2010 strategic funds to increase our research capacity, but also to maintain and replace existing equipment (section 5).

2.  SUB-PROGRAMMES AND RESEARCH LEADERS

 The following brief discussion of the sub-programmes in CEN, illustrates the approach, focus, relevancy, development and quality of research and post-graduate training in CEN. In essence, the sub-programmes are integrated, with all staff members contributing in some capacity to all. The divisions into sub-programmes are to illustrate the focus of specific projects and for obtaining funding by a particular group of researchers for specific goals. In each of these sub-programmes, a particular nutritional problem is examined from molecular to societal level, integrating epidemiological, clinical and molecular (genetic) studies. This approach, combined with the ability and expertise of the researchers in CEN,  has helped to position CEN as a leading and  unique nutrition research group.

The nutrition transition (NT): Leader, Prof. HH Vorster

The relationships between nutritional exposures and health outcomes, as well as modulating and influencing factors, are examined in cross-sectional and prospective epidemiological studies, intervention and clinical trials, and in mechanistic molecular and genetic experimental studies.  Problems such as roles of individual nutrients, the impact of urbanisation, obesity, inactivity, alcohol abuse, undernutrition, HIV/AIDS, poverty, nutrient requirements, and nutrition education of the public are addressed. Results of this work have been used in formulating nutrition policy in South Africa and have focused world attention on the nutritional situation in rural Africa. Running projects are the NRF funded study, “Alcohol: from molecules to society”, the nutrition and health relationships in the multi-funded, international “PURE” study, and the WHO funded “Food-based dietary guideline” study.

Micronutrients and fatty acids : Leaders, Prof. JC Jerling and Prof. CM Smuts

Key micronutrients and essential fatty acids (FAs) are examined in several intervention studies. Aspects such as availability (in food sources, fortificants and specifically designed supplements), absorption, requirements, metabolism, turnover, physiological and pathological effects on human development and health, are researched. These studies are inter alia funded by international corporate sponsors and a grant from the European Union.  Two running cutting-edge intervention projects in this programme (the Beformi and FeFa studies) address the major nutrition problem of micronutrient deficiencies in African children and other developing countries and focus at present on optimal supplementation and fortification strategies for child development. These studies are unique because the interactions between certain micronutrients and FA on both cognitive development and the immune system are researched in depth. The research is positioned internationally with expert co-workers from several countries.

Childhood public health nutrition: Leader, Prof. HS Kruger

Factors affecting the nutritional status and health of South African children are examined in  epidemiological, clinical and intervention studies.  The role of nutrition and activity on body fat distribution, cognitive development of children, as well as interrelationships between nutrition and treatment of HIV-infected children are examined. In addition, this sub-programme  addresses the double-burden of nutrition-related diseases in South Africa, focusing not only on underdevelopment and infectious diseases, but also on the link between maternal malnutrition and risk of non-communicable diseases in their offspring. Important milestones of this programme are participation in national surveys, inputs into fortification policies in South Africa, as well as prize-winning international publications on child health, body composition, and risk of adult non-communicable diseases.

Nutrition and haemostasis: Leader, Prof. M Pieters

The influences of nutrition on levels and functions of blood coagulation and fibrinolytic proteins during health and disease are examined using cutting edge technology.  We are one of the very few groups in the world focusing on these relationships and are generally regarded as leaders in the field.  In addition to our specialised infrastructure developed over the years, access to biological samples obtained in our other programmes offers unique opportunities for in-depth research of the role of nutrition and other exposures on the haemostatic system. Our activities in this field have lead to major new understandings of basic molecular effects of amongst others, alcohol on haemostasis and to the role of hypercoagulability in diseases such as diabetes and coronary artery disease. We have international patents in this field.

Nutrigenetics: Leader, Dr. W Towers

This is a new programme which developed from our need to have a better understanding of the genetic basis of human heterogeneities in responses to nutritional exposures. We appointed a geneticist on our permanent staff as well as post-doctoral candidates to assist in establishing the laboratory and in training the 3 Ph.D. students presently in the programme.  The laboratory and techniques to do DNA extractions and specific genetic analyses have now been developed and standardised, and the first manuscripts have been submitted to high impact-factor journals for publication. The next step is to ensure that the laboratory is better equipped to handle the growing volume of work to include this depth to all our projects.

Sports nutrition:  Leader, Dr. HH Wright

This sub-programme became independent in 2009. A post-doctoral candidate was recruited in 2009, seed funding provided by CEN and applications submitted to the MRC and NRF. Factors affecting the nutritional status and health of South African athletes, especially female athletes, are investigated in cross-sectional, intervention and clinical studies.  The female triad project runs parallel with an American study and focuses on the relationship between energy availability, bone health, and menstrual function in female athletes;  the impact of physical activity and diet on body composition (bone mineral density, fat mass and lean mass) is also examined.  This new sub-program has already received some international recognition. It addresses an urgent need for nutritional assistance in all sports and is especially active in services to the sports community.

Nutrition leadership development: Leader, Prof. JC Jerling

The African Nutrition Leadership Programme (ANLP) initiated by Prof. Johann Jerling  and funded through staff time by the NWU, as well as grants from several international organisations is now in its eighth year. The programme has already developed leadership in 163 young nutrition scientists from 28 different African countries, and is generally regarded as the most successful leadership programme in nutrition under the auspices of the IUNS.  It  serves as a recruitment base for post-graduate students and post-doctoral fellows. Its alumni network is a valuable resource for the CEN’s activities in other parts of Africa. The annual reports and other information about this programme, can be obtained from: johann.jerling@nwu.ac.za.

3. EVALUATION OF CEN ACTIVITIES IN 2009

The outcomes, outputs and impact of our activities in 2009 will be briefly discussed and evaluated in context of our strategic objectives as stated in the introduction. Details about this output in context of the NWU expectations are given in the administrative profile in section 3. Not all outputs mentioned here are those that generate subsidy for the University. They should be seen as a long-term investment in the positioning, research, and service delivery by CEN research staff. The impact of some of these actions on outputs are indirect, such as helping to generate funds from the corporate sector.
 
Cutting edge and quality of research and training of M. and Ph.D. students

The quality, depth and relevance of our research are illustrated by the peer-reviewed publications given in Table 3.2.1 in section 3 (with a 2009 date) and in Box 6.1 in section 6 (with an early 2010 date).  Of the 13 publications with a 2009 date and the 26 with a 2010 date, more than half were in international journals, some with very high to high impact factors (IF), such as Lancet (IF =28.4), British Journal of Nutrition (IF =2.763) and European Journal of Clinical Nutrition (IF =2.686). The 26 with an 2010 date include American Journal of Clinical Nutrition (IF =6.74), Thrombosis and Haemostasis (IF =3.803) and The International Journal of Cardiology (IF = 3.121). Establishing and developing a nutrigenetics laboratory, and appointment of a geneticist (Dr. Wayne Towers) on the permanent staff,  has brought more depth and widened the scope of all our other projects. The first publications and doctoral students in this area are being delivered in 2010, from genetic research conducted on samples obtained in our clinical, intervention and epidemiological research. The equipment in our analytical laboratory enabled us to do specific fatty acid analyses in the PURE study, leading to the manuscript that has been published in American Journal of Clinical Nutrition in 2010 (Stonehouse et al.).

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