Current areas of focus
Capacity building in Africa (CANA study)
While the incidence of cancer is rapidly increasing in low- and middle-income countries (LMICs) and changing dietary patterns play an important role, grant proposals on nutrition and cancer submitted by LMICs scientists rarely qualify for funding. Working with Wageningen University and a newly formed group of African scientists within the African Nutrition Society, Cancer and Nutrition Africa (CANA), the aim is to develop an online course to improve grant writing capabilities across Africa in the first instance, as an imperative for the development of a high quality, relevant and context specific research programme in this region. The longer-term ambition is to develop a series of studies across the continent using standardised and validated methodologies that together will create the equivalent of an EPIC (European Prospective Investigation into Nutrition and Cancer) for Africa.
As part of building technical capability for this ambition, the online grant writing course is based on experience of similar courses within Wageningen University and intends to cover various aspects of grant writing such as formulating a research question, designing the most appropriate study, calculating study size, planning and budget, as well as other training skills relevant for grant writing. A pilot study was conducted early in 2021 as part of Wageningen University’s ongoing distance learning programme, offering a chance to evaluate and refine the course at an early stage. CANA is made up of a group of extremely enthusiastic and committed African scientists who themselves completed the first pilot study. With support from the University and ICONIC, CANA planned and led a second pilot course modified to be sensitive to the African context, which was offered in West Africa later in 2021. The plan is to hold a further two pilot courses across Africa in 2022, and in parallel to develop a more detailed plan of work towards the longer-term ambition.
Nutrition in children, teenagers and young adults (CTYA)
With multiple stakeholders leading and supporting initiatives in research in the area of nutrition and cancer in children, teenagers and young adults (CTYA), ICONIC supports the development of an agreed framework that will help to share current knowledge, identify gaps and set research priorities that together will enhance opportunities for improved care.
Malnutrition poses serious challenges in the management of children throughout their cancer journey, from prior to diagnosis into long‐term survivorship. There is a need to better understand the mechanisms by which poor nutritional state influences the resilience to disease, response to treatment, and outcomes for children with cancer, so that ultimately this knowledge can be incorporated into clinical care and provide individuals and populations with evidence-based guidance.
This area of work was the focus of the first of a series of Virtual Dialogue sessions in 2021, hosted by ICONIC in collaboration with UICC. This brought together experts in the field to share their experience and the group has since been looking to see how they might work together moving forward and where activities might align.
The group is planning to host a second Special Focus Dialogue in 2022, under the broad theme of childhood obesity and cancer.
Following publication of a report by NIHR in collaboration with Macmillan (a cancer care charity) and the Royal College of Anaesthetists “Principles and guidance for prehabilitation within the management and support of people with cancer” in 2019, ICONIC committed to explore opportunities to make these prehabilitation guidelines for people with cancer more widely available and consider how the findings might be projected internationally. The report called for a greater focus on prehabilitation, including nutrition, physical activity and psychological support, in the delivery of cancer care.
In December 2021, ICONIC was pleased to host the second in its series of online Special Focus Dialogues in collaboration with UICC, this one with a focus on prehabilitation and cancer: Special Focus Dialogue: Prehabilitation – Multimodal interventions to improve resilience and response to treatment in cancer | UICC. Experts came together to share their experience in developing, implementing and evaluating prehabilitation interventions, including how being nutritionally, physically and psychologically ‘unfit’ might influence the resilience to cancer and how multimodal prehabilitation can help decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. In 2022, ICONIC will be considering plans for next steps in this area.
- IUNS 22nd International Congress of Nutrition
ICONIC will be hosting a symposium at International Congress of Nutrition on Thursday 8th December 2022 – Supporting better collaboration in nutrition and cancer: A global approach ICN TOKYO (icn22.org). The aim of the symposium is to provide an overview of ICONIC’s work and engage with those interested in its activities.
- Virtual Dialogues in Collaboration with UICC
ICONIC has been hosting a series of Virtual Dialogues in collaboration with UICC, with the following two successful Special Focus Dialogues in 2021 (session recordings can be viewed via the links below):
These sessions are a chance to connect, exchange knowledge, access expert insights and share solutions on respective and common challenges. Further sessions are being planned for 2022 – including a second Special Focus Dialogue on nutrition and childhood cancers and under the broad theme of obesity.
WHO guideline development: severe wasting in children aged 6 months and over
In September 2020, ICONIC joined forces with the International Malnutrition Task Force (IMTF) to conduct a preliminary search of the evidence on severe wasting in infants and oedema in children aged six months and over. This was in response to a call from the World Health Organization‘s (WHO) Department of Nutrition and Food Safety, in collaboration with the Department of Maternal, Child, Adolescent Health and Ageing, to undertake scoping reviews of available evidence in order to propose key questions that the guideline on prevention and treatment on wasting in infants and children would need to address.
The scoping review was led by Professor Ann Ashworth and the completed review was presented to the WHO Guideline Development Group in December 2020 and this was an initial step in a formal process of guideline development.
In May 2021, WHO engaged the IMTF/ICONIC review team to undertake another scoping review on fluid management strategies for infants and children >6 months with moderate or severe wasting or oedema, with signs of shock or severe dehydration. This was to further inform the WHO wasting guideline process, to determine if there was sufficient literature to conduct a full systematic review on this area. The team submitted their report in July 2021 and the decision was made not to proceed with the full review.