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Friday 21 January 2022 3:44pm

Jim Mann image
Professor Jim Mann.

Newly-knighted Otago researcher Professor Jim Mann is calling on the Government to follow its world-leading anti-tobacco policies with a National Food Strategy.

The internationally renowned academic was made a Knight Companion of the New Zealand Order of Merit, for services to health, in the 2022 New Year Honours.

The award follows a CNZM in 2002 and recognises his decades of work demonstrating links between nutrition and health which have informed world-leading interventions in the fields of coronary heart disease and diabetes.

Long before COVID, Professor Mann and his colleagues were sounding the alarm over another looming pandemic – diabetes.

Slower-moving than COVID, and in many cases preventable though diet and exercise, the Type 2 diabetes pandemic is now forecast to swamp the health systems of Aotearoa New Zealand and other nations in the coming decades.

“It was all predicted in the 1980s. And, yes, we [the world] did nothing. So we got the epidemic and now there's a pandemic of diabetes.”

“It was all predicted in the 1980s. And, yes, we [the world] did nothing. So we got the epidemic and now there's a pandemic of diabetes.”

Professor Mann, co-director of the Otago-based Edgar Diabetes and Obesity Research Centre (EDOR) and Director of the Healthier Lives National Science Challenge, wants the Government to make nutrition a key part of its health policy to tackle this crisis.

“They need to take what people eat as seriously as they're taking tobacco. It's more difficult because there's no merit in tobacco and there is merit in food. But we need a National Food Strategy. Food exports are a major contributor to our economy, food is essential for human and animal life, food is of major cultural and societal significance but food is also a major contributor to the global burden of disease in New Zealand.”

Research has clearly established the extent to which obesity and associated health problems like diabetes, cardiovascular disease and some cancers can be appreciably reduced with the right nutrition – that principally involves increasing plant-based food sources (wholegrains, vegetables and fruits) and reducing reliance on animal protein, saturated fat and added sugars.

“The majority of New Zealanders can achieve adequate intakes of all essential nutrients from such a dietary pattern given the wide range of foods we have available. However, food insecurity is becoming an increasing issue and of course in many less affluent countries the situation is quite different.

“In addition to health, economic and cultural considerations, a National Food Strategy requires an evidence-based approach to food production, education, advertising and food labelling. There are relatively few countries that have actually achieved and implemented such a strategy.

"However if any country should be pioneering it, it should be New Zealand because food is a key determinant of our health and wellbeing as well as our economy, and how we produce it, a critical factor in future planetary health.”

He points to New Zealand's “world-leading” Healthy Eating Healthy Action (HEHA) strategy which ran in the 2000s targeting young people before being discontinued.

“If you focus on children it gets through to the family and then has the potential to permeate through communities. The HEHA programme did just that, but we've done away with it. Something along those lines should be reinstated immediately. The current Government has done some stuff but not enough. Not remotely enough.”

Professor Mann is no stranger to prodding the Government into action. Last year EDOR and the Healthier Lives National Science Challenge in collaboration with Diabetes New Zealand commissioned and provided expert advice for The Economic and Social Cost of Type 2 Diabetes report which quantified the impact of the emerging crisis and demonstrated the cost benefit of a range of interventions which, if implemented, have the potential to reduce the disease burden associated with diabetes.

His role as director of Healthier Lives National Science Challenge involves supporting research into the prevention and treatment of cancer, cardiovascular disease, diabetes and obesity with a vision of achieving equitable health outcomes in the people of Aotearoa New Zealand. At present there are considerable health inequities amongst different sections of the population.

At the age of 77, after being published in almost 400 scientific publications and 90 book chapters, Professor Mann remains very much an active contributor to his field. A month at his holiday home to start 2022 will be spent editing the sixth edition of his very successful textbook Essentials of Human Nutrition.

“My father worked as a GP until he was in his mid 80s. So I've got quite a few years yet.”

Born in South Africa, Professor Mann received his medical education, early clinical experience and introduction to research there and in England. His first and only substantive appointment before he and his family migrated to New Zealand was as a lecturer at the University of Oxford and honorary physician at the Radcliffe Infirmary.

He first became known in the research community in the UK after challenging a British Medical Journal article by a prominent UK cardiologist who contended diet did not play an important role in heart disease.

“The entire response did not relate to the pros and cons of the argument or who was right. It was 'Who is this upstart who had the audacity to challenge the opinion of a senior colleague?' That really excited my interest in both the topic and the need for an evidence-based approach to all aspects of medicine.”

Professor Mann moved to Otago in 1988 with the promise of a job which would allow him to balance research and clinical work, becoming Professor of Human Nutrition and Medicine and Head of Endocrinology at Dunedin Hospital.

“Perhaps the major contribution which has been made by my colleagues and myself has been the development of a strong evidence base for some important determinants of human health and potential treatments. An example of this has been the extent to which dietary fibre can improve health outcomes of people with diabetes as well as reducing the risk of developing and consequently premature death resulting from diabetes, colorectal cancer and coronary heart disease.”

This and comparable research relating to added sugars has informed national and international guidelines relating to disease management and health promotion issued by the World Health Organization and other health bodies.
He describes himself as an optimist and cites progress made to curb smoking as an example of how public health initiatives can be implemented to curb non-communicable disease.

“I'm always optimistic because there's no other option. The only alternative is to give up and that's not an option.”

Receiving the knighthood was a pleasant surprise, although Professor Mann says with a laugh that he almost accidentally deleted the email while clearing the torrent of correspondence in his inbox.

“It's great recognition but I see it as recognition for what we as a group of colleagues and collaborators with a shared vision have been trying to achieve rather than recognition for me. And I think that's the way it's intended. Somebody's got to front up and in this instance that seems to be me.”

And what about the title that comes with the honour?

“I can't stop people from using it. But you won't get a letter from me signed Sir Jim,” he laughs.

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