Re-emerging iodine deficiency in high income countries

Re-emerging iodine deficiency in high income countries

Iodine nutrition and metabolism

Iodine is an essential mineral regulating overall metabolism. It plays an important role in foetal brain development and the function of several other organs, particularly the thyroid gland. Because of its nutritional relevance in gestation and child development, even moderate iodine deficiencies in pregnancy increase the risk of preventable intellectual impairment in the foetus. This may go on to affect the educational and economic potential in adulthood. Iodine intake and status of the global population is therefore of key importance to public health stakeholders.

Over a century ago, widespread iodine deficiency led to the implementation of salt iodisation as a food-based strategy to combat insufficient iodine intake. This began in High Income Countries (HICs) like the USA and in Europe. Since then, this strategy has become the most successful fortification effort against micronutrient deficiency in developing countries. However, about 30% of the world’s population are still at risk of iodine deficiency with the highest prevalence in Southeast Asia and East Mediterranean regions.

Iodine sources and iodine status in HICs

Iodine deficiency has also begun to re-emerge in HICs like the USA, UK, and Australia, posing a major risk to the health of women and children. Recent studies have confirmed this re-emergence: Data surveys showed inadequate iodine status of <150 μg/L in about 56% of pregnant women in the United States and only 8 out of 21 countries in the European population showed an adequate iodine status. Also, 17% of women aged 16-49 were iodine deficient in the UK, UK National Diet and Nutrition Survey. This could be a result of changing dietary patterns, agricultural and food production practices, Lee et al 1999.

Iodine deficiency is one of the most common nutrient deficiencies globally and it is estimated to affect 2.2 billion people in the world at varying degrees of severity. The prevalence could be more, as mild deficiency causes sub-clinical effects such as functional and intellectual impairments. Severe iodine deficiency is associated with the development of goitre, neurodevelopmental disabilities and mental impairment in babies born to mothers who are iodine deficient. It also causes delayed physical development in children, decreased fertility, stillbirth, and congenital anomalies.  

Iodine occurs naturally in soil and sea water, with meat, dairy, and eggs known to be good dietary sources of iodine. Inland and mountainous regions of the world have iodine deplete soils hence food crops from these areas are not generally rich in iodine compared to coastal regions. This explains why iodine deficiency occurs most commonly in inland regions of the world like continental Africa, Asia, Central and Eastern Europe and parts of the USA.  Other agricultural and industry practices such as use of inorganic fertilisers, iodate dough conditioners for making bread and use of iodine-supplemented feed for livestock are ways to supplement iodine intakes through the diet in developed countries.

Changing iodine levels in the diets of HICs

In recent years, some variability has been observed in the iodine content of dietary food sources known to be naturally high in iodine such as seafood, eggs, and milk and in bread from the use of iodised salt in industrialised countries. Given this variation in iodine content, an individual may need to consume larger portion sizes of these foods to meet daily iodine requirements and thus the potential overconsumption of other nutrients from that food, i.e. carbohydrates and calories in the case of bread.

Most industrialised countries do not mandate salt iodisation and not all who have salt iodisation standards mandate the use of iodised salt in restaurant and processed foods.  In the USA for instance, only half of table salts sold in retail stores are iodised. Hence a majority of out of home meals and commercially processed food, which are major contributors to the diet in these countries, may be lacking in iodine. Also, ongoing public health messaging on salt reduction recommendations for preventing hypertension and other cardiovascular diseases has led to a general reduction in salt use especially for people who are already hypertensive. Similarly, a reduction in the consumption of refined flour-based products such as breads, as a strategy to prevent obesity, limits the intake of iodine in countries where bread is fortified through iodised salt. This is a typical example of one public health drive working against another.  Several other changes to agricultural, food manufacture and individual consumption practices in HICs are contributing to lower supply of iodine in diets and lower iodine status in these contexts.

Factors associated with the changing iodine levels in food and diets of HICs.

Hatch-McChesney & Lieberman in their recent review named several factors as likely causes of low iodine intakes in HICs. Flachowsky et al. suggest that variation in iodine levels in dairy milk and meat may be due to the reduced use of iodine supplemented feed for livestock and seasonal differences in feed iodine content. The increasing preference for organically farmed products with the use of forage feed, found to have 10x less iodine and yet higher goitrogen content compared to non-organic supplemental feed also contribute to lower iodine content of meat, milk, and eggs from livestock. Organic milk is also 25-40% lower in iodine when compared to conventional milk. The processing of milk in manufacturing plants cleaned without the use of iodophors as sanitising agents as was previously done also contributes to lower iodine levels in milk and diary.

Changing dietary practices

At the consumer level, a shift to veganism and some forms of vegetarianism which have become more common in industrialised countries have been found to contribute to the declines in dietary intakes of iodine. The increased avoidance of dairy intake and shifts to the intakes of plant-based food alternatives such as oat and almond milk-alternatives has doubled in recent years in the UK and USA, but they are not typically fortified with iodine. They are hence not comparable in iodine content to dairy milks which are naturally good iodine sources. Other plant-based food alternatives like soy-based milk alternatives are known to interfere with iodine absorption.

Individual’s food choices and perceptions, which may influence their decision to use sea salt and other salt alternatives rather than regular iodised salt also contribute to the reduced iodine consumption in the diet. An increasing focus on high fibre diets without adequate attention to dietary diversification and balance may also contribute to iodine deficiency disease. Consumption of cruciferous vegetables like broccoli, kale and cabbage which are sources of natural goitrogens may interrupt thyroid function and iodine uptake in the body. Cassava, sorghum, maize, and sweet potatoes are also sources of goitrogens that have been associated with endemic goitre in developing countries in Africa and parts of Asia.

Changing iodine levels of dairy products – New Zealand

In the case New Zealand, despite being coastal, soils in are deficient in iodine and hence the mandatory fortification of bread with iodised salt since 2009 following a long period of salt iodisation. The country is also a major producer and exporter of meat and dairy to many other countries in the world, exporting 95% of the milk it produces as dairy products to over 100 countries. This supplies enough milk to meet the two and half servings of dairy requirement for nearly 100 million people daily. Considering current changes in agricultural practices such as reduced use of iodophors as sanitizers in New Zealand dairy industries and how pasture systems alter supply of iodine in feeds of livestock, it is likely that consumers of New Zealand milk may not be getting the expected level of iodine from this otherwise high dietary source of iodine.

Peter Cressey in his study reported significant variation in iodine levels in milk products sold in New Zealand. As the world’s largest dairy exporter, it may be important to explore how this variation affects iodine intakes of consumers of New Zealand milk in other countries where salt iodisation is not mandated and among those with low iodine intakes from other dietary and fortified food sources.

Promoting iodine intakes in HICs

To address the re-emerging situation of iodine deficiency in industrialised countries, the promotion of diary consumption, up to 3-4 servings per day is a feasible option to meet iodine needs of all age and physiologic groups. Getting iodine from milk and dairy offers a nutrient dense alternative to obtaining it from fortified bread which comes with extra calories or from iodised salt for hypertensive individuals on salt reduction regimes.

 Regarding the variability in iodine levels of milk, they could be fortified during processing to increase their iodine content.  In contexts where availability or access to dairy is limited, mandating the use of iodised salt in commercially processed food such as use in bread and other baked products is a useful alternative. Following the mandatory use of iodised salt in most bakeries from 2009, iodine status of New Zealand adult males and females from different ethnic groups was reported to be adequate in 2015.

Exploring the feasibility of iodising food supplies or enriching dairy and milk with iodine while reintroducing practices such as use of iodine fertilisers are beneficial strategies for increasing iodine intakes of populations. Promoting dietary diversification and a focus on nutrient density is another long-term and sustainable approach to addressing all forms of micronutrient deficiencies.

This Thought for Food was written by Justine Coomson, PhD Student, with the support of the SNi team.

Image from Photka on Getty Images. 



Professor Warren McNabb
Warren McNabb is a Professor of Nutritional Science at the Riddet Institute; one of New Zealand’s Centres of Research Excellence (CoRE), hosted by Massey University. He leads SNi® and his research interests include digestive physiology and metabolism, nutrition for health, and sustainable nutrition.
Project Leader | W.McNabb@massey.ac.nz
Professor Warren McNabb
Warren McNabb is a Professor of Nutritional Science at the Riddet Institute; one of New Zealand’s Centres of Research Excellence (CoRE), hosted by Massey University. He leads SNi® and his research interests include digestive physiology and metabolism, nutrition for health, and sustainable nutrition.
Project Leader | W.McNabb@massey.ac.nz
Dr Nick Smith
Nick works as a mathematical modeller on the Riddet Institute SNi®. He is responsible for a wide range of SNi's work and the continued development of the SNi models like the DELTA Model®. This is a tool for investigating how global food production meets global nutritional requirements as part of a sustainable food system.
Research Officer
Dr Nick Smith
Nick works as a mathematical modeller on the Riddet Institute SNi®. He is responsible for a wide range of SNi's work and the continued development of the SNi models like the DELTA Model®. This is a tool for investigating how global food production meets global nutritional requirements as part of a sustainable food system.
Research Officer
Dr Andrew Fletcher
Andrew is a Chemical Engineer with a PhD in process control and modelling. Andrew is a Honorary Fellow at the Riddet Institute and has been involved with SNi® since the outset. He is based at the Fonterra Research and Development Centre in Palmerston North and is involved in a range of research, management and strategy roles.
Honorary Fellow
Dr Andrew Fletcher
Andrew is a Chemical Engineer with a PhD in process control and modelling. Andrew is a Honorary Fellow at the Riddet Institute and has been involved with SNi® since the outset. He is based at the Fonterra Research and Development Centre in Palmerston North and is involved in a range of research, management and strategy roles.
Honorary Fellow
Professor Jeremy Hill
Professor Jeremy Hill has played a major role in developing SNi®. He has also been involved in developing strategic partnerships between Fonterra and the Riddet Institute. For example, the establishment of three Professorial Chairs in Food Material Science, Nutrition, and Consumer and Sensory Science. Jeremy is the Chief Science and Technology Officer at Fonterra.
Adjunct Professor
Professor Jeremy Hill
Professor Jeremy Hill has played a major role in developing SNi®. He has also been involved in developing strategic partnerships between Fonterra and the Riddet Institute. For example, the establishment of three Professorial Chairs in Food Material Science, Nutrition, and Consumer and Sensory Science. Jeremy is the Chief Science and Technology Officer at Fonterra.
Adjunct Professor
Dr Mahya Tavan
Mahya is a postdoctoral research fellow working on the development of the iOTA model. iOTA is a dietary optimisation tool for designing sustainable diets that are nutritious, acceptable and affordable. Prior to joining SNi®, Mahya held a research role at the University of Melbourne, Australia where she carried out various research projects on sustainable food production, resource use efficiency and biofortification of fresh food.
Postdoctoral Research Fellow
Dr Mahya Tavan
Mahya is a postdoctoral research fellow working on the development of the iOTA model. iOTA is a dietary optimisation tool for designing sustainable diets that are nutritious, acceptable and affordable. Prior to joining SNi®, Mahya held a research role at the University of Melbourne, Australia where she carried out various research projects on sustainable food production, resource use efficiency and biofortification of fresh food.
Postdoctoral Research Fellow
Raquel Lozano
Raquel is a postdoctoral research fellow creating models for national food systems. Her PhD research focused on helping design horticultural packaging systems to minimise the environmental impact. Raquel was awarded the International Society of Horticultural Sciences Young Minds Award in 2023, and is keen to use mathematical modelling to provide holistic information to decision-makers in the area of sustainable nutrition.
Postdoctoral Research Fellow
Raquel Lozano
Raquel is a Postdoctoral Research Fellow creating models for national food systems. Her PhD research focused on helping design horticultural packaging systems to minimise the environmental impact. Raquel was awarded the International Society of Horticultural Sciences Young Minds Award in 2023, and is keen to use mathematical modelling to provide holistic information to decision-makers in the area of sustainable nutrition.
Postdoctoral Research Fellow
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
Ejovi Abafe
Prior to his current PhD, Ejovi obtained a Master’s and a Bachelor’s degree in Agricultural Economics from the University of South Africa (UNISA) and Delta State University, Nigeria. The current focus of his PhD at the Riddet Institute is Global land use for the delivery of nutrition.
PhD Student
Ejovi Abafe
Prior to his current PhD, Ejovi obtained a Master’s and a Bachelor’s degree in Agricultural Economics from the University of South Africa (UNISA) and Delta State University, Nigeria. The current focus of his PhD at the Riddet Institute is Global land use for the delivery of nutrition.
PhD Student
Justine Coomson
Prior to her current PhD, Justine obtained a Masters degree in Population, Family and Reproductive Health and a Bachelor's degree in Dietetics from the University of Ghana. Justine has worked as a research assistant and a clinical dietician in Ghana before coming to New Zealand. The current focus on her PhD is the impact of biofortification and supplementation to diets.
PhD Student
Justine Coomson
Prior to her current PhD, Justine obtained a Masters degree in Population, Family and Reproductive Health and a Bachelor's degree in Dietetics from the University of Ghana. Justine has worked as a research assistant and a clinical dietician in Ghana before coming to New Zealand. The current focus on her PhD is the impact of biofortification and supplementation to diets.
PhD Student
Hannah Ramsay
Hannah is the Project Manager for SNi®. She started her career in the Riddet Institute when she first came to New Zealand and has since done project and event work across various educational institutes. The opportunity to return to Project Management at the Riddet Institute was very welcome, especially given the fascinating research and mahi conducted as part of SNi®.
Project Manager | H.Ramsay@massey.ac.nz
Hannah Ramsay
Hannah is the Project Manager for SNi®. She started her career in the Riddet Institute when she first came to New Zealand and has since done project and event work across various educational institutes. The opportunity to return to Project Management at the Riddet Institute was very welcome, especially given the fascinating research and mahi conducted as part of SNi®.
Project Manager | H.Ramsay@massey.ac.nz
Dr Amelia Barker
Amelia is a Communications Officer at the Riddet Institute. She has many years experience in digital media communications at various organisations. Amelia is passionate about research and enjoys promoting the fantastic mahi (work) that SNi® does.
Communications Officer
Amelia Barker
Amelia is a Communications Officer at the Riddet Institute. She has many years experience in digital media communications at various organisations. Amelia is passionate about research and enjoys promoting the fantastic mahi (work) that SNi® does.
Communications Officer
Rangimarie Hunia
Rangimarie Hunia was appointed an alternate director of Te Ohu Kaimoana at the beginning of 2015 before being appointed a full director in November 2015, and Chair in July 2019. The first wahine (woman) Chair in the history of Te Ohu Kaimoana. In 2017, she was appointed a Chair of Te Pūtea Whakatupu Trust. In 2016, she was appointed Chief Executive of Ngāti Whātua Ōrakei Whai Maia. Whai Maia is responsible for the well-being of its 5,000 tribal members and focuses on education, health, employment and environmental areas. She played an active role as a member of the Iwi Working Group that was established to facilitate understanding and iwi decision making in response to the 11-year Review of Māori Fisheries Settlement entities. Rangimarie is also a member of Global Women and was a finalist in the Westpac Women of Influence Awards 2014.
Ngāti Whātua Chair of the SNi® International Advisory Group Chief Executive of Ngāti Whātua Ōrakei Whai Maia
Rangimarie Hunia
Rangimarie Hunia was appointed an alternate director of Te Ohu Kaimoana at the beginning of 2015 before being appointed a full director in November 2015, and Chair in July 2019. The first wahine (woman) Chair in the history of Te Ohu Kaimoana. In 2017, she was appointed a Chair of Te Pūtea Whakatupu Trust. In 2016, she was appointed Chief Executive of Ngāti Whātua Ōrakei Whai Maia. Whai Maia is responsible for the well-being of its 5,000 tribal members and focuses on education, health, employment and environmental areas. She played an active role as a member of the Iwi Working Group that was established to facilitate understanding and iwi decision making in response to the 11-year Review of Māori Fisheries Settlement entities. Rangimarie is also a member of Global Women and was a finalist in the Westpac Women of Influence Awards 2014.
Ngāti Whātua Chair of SNi® International Advisory Group Chief Executive of Ngāti Whātua Ōrakei Whai Maia
Jeroen Dijkman
Dr. Jeroen Dijkman is the founding head of the Nestlé Institute of Agricultural Sciences at Nestlé Research. The Institute aims to translate novel agricultural science into concrete applications and to identify and develop the most promising regenerative agriculture technologies. Headquartered in Lausanne, Switzerland, the organization has a decentralized structure and incorporates Nestlé’s existing plant sciences research facilities in France, as well as numerous research and reference farms around the world. The Institute has three focus areas: plant sciences, dairy-livestock sciences and agricultural system sciences. Jeroen has worked for over 30 years, in all major regions of the world, with bi- and multi-lateral donors, i-NGOs, international and national research centres, the World Bank, UN agencies and the private sector on finding ways to use research and innovation to transition agri-food systems towards more productive but also more sustainable and socially inclusive pathways. In his last two assignments prior to taking up his current position, Jeroen combined the roles of Director (International) of the New Zealand Agricultural Greenhouse Gas Research Centre and the Senior Technical Adviser of the UN Environment, Climate and Clean Air Coalition agriculture initiative. Subsequently, he was the Managing Director of the Animal Sciences Group, Wageningen University and Research. The Animal Sciences Group consists of the Department of Animal Sciences of Wageningen University and three Wageningen Research institutes: Wageningen Bio-veterinary Research, Wageningen Livestock Research and Wageningen Marine Research.
Head of Nestlé Institute of Agricultural Sciences
Jeroen Dijkman
Dr. Jeroen Dijkman is the founding head of the Nestlé Institute of Agricultural Sciences at Nestlé Research. The Institute aims to translate novel agricultural science into concrete applications and to identify and develop the most promising regenerative agriculture technologies. Headquartered in Lausanne, Switzerland, the organization has a decentralized structure and incorporates Nestlé’s existing plant sciences research facilities in France, as well as numerous research and reference farms around the world. The Institute has three focus areas: plant sciences, dairy-livestock sciences and agricultural system sciences. Jeroen has worked for over 30 years, in all major regions of the world, with bi- and multi-lateral donors, i-NGOs, international and national research centres, the World Bank, UN agencies and the private sector on finding ways to use research and innovation to transition agri-food systems towards more productive but also more sustainable and socially inclusive pathways. In his last two assignments prior to taking up his current position, Jeroen combined the roles of Director (International) of the New Zealand Agricultural Greenhouse Gas Research Centre and the Senior Technical Adviser of the UN Environment, Climate and Clean Air Coalition agriculture initiative. Subsequently, he was the Managing Director of the Animal Sciences Group, Wageningen University and Research. The Animal Sciences Group consists of the Department of Animal Sciences of Wageningen University and three Wageningen Research institutes: Wageningen Bio-veterinary Research, Wageningen Livestock Research and Wageningen Marine Research.
Head of Nestlé Institute of Agricultural Sciences
Berry Marttin
Berry Marttin was born and raised in Brazil. Over the course of his career at Rabobank, he gained extensive experience as an international banker in both wholesale and retail banking, working in various senior executive positions in Australia, Indonesia, Hong Kong, Curacao and Brazil. Mr Marttin moved to the Netherlands in 2004 to become Chairman of the Board of Directors of Rabobank Amsterdam. In 2009, he joined the Managing Board with special focus on Rabobank’s international Wholesale and Rural banking activities and further responsibilities including Leasing (DLL), Rabo Carbon Bank and RaboResearch. His principal other activities outside Rabobank include serving as President of the EACB (European Association of Co-operative Banks) and Member of the Board of Neumann Foundation. Moreover, Mr Marttin serves as the first Chairman of the Global Steering Committee of the Food Action Alliance, where World Economic Forum together with IFAD, WBCSD, CIAT, AfDB and Rabobank and over 20 global leaders unite to deploy large scale action through game changing initiatives for food systems transformation. In 2021, he was invited to join the UN Food Systems Summit Champions network, a network encompassing leadership from a broad range of constituencies, in all parts of the world, who are championing food systems and food systems transformation.
Former Member of the Managing Board Rabobank Group
Berry Marttin
Berry Marttin was born and raised in Brazil. Over the course of his career at Rabobank, he has gained extensive experience as an international banker in both wholesale and retail banking, working in various senior executive positions in Australia, Indonesia, Hong Kong, Curacao and Brazil. Mr Marttin moved to the Netherlands in 2004 to become Chairman of the Board of Directors of Rabobank Amsterdam. In 2009, he joined the Managing Board with special focus on Rabobank’s international Wholesale and Rural banking activities and further responsibilities including Leasing (DLL), Rabo Carbon Bank and RaboResearch. His principal other activities outside Rabobank include serving as President of the EACB (European Association of Co-operative Banks) and Member of the Board of Neumann Foundation. Moreover, Mr Marttin serves as the first Chairman of the Global Steering Committee of the Food Action Alliance, where World Economic Forum together with IFAD, WBCSD, CIAT, AfDB and Rabobank and over 20 global leaders unite to deploy large scale action through game changing initiatives for food systems transformation. In 2021, he was invited to join the UN Food Systems Summit Champions network, a network encompassing leadership from a broad range of constituencies, in all parts of the world, who are championing food systems and food systems transformation.
Member of the Managing Board Rabobank Group
Dr Jason Clay
Jason Clay is the Senior Vice President for Markets and Executive Director of the Markets Institute at WWF, which was created to identify and address emerging global issues, trends, and tools impacting conservation in more timely, cost-effective, and scalable ways. His career has ranged from working on a family farm and for the US Department of Agriculture. He taught at Harvard and Yale and spent more than 35 years with human rights and environmental NGOs. In 1988, Clay founded Rainforest Marketing, set up a trading company within an NGO, helped Indigenous people and local communities access global markets, and launched Ben & Jerry’s Rainforest Crunch, plus more than 200 other products with sales of $100 million. From 1999 to 2003, he co-directed a WWF, the World Bank, UN FAO, and NACA consortium to identify the most significant environmental and social impacts of shrimp aquaculture, as well as practices to reduce them. From 2004 to 2012, he convened multistakeholder roundtables to create performance-based standards for commodities including salmon, soy, sugarcane, cotton, and beef. He developed WWF’s Market Transformation program in 2006 to work on agriculture, aquaculture, livestock, and corporate engagement. Clay continues to lead WWF-US efforts to improve private sector supply chain management and help their producers address the most significant impacts. In 2008, he created the Carbon and Commodities program to address supply chain GHG emissions. He has helped whole sectors improve their sustainability performance (e.g., the Global Salmon Initiative). He is now working with the global leather industry to support a DCF leather fund and is testing support for a 1% environmental performance payments to support the transition costs and incentives to finance what producers need to do to become legal and deforestation and conversion free. He is launching a two-year proof of concept for Codex Planetarius, a set of minimum global standards to reduce the key impacts of food and commodities traded internationally. Clay has authored 18 books and 500 articles, and has given more than 1,500 invited presentations. He studied anthropology and agriculture at Harvard, the London School of Economics, and Cornell (PhD).
Senior Vice President, Markets at World Wildlife Fund (WWF)
Dr Jason Clay
Jason Clay is the Senior Vice President for Markets and Executive Director of the Markets Institute at WWF, which was created to identify and address emerging global issues, trends, and tools impacting conservation in more timely, cost-effective, and scalable ways. His career has ranged from working on a family farm and for the US Department of Agriculture. He taught at Harvard and Yale and spent more than 35 years with human rights and environmental NGOs. In 1988, Clay founded Rainforest Marketing, set up a trading company within an NGO, helped Indigenous people and local communities access global markets, and launched Ben & Jerry’s Rainforest Crunch, plus more than 200 other products with sales of $100 million. From 1999 to 2003, he co-directed a WWF, the World Bank, UN FAO, and NACA consortium to identify the most significant environmental and social impacts of shrimp aquaculture, as well as practices to reduce them. From 2004 to 2012, he convened multistakeholder roundtables to create performance-based standards for commodities including salmon, soy, sugarcane, cotton, and beef. He developed WWF’s Market Transformation program in 2006 to work on agriculture, aquaculture, livestock, and corporate engagement. Clay continues to lead WWF-US efforts to improve private sector supply chain management and help their producers address the most significant impacts. In 2008, he created the Carbon and Commodities program to address supply chain GHG emissions. He has helped whole sectors improve their sustainability performance (e.g., the Global Salmon Initiative). He is now working with the global leather industry to support a DCF leather fund and is testing support for a 1% environmental performance payments to support the transition costs and incentives to finance what producers need to do to become legal and deforestation and conversion free. He is launching a two-year proof of concept for Codex Planetarius, a set of minimum global standards to reduce the key impacts of food and commodities traded internationally. Clay has authored 18 books and 500 articles, and has given more than 1,500 invited presentations. He studied anthropology and agriculture at Harvard, the London School of Economics, and Cornell (PhD).
Senior Vice President, Markets at World Wildlife Fund (WWF)
Professor Manny Noakes
Professor Manny Noakes has a PhD in nutrition as well as having trained as a dietitian in her earlier years. She is more recently a graduate of the Australian Institute of Company Directors. Prof Noakes is a former Director and Senior Principal Research Scientist, Nutrition and Health at CSIRO, Australia. She currently runs her own nutrition consultancy and is also a non-executive Director for Meat and Livestock Australia. She is considered a key opinion leader and advisor in nutrition and health, has extensive media and public speaking experience. She has over 25 years’ experience in many fields of nutrition and health, and has undertaken numerous clinical dietary intervention trials in weight management, functional foods and cardiovascular health. She has also undertaken research on diet and sustainability and redefined the environmental agenda from a food and health perspective. Prof Noakes has authored more than 200 peer-reviewed publications which have been cited more than 9000 times and has an H index of 52. She was instrumental in the development and release of five editions of the CSIRO Total Wellbeing Diet, which was launched in 2004 and has been translated into 17 languages and sold over one million copies in Australia. The Total Wellbeing Diet has been further commercialised to a successful online programme. Prof Noakes is the recipient of three CSIRO Medals, is a Distinguished Alumni of Flinders University, holds a research excellence award from the University of Adelaide and is a recipient of the Zonta Club Woman of International Achievement award.
Nutrition Consultant
Professor Manny Noakes
Professor Manny Noakes has a PhD in nutrition as well as having trained as a dietitian in her earlier years. She is more recently a graduate of the Australian Institute of Company Directors. Prof Noakes is a former Director and Senior Principal Research Scientist, Nutrition and Health at CSIRO, Australia. She currently runs her own nutrition consultancy and is also a non-executive Director for Meat and Livestock Australia. She is considered a key opinion leader and advisor in nutrition and health, has extensive media and public speaking experience. She has over 25 years’ experience in many fields of nutrition and health, and has undertaken numerous clinical dietary intervention trials in weight management, functional foods and cardiovascular health. She has also undertaken research on diet and sustainability and redefined the environmental agenda from a food and health perspective. Prof Noakes has authored more than 200 peer-reviewed publications which have been cited more than 9000 times and has an H index of 52. She was instrumental in the development and release of five editions of the CSIRO Total Wellbeing Diet, which was launched in 2004 and has been translated into 17 languages and sold over one million copies in Australia. The Total Wellbeing Diet has been further commercialised to a successful online programme. Prof Noakes is the recipient of three CSIRO Medals, is a Distinguished Alumni of Flinders University, holds a research excellence award from the University of Adelaide and is a recipient of the Zonta Club Woman of International Achievement award.
Nutrition Consultant
Lain Jager
Lain Jager is best known for his time with the hugely successful kiwifruit marketer Zespri where he was CEO from 2008 to 2017. During his tenure as CEO, Zespri grew strongly through the impact and recovery from the bacterial vine disease Psa, grower returns doubled, and the share price grew from $1.00 to $8.00. Today, Lain is involved in a range of investment projects in Tourism and Agribusiness, serves as a Director on several Boards, was the Chairman of the Primary Sector Council that produced the Fit for a Better World Report focused on the New Zealand Food and Fibre Sector, and is the Co-Chair of Te Puna Whakaaronui – a Food and Fibre think tank. Lain and his wife Debra live on a lifestyle block in Tauranga, New Zealand.
Chair of the Thought Leaders Group for Te Puna Whakaaronui Food and Fibre Think Tank
Lain Jager
Lain Jager is best known for his time with the hugely successful kiwifruit marketer Zespri where he was CEO from 2008 to 2017. During his tenure as CEO, Zespri grew strongly through the impact and recovery from the bacterial vine disease Psa, grower returns doubled, and the share price grew from $1.00 to $8.00. Today, Lain is involved in a range of investment projects in Tourism and Agribusiness, serves as a Director on several Boards, was the Chairman of the Primary Sector Council that produced the Fit for a Better World Report focused on the New Zealand Food and Fibre Sector, and is the Co-Chair of Te Puna Whakaaronui – a Food and Fibre think tank. Lain and his wife Debra live on a lifestyle block in Tauranga, New Zealand.
Chair of the Thought Leaders Group for Te Puna Whakaaronui Food and Fibre Think Tank
Samuel Thevasagayam
Samuel Thevasagayam is the Director of Livestock and Aquaculture within the Agriculture Development Program at the Bill & Melinda Gates Foundation, where he oversees the implementation of foundation’s strategy in animal health, animal production, animal nutrition, animal systems and livestock off-take markets in sub-Saharan Africa and South Asia. Samuel started his career as a small animal clinician and lecturer at the University of Peradeniya, Sri Lanka. He then moved to work in academic research, Pharmaceutical R&D (veterinary and human), Business Development and the not-for profit sector, living/working in four continents before joining the Gates Foundation in 2012. Samuel graduated from the faculty of Veterinary Medicine and Animal Sciences of the University of Peradeniya, Sri Lanka. Gained his PhD in veterinary virology from the University of Hertfordshire for his research on foot-and-mouth disease virus at the Pirbright Institute and holds an MBA from the University of Oxford. He is a Fellow of the Royal Society of Biology.
Director of Livestock and Aquaculture within the Agriculture Development Program, Bill & Melinda Gates Foundation
Samuel Thevasagayam
Samuel Thevasagayam is the Director of Livestock and Aquaculture within the Agriculture Development Program at the Bill & Melinda Gates Foundation, where he oversees the implementation of foundation’s strategy in animal health, animal production, animal nutrition, animal systems and livestock off-take markets in sub-Saharan Africa and South Asia. Samuel started his career as a small animal clinician and lecturer at the University of Peradeniya, Sri Lanka. He then moved to work in academic research, Pharmaceutical R&D (veterinary and human), Business Development and the not-for profit sector, living/working in four continents before joining the Gates Foundation in 2012. Samuel graduated from the faculty of Veterinary Medicine and Animal Sciences of the University of Peradeniya, Sri Lanka. Gained his PhD in veterinary virology from the University of Hertfordshire for his research on foot-and-mouth disease virus at the Pirbright Institute and holds an MBA from the University of Oxford. He is a Fellow of the Royal Society of Biology.
Director of Livestock and Aquaculture within the Agriculture Development Program, Bill & Melinda Gates Foundation
Natalie Ahlborn
Natalie's role is to inform the SNi from a nutritional perspective. She also supports the team by representing SNi's work through speaking engagements and other outputs.
Postdoctoral Research Fellow
Patricia Soh
Prior to her current PhD, Patricia attained a Master of Science in Human Nutrition at Massey University, Albany. The current focus of her PhD is investigating nutritional concerns within vegan diets.
PhD Student
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