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“My PhD helped me define the direction of my career”

Nutritionist Imre Kouw enjoyed her internship at Maastricht University, on muscle mass and nutrition with aging, so much that she decided to do a PhD in this field. Six years later, in December 2018, she defended her PhD thesis titled “Nutritional strategies to support muscle maintenance in clinical populations”.

After gaining a Bachelor in Nutrition and Dietetics at Amsterdam University of Applied Sciences, Kouw felt she wanted to go deeper into the field of nutrition sciences. So she started a two year Master’s at the Karolinska Institute in Stockholm.

Societal value
“When I was almost finished with my study in Sweden, I contacted Prof. Luc van Loon at Maastricht University to apply for an internship during the 2nd half of my Master’s”, she says. “I was impressed with the innovation and societal value of his research: exploring causes and solutions to age-related muscle-mass loss in the elderly. His lab is one of the very few where stable isotope approaches can be used, in humans, to investigate the uptake of dietary amino acids in skeletal muscle tissue.”

After her internship in Maastricht, Kouw became a research assistant before applying for the first PhD vacancy in van Loon’s research group. “I loved the applied research with human volunteers and patients, and I wanted to learn everything I could about muscle-mass maintenance in ageing and disease.”

High-protein snack
Five or so years later and Kouw has her PhD. She demonstrated that a 40- gram protein snack, before sleeping, improves overnight muscle-protein synthesis in older people. “The effect was potentiated by physical exercise, which increased muscle-protein synthesis by 30 percent”, she stresses. Her study was the first using orally-ingested protein drinks instead of infused enteral nutrition and the data was collected via state-of-the-art methodologies. “We included 60 healthy older males who slept in our laboratory for one night, drank specifically produced labelled milk before sleep and underwent two muscle biopsies – while we stayed up all night to take hourly blood samples (without waking them up!).”

The PhD fellow also investigated protein consumption in older hip-surgery patients. “During just six-days in hospital these patients lost a significant 3-4 percent of skeletal muscle mass”, she says. “In addition, their protein intake was substantially lower than recommended, mostly because they left 30-35 percent of their food untouched.”

Optimizing hospital meal services
Kouw’s research provides food manufacturers with new opportunities for product development and hospitals with ways to optimize their meal services – for example by supplying protein-rich meals and supplements and protein-rich snacks before patients sleep.

The PhD project was also very valuable in terms of my personal development, Kouw stresses: “I learnt many new things, from how to teach and supervise students and to lead in-depth discussions with nutrition experts, how to present my research results and translate them into clinical practice.” “I gave many presentations to practitioners, dieticians, physiotherapists and nurses, which motivated me to conduct further research that can be directly translated into clinical practice and support nutritional guidelines for patients and health-care workers.” This gave her a direction for her future career. “Eventually I would like to be involved in clinical research in an academic institution and develop new food and nutritional strategies in hospitals, ideally combined with my work as a dietician.”

Boosting skills
But first, some sun. “I have accepted a two-year Postdoc position at the Australian Catholic University in Melbourne, with Prof John Hawley. I will investigate protein metabolism in obesity and study the metabolism of other macronutrients”, she says. “Working in a different research group (and country) will further boost my research skills and work experience as a scientist, and will be beneficial when applying for personal research grants in the future. Eventually, I am looking forward to returning to the Netherlands in a couple of years, ready and qualified for a senior position at an academic hospital.”