Dr. Aysegül Aksan is a young researcher who trained as a clinical dietitian at Hacettepe University, Turkey before taking up a post-doctoral position at the Goethe University Frankfurt, Germany, and then the Justus-Liebig University of Giessen, Germany. Dr. Aksan has published noteworthy articles addressing the evaluation and management of anemia and iron homeostasis in IBD, percutaneous endoscopic gastrostomy, enteral nutrition, circulating vitamin D metabolites in chronic inflammatory disorders, and the efficacy and safety of different nano colloidal intravenous iron compounds. The current focus of Dr. Aksan's work is the diagnostics and treatment of micronutrient deficiencies, especially iron and vitamin D, in patients with inflammatory bowel disease. In an interview with Jan Rein, she talked about her experience as a young researcher, about her current researchers, and as a postdoctoral lecturer in Germany.
Photo by National Cancer Institute on Unsplash
You are a postdoc at the Justus-Liebig-University in Gießen and originally from Turkey. How did you end up at the University of Gießen?
Well, it is quite a long story; but to cut it short, I took my bachelor’s degree at Hacettepe University, Turkey, and started my master’s degree at the same university immediately after graduation. I worked as Project Manager in an International Food Service Systems Company for about a year to finance my master’s, which was quite fun, but after a year it became a bit of a dead-end. So, I took a job at a hospital as a clinical dietitian. Although I found this work more enjoyable, I realized it was not something I would want to do for the rest of my life. Meanwhile, I finished my classes and began my master thesis, for which I planned a research project on gluten-free diet adherence and its relation to health-related quality of life in patients with coeliac disease. I did not realize at the time, but this was the first step of my long journey to Germany: For my master thesis, I needed to use a specific health-related quality of life index which was originally developed in German and had not yet been validated in a Turkish language version. I contacted the researchers who originally developed the index, a German team from Munich, and asked permission to validate their questionnaire for the Turkish population. Instead of simply giving me permission, they were keen to be involved in the process and supported me at every step. We published our results together and they offered me the chance to come to Germany. It was not an easy decision, but at that time I decided to refuse their offer since I really wanted to get on and start my Ph.D. without a break. We stayed in contact and - having overcome considerable challenges and obstacles on the path to completing my Ph.D. - I came to Frankfurt, and then Gießen, as a postdoc.
What are you currently researching?
At the moment, I am working on the diagnostics and treatment of micronutrient deficiencies, especially iron and vitamin D, in patients with chronic inflammation. To take iron as an example: Iron deficiency anaemia is a common complication of many disorders, including chronic renal failure, chronic heart disease, cancer, and inflammatory bowel disease. Although often largely disregarded, anaemia at presentation is a negative prognostic factor in these patients. Intravenous (IV) iron supplementation is increasingly used to treat iron deficiency in patients with anaemia. While IV iron compounds have been shown to be generally safe and effective, there is still concern regarding their safety, especially in terms of hypersensitivity reactions and hypophosphatemia. Other focuses of concern include the possibility that IV iron might cause endothelial damage and promote atherosclerosis by generating oxidative stress, or promote infection by supplying iron to pathogenic bacteria. In clinical practice, the choice of drug is influenced by efficacy, cost, potential side effects, and complications. Whereas the efficacy of different IV iron products has been compared in many randomised clinical trials, meta-analyses, and reviews, and their economic viability compared in relative cost analyses, data comparing the safety of these products are still controversial. Due to their limited size and duration, randomised clinical trials are generally not the best tools for examining the risk of rare and/or serious adverse events. In addition, adverse events are often independent of the underlying disorder, making it important to see the bigger picture. With this in mind, my objective in my current research on iron is to investigate and summarise the overall safety of IV iron independent of the type of underlying medical disorder, and to compare the safety of different IV iron compounds.
Your responsibilities also include lecturing. How much is this compared to your research activities?
Research is a huge part of my work that dominates my life: I sleep with it, I wake up with it, I live with it every minute. My research is always at the back of my mind, even when I am not actually physically working. However, I believe lecturing is the reflection of my own scientific development and progress. Although it also requires a huge amount of effort and time, against the background of my research activities, I would say that teaching is an important challenge and a welcome contrast; an opportunity to take a breath, to give and receive new input and motivation, and to see, remember and continue to discover what nutrition science is all about.
How does the teaching of nutrition science in Germany differ from your previous stations?
I have worked as a student, researcher, and lecturer not only Turkey and Germany but also in many more countries in all of these countries, lecturing has been exciting and rewarding. Compared to my previous stations, teaching in Germany has a somewhat different feel. Whenever you start somewhere new, it is always a challenge, of course; but so far, I have enjoyed my teaching experience in Germany. Compared with the other countries, it seems to me that here, practical education is rather lacking, since the students don’t usually have the chance to experience and participate in patient education and discussions at the bedside; as a result, even though they have exceptionally good theoretical knowledge, it is not easy to convert this knowledge into practice. Therefore, I believe we need more practical lectures, bedside teaching, or maybe even an extra year with an internship program (as many countries have), to guide them further.
How do you see the role of nutrition science in a medical context (e. g. in the clinic)?
Today, healthcare is recognized to require teamwork. The team includes professionals from a wide spectrum of disciplines, from physicians to nursing staff. Dietitians are an important element of this team in terms of optimizing patient health care. Proper nutrition plays a key role in health maintenance, disease prevention, and treatment. We really are what we eat; nutrition is involved in every single aspect of medicine and health. Good nutritional practice is the easiest and the most economical way to help our community improve health and avoid disease. In actual practice, though, it is often overlooked, its effects and importance underestimated and/or undervalued, and as a result, the nutritional aspects of health and disease are often neglected. I believe we have an important task as nutrition experts to win the attention of our community, physicians, and health authorities and highlight the importance of establishing good nutritional practices under the leadership of qualified nutrition experts.
Want to know more about Dr. Aysegül Aksan? Connect with her via LinkedIn
This interview was conducted by Jan Rein Together with Laura Merten, Jan runs the blog Satte Sache. The two ecotrophologists reach almost 500,000 people every month via the website, with their podcasts, and via social media. We have written about Jan's and Laura's common mission here.