Prof. Jasminka Ilich Ernst: OSA syndrome and the interrelationship of bone, muscle and fat tissue

During November 2020, as part of the knowledge transfer program from emigration to Bosnia and Herzegovina, Prof. Ph.D. Jasminka Ilich Ernst from the USA gave a series of lectures to students at the Faculty of Agriculture and Food of the University of Sarajevo as part of the project "Diaspora for Development" (D4D), a project of the Ministry of Human Rights and Refugees of Bosnia and Herzegovina and the Government of Switzerland in partnership with UNDP and IOM. Prof. Ilich Ernst was born in Sarajevo, where she graduated from the Chemistry Department of the Faculty of Science. She went to America in 1983, to the state of Utah, where she did a master's thesis in the field of nutrition at the University of Utah and did an internship, after which she obtained the title of registered dietitian (RD). In 1991, she moved to the state of Ohio, where she completed her doctorate at the Ohio State University in cooperation with the University of Zagreb. Her doctoral thesis was focused on research on the development of bone mass in adolescents. Academic affairs further took her to the University of Connecticut and finally to Florida State University, where she spent 12 years as a professor. Prof. At Florida State University, Ilich Ernst continued her research on bone mass and completed it with a comparative study of muscle mass of adipose tissue in the elderly. It all started with a competitive million-dollar project funded by the US government in which she investigated weight loss in postmenopausal obese women. The study lasted several years, and the intervention included three options/groups, each with a slightly reduced food intake (calories, energy). One group of women received calcium and vitamin D supplements (tablets); another group was taught how to increase their intake of low-fat dairy products; and the third group received placebo pills. The results showed that the group that took a larger amount of dairy products 4-5 times a day (a glass of yogurt or a glass of milk) finished the most successfully. These women lost weight more easily and more than others who were on the same caloric intake. Also, in that group, there was less loss of bone and muscle mass during weight loss and greater loss of fat tissue. By further researching bone, muscle, and fat tissue, it became clear to Professor Ilich Ernst that these tissues cannot be viewed in isolation because they are interconnected on multiple levels (e.g., hormonal, cellular signals, and others) and always influence each other. Thus, it has been shown that women who have sarcopenia (loss of muscle mass) get osteoporosis (loss of bone mass) more easily. While it was previously thought that people were generally protected from osteoporosis and sarcopenia if they were obese because of the greater weight that muscles and bones have to carry, her studies, as well as some others, have shown that this is not always the case. Fat tissue, either in people who are obese or in the elderly, is distributed in the stomach area with age and becomes very active in the secretion of harmful molecules (cytokines). Adipose tissue also infiltrates bones and muscles, weakening them. Such a combined state of osteoporosis, sarcopenia, and increased/infiltrating fat she called osteosarcopenic adiposity syndrome (OSA). This new syndrome is now accepted worldwide, and many other studies confirm the findings of reduced physical ability and metabolic inferiority in people with OSA syndrome. In contact with the Ministry of Human Rights and Refugees of BiH, Prof. Ernst confirmed that since 2017 she has been working with Prof. Irzadom Taljić at the Faculty of Agriculture and Food in Sarajevo, who together with her colleagues started the master's program in nutrition that began in the fall of 2017.Jasminka-Ilic-predstavlja 2 Prof. Ernst gave several lectures to the first generation of students and was, as she says, very impressed by the knowledge, interest, and seriousness with which they approached their studies. They were at the world level, says Prof. Ernst. Prof. Ernst also secured a donation for the Faculty of Agriculture and Food, which includes two instruments for measuring body mass, bones, and the autonomic nervous system from the Italian company BioTekna (https://www.biotekna.com/) which will help the planned research of Prof. Taljić and their further mutual cooperation. Prof. Ernst also collaborates with SSST and Prof. Semirom Galijašević. She gave several lectures to their students and will be involved in their nutrition program after its establishment. Speaking about the knowledge transfer program from emigration to BiH within the D4D project, Prof. Ilich Ernst said that it was well-designed, organized, and managed. "I assumed that when I found out about him through the Bosnia and Herzegovina American Academy of Arts and Sciences (BHAAAS) in 2019, and I was convinced this year when I had the opportunity to directly get involved and participate. The organization and management of the program exceeded my expectations,'' says Prof. Ilich Ernst. Diaspora can help the development of BiH, and one of the ways is through the Knowledge Transfer Program. The connection between the diaspora and the program is very important. The program can be very influential because it enables direct contact between highly educated experts and, through them, academic institutions. This further leads to expanded cooperation in research, such as plans between Prof. Ilich Ernst, Prof. Taljić, and BioTekne. In this way, it would be possible to organize the exchange of students and experts. Both students and experts in Bosnia and Herzegovina could benefit greatly from such an exchange and also contribute to foreign institutions with their knowledge and work. The diaspora can help in countless other ways, beyond the academic framework, which is what is happening. However, some organized way, such as, e.g., the case with D4D, provides many more opportunities and many more chances for success, says Prof. Ernst. At the end of the conversation, Prof. Ilich Ernst added that, despite the difficult conditions during the pandemic and the impossibility of direct interaction and contact with students and staff, she enjoyed the lectures she held during November 2020 and expressed her hope that she will soon be able to start the planned research works in BiH and expand cooperation with other faculties and institutions in Bosnia and Herzegovina. (https://dijaspora.mhrr.gov.ba/)