nutritional ingredients for health and well-being...
TRANSCRIPT
Food Matters Live, Excel, London
Nutritional ingredients for health and well-being – opportunities and challenges
November 18th, 2014 Dr. Rob Winwood Dr. Manfred Eggersdorfer Professor for Healthy Ageing Senior Vice President Nutrition Science & Advocacy
Page 1
Contributing to health and wellness
9 billion
(2040/50)
Healthy nutrition in a growing and aging population is a global challenge !
Chronic diseases (NCDs)
• 366 mln with diabetes
• 160 mln with osteoporosis
(US, EU and JP)
Aging population
Under-/overnutrition
• 1 bln people hungry
• 1.6 bln people overweight
Page 2
Nutritional ingredients for health and well-being – opportunities and challenges
Topics to address:
• For micronutrients there are still many untapped opportunities
• Innovative health-promoting ingredients/foods offer additional benefits
• Nutrients work in concert – there is no «one ingredients fits all»
Nutrition is the most important challenge in the 21st century
Page 3
Around forty micronutrients are essential …
Vitamins Biotin
Folic acid
Niacin
Pantothenate
Riboflavin
Thiamine
Vitamin A
Vitamin B6
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Vitamin K
Minerals Calcium
Chloride
Chromium
Cobalt
Copper
Iodide
Iron
Magnesium
Manganese
Molybdenium
Phosphorus
Potassium
Selenium
Sodium
Zinc
Pufas
linolenic acid/DHA [-3]
linoleic acid [-6]
Carotenoids
B-carotene
Lutein
Zeaxanthine
... so we should care not for single ingredients alone because most act in
concert!
Amino acids Isoleucine
Leucine
Lysine
Methionine
Phenylalanine
Threonine
Tryptophan
Valine
Histidine
Choline
Page 4
Micronutrient deficiencies still affect people all over the globe
<25nmol/L
25-49nmol/L
50-74nmol/L
>75nmol/L
<25nmol/L
25-49nmol/L
50-74nmol/L
>75nmol/L187 billion € – potential health care savings
if >300 million people in 17 European
countries have access to 2000-3000 IU
vitamin D daily
per cent of world population
estimated to be vitamin D deficient 40– 75
200 million women estimated to be
affected by osteoporosis, linked to
vitamin D deficiency, worldwide
million underfive lives lost due to
vitamin A & zinc deficiencies 1.1
600 thousand stillbirths due to iron
deficiency
18 million babies born mentally impaired
due to maternal iodine deficiency
30 billion US$ per year – estimated direct
cost of child & maternal undernutrition
in developing countries
Page 5
We need innovative approaches to provide nutritional solutions
Conventional fortification
• Staple foods (flour, sugar, milk, oil, rice) • Dairy (milk, yoghurt) • Spreads (margarine) • Condiments (salt)
Home fortification
• Crushable/soluble tablets • Powder • Spreads
Bio-fortification
• Agricultural products (rice, maize, sweet potato,…)
Educational programs
• Balanced nutrition
combined with
Page 6
Example Vitamin D: the inadequate status impacts a number of body functions
Classical role of vitamin D: bone health
• Improves bone mineral density through
calcium absorption and deposition
• Necessary to prevent rickets & osteomalacia
Emerging health benefits of vitamin D
• Muscle - Reduces risk of falling by
improving muscle strength
• Immunity - Strengthens the immune system
- Reduces risk of multiple sclerosis
and diabetes type II
• Cardiovascular - Lowers blood pressure
• Cancer - Inhibits cell proliferation
osteoporotic
normal
Page 7
We develop a global Vitamin D deficiency map…
Impact on
health care costs:
€ 37 bln / y
Impact for
other countries ?
A number of professional and national health organizations advocate for new recommendations
Page 9
New ingredients with promising health benefits complement portfolio
Ingredient Focus Activity / Benefit
resVida Aging Resveratrol; mimics a calorie-restricted diet to slow the aging process.
geniVida Bone health Genistein; demonstrated reduction in hot flashes and improvement in mood in postmenopausal women.
HyD Bone health 25-hydroxycholecalciferol; much higher bioavailability in animals and humans than Vitamin D3.
FruitFlow Heart health
Tomato extract; reduces platelet aggregation and improve blood flow.
PUFAs Cognitive function
DHA from algal and fish sources; may reduce cognitive decline.
Olive II Energy / Endurance
Provides protection against oxidative stress, increases cellular energy production and endurance.
broccoVida Aging Derived from Broccoli seeds; helps to boost immune response and to detoxify the body.
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Efficacy:
• Antibacterial, antiviral & antifungal
• Antioxidant & free radical scavenging
• Inhibition of lipid peroxidation
• Inhibition of platelet aggregation
• Anti-tumor activity
• Anti-inflammatory
Example Resveratrol: an anti-aging ingredient which fits in various nutritional benefit areas
Anti-aging Benefits:
The nutrient with most promising calorie restriction
(CR) mimetic properties
Page 11
Resveratrol extents the life span of obese mice
Baur et al. Nature, 2006
2 year
59 %
77 %
Page 12
Resveratrol increase endurance, oxidative capacity, locomotor function
Treadmill test
0
500
1000
1500
2000
2500
Avera
ge d
ista
nce r
un
at
exh
au
sti
on
(m
)
Control resv. 400 mpk HF HF+resv. 400 mpk
*
* String test
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
La
ten
cy
(s
)/ B
W(g
)
HF HF+resv. 400 mpk
*
Lagouge et al. Cell 2006
Page 13
Flow Mediated Dilation (FMD) by Ultrasound
Flow-Mediated endothelial dependent vasoDilation (or Dilatation) of the
right brachial artery
Occlusion cuff on forearm
FMD is expressed as %-change in diameter of the artery
Page 14
resVidaTM significantly increased FMD
compared to placebo
resVidaTM dose (mg)
0 mg 30 mg 90 mg 270 mg
FM
D r
esponse (
%)
0
2
4
6
8
10
**
*
+62% +58% +91%
* p<0.05 vs. plc
mean ± SEM
Page 15
resVida supplementation improves metabolic health in obese humans
S. Timmers et al., Cell Metab Vol 14, 2011 Suppl Info
Study features - randomized, double-blind, placebo
controlled study
- subjects: 11 healthy, obese men
- dose: 2 x 75mg resVida per day
resVida reduces risk factors
associated with obesity - reduction of blood pressure
- improvement of blood glucose and insulin
levels
- reduction of liver fat
- reduction of inflammation markers
-resVida induces an endurance
training like effect in skeletal muscle - increase of fat oxidation capacity
- increase of fat storage capacity of muscle
resVida mimicked calorie restriction
Page 16
• Fruitflow® is the first ingredient with an European Food Safety
Authority Art. 13.5 health claim
“Helps maintain normal platelet aggregation,
which contributes to healthy blood flow”
• Fruitflow® is a breakthrough anti-thrombotic ingredient
• Multiple (8) human trials confirm Fruitflow® reduces platelet aggregation
– No side effects reported
– Works in 97% of subjects
– Starts to work within 1.5 hours
and continues for 12 to 18 hours
– When taken regularly on a once per
day basis, the effect is continuous
Example Fruitflow® - a new ingredient for healthy blood flow
Page 17
Non activated /smooth platelet Activated / spiky platelet Blood clot
• Platelets can become “spiky” i.e. more prone to clotting due to a variety of factors like stress,
overweight, high cholesterol.
• Fruitflow works by keeping blood platelets smooth to avoid aggregation inside blood vessels.
• Fruitflow does not disrupt the rest of the blood clotting process so clotting will still take place
as usual after injury.
•Three major factors in cardiovascular disease: cholesterol, blood pressure and platelet aggregation,
the cause of blood clots.
•Fruitflow® is the only functional food ingredient addressing platelet aggregation
Fruitflow acts on the first stage of the clotting
Page 18
Fruitflow: Onset and duration of in vivo antiplatelet effect
O’Kennedy et al. 2006, AJCN
Fruitflow n = 23 Control
***
*** -30.0
-25.0
-20.0
-15.0
-10.0
-5.0
0.0
5.0
10.0 t 1.5hr t 3 hr t 6 hr
% C
han
ge
from
bas
elin
e (t
0)
agg
reg
atio
n
• Onset of antiplatelet effect seen within 1.5 hours
after ingestion – measured as a significant
difference from baseline platelet function
• Duration of effect variable, but after 18 hours
platelet function returned to baseline in all
subjects tested.
Results
• Randomized, placebo-controlled, single-blinded
study design.
• 23 normal healthy subjects (40-65 y) completed
the study
• Subjects consumed Fruitflow® equivalent to
the total active fraction found in 6 fresh
tomatoes or a control drink
• Blood samples were collected at baseline, 1.5, 3
and 6h.
Study design
Page 19
Example: long chain PUFAs and human health
Health Condition
DHA
EPA
DHA + EPA
Central Nervous System Development & Function
Cognitive Development & Function
Retinal Development & Function
Retinal Disorders
Mental Health & Neuropsychiatric Disorders
Cardiovascular Health
Inflammation
Key: = confirming evidence; = strong evidence
Page 20
DHA is Important Throughout Life
Pregnancy
Maternal Health &
Outcomes
Promotes maternal
DHA status
Increases DHA
content of breast milk
Supports normal
gestation period
Promotes fetal brain
and eye development
Infants &
Children
Brain & Eye
Development and
Function
Improves visual
acuity
Promotes cognitive
performance
Children &
Adults
Cardiovascular
Heart Health
Lowers
triglycerides
Increases HDL
Improves blood
vessel function
Adults
Brain & Eye Health
and Function
Maintains DHA blood
levels which is
associated with:
• less cognitive decline
• lower risk of dementia
• lower risk of age-
related macular
degeneration
Page 21
Current Global Adult Intakes versus
Recommendations of Long-Chain Omega-3s
Reference list available
Recommendations:
• LC n-3 ADA (2007)
ISSFAL (2004)
WHO/FAO (2003)
France (2001)
UK (2003)
Netherlands (2006)
Canada (2005)
Australia (2005)
• DHA alone France (2001)
Intake:
Page 22
Benefits of DHA Alone & Cardiovascular Health
• Favorable effects on blood lipid profile – Reduced triglycerides
• Schwellenbach et al, AJCN, 2007
• Keske et al, abstract 2007
• Kelly et al, AJCN, 7/2007
– Increased HDL (good cholesterol)
– Improved LDL particle size
• Cardiac rhythm – Stabilizes heart rhythm
– Lowers heart rate • Kelly et al, AJCN, 7/2007
• Theobold et al., 2007
• Modest reductions in blood pressure • Kelly et al, AJCN, 7/2007
• Theobold et al., 2007
– Improved arterial compliance
– Anti-thrombotic effects
Page 23
Evaluate the effects of Life DHA on cognitive outcomes in healthy elderly (>55 yrs.) with a mild memory complaint •Randomized, double-blind, placebo-controlled, parallel, multi-center (19 US sites)
• Oral Dose: 900 mg algal DHA/day or
placebo (corn/soy)
• Study treatment: 6 months
• Sample size: 485 subjects
• Primary Endpoint: cognitive test of memory, attention &
learning
• Secondary Endpoints: cognitive tests of executive
function, Activity of Daily Living (ADL) skills, plasma
phospholipid fatty acid levels, safety and tolerability
Memory Improvement with Docosahexaenoic Acid
Study (MIDAS)
Alzheimer’s and Dementia, 2010
Goal
Design
Page 24
Results of MIDAS study
Primary endpoint: Paired Associate Learning test - learning and memory recall test that discriminates well between aging, MCI, AD and is sensitive to early episodic memory changes. (de Jager, 2002;Fowler, 2002; Egerhazi, 2007)
-6
-5
-4
-3
-2
-1
0
change score
decre
ase i
n P
AL
err
ors
Week 24 change from baseline score
DHA
PBO
* *p=0.03
Significant improvement in learning: ~50% less errors
were
made on this test in DHA group
Page 25
Conclusions of MIDAS study
• First-ever large, randomized and placebo-controlled study
demonstrating the benefits of algal DHA in maintaining and
improving brain health in older adults
• (900mg/d, 6 months) DHA improves learning and memory
recall in age-related cognitive decline, demonstrating a
significant impact on early episodic memory changes
• DHA significantly decreases heart rate in this older population,
demonstrating cardiac benefit
• DHA has an excellent safety profile and is well-tolerated by
this population
A number of prebiotics are available
• Breast milk oligosaccharides represent a large component of
human milk
• Polydextrose – Fructans fruits
• Inulin wheat, banana, onions, garlic, ..
• Fructo-oligosaccharides plants
• Galacto-oligosaccharides milk
• Lactulose milk
• Soy-oligosaccharides
• Xylo-oligosaccharides
• Isomalto-oligosaccharides corn, wheat
• Lactitol
(Journal of the American Dietetic Assosciatio,2008)
• Short chain fatty acids (SCFAs) are
produced by colonic bacterial
degradation of unabsorbed starch and
non-starch polysaccharide (fibre).
Main short chain fatty acids:
Acetate, propionate, butyrate and
lactic acid.
How do they work in the gut?
SCFAs are important anions in the colonic lumen, affecting
both colonocyte morphology and function
Soluble beta-glucan and insoluble fibres work in concert
Benefits in improvement of bowel function of OatWell® in relation to
fermentation of soluble and insoluble fibres demontrated in human studies
Increased water binding capacity
Soluble ( oat beta-glucan ) ,
fermentable DF Insoluble, poorly fermentable DF
Stimulation of microflora
Increased gas
SCFA‘s
Enlargement of food-volume
Acceleration of transit time
Reduced water resorption in colon
Increased stool bulking and improved stool consistency
2011:
positive opinion to
improve bowl function
… and OatWell brings the benefit
Blood glucose
Control
(Diabetes)
Cholesterol
Lowering
(CVD)
Satiety
(Obesity)
Gut Health
(IBS)
Oat beta-glucan health benefits
(3-4 grams bioactive oat beta-glucan daily)
EFSA art 13.1
EFSA art 14 (1)(a) EFSA art. 13.1
Work in
progress
EFSA art. 13.1
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Health
status
HLY / LE
Age
> +2HLYs LE + QoL => HLY
Double win:
1. HLY & QoL
2. Health costs
‘early
detection’
‘Health
Systems’
‘Active
Ageing’
Nutrition provides the opportunity to add
healthy and productive life years for all
‘1000 days’
HLY = Healthy life years
LE = Life expectancy
QoL Quality of life
… and achieving a healthy nutrition requires the action and
commitment of all stakeholders
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DSM Health benefit solutions... continuously innovating on science & consumer research
...
Page 32
We at DSM are committed to making a difference
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Partnership Not-for-profit nutrition think-tank
and humanitarian initiative
Largest producer of vitamins
in the world
100+ scientific publications
(2005-2011)