Personalized Nutrition: Principles and Applications

306 Pages·2007·4.13 MB·English

by  Frans Kok, Laura Bouwman, Frank Desiere

9281_C000.fm Page i Thursday, July 26, 2007 7:30 PM
PERSONALIZED
NUTRITION
Principles and Applications
Ed i t e d by
Frans Kok
Laura Bouwman
Frank Desiere
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
9281_C000.fm Page ii Thursday, July 26, 2007 7:30 PM
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2008 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Printed in the United States of America on acid-free paper
10 9 8 7 6 5 4 3 2 1
International Standard Book Number-10: 0-8493-9281-0 (Hardcover)
International Standard Book Number-13: 978-0-8493-9281-8 (Hardcover)
Tis book contains information obtained from authentic and highly regarded sources. Reprinted
material is quoted with permission, and sources are indicated. A wide variety of references are
listed. Reasonable efforts have been made to publish reliable data and information, but the author
and the publisher cannot assume responsibility for the validity of all materials or for the conse-
quences of their use.
No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any
electronic, mechanical, or other means, now known or hereafter invented, including photocopying,
microfilming, and recording, or in any information storage or retrieval system, without written
permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.
copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC)
222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that
provides licenses and registration for a variety of users. For organizations that have been granted a
photocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and
are used only for identification and explanation without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Personalized nutrition : principles and applications / editors, Frans Kok, Laura
Bouwman, and Frank Desiere.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-8493-9281-8 (alk. paper)
1. Nutrition--Genetic aspects. 2. Genomics. I. Kok, Frans. II. Bouwman,
Laura, 1971- III. Desiere, Frank. IV. Title.
QP144.G45P47 2007
612.3--dc22 2007012503
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
9281_C000.fm Page iii Thursday, July 26, 2007 7:30 PM
Table of Contents
Section I
Scientific Principles of Personalized Nutrition .....................................................1
Chapter 1 Nutrigenomics and Transcriptomics: Applications
of Microarray Analyses in Nutrition Research ...................................3
Lydia A. Afman and Michael Müller
Chapter 2 Exploring the Proteome for Markers of Health.................................13
Manuela Rist and Hannelore Daniel
Chapter 3 Metabolomics and the Personalized Metabolic Signature ................23
Michael J. Gibney, Marianne Walsh, and Lorraine Brennan
Chapter 4 Nutrition, Genomics, and Cardiovascular Disease Risk ...................33
Jose M. Ordovas and Dolores Corella
Chapter 5 Nutrigenomics and Chronic Inflammation ........................................49
Lynnette R. Ferguson and Martin Philpott
Chapter 6 Personalized Prevention of Type 2 Diabetes .....................................61
Hans-Georg Joost
Chapter 7 Toward Personalized Nutrition for the Prevention
and Treatment of Cancer ...................................................................75
John C. Mathers
Chapter 8 Nutrigenomics and Angiogenesis in Obesity ....................................89
Aldona Dembinska-Kiec´
Chapter 9 Metabolic Programming during Pregnancy: Implications for
Personalized Nutrition......................................................................101
Simon C. Langley-Evans
9281_C000.fm Page iv Thursday, July 26, 2007 7:30 PM
Chapter 10 Taste as the Gatekeeper of Personalized Nutrition .........................115
Toshiko Tanaka, Danielle R. Reed, and Jose M. Ordovas
Chapter 11 Personalized Nutrition and Public Health .......................................133
Pieter van’t Veer, Edith J.M. Feskens, and Ellen Kampman
Section II
Personalized Nutrition and Stakeholders in Society........................................149
Chapter 12 Imminent Applications of Nutrigenomics:
A Stakeholder Analysis....................................................................151
J.T. Winkler
Chapter 13 The Personal Factor in Nutrition Communication ..........................169
Laura I. Bouwman, Maria A. Koelen, and Gerrit J. Hiddink
Chapter 14 A Marketing and Consumer Behavior Perspective
on Personalized Nutrition ................................................................185
Hans C.M. van Trijp and Amber Ronteltap
Chapter 15 U.S. Consumer Attitudes toward Personalized Nutrition................205
David B. Schmidt, Christy White, Wendy Reinhardt Kapsak, Josh Conway,
and Elizabeth Baily
Chapter 16 Ethics of Personalized Nutrition......................................................221
Michiel Korthals
Section III
The Future of Personalized Nutrition ...............................................................235
Chapter 17 International Efforts on Nutrigenomic Health
for Individuals in the Global Community .......................................237
Jim Kaput
Chapter 18 The Future of Foods ........................................................................261
Heribert J. Watzke and J. Bruce German
Index......................................................................................................................279
9281_C000.fm Page v Thursday, July 26, 2007 7:30 PM
Foreword
PERSONALIZED NUTRITION: HISTORY
AND PROMISES?
Personalized nutrition is an emerging but controversial new discipline among nutri-
tion scientists. Due to its possible genetic component, it has become an attractive
topic for the media. So far, the “science fiction” stories of a lady doing food shopping,
guided by a PDA containing her genome information are not taken very seriously.
Of course, in the developed world, personalized food choice is taken for granted.
Did you realize that while ordering Italian three-taste gelato, you can choose from
over a million combinations and variations, if you consider tastes, sizes, toppings,
and packaging? The same is true for coffee or take-away pizzas.
In the context of this book, personalized nutrition is related to a differentiated
health effect, with the key questions targeted at the possible scientific basis for this
phenomenon. In order to put this in the right perspective, let us have a look at the
historical development of the diet and health relationship. Until the early twentieth
century, nutritional sciences dealt with hygiene and processing. This was followed
by the incorporation of biochemistry and (molecular) physiology: the vitamins were
described, energy metabolism was understood, etc. During the second half of the
twentieth century, knowledge of cellular and molecular biological processes allowed
for further optimizing of our diet toward a balanced macro- and micronutrient
composition. This contributed to a prolongation of life span and produced a com-
mercial wave of supplements.
Gradually, nutrition scientists indicated the involvement of diet in a large number
of diseases and disorders (e.g., colon cancer, cardiovascular disorders, type 2 diabetes
mellitus, a number of inflammation-related health problems, and many more. During
the 1990s, this development triggered the introduction of functional foods, dietary
components with “added health value.” So far, these functional foods, apart from
the aforementioned supplements (vitamins, cofactors, minerals, and so forth, which
I do not consider to be real functional foods), have resulted in only a limited number
of successful products (cholesterol-lowering stanols, probiotics, a number of specific
fatty acids). Except for the cholesterol-lowering products, where an established
biomarker (the relationship between CVD and HDL/LDL cholesterol) was estab-
lished by the biomedical research community, it was very difficult to obtain scientific
proof of efficacy for most other functional foods. In many cases, the advertisement
and PR efforts by far outreached the scientific efforts accompanying the market
introduction.
Why does nutrition science have such a hard job in providing evidence for health
claims related to a dietary component? In pharmacological and biomedical research,
bioactive compounds are developed to treat a well-characterized disease. In contrast,
nutrition deals with prevention of disease and optimizing health. Here, biomarkers
9281_C000.fm Page vi Thursday, July 26, 2007 7:30 PM
quantifying the health status are essentially missing, and much of the nutrition
research (the large observational and intervention cohorts) rely on disease endpoints
instead of health endpoints. Also in the “gold standard” of diet and health research,
the (cross-over) dietary intervention trial, the quantification of the effect is a major
issue. Usually, the observed effects are small, and great efforts have to be made to
unravel the intervention effect from potential confounding variables. In other words,
the confounding parameters have a larger impact than the intervention effects. The
recent omics-related observations in human intervention studies, using very accurate
biomarkers, confirm that intraindividual variation is much smaller than interindividual
variation. Differences between study subjects may be much larger than differences
affected by the dietary treatment.
The keys for personalized nutrition actually are these “confounders” that make
the life of nutrition scientists so difficult. Age, gender, lifestyle (e.g., exercise),
phenotype (e.g., body mass index), genetic makeup, and epi-genomic imprinting —
all possibly determine our nutritional needs, the way we respond to nutrition, and
thus our “personal diet-and-health relationship.” Infant nutrition clearly differs from
a sports diet. Now, a triad of questions arise:
1. To what extent is this personal diet-and-health relationship practically
valid?
2. How can nutrition science demonstrate this?
3. What is the proposition of stakeholders in society, including the con-
sumer?
This book at least attempts to answer these questions. My personal opinion is that
indeed this relationship exists to a much greater extent than assumed until now, and
that nutrition science will need to do a much better job in accurately identifying and
quantifying the subtle differences in health status related to dietary treatment. A
complete merger of nutrition with a number of fundamental scientific disciplines
(molecular biology, biochemistry, bioinformatics, statistics, etc.) will be essential to
reach the goal.
Now, what about this specific and overemphasized part of personalized nutrition,
the impact of genetic differences? Of course, we know the examples of cholesterol
and folate, where genetic predisposition partly determines plasma concentration and
related health effects. In the case of cholesterol, a phenotypic assessment of LDL
and HDL provides a solid phenotypic biomarker, which makes genetic testing (at
least partly) unnecessary. In fact, this phenotypic readout is the gross result of at
least 20 genetic different makeups. The HDL/LDL relationship partly determines
biomedical intervention and the consumer’s food choice. In the case of folate, the
occurrence of a genetic polymorphism in one of the enzymes involved in folate
biotransformation results in a relatively low plasma folate concentration. In extreme
cases, this leads to embryonic deformation (spina bifida) due to impaired DNA
synthesis. Folate is essential for DNA synthesis as it provides the methyl group for
nucleotide synthesis. Folate is cheap, and some countries have turned to folate
supplementation to the general population (e.g., by fortification of bread). In other
words, a genetically based differential dietary advice is overruled by mass treatment.
9281_C000.fm Page vii Thursday, July 26, 2007 7:30 PM
Possible negative consequences in persons efficiently dealing with folate (high folate
levels have been shown to overmethylate DNA and are thus potentially mutagenic
and carcinogenic) were considered nonrelevant. Time will tell whether a personalized
approach would be better.
A number of disorders related to nutrition are packed with genetic variation, but
the effect of nutritional modulation of the phenotypic outcome of these variations
is difficult to assess as yet. Nutrition is the worst-case scenario for this approach in
science as multiple minor genetic differences can occur, possibly modulated by
multiple food bioactives, usually with low receptor affinity, and resulting in multiple
minor changes in gene expression and resulting phenotypic expression.
Eventually, nutrition science may very likely determine a large number of per-
sonalized nutrition and health relationships. However, this is only a small part of
the equation. Food consumption nowadays is only partially driven by health con-
cerns. It is still much more driven by convenience and price. “Food is pleasure”
rightfully is a universally held credo, and science will have a hard job in promoting
healthy diet if this aspect is compromised. Therefore, a personalized diet needs to
be both optimized toward personal health and also for personal convenience, plea-
sure, and affordability. What a challenge!
Ben van Ommen
Senior Research Fellow, Nutritional Systems Biology
Director, European Nutrigenomics Organisation (NuGO)/TNO Quality of Life
Zeist, The Netherlands
9281_C000.fm Page viii Thursday, July 26, 2007 7:30 PM
9281_C000.fm Page ix Thursday, July 26, 2007 7:30 PM
Preface
The primary role of diet is to provide an individual with optimal levels of nutrients
to meet metabolic requirements, and to give the consumer a feeling of satisfaction
and well being through the pleasure of eating. In addition, particular diets, foods
and food components can provide additional physiological, cognitive and psycho-
logical benefits, and result in biological activities beyond their widely accepted
nutritional effects. Moreover, diet not only helps to achieve and maintain optimal
health and development but can also play an important role in reducing the risk of
specific diseases and disorders.
However, a diet that serves the health of one individual does not necessarily
work for all individuals due to differences in (genetic) predisposition, and environ-
mental and lifestyle factors. Hence, diagnostic tools that reflect both the overall
health status and (genetic) predisposition of a particular person at a given time need
to be developed. The knowledge obtained thereby will facilitate appropriate nutri-
tional advice to individuals according to their immediate and long-term health needs
and, ultimately, we can foresee the time when nutritional products will be tailored
for individual consumers.
The success of the introduction of personalized nutrition in society depends on many
factors. The scientific background for this must be established, the regulatory system
must be in place, ethical issues need to be addressed, services and products with clear
health benefits must be available, and the accompanying communication must be clear.
This textbook has the aim of defining the area of personalized nutrition both
from a biomedical and social science perspective. A selected group of leading
scientists in the field will comprehensively address the molecular, physiological,
epidemiologic, and public health aspects of personalized nutrition, highlighted with
examples from major diseases. Another group of well-known social scientists will
discuss the behavioral, ethical, and consumer perspectives that will influence a
legitimate successful introduction of personalized nutrition.
We expect our book will be useful for the education of students in several
disciplines, for example, nutrition, behavioral and communication science. More-
over, stakeholders involved in personalized nutrition in government, health care, and
business may use the book as a reference guide.
Our book is divided in three sections: (1) Scientific Principles of Personalized
Nutrition, (2) Personalized Nutrition: Consumer and Society, and (3) Future Per-
spectives on Personalized Nutrition.
In the first section, Scientific Principles of Personalized Nutrition, the state of
the art of nutrigenomics technologies, including transcriptomics, proteomics, and
metabolomics, are discussed. Subsequently, the use of genomics technology for a
better understanding of the molecular mechanisms involved in major diet-related
chronic disorders — i.e., chronic inflammation, cardiovascular disease, type 2
diabetes, cancer, and obesity — is addressed.