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

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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

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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

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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

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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

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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

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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

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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

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Resveratrol extents the life span of obese mice

Baur et al. Nature, 2006

2 year

59 %

77 %

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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

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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

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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

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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

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• 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

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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

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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

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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

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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:

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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

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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

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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

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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

...

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We at DSM are committed to making a difference

World Food Programme

Partnership Not-for-profit nutrition think-tank

and humanitarian initiative

Largest producer of vitamins

in the world

100+ scientific publications

(2005-2011)