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8th Annual Conference of the European Nutraceutical Association

28.11.2012 |  

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Brain health and the means of influencing it with nutraceuticals were some of the central topics at the 8th Annual Conference of the European Nutraceutical Association (ENA). The Klinikum rechts der Isar in Munich (Medical School of the Technical University Munich), Germany provided a modern and comfortable atmosphere for a keenly interested audience, senior scientists from various European and international universities and young scientists with posters who came together for a demanding programme.

The subject of brain health was accorded special relevance because, according to experts' estimates, neurological diseases and cognitive disorders could develop into the world's number two illnesses after cardiovascular disease until 2020.
The outstanding importance of nutrition was illuminated from several angles. 

Prof Michael Crawford, from Imperial College in London and one of the pioneers of neurological omega 3 research, focused on the relationship between maternal nutrition during pregnancy and lactation. While an infant's skull is virtually the same size as an adult's, the development of a child's brain cannot be made good in later life. In the event of poor nutrition before and during pregnancy, the consequences for mental disorders, cognitive, learning and behavioural deficits and dementia in old age are pre-programmed, especially for premature babies. For instance, nutrition for preterm babies must be critically re-examined. There are clear indications that it does not satisfy the actual requirements (it should be based on the placental nutrition mix). These connections must be taken particularly seriously in view of the continuously growing incidence of mental disorders and brain diseases.

Prof David Coghill, from the University of Dundee, United Kingdom, devoted his talk to the question of the extent to which ADHS can be impacted by neutraceutical intervention. He focused here on intervention using long-chain polyunsaturated fatty acids (PUFAs). The biological rationale for the use of these fatty acids has been soundly proven in animal models; there are also data on file from human intervention studies. In addition to some of these individual studies, Coghill primarily presented reviews on this topic. These demonstrate a clearly positive effect of omega 3 combinations, whereby eicosapentaenoic acid (EPA) apparently plays a special role. The effects can, on the whole, be considered slight to moderate, so although not suitable for monotherapy, they most certainly are suitable as add-on treatment or when tapering other medication. 

Prof Theoharis Theoharides, from Tufts University in Boston, USA, reported on the influence of specific flavonoids on the pathophysiological mechanisms of Alzheimer’s and autism. Theoharides is researching the connection between inflammatory processes and allergic disposition and the brain diseases mentioned. A stabilisation of mast cells by the flavonoids luteolin and quercetin as well as their anti-inflammatory effects apparently enable a protective or therapeutic effect to be achieved. Although animal models and initial clinical data point in this direction, the data on file are not yet so robust that the desired effect can be considered certain.

Prof Jeremy P.E. Spencer, from the University of Reading, UK, confirmed the cited protective effects of flavonoids on brain health in his lecture. His team conducts basic research in this field using flavonoid-rich nutrients, such as dark berries, citrus fruits, cocoa products etc., as well as suitable concentrates and extracts. The research has been able to distinguish between acute cognitive effects (within a few hours) and longer-term effects (improved circulation, anti-inflammatory and gene expression). Besides underpinning the message to eat a diet rich in fruit and vegetables, this also raises the question as to what extent such substances, when given in a concentrated form, could develop a neuroprotective effect.

The first part of the conference was concluded by the talk by Prof Maria-Cristina Polidori, from Ruhr University Bochum, on the role of individual micronutrients in cognitive impairment (with and without dementia). She reported on interim results of the so-called "OVID study" (Oxidative stress, Vascular comorbidities and their Impact on Dementia in the elderly), which have indicated the protective effect of carotenoids, tocopherols and retinol. However, she also pointed out the considerable importance of various lifestyle factors besides diet, for this multifactorial process that presents as dementia.

The speakers for the second session of the conference examined the different nutrients that currently play important roles in neutraceutical research. These include antioxidants, vitamin D, fruit and vegetable concentrates, probiotics and omega 3 fatty acids.

Prof Helmut Sies, from the University of Düsseldorf and one of the pioneers of antioxidant research, put forward the argument for terming antioxidants "bioactives", because this does more justice to their properties. On the basis of results from flavonoid studies, he explained that the positive effects of these antioxidative substances demonstrably do not stem from their direct antioxidative action. The idea that the higher the ex vivo ORAC value of a foodstuff, the more healthy it is, must be considered misleading on the basis of these results. The US American Department of Agriculture has withdrawn a database with such values from the Internet because of this. What is far more important is the evidence for functional changes, such as the effect on the endothelial function of the blood vessels (e.g. by measuring the flow mediated dilation FMD). Similarly, measuring the serum "total antioxidative capacity” (TAC) with various test kits such as TRAP, TEAC, ORAC, FRAP etc. is just as unlikely to lead to the desired result. The oxidation status of LDL cholesterol is another functional biomarker in this regard. In this connection, the study results, which prove that there is a reduction in the oxidation of LDL cholesterol when drinking red wine with a meal, are interesting, as they suggest the possible existence of a mechanism, by which the known vasculoprotective effect of red wine may be exerted.

In line with these explanations, Prof Cyril WC Kendall, from the Department of Nutritional Sciences, University of Toronto, Canada, presented a review of studies with fruit and vegetable juice concentrates, in which many functional biomarkers have already been investigated. The background to his investigations is the search for alternatives, or for support, which would help the population move closer to following the recommendation that they should eat at least five portions of fruit and vegetables (according to US American figures from 2010, over 80% of the population does not eat enough fruit, and 95% consume too few vegetables). Ultimately, 21 studies that satisfied the inclusion criteria were included in the review. Nineteen of these were interventional with encapsulated powdered products, and two with liquid products. In his conclusion, Prof Kendall stated that these products increase several key micronutrients, such as carotenoids, the vitamins C and E and folic acid, which can reduce oxidative damage to proteins, lipids and DNA, and exert positive effects on inflammatory markers, immune function and cardiovascular markers (such as the FMD described above). His review was published in the Journal of the American College of Nutrition in 2011.

Prof Peter Weber, Professor of Nutrition at Hohenheim University, Germany, and senior scientist at DSM Nutritional Products, presented global data from a systematic review of serum vitamin D levels. He also presented additional data on the general importance of this vitamin, which showed that it goes far beyond any bone-specific functions, on behalf of Prof Heike Bischoff-Ferrari, from Zurich University Hospital, who was scheduled in the programme to hold the talk, but was prevented from doing so at short notice. Prof Weber presented a map of the world that shows the intake situation on a colour scale, with children and adults depicted separately (published by Wahl D.A. et al. in Archives of Osteoporosis 2012). This revealed that 88.1% of the world's population lies below the recommended serum level of 75 nmol/L (equivalent to ng/mL), with 37.7% under 50 nmol/L and 6.7% under 25 nmol/L and therefore with a genuine vitamin D deficiency. This affects developing countries and industrialised nations equally! For instance, the situation in Germany is anything but rosy, with marked seasonal differences, whereby even in summer the highest levels only average 56.6 nmol/L and thus lie in the inadequate range. The current DACH reference values for the vitamin D intake were sharply increased this year and now, with the exception of infants, are 800 IU (equivalent to 20µg) daily (infants half of this). Prof Weber called for demands for concrete measures in view of these dramatic figures.

In his talk on probiotics, Prof Dirk Haller, from the Technical University of Munich, examined three questions: first, why the probiotic concept can work; second, the suitable target groups for the use of probiotics; and third, the required bacteria specificity. He presented the possible positive effects of adjuvant probiotic use in diabetes, autoimmune diseases and chronic inflammatory conditions. The target groups were described as individuals with antibiotic-associated diarrhoea, traveller's diarrhoea, infectious diarrhoea, Clostridium difficile-associated diseases, necrotising enterocolitis, irritable bowel syndrome and others, who might profit from probiotics intervention. Prof Haller also explained the possibilities of using probiotics in weight management, atopic dermatitis or in the prevention of acute airway infections. However, the use of probiotics as functional food is handicapped by the absence of any recognition by the European Food Safety Authority (EFSA). This, according to Prof Haller, is because there are no valid surrogate parameters to demonstrate the effect of probiotics as functional food in the field of prevention. Towards the end of his lecture, Prof Haller presented lactocepin, an extracellular surface protein bound to the cell wall of L. paracasei and L. lactis, which has positive effects on the immune system of the intestinal wall and might be used as a surrogate marker for the integrity of the intestinal wall.

Omega 3 fatty acids represent a further subject of intensive research, and Prof Philip Calder, from Southampton, UK, presented the current situation. A number of aspects have already been intensively researched, including the known low intake by the majority of the European population, the direct dependence of the tissue EPA and DHA status on the dose and duration of intake (both from the normal diet and from supplements), the healthy physiological effects that require a daily intake of at least 500mg and the very limited conversion rate of the vegetable omega 3 fatty acids alpha linolenic acid and stearidonic acid to EPA (but none at all is converted to DHA). Other aspects require further research, such as the question of different physiological effects of EPA and DHA (with the resulting recommendations for daily intake), the question of the effectiveness of different chemical forms of the fatty acids (triglycerides and phospholipids) and finally, the question of a variable responder rate in the case of genotypic differences (nutrigenomics). However, irrespective of these unanswered questions, it can be clearly stated that an adequate intake of omega 3 fatty acids is an important aim of health promotion, whereby supplements may also be used.

The poster prize awarded at the annual conference has already become a firm tradition; but this year three poster prizes were awarded for the first time ever. The scientific committee selected the best five submissions from all the poster abstracts sent in. These were then shown as brief presentations during the plenary session. Three posters on probiotics (Marie Christine Simon from the German Diabetes Centre, Heinrich-Heine University Düsseldorf, Saskia van Hemert from Winclove in Holland and Manfred Lamprecht from Graz Medical University, Austria, who took part without competing), a poster on fruit and vegetable juice concentrates (Georg Obermayer from Graz Medical University), and a poster explaining the relationship between oxidative status and osteoporosis (Rachele DeGuiseppe from the University of Milan) successfully reached this selection stage.

Georg Obermayer's poster was distinguished as the best research project because it concerned a state-of-the-art interventional study on humans; this type of research deserves special support because there is a dearth of these in the field of nutraceuticals.
Second place was awarded to Marie Christine Simon and third place to Saskia van Hemert, who had submitted and presented a very innovative project which, regrettably, was only a pilot study with an open-label design.

We congratulate the young scientists and wish them continuing motivation and success for their contributions to future nutraceutical research.

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Programme

Abstracts Annals of Nutrition & Metabolism, 61(4) 322-336 (2012)

Conference Report

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