What is the effect of personalized nutrition? How can we stimulate healthy ageing? What is the role of supplementation? These issues were discussed during the Food Valley Summit Personalized Nutrition - Food for the Elderly, held October 12th 2017 in Ede, The Netherlands.
Pharmacologist Paul Clayton, fellow of the Institute of Food, Brain and Behaviour in Oxford UK, argued 90% of the population doesn’t need personalized nutrition. Only 10% has a genetic higher risk of diseases. He studies Victorian society (second half of the 19 th century) and claims people in those days were much healthier when they were old. They worked until their last month or even de last week before they died. He claims higher life expectancy now is mostly related to antibiotics and dying before the age of five during mid-Victorian age. The physical condition of people nowadays is comparable to that of people in mid-Victorian age who were 15 years older. “People had 90% less cancer, heart diseases and diabetes.”
We have bad diets and not enough physical activity. The mid-Victorians ate ten or more portions of fruit and vegetables a day, while the average consumption now is three. The intake of polyphenols has fallen 90%. Heritage fruits and vegetables contained three times as much polyphenols. The Omega-6 to Omega-3 ratio has turned from 2 to 1 in mid-Victorian age tot 16 to 1 today. The intake of prebiotics is too low.
Clayton argued that poor nutrition leads to chronic inflammation. He compared the consequences of chronic inflammation with the effect of a flesh-eating bacteria, only much slower. “You are all chronically inflamed”, he told the audience. But there is hope. Chronic inflammation can be stopped with supplementation, by taking a liquid with a blend of Omega-3 with polyphenols.
Lisette de Groot, professor at Wageningen University & Research spoke about the nutritional requirements of the elderly. She explained that healthy ageing is about ageing in good shape. It is not just about preventing diseases, but also about push back limitations in malfunctioning. She discussed three nutrients: vitamin D, malabsorption of B12, and protein muscle resistance.
Elderly have a higher risk on fractures. A daily dose of 20 micrograms reduces the risk of fractures with 28% in people aged 70+. The diet provides 4 to 5 micrograms and sunlight 6 to 7 micrograms per day. Hence, supplementation is needed. She pointed at one study which suggests that there are more fall incidents with higher dose of vitamin D over a longer period. Therefore the standard dose is preferred. Vitamin D is probably most effective in combination with protein.
Around a quarter of the elderly suffer from malabsorption of protein-bound vitamin B12. Like vitamin D, B-vitamins play a role in the prevention of fractures. Supplementation of high doses of vitamin B12 in combination with modest doses of folic acid can reduce risks significantly in the 80+ population.
Age results in loss of muscle health. In the new Dutch dietary guidelines there is a higher level of protein intake for elderly people of 1,0 grams per kilo body weight a day. Elderly are advised to exercise twice a week to strengthen muscles and bones. De Groot explained that research showed that the combination of exercise and more proteins had the most effect on both muscle mass and muscle strength. The ProMuscle project found evidence that after half a year the participants that had 25 to 30 grams of protein per meal increased their body mass, while the control group that exercised twice a week without the extra protein even lost body mass.
Clinical Trial Manager Volker Elste from DSM Nutritional Products also spoke about age related diseases and the role of supplementation. Age related macular degeneration (AMD), which is the major cause of severe loss of vision in people over 50, is caused by a deficit of anti oxidants. Researchers developed a formula with lutein, zeaxanthin, Omega-3 fatty acids, vitamin C and vitamin E, zinc and copper. They managed to realize a 26% risk reduction for progression to advanced AMD. Supplementation can also play an important role in the prevention of other diseases. Omega-3 fatty acids reduces risks of heart attacks and sudden death.
Elste called healthy ageing a realistic objective. It requires the collaboration and engagement of all stakeholders to develop nutritional solutions for a sustainable public health. Together with partners DSM is developing a new generation tests for measuring the amount of vitamins in body fluids. The research is aimed at defining the specific nutrient needs of people with different diets and life-styles, patients as well as consumers. He argued that the best way is not only measure the intake of nutrients, but also the vitamin status.
Liesbeth Luijendijk, Iris de Hoogh and André Boorsma from Wageningen University & Research and TNO presented a workshop DIY analysis tools in a ‘living lab’. Onstage they measured the effect of liquorice consumption on blood pressure, the consumption of a sugar syrup waffle on blood sugar levels, and the effect of coffee on cognitive reaction. The researchers showed that individuals differ in their physical reactions. Therefore, analyses like these can help to give dietary advises.
They argued that the old method with clinical trials has a high accuracy, but it is not suitable for complicated methods. New technologies including the use of wearables have many advantages. There is a higher sampling frequency and it is scalable. In a personalized advice system data about behavioural markers are combined with both genetic information and phenotypic markers. Moreover, the researchers claim personalized recommendations are more relevant, and feel more relevant to the individual.
But how do these analyses relate to the regular dietary guidelines? “It highlights the advise. For example it can show you really need to consume more fatty fish”, Boorsma explained. Luijendijk added that they do apply the dietary guidelines. “But those guidelines are generic and everyone is different. Analyzing can lead to a real tailor made advise for a healthier lifestyle. It is about making the personal choice easier.”
In the Personalised Nutrition & Health project WUR and TNO are doing research in real life on highly motivated people in the Netherlands who suffer from metabolic syndrome. The researchers want to find out what is the effect of specific personal advise about food and life-style choices versus generic advise. The researchers use data from the ‘Bonus card’ (client card) from retailer Albert Heijn which registers all costumers purchases. There is also a study on what the researchers call ‘less motivated people’. They are studied in a test supermarket. Aim of this study is long term change in behaviour. A third study is looking at the effects of self measurement and dietary advice for people in their working environment.
Catering and care
CEO Bob Hutten from Hutten Catering pleaded for teaming up with public authorities and hospitals. Together they can help the elderly better with health issues. He argued that in hospital catering is 80% to 90% about hospitality and 10% to 20% about care. “Why don’t we run this like a hotel?”
When it comes to health issues caterers play an important role, he argued. Whether it is pre-operation, post-operation or when the patients are recovering at home. He blamed health insurance companies for not recognizing the importance of food. “I am sure we make the best food for oncological patients, but when they are at home after leaving the hospital, the health insurance companies don’t cover the costs.”
Hutten also stressed the importance of the family doctor to give life-style advise. He preferred the word ‘vitality doctor’. He pleaded for a program to monitor vitality. Just as the dentist gives us advise on maintaining our teeth, the GP should advise on life-style.
Food Valley Summits
The Food Valley Summit Personalized Nutrition - Food for the Elderly was the third Food Valley Summit this year. The first summit was on the 8 th of June on Salt reduction . The second on Green Proteins took place on the 11 th of October 2017 . The last Summit in 2017 will be on the 7 th of December 2017 . This Summit will be dedicated to Food Packaging .