Tailor-made food: Onset of the genotype diet
Elsevier Food International Vol.7, No.1, February 2004 Vincent Hentzepeter
“Leave your drugs in the chemist's pot if you can heal the patient with food.” It was Hippocrates, the Greek father of medicine, who spoke these famous words more than 2000 years ago. His vision has not lost power since.
On the contrary, the conviction that medicines can heal everything, a deeply rooted belief fed by the spectacular progress in medical science since World War II, has recently made place for another sound. Medical experts agree that the only way to successfully fight food-related diseases such as coronary heart disease, diabetes and certain types of cancer, is by taking diet into account as well. This means customisation of foods. The perfect and most convenient option would be the creation of foodstuffs that take account of our different genetic makeup. After all, who can stick to a healthy diet?
In 2015, 'instant health by the consumption of your favourite snack or drink' may be a widespread USP. Those who are in a hurry will need to be patient though. The development of so-called novel foods with a proven health effect on consumers, is a time-consuming process. Firstly, food authorities are reluctant to give approval for a market launch. Getting permission to market approved claims is a procedural nightmare. Protection of the consumer has top priority, once food becomes medicine. Overwhelming evidence is requested that a product both works as promised and shows no safety risks. This process may take years. Faster than the clinical trials that pharmaceutical have to pass to get new medicines registered, but tediously slow in the minds of food producers that are fixed to keep time-to-market as short as possible.
Good old chemistry
Even so, some progress has been made in this novel food field. Since the late nineties a limited range of specific health products with powerful claims have been available at the local store. To make matters clear, 'no genes' are involved yet. It is still good old chemistry that is doing the trick. Nevertheless, these niche products can be seen as a first step towards the introduction of health products that go beyond the needs of the mass consumer. Good examples are the cholesterol lowering margarines of Johnson & Johnson and Unilever, Benecol and Becel/Flora pro.activ. Both products contain phytosterols, wood chip extracts with a cholesterol likewise chemical structure. By spreading the product on bread the body will absorb less of the so-called LDL cholesterol, which is the low-density type that also determines the risk of developing heart disease. Regular use will lower the intake of so-called bad cholesterol by up to ten per cent. This effect has been scientifically proven and works for everybody. Phytosterols are now added to all kinds of products, including dairy products and drinks, opening a new market for multinationals to target specific health foods to selected consumer groups.
The R&D of Benecol and Becel/Flora pro.activ, based on the activity of a single chemical component, kept food scientists at research laboratories busy for years. Multiple energy will have to be put in the development of foods that take genetic background into consideration. More specific and better targeted at the needs of the individual, this will be an extremely big job. How wonderful it would be to add an antigene to Frito Lay chips in order to block overweight people’s calorie intake from starches. Alas, in spite of what paper headlines suggest, there is no such thing as an obesitas gene. Most oversized waistlines have nothing to do with genetics at all. Overeating is the problem.
DNA key role
Nevertheless, genes do largely control our metabolism at a molecular level. Understanding what is behind our DNA, helps to solve complex nutrition problems. This may also contribute to finding foods that are better suited for persons with certain metabolic disorders. There are many diseases that have in some way a food-related origin. For example, there is increasing evidence that the consumption of certain foodstuffs encourages the development of typical welfare diseases like diabetes, cardio-circulatory disorders and cancer. Although it is not exactly clear how disorders develop, genetic changes seem to play a key role in these complex processes.
Over the last years, it has become more and more accepted that nutrients can alter molecular processes such as DNA structure, gene expression and metabolism. This again may trigger diseases if people stick to unhealthy eating patterns. Individual genetic variation can influence how nutrients are assimilated, metabolised, stored, and excreted by the body. Therefore, even with the same diet different health problems may occur. This also explains why some individuals never reach the danger zone.
Nutrigenomics
As a result, a completely new science has emerged. It is called nutrigenomics and is part of a growing ‘omics’ research family In a nutshell it is a study of how different foods can interact with particular genes to increase the risk of diseases such as type II diabetes, obesity, heart disease and some forms of cancer. Although this research field is still in its infancy, rapid progress is being made by breaking discoveries in the life sciences sector. Advanced techniques generate billions of detailed data that can be analysed by ever-faster computers and customised software solutions.
The starting point was the unravelling of the human genome structure some years ago. It is the roadmap to a better understanding of how the genetic makeup may influence the way a body reacts to certain foods. It is a typical individual approach. Nutrigenomics researchers try to target diets to specific people, just like pharmacogenomics is focused on 'designer drugs'. Here the right chemotherapy for the right cancer patient could eliminate harmful side effects. In the same way, nutrigenomics opts with 'personalised nutrition' for the right nutrition for the right consumer. By understanding nutritional needs, nutritional status, and personal genotype, individuals will be better able to manage their health and wellbeing.
Measuring bioactivity
It will take years of research to precisely match individual diets with a person's unique genetic makeup. At this moment, so-called genotype foods are still in the laboratory stage. Not humans but mice are the subject of intensive research. This will change in the next decade, when more and more human inventory studies will be done. The crucial thing, will be to assess the positive effects of genotype foods that improve health in people with food-related disorders. These could be people with a genetic predisposition to hereditary hypercholesterolemia, causing much higher cholesterol levels than normal. They run a greater risk of having a heart attack.
First, scientific proof is needed. Therefore, scientists are very interested in the identification of biomarkers. Biomarkers are specific chemical compounds in the body that are released by metabolic processes. Recognition of biomarkers makes it possible to measure and register what actually happens in a human after eating certain foods. It is an efficient way to show that new ingredients are bioactive and work as expected for a specific person.
From designer to consumer
For the time being there are more questions than answers. What might be possible in five years from now was revealed at the Second International Nutrigenomics Conference, last November in Amsterdam. If one thing became clear, it is that research in this field has gained momentum. Scientists from all over the world agreed that nutrigenomics will ultimately lead to improved vitality and can contribute to the prevention of food-related health problems like obesitas. However, first of all, a better understanding of the genetic role in the daily diet is needed. After all, what is good for one person, can be harmful to another. Personalised foods should therefore be truly tailor made. Otherwise they will not fulfil their promise to the consumer.
Speaking of the 'Nutrigenomics Revolution', Professor Bruce German of Nestlé Research Centre in Switzerland is positive about the future possibilities in food sciences. German is convinced that the food industry will eventually exploit nutrigenomics to improve foodstuffs. Once science is ready for it, new functional food products with well-established claims will make the step from designer to consumer table.
Sky rocketing
However, how feasible is the concept of genotype foods? Prospects are good for the clinical food sector. Tailor-made diets for certain groups of cancer patients with a genetic background are certainly no science fiction. They can make therapies more effective, improve recovery and increase survival rate. Genotype foods for the retail sector are a different story. How to mass-produce genotype meals? Current production lines cannot cope with that. How to niche market them? Together with extreme R&D costs, sky rocketing prices will be the result, making products only affordable for the rich.
So we cannot expect genotype meals in the supermarket shelves in the foreseeable future. Before this leap forward in food sciences, dietary guidelines can be adapted to current insights. While scientists focus on the influence of the individual genetic makeup, diet recommendations do not even reflect the diversity of the population. The US food pyramid and the recommended dietary allowances (RDA) from the National Research Council, assume that all Americans are the same, culturally, socio-economically, physiologically and genetically. This is a gross oversimplification of the current state of art in food sciences.
Mystery
Yes, there is a knowledge gap and several scientific hurdles have to be taken. Even so, multinationals like Nestlé and Unilever realise that offering personally designed products to consumers with food-related health problems is tomorrow's ultimate marketing challenge. Designer foods for obese people will be high on their R&D agenda. Obesitas has become a worldwide problem. The World and Health Organisation warns that health-related problems will spread as an epidemic around the globe. Already the incidence of type II diabetes is rapidly increasing among people in their thirties and even among children. The same can be expected for coronary heart diseases that as a consequence will strike at younger age. It will be hard to change the dietary pattern of the overweight or to get them into sport. Special foods for the obese might be more appealing to this group. The industry is currently exploring this niche and other (health) food directions. After all, it is not just overweight that causes health problems. For instance, why can one person eat large amounts of saturated fats and maintain perfect cholesterol levels, while a second one gets in the danger zone? The genetic constitution often makes the difference. This is a mystery that is just about to be unravelled and will some day change the world of food.
The tenets of nutrigenomics:
• Diet can be a serious risk factor for a number of diseases.
• Common dietary chemicals can (in)directly act on the human genome to alter gene expression or structure.
• The influence of diet on vitality may depend on an individual's genetic makeup.
• Some diet-regulated genes may determine the onset, incidence, progression, and/or severity of chronic diseases.
• Intelligent nutrition based on genotyping can be used to prevent, mitigate or cure chronic disease.
Functional food consumers in Europe 1997-2007 (millions)
| 1997 | 2002 | 2007 | CAGR '02-'07 | |
| Germany | 2.5 | 5.4 | 7.3 | 6.1% |
| UK | 1.6 | 3.4 | 4.7 | 6.5% |
| France | 0.9 | 2.7 | 3.8 | 7.0% |
| Italy | 0.9 | 2.1 | 2.9 | 6.7% |
| Spain | 0.7 | 1.5 | 2.1 | 6.3% |
| Netherlands | 0.3 | 0.6 | 0.7 | 5.6% |
| Sweden | 0.1 | 0.2 | 0.3 | 6.7% |
| Other | 1.4 | 3.2 | 4.4 | 6.4% |
| Overall | 8.5 | 19.2 | 26.2 | 6.4% |
European functional food and drink sales by purpose 1997-2007 (€mn)
| 2002 | 2007 | CAGR '02-'07 | |
| Heart health | 792 | 1,112 | 7.0% |
| Bone health | 464 | 666 | 7.5% |
| Gut health | 857 | 1,216 | 7.2% |
| Energy | 280 | 372 | 5.9% |
| Other | 433 | 522 | 3.8% |
| Overall | 2,826 | 3,888 | 6.6% |
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