Next-Generation Nutritional Biomarkers to Guide Better Health Care

Description

There are only a few areas in human nutrition and metabolism where biomarkers are routinely used to predict health and functional outcome. For instance, of the four major nutritional deficiencies, only iron deficiency can be precisely diagnosed by employing biomarkers. They therefore play a limited role in research and decision making, and intervention strategies are still mostly targeted at the population level. What is needed at this stage are biomarkers that are predictive of later functional health and that stay stable from infancy to childhood and adult health. Moreover, individual variability must be considered, taking into account the complexity of foods, lifestyle, and metabolic processes that contribute to health or disease. These factors present significant challenges when it comes to personalizing dietary advice for healthy or diseased individuals. This book focuses on the values and limitations of traditional nutritional biomarkers and on opportunities for new biomarkers. Contributions are divided into three parts: Methodologies with regard to global epidemiology; applications/end users, and future horizons. The main goal is to review recent developments and predict how exciting new technologies could be used to drive advances in nutrition-related health care.

Informations

• Publié par: S. Karger AG
• Date de parution: 14 janvier 2016
• Nombre de lectures: 0
• EAN13: 9783318055993
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Next-Generation Nutritional Biomarkers to Guide Better Health Care
Nestlé Nutrition Institute Workshop Series
Vol. 84
Next-Generation Nutritional Biomarkers to Guide Better Health Care
Editors
Emmanuel E. Baetge Lausanne, Switzerland
Anil Dhawan London, UK
Andrew M. Prentice London, UK
Nestec Ltd., 55 Avenue Nestlé, CH-1800 Vevey (Switzerland) S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) www.karger.com
Library of Congress Cataloging-in-Publication Data
Names: Nestlé Nutrition Workshop (84th: 2014: Lausanne, Switzerland), author. | Baetge, Emmanuel E., editor. | Dhawan, Anil, editor. | Prentice, Andrew, editor.
Title: Next-generation nutritional biomarkers to guide better health care / editors, Emmanuel E. Baetge, Anil Dhawan, Andrew M. Prentice.
Description: Basel ; New York: Karger, [2016] | Series: Nestlé Nutrition
Institute workshop series, ISSN 1664-2147 ; vol. 84 | Includes bibliographical references and indexes.
Identifiers: LCCN 2015037463| ISBN 9783318055986 (hard cover: alk. paper) | ISBN 9783318055993 (electronic version)
Subjects: | MESH: Biological Markers--Congresses. | Nutritional Physiological Phenomena--Congresses. | Forecasting--methods--Congresses. | Health Status Indicators--Congresses.
Classification: LCC R857.M3 | NLM QW 541 | DDC 610.284--dc23 LC record available at
http://lccn.loc.gov/2015037463
The material contained in this volume was submitted as previously unpublished material, except in the instances in which credit has been given to the source from which some of the illustrative material was derived.
Great care has been taken to maintain the accuracy of the information contained in the volume. However, neither Nestec Ltd. nor S. Karger AG can be held responsible for errors or for any consequences arising from the use of the information contained herein.
© 2016 Nestec Ltd., Vevey (Switzerland) and S. Karger AG, Basel (Switzerland). All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, or recording, or otherwise, without the written permission of the publisher.
Printed on acid-free and non-aging paper
ISBN 978-3-318-05598-6
e-ISBN 978-3-318-05599-3
ISSN 1664-2147
e-ISSN 1664-2155
Contents
Preface
Foreword
Contributors
Methodologies: Global Epidemiology
Systems-Level Nutrition Approaches to Define Phenotypes Resulting from Complex Gene-Environment Interactions
Kaput, J. (Switzerland)
Applications of Nutritional Biomarkers in Global Health Settings
Prentice, A.M. (UK)
Next-Generation Biomarkers of Health
van Ommen, B.; Wopereis, S. (The Netherlands)
Bioinformatics: Novel Insights from Genomic Information
Hancock, R.E.W. (Canada)
Summary on Methodologies: Global Epidemiology
Prentice, A.M. (UK)
Applications/End Users
Biomarkers in Pediatric Liver Disease
Kyrana, E.; Fitzpatrick, E.; Dhawan, A. (UK)
Next-Generation Biomarkers for Iron Status
Drakesmith, H. (UK)
The Search for Biomarkers of Long-Term Outcome after Preterm Birth
Parkinson, J.R.C.; Hyde, M.J.; Modi, N. (UK)
Beyond Cholesterol - New Cardiovascular Biomarkers
Mangge, H. (Austria)
Summary on Applications/End Users
Dhawan, A. (UK)
Future Horizons
Stratified Medicine: Maximizing Clinical Benefit by Biomarker-Driven Health Care
Singh, S. (USA)
The Gut Microbiome, Its Metabolome, and Their Relationship to Health and Disease
Wu, G.D. (USA)
The Scientific Challenge of Expanding the Frontiers of Nutrition
Rezzi, S.; Solari, S.; Bouche, N.; Baetge, E.E. (Switzerland)
Summary on Future Horizons
Baetge, E.E. (Switzerland)
Subject Index
For more information on related publications, please consult the NNI website: www.nestlenutrition-institute.org
Preface
There are diverse definitions of what constitutes a biomarker for health and currently used formulae driving health care decisions frequently combine a broad range. For instance prediction of a patient's 10-year risk of a coronary event might combine measures of age, body mass index, waist circumference, blood pressure, and blood lipids. Such predictions have sufficient predictive value to have been adopted to set qualifying criteria for long-term antihypertensive and statin treatments. The purpose of the Nestlé Nutrition Institute's 84th Workshop on 'Next-Generation Nutritional Biomarkers to Guide Better Health Care', was to take stock of recent developments unleashed by the 'omics' sciences and make some over-the-horizon predictions of how these exciting new technologies could be harnessed to drive advances in nutrition-related health care.
The potential power of new technologies is breathtaking but, like a wild stallion, the challenges of taming these powers and directing them to useful ends is daunting. Even the most fervent advocates of the new technologies admit that, to date, they have promised more than they have delivered; so it is timely to take stock and ask whether we have reached a take-off point.
Jim Kaput sets the scene with a characteristically revolutionary vision of how 21 st century systems thinking must supplant 20th century reductionism and will require not only the new technologies of high-throughput metabolomics, proteomics, genomics, and epigenomics, but also a whole new approach to experimental design in order to tease out how each individual responds to nutritional change. This theme is further developed by Ben van Ommen and Suzan Wopereis, who base their arguments around a concept of 'systems flexibility' essential to the maintenance of optimal health. Foods and nutrients can play positive or negative roles in determining systems flexibility and their effects can be assessed by interrogating the complex patterns of, for instance, stress response biomarkers. Methodologies for extracting novel biological insights from the terabytes of information that can be generated by omics methods are described by Robert E. W. Hancock, whose laboratory has been at the forefront of developing supervised and unsupervised methods for interpreting innate immune and inflammatory responses to infection. The bioinformatic principles involved are representative of the challenges that are faced with next-generation nutritional biomarkers.
Subsequent papers pull back a little from these prophetic visions of what the future holds and concentrate on some of the less complex, but nonetheless state-of-the-art biomarker developments in particular settings or disease states. Andrew M. Prentice takes a pragmatic view of the numerous challenges still faced in providing laboratory methods, preferably point-of-care ones, for assessing nutrient deficiencies in poor populations from low-income countries. One example where recent discoveries show great promise for delivering a much needed point-of-care diagnostic is covered by Hal Drakesmith. He describes the range of classical, but individually problematic, biomarkers for iron status and concludes that hepcidin, the master regulator of iron metabolism, might yield an advanced biomarker because its levels represent an innate molecular integration of iron status in several body stores and balance the need for iron against the threat of infections that might be promoted by iron administration.
A similar integrative view of biomarker development is presented by Anil Dhawan et al. who describe recent advances in the identification of biomarkers of pediatric liver disease, including those corresponding to inflammation, cell death, fibrosis, and the development of malignancy.
In many instances the challenge is to assess existing nutrient status or the state of a diet-related disease so that remedial action can be taken at the individual, group, or even country level. A separate challenge, and the holy grail of many biomarker endeavors, is to discover biomarkers that are predictive of the likelihood of future disease, which could be prevented if detected at an early stage. To this end, Neena Modi et al. review the available methods for the prognostic assessment of the likelihood of a preterm birth as well as biomarkers of possible downstream sequelae. They urge the establishment of large prospective cohorts linked with omics methods to advance what is presently a very limited portfolio of methods.
Harald Mangge leads us beyond cholesterol with a discussion of novel cardiovascular biomarkers. He concentrates on the need for early detection of vulnerable atherosclerotic plaques that are undetectable by conventional imaging and classical risk factors. He concludes that, although novel markers exist they may require longitudinal studies of variations within patients in order to detect the onset of a likely critical event. The concept of developing computerized longitudinal monitoring of complex biometric signatures within individual patients is likely to be a future trend and will require prodigious data storage systems within future health services.
The series concludes with three papers taking us into that future. Sharat Singh shares his commercial experience of developing tools for the diagnosis and clinical staging of inflammatory bowel diseases to illustrate how such tools can assist in developing stratified and personalized approaches to patient care. Gary D. Wu tackles the huge challenge of how to integrate knowledge on the composition and activity of our gut microbiome into clinically tractable information that will benefit future strategies for the prevention and treatment of numerous disord