Toward guidelines for maternal and infant nutrition to influence long-term health of the offspring: The past and future of ILSI Europe work on

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1 Toward guidelines for maternal and infant nutrition to influence long-term health of the offspring: The past and future of ILSI Europe work on metabolic imprinting Ricardo Rueda, MD PhD Abbott Nutrition Chair, ILSI Europe Metabolic Imprinting Task Force

2 ILSI Europe Tripartite approach Applying state-of-the-art science to topics of common concern, this collaboration provides balanced, practical and high quality contributions to public health science. 2

3 The Metabolic Imprinting Task Force Metabolic imprinting refers to the effects of early life exposures (during pregnancy and infancy) on the development of chronic diseases, including obesity and diabetes. The next generation is expected to have a shorter life expectancy partly due to the obesity epidemic. The Metabolic Imprinting Task Force is looking at the effects of the diet in various phases of early life on later disease and health endpoints. 3

4 Task Force Expert Group This process: Involves representatives from the tripartite Includes close involvement with experts in the field Workshops Symposia Publications Provides a forum for scientific discussion and debate Moves the field forward by collective expert and stakeholder evaluation of existing science 4

5 2013 Task Force Membership Dr Ricardo Rueda Chair Abbott Nutrition ES Prof Stewart Forsyth Vice-Chair DSM - Martek Division UK Dr Eurídice Castañeda Gutiérrez Nestlé CH Dr Dianne Delsing Royal FrieslandCampina NL Dr Marieke Schoemaker Mead Johnson Nutrition NL Dr Julie Davey Dalsgaard Lund Arla Food Ingredients DK Dr Eline van der Beek Danone SG 5

6 Foundational project: 2007 Workshop in Florence, Italy Workshop on Mechanisms and definitions of metabolic imprinting, programming and epigenetics Outcomes Validated biomarkers are key for determining the link of risk factors to outcomes; Links have been established between perinatal nutrition, nutritional epigenetics and programming at an early developmental stage and a range of future health risks such as CVD and diabetes. In some cases this appears as an association; in others it appears more causal. Communication to a broad audience (consumers, industry, health care providers, policy-making bodies and the scientific community should be acknowledged. Ultimately, programming and reprogramming can become effective tools to improve health through 6 dietary intervention.

7 Next Question of Interest: What are the long-term offspring effects of maternal obesity and overweight? Objective: Outline actions that could lead to improved outcomes in obese pregnancies and protect the health of the mother and the lifelong health of the unborn child. Outcomes of Sept 2009 Roundtable: Urgent need for RCTs evaluating the effect of nutritional and behavioural interventions in pregnancy on short- and long-term outcomes in the mother and child. Additional RCTs are needed to evaluate nongenomic transfer of obesity risk from mother to child. 7

8 Follow-up project Cohort studies: Maximising the research potential Objectives: Identify gold standards to address research questions from pregnancy to early adulthood. Highlight gaps in protocols which could be filled to provide more (long-term) information on metabolic programming. Enable transversal evaluation Outcomes: Workshop in October 2011 Publication in Ann Nutr Metab: Early Life Nutritional Programming of Obesity: Mother-Child Cohort Studies, Symonds ME et al

9 Follow-up project Cohort studies: Maximising the research potential Key outcomes 9

10 Current activity: Recognizing the challenges of compromised birth state: A look into relationships between growth velocity and metabolic health outcomes Objective Rapid growth early in life may increase the risk of chronic diseases later in life. Experts will identify patterns of growth associated with disease risk. Expected outcome The expert group plans to characterise the association between growth and later health. It will provide recommendations for future clinical studies working on growth rates as well as guidance on how to assess the role of nutrition in human studies. 10

11 Dissemination a critical focus World Congress on Developmental Origins of Health and Disease (DOHaD): Santiago, Chile, November 2009 Singapore, November 2013 The Power of Programming: Munich, Germany, May 2010 European Congress on Obesity (ECO): Amsterdam, NL, May 2009 Istanbul, Turkey, May 2011 Lyon, France, May

12 Focus on Impact Develop scientific rationale: For addressing and updating current guidelines for obese and overweight women of child bearing age To limit the detrimental effects of overweight and obese pregnancy and lactation on latter generations Collaborate and communicate with: EU Research projects, e.g. EARNEST, EARLY NUTRITION Scientific Societies: DOHaD, ESPGHAN, ENA WHO Public health professionals Academic researchers e.g. cohort studies, dietary intervention studies Diabetic associations 12

13 Thank you!!