Your Future In Asia: Developing a market and protecting its health

Transcription

1 Your Future In Asia: Developing a market and protecting its health Professor Jeyakumar Henry Director, Clinical Nutrition Sciences, Singapore Institute for Clinical Sciences, Professor, Department of Biochemistry, NUS Yong Loo Lin School of Medicine Jeya_henry@sics.a-star.edu.sg Phone:

2 Do Asians respond to foods differently? Can food be the new medicine? What are the opportunities and challenges in this region?

3 Number of people with diabetes by International Diabetes Federation Region, 2013 Pg 3 IFMAS. (2014). Number of people with diabetes in the IDF Region [Image]. Retrieved March 13, 2017, from

4 Asian Context Amongst the 382 million people affected with diabetes in 2013, over 200 million come from Asia Four of the top ten countries with the most cases of diabetes: China, India, Indonesia and Japan Diabetes affecting younger people in Asia. Largest number of people with diabetes are aged years old, compared to Europe where most diabetics are over 60

5 Plasma Glucose Response to Ingestion of 50 g CHO

6 Phenotypical Difference Chittaranjan S Yajnik, John S Yudkin THE LANCET Vol 363 January 10, 2004

7 Ethnic Differences in Postprandial Insulinaemia and Glycaemia Dickinson S et al 2002, J Nutr. 132: SE Asians vs Caucasians Chinese vs Caucasians Indians vs Caucasians

8 Blood Glucose and Insulin Response after Isomaltulose or Sucrose Sucrose Sucrose Isomaltulose Isomaltulose Isomaltulose shows a low glycaemic and insulin response GI of 32: It clearly falls within the low-gi range of foods (GI<55) From: Holub et al. Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose). Br J Nutr Jun;103(12): Atkinson et al.: International table of Glycemic Index and Glycemic load values: Diabetes Care 31, 2281 (2008)

9 Change in blood glucose from baseline (mmol/l) Sucrose - Glycemic Response Study Sucrose Chinese Malay Indian Caucasian Time (min)

10 Change in blood glucose from baseline (mmol/l) Isomaltulose - Glycemic Response Study Isomaltulose Chinese Indian Malay Caucasian Time (min)

11 from sucrose to isomaltulose IAUC (mmol x min/l) Isomaltulose Glycemic Response Study 0 Chinese Malays Indians Caucasians

12 Continuous Glucose Monitoring System (CGMS) CGMS Blood Glucose Calibration Can collect data up to 7 days Up to 4 x per day

13 h incremental change in glucose (mmol/l) The effect of inclusion of isomaltulose to a 24h daily meal sequence in Chinese males 2.5 Dinner 24h glycaemic response (continuous glucose monitoring) 2.0 Breakfast Lunch 1.5 low GI high GI Inclusion Isomaltulose or sucrose during the test meals: 30g with dinner in fruit drink 30g with breakfast added to tea 20g with lunch in fruit drink 20g with snack added to tea Snack h inside whole body calorimeter Updated: 2- May-17 Pg time (min) n = 20, (age: 21-29; BMI:18-29)

14 Opportunities & Challenges Demographic Dividends Aging Population Expanding Middle Class Bottom of the Pyramid

15 Ageing Population in Asia

16 The Aging Population

17 Ageing and Changes in Smell Perception Median smell identification test value Females (n = 1158) Males (n = 797) Total group (n = 1955) Age group (years) Doty et al. (1984)

18 Reasons behind Poor Food Intake in the Elderly Decline in sensory perception (taste & smell) Poor appetite Poor dentition Medicine

19 Opportunities & Challenges Demographic Dividends Aging Population Expanding Middle Class Bottom of the Pyramid

20 Decline in Milk Consumption in USA

21 Increase in Milk Consumption in China

22 Increase in Milk Consumption in India

23 Demand of plant based vs animal protein

24 Soy based meat substitutes Tofu Tempeh Gluten-Free, Vegan Meat Seitan Jackfruit Texturized vegetable protein Mushrooms Lentils

25 Opportunities & Challenges Demographic Dividends Aging Population Expanding Middle Class Bottom of the Pyramid

26 POVERTY HEADCOUNT AT $1.90 (% of population below poverty line) China 6.5% India 21.2% Indonesia 11.8%

27 Double burden of under and over nutrition in Asia

28 Over-nourished Over-nourished and under-nourished

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30 Clinical Nutrition Research Center, Singapore Whole-body Calorimeter Indirect Calorimeter (Basal Metabolic Rate measurement) Bomb Calorimeter Differential Scanning Calorimeter Blood Biochemistry and Analytical Labs Food Chemistry Analysis Labs In vitro Digestion System Product Development Kitchen Sensory Analysis Booths Computer-based Cognitive Testing Booths Treadmill and Ergometer Room Metabolic Rooms CALORIMETERS SPECIALIZED LABORATORIES & EQUIPMENT Continuous blood pressure monitor Triaxial accelerometer Facilities ENDOPAT (Blood vessel integrity) BODY COMPOSITION IMAGE COSMED BodPod and PeaPod Scanning (Air Displacement Plethysmography) Dual-energy X-ray Absorptiometry (DEXA) Scanning Laser Body Imaging (for Volume Determination) OTHER MONITORING CAPABILITIES Updated: 2- May-17 Continuous Glucose Monitoring Systems (including Hyperinsulinemic Euglycemic Glucose Clamps) Continuous Blood Pressure/ Heart Rate Measurements Brachial Artery Flow-Mediated Dilation (FMD) Electromyography Measurements Muscle Biopsy Anthropometric Measurements Infra-red Camera Imaging Micro Oxygen Sensors Pg 31 Continuous Glucose Monitor

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32 Addressing Asia s public health and nutrition challenges through partnerships and innovations

33 Why is there a need for Food & Nutrition research in this region The nutrition and public health issues in Asia are markedly different to that seen in the West (double burden) The metabolic response to food differs in these populations The etiology of obesity and type 2 diabetes appears to be also distinct Diet in this region is predominantly based on high carbohydrate and high glycemic index rice/wheat Public health and food policy based on research conducted on Western subjects may not be of relevance/applicable to this region

34 Considerable opportunities exist for food companies to grow in Asia The Asian palate and phenotypes necessitates the development of new food for this region Renovation, innovation will be the key drivers Bilateral exchange of ideas and foods will increase in future

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