Prebiotic fibres and the microbiome in dietary guidelines new developments TNO, the Netherlands
Public health, dietary guidelines and MyNewGut Statement in MyNewGut Description of Work Special attention rests on the development of new food-based public health recommendations to identify valid endpoints / markers to support health claims and EU legislation. Final Deliverables include Recommendations and guidelines for European public health and scientific requirements for health claims Integrated, semi-scientific summary of the project results formulation of recommendations for public and private health policy. p. 2 - TNO
Dietary Guidelines Issued and updated per country by authoritative body Process description - Experts appointed by authoritative body (Nutritionists, medical doctors,., sometimes a food spoilage microbiologist) USA Dept. s of Health and Agriculture; Germany Nutrition Society; Netherlands Health Council - Scientific basis: literature searches (e.g. PubMed) Human studies only rigorous criteria for inclusion in search Studies relating diets to key diseases, disorders and mortality (Heart, blood pressure, type-2 diabetes, cancer, obesity, (sometimes included: severe mental diseases/ disorders) - Conclusions per type of food and for key components (fats/oils, proteins, carbohydrates, fibre) p. 3 - TNO
Rigorous selection of relevant publications (example German Nutrition Society - Hauner, 2012) p. 4 MyNewGut and Public Health
Recent key documents relevant for dietary guidelines Documents related to current guidelines - EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFSA Journal 2010; 8(3):1462 - German Nutrition Society: Hans Hauner et al. Evidence-Based Guidelines Carbohydrate Intake and Prevention of Nutrition-Related Diseases Ann Nutr Metab 2012;60(suppl 1):1 58-2010 Dietary Guidelines for Americans (Departments of Agriculture and Health) - Voedingscentrum (Netherlands) current recommendations Future guidelines - UK Scientific Advisory Committee for Nutrition (SACN) Draft Carbohydrates and Health report Scientific consultation: 26 June to 1 September 2014 (> with Annexes 1000 pages). SACN pays attention to added and low MW fibres - USDA Background document for 2015 Dietary Guidelines for Americans (> 600 pages) - Health Council of the Netherlands discussions for the 2015 Dietary Guidelines p. 5
Current dietary guidelines Fibres are relevant prebiotic s not mentioned Bacteria only associated with food spoilage Dietary fibre - In all guidelines increased consumption recommended Emphasizing fibres naturally occurring in foods - Prebiotic function of fibre not mentioned in guidelines, nor in health claims Common opinions: Fiber is sometimes added to foods and it is unclear if added fiber provides the same health benefits as naturally occurring sources. (USDA 2010) Other fibres than from fruits, vegetables and wholegrain: Little research has been done no conclusions can be drawn (NL 2015 draft opinion) Note: health claims approved for specific (added) fibres in Europe and USA Bacteria if mentioned in Guidelines: only related to food spoilage p. 6
Dietary guidelines new developments USDA Scientific Report 2015 Dietary Guidelines Advisory Committee Part D. Chapter 2: Dietary Patterns, Foods and Nutrients, and Health Outcomes In addition to its work on dietary patterns, the DGAC considered conducting an evidence review on the relationship between the role of the microbiome and various health outcomes. This novel area of research has generated considerable interest in the scientific community and the lay public. Investigators are examining the diversity of organisms (i.e., microbes) that inhabit different parts of the body such as the gut, mouth, skin, and vagina, and are attempting to understand how the microbial communities are influenced by diet, environment, host genetics and other microbes, as well as their association with various health outcomes. The DGAC conducted an exploratory search but did not find sufficient evidence to address this question in the 2015 report. However, the Committee considers the microbiome to be an emerging topic of potential importance to future DGACs. p. 7
UK Scientific Advisory Committee for Nutrition (SACN) Draft Carbohydrates and Health report State of affairs and Selected conclusions - 1 State of affairs: - Many comments received - Final report, + reactions on comments, expected late spring 2015 Selected conclusions - 1 The supplement doses of resistant starch, non-digestible oligosaccharide or inulin at which the effects described above become apparent is above levels currently consumed in typical diets in the UK, but recent and future developments of novel food ingredients may substantially increase the intake of these carbohydrates. The effects on faecal parameters demonstrate the colonic fermentation of these carbohydrates, but whether they have an effect on health outcomes is unclear p. 8
SACN selected conclusions - 2 Prebiotics for infants Relationship faecal parameters and health is unclear Randomised controlled trials conducted in infants aged less than three months tend to report that supplementation of infant formula with non-digestible oligosaccharides (mainly galacto-oligosaccharide, but also fructooligosaccharide) increase the faecal content of Bifidobacterium spp., lower faecal ph and increase faecal acetate concentration, as compared with unsupplemented infant formula. These effects are less consistent in trials conducted in infants aged more than three months. It is, however, unclear what the relationship is between these faecal parameters and relevant outcomes on health. p. 9
The gut microbiome and dietary guidelines conclusions and questions - Expert committees involved in development of dietary guidelines are starting to recognise importance of the human gut microbiome for health and well-being - Is it possible to establish relationships between - Intake of common foods (and not only specific fibres and bacteria) - Gut microbiome composition - Associated health benefits? - How to strengthen relationships between nutrition microbiologists, nutritionists and and nutrition policy makers? - Can nutrition microbiologists (and not only food spoilage microbiologists0 be included in relevant advisory committees? p. 10 - TNO MyNewGut Public health dietary guidelines