Tackling Chronic Diseases: the Tackling Chronic Diseases: the Potential of Preventive Potential of Preventive
Medicine through Medicine through Improvements to DietImprovements to Diet
Cathie Martin, MA, PhD, ProfessorDepartment of Metabolic BiologyJohn Innes CentreNorwich Research Park,United Kingdom Niels Bohr Professor,Department of Plant Biology and BiotechnologyCopenhagen University,Denmark
May 2009
Other chronic disease 9%
Injuries 9% Respiratory 7%Diabetes 2%
Communicable diseasesmaternal and perinatal
nutritional deficiencies 30%
Cardiovascular disease 30%
Cancer 13%
Source: World Health Organisation
Leading causes of death worldwide, 2005
2005
Facts:Facts:
• The total number of people dying from chronic diseases is twice the number of people dying from infectious diseases including HIV/AIDS.
• 80% of mortality from chronic disease occurs in low and middle income countries
• The poor are more vulnerable to chronic disease because of increased exposure to risks and decreased access to health care
• Chronic diseases cause poverty• Without action deaths from chronic diseases will
increase by 17% between 2005 and 2015 (WHO report 2005)
Cardiovascular disease (CVD) Diabetes Obesity Cancers Respiratory diseases
Chronic Conditions:Chronic Conditions:
Chronic conditions, including cardiovascular diseases (CVD), diabetes, obesity, cancers and respiratory diseases, account
for 59% of the 57 million deaths annually and 46% of the global burden of disease.
Of those with chronic conditions 60% are between the ages of 18 and 64. 90% of seniors have at least onechronic disease and 77% have two or more chronic
diseases.
Globally, chronic disease is projected to cause 388 million
deaths in the next 10 years
Socio-Behavioural Risk Factors for Chronic Disease
OBESITY
Obesity is a major emerging disease, particularly
afflicting the poor.
Obesity has a strong correlation with the incidence of
several degenerative diseases, such as type II diabetes,
glucose intolerance, cardiovascular disease, and cancer.
Obesity is reaching epidemic proportions
Even in Italy obesity is becoming a problem particularly in the young
What can plant science do to combat chronic disease?
Emphasise the good things in food
Objectives: To generate defined dietary material (model foods) to test the impact of specific flavonoids on cardiovascular and age-related degenerative diseases in a whole food context using animal model systems.
EU: FP6
To find out what foods are good for you
Special dietsIntroduction of 20% of corn seeds powder in a standard pellet formula
Effects on ex vivo
myocardial infarction
Effects on vascular reactivity
8-week treatment(~15 mg/kg/day)
Control line (r1)Control line (r1)Genotype: Genotype: p1r1c1A1p1r1c1A1
Flavo-enriched line Flavo-enriched line (ACR)(ACR)
Genotype: p1R1C1A1Genotype: p1R1C1A1
Example of TTC staining for infarct size Example of TTC staining for infarct size determinationdetermination
Risk Zone+ =
Group r1
Group ACR
Infarcted zone(white)
Ischemic viable zone
(red)
Non-ischemic Zone (blue)
Marie-Claire Toufektsian, Michel de Lorgeril
Infarct SizeInfarct Size
Marie-Claire Toufektsian, Michel de Lorgeril
AnthocyaninsAnthocyanins offer offer cardioprotection against cardioprotection against
ischaemia/reperfusion injuryischaemia/reperfusion injury
National Cancer Institute and National Cancer Institute and National Research Council in the USNational Research Council in the US
recommend:recommend:
5 servings of fruit and/or vegetables5 servings of fruit and/or vegetables per dayper day
(www.5aday.org)(www.5aday.org)
Out of 15,000 surveyed only 23%Out of 15,000 surveyed only 23% Americans achieved this intakeAmericans achieved this intake
More worryingly the numbers attaining 5-a-day have decreased over the
past 10 years
Using genetic engineering Using genetic engineering techniques we can develop techniques we can develop
healthier foods, rapidlyhealthier foods, rapidly
del/rosdel/ros (line N)(line N)
del/rosdel/ros (line C)(line C)
WTWT
del/rosdel/ros (line N)(line N)
Antioxidant capacity of purple compared to red tomatoes
Eugenio Butelli, Cathie Martin
p53-/p53- knockout mice
Red tomato – supplementedpellets
Purple tomato –supplementedpellets
Life span, pathology
Diet Number of mice
AverageLifespan (days)
Std Error
MaximumLifespan(days)
Standard diet 24 142.0 8.7 211
Diet supplemented with 10% red tomato powder
15 145.9 12.6 213
Diet supplemented with 10% purple tomato powder
20 182.2 8.6 260
Lucilla Titta, Marco Giorgio
So what can society do about chronic disease?
Grand challenges in chronic non-communicable diseases: The top 20 policy and research priorities for conditions such as diabetes, stroke and heart disease.
Nature, 450, 494-496 22 November 2007
Sponsored by the Oxford Health Alliance
Many chronic conditions could be prevented:
• 36 Million of the projected deaths from chronic disease could be avoided by 2015
• 50% of avoided deaths would be in people <70 years old
• Economic impact would be enormous: calculated loss in national income to chronic disease in UK is: $33Billion
Commentary posted by Rachel Nugent
Alas, this Grand Challenge has no money, no Foundation, no benefactor. Indeed, it is a kind of reverse Grand Challenge, as it consists of scientists telling us what needs to be done to address chronic NCDs and hoping that someone will pony up the money
to do it.
Increase the availability and Increase the availability and consumption of healthy foodconsumption of healthy food
We need to start by ensuring that children eat well
Jamie Oliver
…….we need second generation GMOs
to help combat chronic disease
One important feature of the tomato study One important feature of the tomato study was that it showed that genetic modification was that it showed that genetic modification is not just a generic technology that is either is not just a generic technology that is either good or bad, but that very different things good or bad, but that very different things can be done with genetic modification of can be done with genetic modification of plants—including the development of plants—including the development of products that have very real advantages for products that have very real advantages for consumers.consumers.
This displaces the debate from ‘it is alright This displaces the debate from ‘it is alright for them’.for them’.
• Research on functional foods is best Research on functional foods is best undertaken by publicly-funded undertaken by publicly-funded organisations:organisations:
To promote consumer confidence in To promote consumer confidence in the resultsthe results
To access and assess the entire range To access and assess the entire range of health-promoting phytonutrients not of health-promoting phytonutrients not just those of commercial interestjust those of commercial interest
• But the regulatory burden is too costly for ‘not-for-But the regulatory burden is too costly for ‘not-for-profit’ organisations to bring improved GMO profit’ organisations to bring improved GMO products to the consumerproducts to the consumer
• The social burden is also very heavy in undertaking The social burden is also very heavy in undertaking this research:this research:
One really has to wonder exactly who this tomato One really has to wonder exactly who this tomato will benefitwill benefit, asked VAS's biosecurity representative, , asked VAS's biosecurity representative, Simona Capogna. Simona Capogna. It will undoubtedly help those who It will undoubtedly help those who hold the patent, those firms that sell it (at an inflated hold the patent, those firms that sell it (at an inflated price) and those researchers who use it as a career price) and those researchers who use it as a career move or who buy shares in biotech firms……move or who buy shares in biotech firms……
Detractors do not believe it is possible to use GM Detractors do not believe it is possible to use GM technology for the ‘common good’.technology for the ‘common good’.
The Future?The Future?
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