Transcript 35461
Tackling Chronic Diseases: the Potential of Preventive Medicine through Improvements to Diet Cathie Martin, MA, PhD, Professor Department of Metabolic Biology John Innes Centre Norwich Research Park, United Kingdom Niels Bohr Professor, Department of Plant Biology and Biotechnology Copenhagen University, Denmark May 2009 Leading causes of death worldwide, 2005 Injuries 9% Respiratory 7% Diabetes 2% Other chronic disease 9% Cancer 13% Cardiovascular disease 30% Communicable diseases maternal and perinatal nutritional deficiencies 30% Source: World Health Organisation 2005 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) Chronic Conditions: Cardiovascular disease (CVD) Diabetes Obesity Cancers Respiratory diseases 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 one chronic 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 EU: FP6 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. To find out what foods are good for you Control line (r1) Flavo-enriched line (ACR) Genotype: p1r1c1A1 Genotype: p1R1C1A1 Special diets Introduction of 20% of corn seeds powder in a standard pellet formula 8-week treatment (~15 mg/kg/day) Effects on ex vivo myocardial infarction Effects on vascular reactivity Example of TTC staining for infarct size determination Non-ischemic Zone (blue) Group r1 Infarcted zone (white) + Ischemic viable zone (red) = Risk Zone Group ACR Marie-Claire Toufektsian, Michel de Lorgeril Infarct Size Marie-Claire Toufektsian, Michel de Lorgeril Anthocyanins offer cardioprotection against ischaemia/reperfusion injury National Cancer Institute and National Research Council in the US recommend: 5 servings of fruit and/or vegetables per day (www.5aday.org) Out of 15,000 surveyed only 23% Americans achieved this intake More worryingly the numbers attaining 5-a-day have decreased over the past 10 years Using genetic engineering techniques we can develop healthier foods, rapidly del/ros (line N) WT del/ros del/ros (line C) (line N) Antioxidant capacity of purple compared to red tomatoes Eugenio Butelli, Cathie Martin Red tomato – supplemented pellets Purple tomato – supplemented pellets p53-/p53- knockout mice Life span, pathology Diet Number of mice Average Lifespan (days) Std Error Maximum Lifespan (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 noncommunicable diseases: The top 20 policy and research priorities for conditions such as diabetes, stroke and heart disease. Nature, 450, 494-496 Sponsored by the Oxford Health Alliance 22 November 2007 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 consumption 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 was that it showed that genetic modification is not just a generic technology that is either good or bad, but that very different things can be done with genetic modification of plants—including the development of products that have very real advantages for consumers. This displaces the debate from ‘it is alright for them’. • Research on functional foods is best undertaken by publicly-funded organisations: To promote consumer confidence in the results To access and assess the entire range of health-promoting phytonutrients not just those of commercial interest • But the regulatory burden is too costly for ‘not-forprofit’ organisations to bring improved GMO products to the consumer • The social burden is also very heavy in undertaking this research: One really has to wonder exactly who this tomato will benefit, asked VAS's biosecurity representative, Simona Capogna. It will undoubtedly help those who hold the patent, those firms that sell it (at an inflated price) and those researchers who use it as a career move or who buy shares in biotech firms…… Detractors do not believe it is possible to use GM technology for the ‘common good’. The Future?