Addressing the role of diet in the prevention and management of diabetes, obesity and cardio-metabolic dysfunction

Background

Obesity, in particular central obesity, is a major risk factor for a number of non-communicable diseases including diabetes, cardiovascular diseases, cancer and dementia. Once considered a problem only in high-income countries, the prevalence of overweight and obesity is also increasing dramatically in low- and middle-income countries, particularly in urban settings. Together with an ageing population, this leads to an increasing worldwide prevalence of diabetes and other obesity-associated cardio-metabolic disorders, reaching epidemic proportions

Objectives

The task force aims to explore the aetiology, prevention, metabolic consequences and management of obesity and associated co-morbidities. A particular focus is on dietary strategies for the prevention and treatment of obesity and cardio-metabolic diseases. In addition, the task force aims to review methodologies and biomarkers used to assess the risk or severity of cardio-metabolic diseases in order to identify ‘at-risk’ populations that could benefit from dietary interventions.

Impact

A systematic review (P.C. Calder et al., 2011) was cited 336 times. This review helps to understand the nature of chronic low-grade inflammation in the context of being overweight or obese. It describes the key modulators of inflammation, in particular those related to diet.

A recent publication on low grade inflammation (A.M. Minihane et al., 2015) was produced along with a podcast on the series of ILSI Europe’s publications in the area of low-grade inflammation. It was featured in several media, including Medical News Today, currently the largest independent medical and health news website with over 11,000,000 unique users per month. It shows that controlling inflammation is crucial to human health and prevention of inflammation is a key future preventive and therapeutic target.

What’s New

  • A new comprehensive review (W.R. Russell et al., 2016) summarises the results from human dietary interventions exploring the impact of dietary components on blood glucose levels.
  • A New Activity on ‘Efficacy of Markers of Diabetes Risk’ .will critically evaluate the efficacy of markers of insulin sensitivity and secretion. It will also systematically review the use of selected markers of insulin sensitivity and secretion in dietary intervention trials.

For more detailed information, please contact Ms Lilou van Lieshout at lvanlieshout@ilsieurope.be

Task Force Members

Dr Marjan Alssema – Chair Unilever NL
Prof. Anne Marie Minihane – Co-Chair University of East Anglia UK
Dr Jessica Smith General Mills US
Dr Christian Baz Ajinomoto Europe FR
Dr Lea Brader Arla Foods DK
Dr Hana Koutnikova-Rousselin Danone FR
Dr Luc Sterkman Caelus Health NL
Dr Stephan Theis Südzucker Group DE
Dr Sophie Vinoy Mondelēz International FR
Ms Lilou van Lieshout ILSI Europe BE

Expert Groups

Efficacy Markers of Diabetes Risk – NEW

Objectives

Insulin resistance and diminished insulin secretion are the key features of development and progression of type 2 diabetes. There is a wide range of measures of these features ranging from fasting blood sample measurements to relatively invasive clamp methodology. Despite a large body of literature on the methodology and validation of these measures, there is currently no consensus on the optimal markers for use in dietary intervention studies. The aim of this expert group is to critically evaluate the efficacy of markers of insulin sensitivity and secretion and more specifically to provide guidance on the use of different markers in dietary intervention studies.

Activity

This activity will review markers of insulin sensitivity and beta-cell function. The current activity complements the activity of the Dietary Carbohydrates Task Force on ‘Characterisation of and Criteria for Glycaemic Exposure Markers in the Non-Diabetic Population’ (see p. 96) which focuses on markers that can identify (diet-induced) changes in glycaemic exposure. This activity will result in a publication split into two main sections: (1) a critical review on the quality of fasting and postprandial markers on the different physiological aspects of insulin sensitivity and secretion; and (2) a systematic review on the use of selected markers in dietary intervention trials.

Expected Output

Academic and industrial research would benefit greatly from an increased understanding and confidence in the use of established markers to evaluate efficacy on key intervention targets for diabetes (insulin sensitivity and secretion).

Gestational Diabetes & Diet – NEW

In collaboration with the Metabolic Imprinting Task Force

Objectives

Gestational Diabetes Mellitus (GDM) is defined as a glucose intolerance (of any degree), which occurs during pregnancy (Metzger et al., 1998). It is estimated that 2-6% of pregnancies in Europe result in GDM and the numbers are much higher in Asia. High maternal weight is associated with a higher risk of GDM. Nutritional advice on GDM aims to control postprandial glucose levels and to provide adequate nutrition for the developing foetus. But as yet, there is still no consensus on the optimal nutritional recommendations for GDM management. The overall aim will be to provide a clear, comprehensive and critical overview of the current knowledge on treatment of GDM via diet.

Activity

This activity will assess state-of-the-art nutritional management of GDM by means of a literature review. Treatment goals will be considered regarding optimal macronutrient distribution, micronutrient intake, energy balance, weight gain, the use of supplements and functional foods (i.e. pre- or probiotics), carbohydrate quality and the use of (low calorie) sweeteners, as well as glycaemic index and glycaemic load. Moreover, the activity will identify limitations and gaps in the existing literature.

Expected Output

It is anticipated that such an initiative would support the development of evidence-based recommendations by national and international policy makers. Thereby this activity will contribute to reducing short- and long-term complications for mother and baby.

Establishment of the Efficacy of Intervention in those with the Metabolic Syndrome

Objectives

The objectives of this project are to better understand the independent and interactive impacts of single components of the metabolic syndrome (i.e. low HDL-cholesterol, high blood pressure, hyperglycemia / insulin resistance, hypertriglyceridaemia and adiposity), on the risk of cardio-metabolic diseases. Leading on from this, the expert group aims to establish an efficacy model for food interventions so that the overall benefits of dietary change can be assessed based on a selection of disease biomarkers. The dietary benefits are likely to be underestimated based on a focus on a single risk biomarker considered in isolation instead of considering the wider physiological dysfunction which constitutes the metabolic syndrome.

Activity

A multi-disciplinary expert panel is reviewing the literature on associations between metabolic syndrome and the main related diseases. Moreover it is identifying any published methods that assess the impact of treatment (drug or lifestyle) on multiple combined features of the metabolic syndrome. The activity takes on two challenges. First, it is preparing a systematic review on the effect of diet on the hallmarks of the metabolic syndrome and second, a systematic review will be performed on the relationship between the hallmarks of the metabolic syndrome and the final disease risk (type 2 diabetes and cardiovascular diseases).

Expected Output

A ‘fit-for-purpose’ model will be developed to illustrate the impact of foods, food extracts and dietary supplements on the risk, presence or penetrance of the metabolic syndrome.

Expert Group Members

Efficacy Markers of Diabetes Risk – NEW

Prof. Ian Macdonald – Chair University of Nottingham UK
Prof. Mikael Fogelhom – Vice-Chair University of Helsinki FI
Dr Marjan Alssema Unilever NL
Dr Kristine Færch Steno Diabetes Center DK
Prof. Edith Feskens Wageningen University NL
Dr Andrea Mari National Research Council, Padova IT
Dr Ana Piekarz The Coca-Cola Company BE
Dr Jessica Smith General Mills US
Dr Stephan Thiel Südzucker Group DE
Ms Lilou van Lieshout ILSI Europe BE

Gestational Diabetes & Diet – NEW

Prof. Helen Murphy – Chair University of East Anglia UK
Dr Eline Van Der Beek – Vice-Chair Danone Nutriticia Research NL
Dr Eurídice Castañeda Gutiérrez Nestlé CH
Dr Rosa Corcoy Universitat Autònoma de Barcelona ES
Dr Eran Hadar Tel-Aviv University IL
Prof. Seppo Heinonen University of Helsinki FI
Prof. Jeya Henry University of Singapore SG
Prof. Moshe Hod Tel-Aviv University IL
Ms Joanne Kellett University of East Anglia UK
Prof. Kirsi Laitinen University of Turku FI
Prof. Sjurdur F. Olsen Danish Centre for Fetal Programming DK
Dr Ana Piekarz The Coca-Cola Company BE
Prof. Lucilla Poston King’s College London UK
Dr Ricardo Rueda Abbott Nutrition ES
Prof. Petra Rust University of Vienna AT
Dr Bettina Schelkle ILSI Europe BE
Ms Lilou van Lieshout ILSI Europe BE

Establishment of the Efficacy of Intervention in those with the Metabolic Syndrome

Dr Wendy Russell – Chair University of Aberdeen UK
Dr Harry Peters – Vice-Chair Unilever NL
Dr Christian Baz Ajinomoto Europe CH
Prof. Maria Bes-Rastrollo University of Navarra ES
Dr Kristina Harrison University of Aberdeen UK
Dr Hana Koutnikova-Rousselin Danone FR
Prof. Julie Lovegrove University of Reading UK
Prof. Massimo Massi-Benedetti International Diabetes Federation IT
Dr Claus Mayer Biomathematics & Statistics Scotland UK
Prof. Ronald Mensink Maastricht University NL
Dr Julie Anne Nazare Univerity of Lyon FR
Dr Hervé Nordmann Ajinomoto Europe CH
Prof. Jogchum Plat Maastricht University NL
Dr Katerina Vafeiadou University of Hertfordshire UK
Dr Sophie Vinoy Mondelēz International FR
Ms Lilou van Lieshout ILSI Europe BE

Poster

Nutritional Management of Blood Glucose Levels

Publications

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