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NUTRITION

Introduction

In the past nutrition and pharmacology were seen as complimentary that needed to be used next to each other to improve health of people or to treat diseases. The ancient Greek divided medicine into three categories: diet, pharmaceutical and surgical medicine. Also in so called traditional medicinal systems such as Ayurveda and Traditional Chinese Medicine there is no fundamental difference between both disciplines, and nutrition is a normal part of prevention and healthcare.

The interaction between pharmacology and nutrition science is on the rise. Nutritional status is considered one of the important determinants of health and disease. Several diseases in our time have a clear link with lifestyle factors including the diet. There is also increasing realisation that a continuum between health and disease often exists without strict boundaries, especially in chronic diseases.
Nutrition plays a key role in human health and wellbeing. This is true through-out the life-cycle. In the developing world the prevalence of malnutrition is high, primarily because of the limited availability of nutritionally adequate foods. There is however, also a lesser known problem of micronutrient deficiency in the developed world. Although the supply of food can be plentiful, some population groups are not achieving the right level of micronutrients in their diets to support good health. The reason why IGA addresses nutrition is that nutrition itself is not recognized generally as an important topic for most patient groups. While at the same time most patient groups have direct or indirect (latent) nutritional needs.

Relevance for patient groups

The relevance of ‘nutrition’ for patient groups can differ significantly. Its importance strongly depends on the role nutrition or nutritional aspects can play in the prevention, treatment and management of the disease or disability. Many families affected by a disease are looking for information on how to best manage the disease outcomes of themselves or affected children. Besides the personal interest of many patients also society is interested in optimal health outcomes and healthier longer life, longevity.
So far, only a number of specific disease groups such as Coeliac disease, COPD and Crohn Disease have addressed nutritional issues directly. It is essential, however, that specific disease groups with nutritional problems actively participate in the development of nutritional products. It is essential however, that specific disease groups with nutritional problems actively participate in the development of nutritional products. A ‘pull’ approach to identifying the needs of individual patients or patient groups is advisable. Another recommendation could be the organization of a series of roundtables with patient groups to address the nutrition issue at large. A first roundtable will be scheduled for early 2012. 

Identified subgroups of diseases and people

There are specific groups of diseases and people that can benefit from good and optimal nutrition. These are:

  • Specific diseases: Coeliac disease, Anemia, Diabetes, Crohn & Colitis, COPD, etc.
  • Perinatal, maternal and older adults: Nutrition following the life cycle.
  • Malnutrition and nutritional supplements: HIV/AIDS, Cancer, Pre-and Post operational patients
  • Nutritional aspects of metabolic diseases: Phenylketonuria, Mitochondrial diseases, Lysosomal storage diseases, Glycogen storage diseases, Lipid storage diseases etc.
  • Nutrition and prevention aimed at life style
  • Global World Issues: Vitamin D and Iodine deficiency

In a recent publication of the European Journal of Pharmacology, an interesting review can be found which describes a number of new developments that are taking place at the interface of pharmacology and nutrition. Georgiou NA et al., Pharma-nutrition interface: the gap is narrowing, Eur J Pharmacol 651, 2011;1-8.

Nutrition in the perinatal period  of pregnancy

In addition to the risks people have to face if they don’t have access to sufficient and optimal nutrition during their life, people also are at risk when their physical bodies are developed in the prenatal stage.  The periconceptional period  is the most important period in which reproductive failures originate. These reproductive failures comprise low birth weight, preterm birth, and congenital anomalies and are major contributors to perinatal mortality and morbidity. Maternal nutrition has been recognised as one of the main environmental factors influencing the development of the embryo, foetus, and placenta with short and long term health consequences. Much knowledge has been obtained on the role of folate in reproduction, but recently the identification of dietary patterns has emerged relationships between maternal malnutrition and pregnancy outcome as well. Outcomes that show optimal nutrition during pregnancy is essential to reduce the risk of birth defects.

In 2004, the World Alliance of Organizations for the Prevention and Treatment of Genetic and Congenital Conditions (WAO) had already published a book on the increasing role nutrition and genomics in the prevention and management of disease. See: The increasing role of nutrition and genomics in the prevention and management of disease. World Alliance of Organizations for the prevention of birth defects. VSOP, Soest, 2004

The European Nutrition for Health Alliance (ENHA) was established in 2005. In particular, it tackles malnutrition as a health issue by influencing the European Union Health Agenda. It is raising awareness of mandatory nutritional risk screening for all patients, especially the elderly. For more information: see www.european-nutrition.org

As one of the first patient alliances world wide IGA and its European member EGAN are involved in better incorporation of nutrition for health. IGA, EGAN and The Preparing for Life Initiative co-organised the Nutrition Summit during Biovision on 28 March 2011 in Lyon and during the FENS conference on 28 October in Madrid to discuss the interaction between nutrition and health with nutrition and health experts.
During the first Nutrition Summit in Lyon, leading participants have joined forces to publish a ‘nutrition call to action’ a set of science-based, cost-effective recommendations to support good nutrition, which will benefit patients, people with impaired health, and other citizens, by having a positive impact on overall public health. This call to action has been send to over 80 Ministers of health worldwide. View the Call to action here.
The presentations led to the booklet ‘Nutrition throughout the Life Cycle’ which was launched at the second Nutrition Summit. Click here for the Booklet of the Summit.

During the second Nutrition Summit in Madrid new companies joined in and an outline for a memorandum to establish a Nutrition & Health Forum has been designed.
This multi-stakeholder forum brings together nutrition experts from industry, and academia, patient alliances, representatives of public private partnerships, consumer groups, health insurers, wellness sector, regulatory bodies and policymakers to drive the agenda, influence policy, incorporate nutrition into healthcare and in prevention, deliver improvements in micronutrient intakes and other nutritional solutions to meet health needs of patients and other people with impaired health, other citizens and society.
This Forum will address primarily nutrition issues world wide with an initial focus on:

  • Undernutrition
  • Non communicable diseases as part of the Global Strategy of the UN
  • Preconception care
  • The elderly
  • Nutrition economics

Presentations

Combatting Malnutrition, november 2011

Website: Websteen