Transcript PowerPoint Presentation - International Life Sciences Institute
6 th International Conference on Polyphenols and Health University of Buenos Aires, Argentina 19 October 2013
The Road to Evidence-based Dietary Recommendations for Flavonoids: How Do We Get There?
From Data to Databases to Adequate Intakes
Jeffrey Blumberg, PhD, FASN, FACN, CNS Friedman School of Nutrition Science and Policy Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston, MA USA
Disclosures for: Jeffrey B. Blumberg AFFILIATION FINANCIAL INTERESTS Grants/Research Support CORPORATE ORGANIZATION None Scientific Advisory Board Speakers Bureau Herbalife, GlaxoSmithKline, Pharmavite None Stock Shareholder None Other Financial or Material Support/Honorarium None
Why Develop Reference Values for Flavonoids?
• Provide consumers with guidance about healthy food choices via education and food product labeling • Provide the nutrition industry with definitions to guide innovative product development as well as truthful and non-misleading communications about products
Knowing is not enough; we must apply Willing is not enough; we must do.
- Johann Wolfgang von Goethe (1749-1832) IOM FNB. DRI Coverpage 2000
From Data to Databases Data
analytical methods experimental design nomenclature quality control reporting
From Data to Databases Data Food Composition Analysis
cultivar environment geography post-harvest preparation sample size replication
From Data to Databases Data Food Composition Analysis Database Classification and Organization
accuracy analytical methodology aglycone vs. glycone nomenclature incompleteness
Flavonoid Databases USDA ARS Database for the Flavonoid Content of Selected Foods USDA ARS Database for the Proanthocyanidin Content of Selected Foods USDA ARS Database for the Isoflavone Content of Selected Foods European Food Information Resource (EuroFIR) Bioactive Substances in Food Plants Information System (BASIS) French National Institute for Agricultural Research Phenol-Explorer
From Data to Databases Data Food Composition Analysis Database Classification and Organization Dietary Intake
assessment tools bioavailability reliability
Dietary Intake of Polyphenols in French Adults
SU.VI.MAX
Pérez-Jiménez et al. Am J Clin Nutr 2011
From Data to Databases Data Food Composition Analysis Database Classification and Organization Dietary Intake Validation of Exposure
matrix (blood, urine) pharmacokinetics single vs. multiple exposures
Urinary (not Dietary) Polyphenols Are Associated with Decreased Mortality
InCHIANTI Study
Total Urinary Polyphenols Total Dietary Polyphenols Zamora-Ros et al.
J Nut
r 2013
From Databases to Function Range of Intake
usual national vs. international duration in cohort
From Databases to Function Range of Intake Function
maintenance of physiological function modification of intermediary biomarkers reduction of disease risk
Cocoa Flavanols Reduce Prehypertension Systolic Blood Pressure RCT: • 15 trial arms •
2 wk • 18-70 y • 168-902 mg flavanols • 30-1008 mg polyphenols Diastolic Blood Pressure Ried et al.
BMC Med
2010
• n=156,957 • 25-75 y • 14 y F/U Anthocyanins Reduce the Risk of Incident Hypertension NHS II NHS I Intake mg/d • Q1= 5.7
• Q5= 21.9
HPFS Pooled Quintiles RR: 0.92 95% CI:0.86-0.98,
P
<0.03
Cassidy et al.
Am J Clin Nutr
2011
Intake of Anthocyanins and Polymers Reduce the Risk of Myocardial Infarction
Nurses Health Study II
Intake, mg/d Anthocyanins 1 2.5
2 5.0
3 8.4
4 13.5
5 25.1
P
1.0
- 0.80
0.60-1.07
0.71
0.52-0.97
0.85
0.63-1.15
0.68
0.49-0.96
0.047
Polymers* 65.4
1.0
- 110.1
160.9
0.89
0.66-1.19
0.80
0.59-1.08
256.7
0.64
0.46-0.89
578.6
0.83
0.62-1.11
0.051
* Polymers: proanthocyanidins, theaflavins, thearubigins • n=93,600 • 25-42 y • 18 y F/U Cassidy et al.
Circulation
2013
From Databases to Function Range of Intake Function Flavonoid Reference Value
frameworks for reference and risk FAO/WHO Codex Alimentarius U.S. Institute of Medicine
From Function to Reference Values IOM framework – DRI: EAR, AI, RDA, UL Codex framework – NRV Adequate Intake: When sufficient evidence is not available to set an EAR, the AI is a goal for the intake of individuals. The AI is expected to cover the needs of most all people.
From Function to Reference Values IOM Tolerable Upper Intake Level (UL): The highest level of daily intake likely to pose no risk of adverse health effects to almost all individuals in the general population.
FAO/WHO Highest Observed Intake (HOI): Where no toxicity has been observed, the highest dose tested that can be confidently concluded as safe.
Le mieux est l'ennemi du bien
The perfect is the enemy of the good
Voltaire (François-Marie Arouet) 1694-1778