Nutrigenómica, obesidad y salud pública / Nutrigenomics, obesity and public health

El desarrollo de la genómica funcional en los próximosaños condicionará cambios en el conocimiento teórico y lapráctica clínica de la nutrición. La posibilidad de determinar elperfil genético de un individuo (variaciones genéticas y modificacionesepigenéticas) y de conseguir la integración de estosdatos en una compleja red de interacciones metabólicas constituyeun desafío sin precedentes en la nutrición humana. Laaplicación práctica del conocimiento científico puro derivadode la nutrigenómica, en términos de prevención y tratamientode la obesidad, la DM2 y las enfermedades cardiovasculares, ysus implicaciones en la salud pública, son en este momentotodavía indeterminadas. La posibilidad de una intervenciónnutricional en periodos críticos del desarrollo y la capacidadde modificar la susceptibilidad genética a ciertas enfermedadesa través de la alimentación es el gran reto de la nutrigenómica,más allá del diseño de dietas o alimentos funcionales“personalizados”(AU)

Functional genomics will change knowledge and practicein clinical nutrition in the forthcoming years. The possibilityof performing an individual’s genetic profile (geneticvariations and epigenetic modifications) as well as the abilityof its integration in a complex network of metabolicinteractions represents a huge challenge in Human Nutrition.The influence of nutrigenomics in terms of prevention andtreatment of chronic diseases, such as obesity, type 2 diabetesand cardiovascular disease in a population level remainsundetermined for the moment. The opportunity of nutritionalintervention in critical stages of development and the chanceof changing genetic susceptibility to diseases through diet in aPublic Health basis should lead the future of nutrigenomicsbeyond the mere design of “personalized” functional food ordiets(AU)

[Nutrigenomics, obesity and public health]. / Nutrigenómica, obesidad y salud pública.

Functional genomics will change knowledge and practice in clinical nutrition in the forthcoming years. The possibility of performing an individual's genetic profile (genetic variations and epigenetic modifications) as well as the ability of its integration in a complex network of metabolic interactions represents a huge challenge in Human Nutrition. The influence of nutrigenomics in terms of prevention and treatment of chronic diseases, such as obesity, type 2 diabetes and cardiovascular disease in a population level remains undetermined for the moment. The opportunity of nutritional intervention in critical stages of development and the chance of changing genetic susceptibility to diseases through diet in a Public Health basis should lead the future of nutrigenomics beyond the mere design of "personalized" functional food or diets.

[New approaches in obesity treatment: the gastrointestinal tract as an endocrine organ]. / Nuevas perspectivas en el tratamiento de la obesidad: el aparato digestivo como órgano endocrino.

The gastrointestinal tract, besides digesting and processing nutrients, is now regarded as an endocrine organ able to modulate appetite, satiety, and carbohydrate metabolism. Several enteroendocrine cells produce numerous peptides codifying either orexigenic (ghrelin, orexins) or anorexigenic signals (pancreatic polypeptide, peptide YY, cholecystokinin, amylin, bombesin homologs, apolipoprotein A-IV, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, oxyntomodulin), which interact in a complex network with other peripheral signals of energy balance and with different neuropeptides involved in the central control of appetite and energy homeostasis. The growing knowledge of the actions of these gastrointestinal peptides on appetite regulation and carbohydrate metabolism, and subsequent synthesis of analogs, particularly those derived from amylin and incretins, herald a new era in the therapy of 2 closely related diseases, obesity and type 2 diabetes mellitus.

Nuevas perspectivas en el tratamiento de la obesidad: el aparato digestivo como órgano endocrino / New approaches in obesity treatment: the gastrointestinal tract as an endocrine organ

El aparato digestivo, más allá de la digestión y absorción de nutrientes, es un órgano endocrino modulador del apetito, la saciedad y el metabolismo hidrocarbonado mediante la producción, por parte de diversas células enteroendocrinas, de numerosos péptidos codificadores de señales orexígenas (ghrelina, orexinas) o anorexígenas (polipéptido pancreático, péptido YY, colecistoquinina, amilina, homólogos de bombesina, apolipoproteína A-IV, polipéptido insulinotrópico dependiente de la glucosa, péptido similar al glucagón tipo 1, oxintomodulina). El conocimiento de las acciones reguladoras del apetito y el metabolismo energético de estos péptidos, a través de su compleja interacción con otras señales periféricas (leptina, adiponectina) y con distintos neuropéptidos centrales, así como la síntesis de análogos, en especial los derivados de la amilina e incretinas, proporciona nuevos enfoques terapéuticos para 2 trastornos íntimamente relacionados: la obesidad y la diabetes mellitus tipo 2

The gastrointestinal tract, besides digesting and processing nutrients, is now regarded as an endocrine organ able to modulate appetite, satiety, and carbohydrate metabolism. Several enteroendocrine cells produce numerous peptides codifying either orexigenic (ghrelin, orexins) or anorexigenic signals (pancreatic polypeptide, peptide YY, cholecystokinin, amylin, bombesin homologs, apolipoprotein A-IV, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, oxyntomodulin), which interact in a complex network with other peripheral signals of energy balance and with different neuropeptides involved in the central control of appetite and energy homeostasis. The growing knowledge of the actions of these gastrointestinal peptides on appetite regulation and carbohydrate metabolism, and subsequent synthesis of analogs, particularly those derived from amylin and incretins, herald a new era in the therapy of 2 closely related diseases, obesity and type 2 diabetes mellitus

[Functional nutrition and optimal nutrition. Near or far?]. / Alimentos funcionales y nutrición óptima. Cerca o lejos?

The concept of functional food, about which scientific agreement is still lacking, springs from the field of Optimum Nutrition, aimed at modifying genetic and physiological aspects of human life and at the prevention and treatment of a growing number of diseases, far beyond merely covering nutritional requirements. From the European Union perspective, functional foods can be natural as well as industrially processed foods. The leading functional foods regarding which the soundest scientific evidence exists are probiotics, live microbial food ingredients represented mainly by fermented dairy products. Prebiotics, such as inulin-type fructans, are the trophic substrate of probiotics and potential intestinal microflora selectors. The combination of prebiotics and probiotics is termed synbiotic. Innumerable substances are known to have functional effects: soluble and insoluble fiber, phytosterols, phytoestrogens, monounsaturated and polyunsaturated fatty acids, phenol derivatives, vitamins and other phytochemicals. Functional foods exert their actions on different systems, especially the gastrointestinal, cardiovascular and immunological ones, acting too as enhancers of development and differentiation and positively modulating nutrient metabolism, gene expression, oxidative stress and the psychic sphere. The establishment of Health Claims must be firmly based upon scientific knowledge and legal regulation. Efficient biomarkers related to biological response must be found. Furthermore, it is essential to analyze possible diet or drug interactions as well as it is indispensable to conduct valid studies on humans. The prime objective must be the diet as a whole. Thus, the future challenge of a functional diet emerges.

Alimentos funcionales y nutrición óptima.¿Cerca o lejos? / Functional Foods and Optimum Nutrition: A Way or Away?

El concepto de alimento funcional, aún no consensuado científicamente, surge en el seno de la Nutrición Óptima, encaminada a modificar aspectos genéticos y fisiológicos y a la prevención y tratamiento de enfermedades, más allá de la mera cobertura de las necesidades de nutrientes. Bajo la perspectiva de la Unión Europea, pueden ser tanto alimentos naturales como procesados industrialmente. Los alimentos funcionales más relevantes y sobre los que recae la más sólida evidencia científica son los probióticos, microorganismos vivos representados fundamentalmente por los derivados lácteos fermentados. Los prebióticos, como los fructanos tipo inulina, son el sustrato trófico de los probióticos y potenciales selectores de la flora colónica. La asociación de un prebiótico y un probiótico se denomina simbiótico. Se conocen innumerables sustancias con actividad funcional: fibra soluble e insoluble, fitosteroles, fitoestrógenos, ácidos grasos monoinsaturados y poliinsaturados, derivados fenólicos, vitaminas y otros fitoquímicos. Los alimentos funcionales ejercen su actividad en múltiples sistemas, especialmente el gastrointestinal, cardiovascular e inmunológico. Se comportan como potenciadores del desarrollo y la diferenciación, moduladores del metabolismo de nutrientes, la expresión génica, el estrés oxidativo y la esfera psíquica. La construcción de alegaciones sanitarias dirigidas al consumidor debe cimentarse en el conocimiento científico y la regulación legal. Es preciso encontrar biomarcadores eficientes del efecto biológico, analizar las posibles interacciones y realizar estudios válidos en humanos. El objetivo prioritario, sin embargo, debe ser la dieta en su conjunto. Emerge así el futuro reto de una dieta funcional (AU)

The concept of functional food, about which scientific agreement is still lacking, springs from the field of Optimum Nutrition, aimed at modifying genetic and physiological aspects of human life and at the prevention and treatment of a growing number of diseases, far beyond merely covering nutritional requirements. From the European Union perspective, functional foods can be natural as well as industrially processed foods. The leading functional foods regarding which the soundest scientific evidence exists are probiotics, live microbial food ingredients represented mainly by fermented dairy products. Prebiotics, such as inulin-type fructans, are the trophic substrate of probiotics and potential intestinal microflora selectors. The combination of prebiotics and probiotics is termed synbiotic. Innumerable substances are known to have functional effects: soluble and insoluble fiber, phytosterols, phytoestrogens, monounsaturated and polyunsaturated fatty acids, phenol derivatives, vitamins and other phytochemicals. Functional foods exert their actions on different systems, especially the gastrointestinal, cardiovascular and immunological ones, acting too as enhancers of development and differentiation and positively modulating nutrient metabolism, gene expression, oxidative stress and the psychic sphere. The establishment of Health Claims must be firmly based upon scientific knowledge and legal regulation. Efficient biomarkers related to biological response must be found. Furthermore, it is essential to analyze possible diet or drug interactions as well as it is indispensable to conduct valid studies on humans. The prime objective must be the diet as a whole. Thus, the future challenge of a functional diet emerges (AU)