Twin Burdens: Over & Under Consumption
Nutritional genomics research, in its early stage, has focused on chronic diseases of economically developed nations such as obesity, CVD, T2DM. These are afflictions that could be avoided by ~90% of the population by eating less and exercising more. Chronic diseases affects several billion individuals in developed countries and the incidence of these diseases have been increasing dramatically in less developed countries. Most of the increase in these diseases is caused by adapting Western foods and lifestyles, which occurs more frequently in urban areas. Although these increases may seem to have little to do with nutritional genomics on the surface, certain thrifty genotypes are thought to be more susceptible to high fat and calorie foods and inactivity levels found in developed countries. The genetic and molecular differences that produce the thrifty genotype, which are likely to be a collection of variants in genes involved in regulatory and metabolic functions, have not been identified.
According to the 2003 World Health Report, approximately 80% of all deaths from CVD disease occurred in low to middle-income countries and by 2010, CVD will be the leading cause of death in developing countries. In 1998, the World Health Organization (WHO) declared obesity a global epidemic, with more than 1 billion adults with BMIs greater than 25 and at least 300 million adults with BMIs greater than 30. At least 171 million people worldwide suffer from Type 2 diabetes and this figure is expected to more than double by 2030. Additional information can be found in Diet, Nutrition, and the Prevention of Chronic Disease (Report of the Joint WHO/FAO Expert Consultation, 2002). Health disparities are a global problem that can be addressed by not only political and economic initiatives, but also cutting-edge technologies and international collaborations in biomedical, behavioral, and social science research.
Undernutrition Continues in Many Countries
While the incidence of chronic diseases are increasing in both developed and developing countries, undernutrition continues to plague many people, particularly women and children in rural areas of economically deprived countries. Protein - energy malnutrition contributes to the deaths of about 6.6 million children under 5 in developing countries and stunted growth of another 161 million. Deficiencies of micronutrients, particularly iodine, vitamin A, iron, and zinc compromise short- and long-term physical growth, mental development, health, performance and productivity, and survival (information from WHO Childhood nutrition and progress in implementing the International Code of Marketing Breast-milk Substitutes). Little wonder that in addition to the political, geographical, and historical factors, these nutrition-related problems contribute to extreme poverty of many developing countries.
The Need for International Alliances for Nutrigenomics Science & Applications
Many nutrigenomic researchers expect that addressing the health issues in developed countries must be done by comparing different genetic makeups and environments throughout the world. As a part of that analyses, the differences observed among different ancestral populations are likely to identify nutrients and supplements best suited for individuals sharing similar nutrigenomic profiles regardless of their geographic origin. Such evidence-based nutrient recommendations can then be developed for subgroups in a population allowing those individuals to by-pass the deleterious diets developed and consumed in more privileged countries.
Nutrigenomics research nor its applications can by themselves solve the complex problems faced by individuals in either developed or developing countries. Nutrigenomics can however, provide data, explanations, and advice for public policy experts throughout the world for treating and preventing chronic diseases, and for targeting specific policies for reducing or eliminating malnutrition. The latter is of particular importance with the growing awareness that maternal and early childhood nutrition may program health or disease. Such knowledge will allow policy planners and implementers to spend limited resources in ways to effect the most change in both developing and developed countries.
The Center of Excellence for Nutritional Genomics is contributing to the development of an international community of nutrigenomics researchers who intend to form strategic alliances and collaborations for improving personal and public health.
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