Food and Health Research in Europe – FAHRE Thematic Expert Report Dr Zeinab Mulla Area: Nutrition/Biochemistry November 2010 1 Introduction The current main areas of molecular and cellular research in relation to food and health are as follows: micronutrients, macronutrients, nutrigenomics, metalobomics, and the development of biomarkers as a tool for dietary assessment. The research with micronutrients and macronutrients is both clinical (randomised controlled trials and laboratory work) and epidemiological. The key micronutrients being currently researched are B vitamins/folate (although this is beginning to drop off now), Iron and vitamin D. Polyphenols/flavonoid have emerged as a big area of research in the last few years. The focus has begun to shift from micronutrients in the last 5 years as a lot of research has been done and there has been a lack of positive results, for example trials of micronutrients in relation to cardiovascular and cognitive outcomes. But there is still scope for further investigation with the micronutrients mentioned above. There is now a lot more focus on whole foods and dietary patterns in research with randomised controlled trials now focusing on this. Developing biomarkers for use as dietary assessment methods is a newly emerging area as the limitation of the current dietary assessment methods is recognised. It is thought the measurement error involved in current methods may be obscuring diet-disease relationships (due to the lack of positive finding in diet-disease studies). Current methods have been the same for a long time (past 20 plus years): weighed food diet, estimated food diary, recalls, food frequency questionnaire, dietary checklist, diet history, observation, duplicate diets. Currently the most commonly used in both epidemiological studies and randomised clinical trials are weighed food diet, estimated food diary, recalls and food frequency questionnaire. All have error involved, but all of the above mentioned are regarded as good and valid measures and some are better than others depending on study type, diaries involve the least error. To date some biomarkers for the validation of dietary assessment methods have been developed but the area is limited by the lack of biomarkers to reflect wider aspects of diet (Doubly labelled water, urinary nitrogen and potassium are recognised as routine methods in validation studies). This is an important priority for research. Due to the interest in whole foods/dietary patterns, researchers have now started to investigate the bioavailability of foods/nutrients from foods. This is an important metabolic area and is related to the nutrigenomics area. How gene expression and the metabolic response is affected by foods is a new and cutting edge area but has been slow-moving thus far as it is technically and methodologically challenging. The hope from this research is that it can lead to personalised nutrition by assessing how the food/nutrient-gene interaction can affect susceptibility to disease. There is still a long way to go in this area of research. This cellular/molecular area of food and health research is one ripe for industry involvement-due to the current interest in nutrition from the public and the many food linked diseases currently prevalent. Industry has been very interested in being able to find health benefits for their products and there are many examples where industry has collaborated with universities to do this for example plant stanols being incorporate into products such as margarine and the benefits of chocolate due to polyphenols. Industry will either fund research or provide products to be used in trials. Some areas have had good industry involvement while others have not; the area of micronutrients research has been utilised well by industry, other areas such as nutrigenomics have not been so well utilised by industry perhaps because the time and labour required before output was obtained would be greater than in other areas. This trend is likely to continue. 2 1. Research at European level in your area of expertise Table 1.1 Main programmes and projects Cross-European/International project Outline of project EC funding? The European Prospective Investigation into Cancer and Nutrition (EPIC) & European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home and Obesity (EPIC-PANACEA) A prospective cohort study investigating nutrition and cancer, with the potential for studying other diseases. 10 European countries taking part, cancer incidence and cause-specific mortality to be followed for several decades. EPIC-PANACEA- A branch off the EPIC study above-same as above but looking at Obesity. European Commission (SANCO) European Micronutrient Reccomendations Alligned (EURRECA) A Network of Excellence working to harmonise European micronutrient recommendations with a focus on a strong scientific basis for recommendations and needs of vulnerable groups and impact of socio-economic, ethnic and genetic factors.8 countries. An integrated study of the nutritional status of European adolescents. Will look at intakes, choices and preferences, obesity prevalence, dislipidemia, insulin resistance, vitamin and minerals status, immunological markers for sub clinical malnutrition, physical activity and fitness patterns, and variations of the nucleotide sequence in selected genes. 11 countries Investigating cross-cultural differences in nutritional issues and life-style factors affecting health and performance of elderly people in Europe. Using a mixed longitudinal design. Data regarding nutrient and food intakes, diet habits, diet awareness, nutritional status, health, and life-style factors collected.11 countries European Commission FP6 The MONICA (Multinational Monitoring of trends and determinants in Cardiovascular disease) Project Set up to explain the diverse trends in cardiovascular disease mortality which were observed from the 1970s onwards. 21 countries took part. Ten million people monitored. The data are still being used for Ana lyses. 19 countries WHO The European Male Ageing Study (EMAS) A multicentre prospective cohort designed to examine the prevalence, incidence and geographical distribution of gender-specific and general symptoms of ageing in men, including their endocrine, genetic and psychosocial predictors. Men aged 40–79 years from eight European centres. Prospective study of the association between vitamin D status, measured as serum concentrations of 25hydroxyvitamin D (25(OH)D), and the development of 7 rarer cancer sites. The cohorts come from 3 continents. Finland taking part. Formed in 2008. It represents a collaboration of 15 cohorts from the United Kingdom, United States, Canada, Netherlands, Sweden, and Finland. Studying genetic determinants of Vit D status. Healthy Lifestyle in Europe by Nutrition in Adolescence (The HELENA Project) EURONUT-SENECA The Cohort Consortium Vitamin D Pooling Project of Rarer Cancers (VDPP) The SUNLIGHT consortium (Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits) Heart Outcomes Prevention Evaluation Study (The HOPE study) European Community FP6 EC A large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. 3 European countries. The Italian American clinical trial of nutritional 3 supplements and age-related cataract. European Nutrition and Health Report (ENHR) The ZENITH study (Zinc effects on Nutrient Interactions and Trends in Health and Ageing) ZINCAGE’ "Nutritional zinc, oxidative stress and immunosenescence: biochemical, genetic and lifestyle implications for healthy ageing" The EARNEST programme (the Early Nutrition Programming Project website.) HEPADIP NuGO LIPGEN European Vascular Genomics Network The European Commission (EC) initiated a Health Monitoring Programme, The aim of the study was to investigate the effects of zinc, given as a nutritional supplement to late middleaged and older population groups, on psychological and behavioural factors and on surrogate cellular markers. The project will provide a scientific basis for formulation of public health recommendations on dietary zinc intake in aged Europeans. 14 European countries. 17 European research groups which will study biochemical, genetic and lifestyle factors for healthy ageing with a particular focus on nutritional zinc, oxidative stress and immunosenescence. T This project is a large collaborative investigation into the long-term consequences of early nutrition by metabolic programming. It brings together a multi-disciplinary team of scientists from 38 institutions in 16 European countries. Hepatic and adipose tissue and functions in the metabolic syndrome-looking at diogenes. Diet, obesity and genes. Aims to provide tools to combat metabolic syndrome. 11 European countries. European nutrigenomics organisation - linking genomics, nutrition and health research across Europe to integrate research and create a network of excellence.10 European countries Investigating the interaction of nutrients and genotype in the metabolic syndrome, also looking at lipid metabolism. 10 European countries involved Aims to maximise the impact of the post-genome era on vascular biology so as to optimise the conversion of research results into concrete health, social and economic benefits. European Commission FP5 a EU 6th Framework project EU FP6 EU FP6 EU EU FP6 Countries involved the most in cross-European research projects (involved in 5 of the above projects or more): Belgium (7), UK (11), Norway (7), Denmark (7), Finland (7), France (11), Germany (9), Hungary (6), Italy (10), Netherlands (10), Poland (7), Spain (9), Sweden (10), 4 1.2 Infrastructure and equipment. Uniform methods across countries of dietary assessment are needed. EPIC has set a precedent for this with the dietary assessment lots of dietary assessment validation studies but more of these kinds of studies are needed. Perhaps there could be better coordination and agreement across Europe to use a certain types of dietary assessment and if different methods are used what statistical methods should be used to compare findings from studies across Europe. Guidelines on this could be set up and circulated to all nutrition centers across Europe. General procedures for running trials also needs to be harmonised, again EPIC has set a very good example for this. The approach to genetic research in Nutrition is increasingly metalobomics/metabonomics. This is partly because nuclear magnetic resonance (NMR) and mass spectroscopy (MS) are established techniques and partly because progress in other techniques such as transcriptiomics and proteomics has been slow due to techniques in these areas being technically challenging. The European commission has already set up the European nutrigenomics organisation which should be sufficient infrastructure for networks to form. Funding should be put into collaborative research projects and to train people as the field needs more projects and trained personnel to speed up output-it seems there is a lot of duplication of research currently and also centres which have equipment necessary for this field are not being utilised fully, for example many medical/pharmaceutical/chemistry departments have the equipment needed for the techniques used, so nutrition departments in universities and/or private companies can collaborate with these departments. Therefore there needs to be an engagement of molecular scientists/gentecists/chemsists into the nutrition field. Nestle in Switzerland and Imperial College London have a nutritional metabonomics project set up which aims to move towards personalised nutrition. Unilever PLC in the UK is also involved in some metabonomics research with various universities. Other countries also appear to collaborate with food companies. It seems this collaboration between public and private partners could be increased and harmonised better across Europe. 1.3Major researcher groups. It is difficult to say who the major research groups are as there huge amount of centres across Europe involved in all the projects. The projects are led/coordinated by various research groups in universities across Europe- University of Wageningen in The Netherlands stands out as particularly coordinating a lot of projects. The International Agency for Research on Cancer (IARC) part of the World Health Organisation also coordinates a lot of projects. 1.4 Network/resource EuroFIR (European Food Information Resource) was a five-year Network of Excellence funded by the European Commission's Research Directorate General under the "Food Quality and Safety Priority" of the Sixth Framework Programme for Research and Technological Development. The network involved 49 partners from universities, research institutes and small-to-medium sized enterprises from 27 European countries. EuroFIR aimed to provide the first comprehensive panEuropean food information resource, using state-of-the-art database linking, to allow effective management, updating, extending and comparability. One of the key achievements of the EuroFIR project is the establishment of the EuroFIR AISBL new legal entity, which forms the basis of an international, non-profit Association based in Belgium (Association Internationale Sans But Lucratif; abbreviated AISBL). http://www.eurofir.net/ 5 The European Food Information Council (EUFIC) is a non-profit organisation which provides science-based information on food safety & quality and health & nutrition to the media, health and nutrition professionals and educators, in a way that promotes consumer understanding. http://www.eufic.org/index/en/ The International Life Sciences Institute (ILSI) is a non-profit, worldwide foundation established in 1978 to advance the understanding of scientific issues relating to nutrition, food safety, toxicology, risk assessment, and the environment. By bringing together scientists from academia, government, industry, and the public sector, ILSI seeks a balanced approach to solving problems of common concern for the well being of the general public. ILSI Europe was established in 1986 to identify and evaluate scientific issues related to the above topics through symposia, workshops, expert groups, and resulting publications. The aim is to advance the understanding and resolution of scientific issues in these areas. ILSI Europe focuses on the specific needs defined by the Institute’s European partners. ILSI Europe is funded primarily by its industry members. The European Research Area in Ageing 2 (ERA-AGE 2) is a three year project funded by the European Commission, under the Seventh Framework Programme. ERA-AGE 2 aims to continue the work of the highly successful ERA-AGE which ended in February 2009 after 5 years under the Sixth Framework Programme. The project will secure, for the long term, the future of the European Research Area in ageing research and launch Europe's first joint research programme on ageing. All partners are also committed to delivering the second round of the pioneering FLARE programme, progressively expanding the partnership and developing the resources on research infrastructure. The European Public Health Association The European Public Health Association, or EUPHA in short, is an umbrella organisation for public health associations in Europe. EUPHA was founded in 1992. EUPHA is an international, multidisciplinary, scientific organisation, bringing together around 12000 public health experts for professional exchange and collaboration throughout Europe. They encourage a multidisciplinary approach to public health ESPEN-The European society for clinical nutrition and metabolism ESPEN is dedicated to all issues relevant to the field of clinical nutrition and metabolism and promotes: basic and clinical research, basic and advanced education, organization of consensus statements about clinical care and care quality control. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of Parenteral and Enteral Nutrition or, more broadly, Clinical Nutrition and Metabolism. Metalobomics society: The Metabolomics Society is an independent, non-profit organization, composed of dedicated members of the metabolomics community. The Metabolomics Society's vision is to become the premier organization devoted to the development of metabolism-based research. ISNN-International society of nutrigenetics/nutrigenomics It is the purpose of the Society to increase understanding through research and education of professionals and the general public of the role of genetic variation and dietary response and the role of nutrients in gene expression. 6 2. Publications and Congresses Cross-European project Number of publications relating to microor macronutrients The European Prospective Investigation into Cancer and 63 Nutrition (EPIC) European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home and Obesity (EPICPANACEA) 1 European Micronutrient Reccomendations Alligned (EURRECA) 18 Healthy Lifestyle in Europe by Nutrition in Adolescence (The HELENA Project) EURONUT-SENECA 1 The MONICA (Multinational Monitoring of trends and determinants in Cardiovascular disease) Project 6 The European Male Ageing Study (EMAS) The Cohort Consortium Vitamin D Pooling Project of Rarer Cancers (VDPP) The SUNLIGHT consortium (Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits) Heart Outcomes Prevention Evaluation Study (The HOPE study) The Italian American clinical trial of nutritional supplements and age-related cataract. European Nutrition and Health Report (ENHR) The ZENITH study ZINCAGE study The EARNEST consortium HEPADIP NuGO EVGN 4 4 3 1 2 2 3 16 13 10 0 10 0 7 Pubmed search for Europe and individual micronutrients Pubmed search terms Europe AND micronutrient/macronutrients Vitamin A B Vitamins Vitamin C Vitamin D Vitamin E Vitamin K Iron Caretenoids Folate Zinc Polyphenols/flavonoids Minerals Macronutrients Protein Fat/Lipids Carbohydrate nutrient 106 441 185 644 150 118 633 172 512 241 7097 540 40 16336 74695 3364 Congresses: 1) European Congress on Nutrition and Health in the http://nhecongress2008.sggw.pl/ Theme: Dietary patterns and ageing. Elderly People. 2) Federation of European Nutrition Societies (FENS) http://www.fensweb.eu/ covers a very wide range of topics 3) International congress of Nutrition http://icn2013.com/ covers a very wide range of topics 4) 2nd World Congress of Public Health Nutrition: http://nutrition2010.com.pt/ 5) International Conference on Nutrigenomics (INCON) http://www.nutrigenomicabrasil.org/congresso/ingles/about.html Theme: gene-diet interactions for personalised health and disease prevention 6) Congress of Clinical Nutrition and Metabolism http://www.espen.org/congress/nice2010/default.html covers a very wide range of topics 7) Metalobomics society congress: http://www.metabolomics2010.com/ Breakthroughs in plant, microbial and human biology, clinical and nutritional research, and biomarker discovery. 8) Congress of the International Society of Nutrigenetics/Nutrigenomics (ISNN) theme “From reference intakes to personalized nutrition” http://www.isnn.info/ The above congresses have different themes every year –given below is the theme for the latest congress. 8 3. Comparison of country reports Country Austria Institutions R&D activities; Investment in infrastructures; Individual researchers; Research group; SMEs, Industry; NGO Belgium Walloon Region- Department of Research and Technologies (DG06) A regional agency -IWT (Institute for the Promotion of Innovation by Science and Technology, Flanders) National Center for Public Health Protection Military Medical Academy Universities Research institutes and universities Bulgaria Croatia Cyprus Czech republic Denmark Research / Academic Organisations or mutual benefit Organisations with a permanent seat at the areas controlled by the Cyprus Republic (except the British bases’ areas). Public and private beneficiaries Public – Private R&D activities (good well defined description) Estonia Faculty of Medicine in the University of Tartu (www.ut.ee) Programmes/projects GEN-AU genome research (one of the highest funded projects in Austria) and two other programmes named Programme for Research and Development at the Ministry of Life 2006 - 2010 (PFEIL 10) and LISA Life Sciences Austria are related to natural sciences and the biomedical field of research so there is quite a bit of biomedical research. However at the moment neither a national strategy nor a programme with special focus on food and health research exist in Austria therefore Nutrition research can definitely be increased in a targeted manner. Not much food and health research in biomedical field especially related to micronutrients or to nutrigenomics Programmes: Nutrition and nutrition-related diseases, Physiology, Nutrigenomics, Endocrinology, Nutrition and nutrition-related diseases, Functional foods. Topic is well covered but need more funding for research for researchers and liaison with government officials to ensure that EU funds are used effectively. Programme: zProjects . Investigator-led basic research. Sufficient detail on types of biomedical research not given, it appears more molecular research needed. Health and biological sciences: Biomedicine Sciences and Biotechnology: Nutrition and health, Chemistry and food technology, Gene technology, Biotechnology, molecular biology and genetics. Biotechnology and medicine. Area covered well but little industry involvement in research and could do with more funding. Research programme of the Ministry of Health II & III: a lot of molecular research and very well funded but has no specific public programme on food and health & industry involvement is not sufficient -Interdisciplinary research programme on the relationship between food, nutrition and health: Interactions between lifestyle and genes, including diet and microbiological resistance, Interaction between nutrition, health perceptions and food consumption, including food related diseases, Interaction between food and life quality -Food Research Programme 2006 : Diet and genes including nutrigenomics Area is well covered and well funded NO ongoing programmes-one due to start 2010-details not available To some extent the research includes the topics of food related diseases like coeliac disease, type 1 diabetes, obesity etc. In the department of microbiology and department of biochemistry research is targeted also identifying new possible probiotics. Small number of researchers and programmes, area not covered well despite being part of 9 the JPI. Same as Bulgaria –seems EU funds are not used effectively. Nutrition, Food and Health (ELVIRA):Nutrition, genetic factors and metabolism - Food, immunity, intestinal microbes and health. Area well covered and well funded. Good collaboration between public and private. Have a strategy and specific food and health area. Finland Mainly universities Public- Private R&D activities France R&D,universities, private actors, public research centers run by Ministries of research Area very well covered –a lot of research but could have more genetic/nutria-genomics type research-very little research looking at genes. Germany R&D, Universities,institutes Greece Research is conducted by research centers within the country’s academic institutions. Area VERY well covered-one of the best for molecular research. Very well funded. Have a national genome project Medium level of research on food and health at the molecular level-could definitely be more considering R&D budgets are quite high at the moment. Very good public-private partnerships. No involvement in JPI. Hungary Universities Iceland RANNIS, the Icelandic Research fund is the main actor involved in all research in Iceland and covers all fields of research, from natural science to linguistics. The INRAN, National Research Institute for Food and Nutrition, is a public research body under the supervision of the Ministry of Agriculture, Food and Forestry. Government labs, institutes and universities Alimentary Pharmobiotic Centre Italy Ireland Latvia Govt. institutes and universities Do have a specific national programme dedicated to food and health and some institutes dedicates Very little if any molecular/clinical research linking food to disease/health outcomes despite being involved in JPI. There are very few public organisations being involved in the food and health research. The research activities are concentrated mainly at 4 universities Postgenomic Biomedicine Nanoscience and Nanotechnology (RANNIS) Very little if any other molecular/clinical research linking food to disease/health outcomes/little detail given on above program Report is very unclear –section .1 is wrongly filled in-instead of “biomedical field” it has research relevant to “production field. However it seems that the molecular area is covered very well and is a key focus. INRAN is the only Italian institution whose research, training and dissemination are addressed to the study of foodstuffs and their role in maintaining health and preventing risk nutrition-related diseases. Part of JPI JINGO – National Nutrition Phenotype Database, ELDERMET – Gut health in the Elderly Area covered very well. Involved in JPI. Have national programmes for food and health. The APC aims to deliver innovative research that establishes Ireland as a centre of excellence in GI health, to help the development of indigenous industry and to attract multinational companies to Ireland to instigate collaborative research programmes. The work of the APC is of tangible importance to several industries, including human health maintenance, agriculture, and animal husbandry, and is pitched at the interface of the food and pharmaceutical sectors. There are two very significant industry partners involved in the APC research programme – Alimentary Health Ltd., an Irish biotech company, and GlaxoSmithKline, National Research Program: The program aims at using clinical medicine, molecular genetics and cell biology, medicinal chemistry and pharmaceutical methods to create new personalized medical technologies and treatments for public health improvement. So area well covered. Not in JPI, good involvement of private sector and EU funds already have been very helpful. 10 Lithuania Luxemburg to biomedical research R&D, Agency for International Science and Technology Development, Lithuanian Science and Studies Foundation, International support (Welcome Trust fund, collaboration with Oslo university); Lithuanian Science and Studies Foundation, Agency for International Science and Technology Development Centre de Recherche Public (Public Research Center) Malta Netherlands Poland Research activities funded by the universities, intermediary organizations and industry Mainly institutes and universities Portugal FCT Projectos de I&D (R&D Projects) Institutes and universities Romania Slovakia Government Slovenia Spain Sweden Switzerland National Health System (NHS) Biomedical Research Networking Centres Lund University Research at Karolinska Intitutet Research at Gothenburg University Research at the Swedish University of Agricultural Science Research at Sahlgrenska Academy at Gothenburg University Uni Düsseldorf and participants (Switzerland: Decanat Faculty of Medicine Universite de Geneve CMU, University Bioactive food components, mitochondrial functions and health; Fruit Plants as Producents of Natural Anthocyanins - antioxidant activity, antimicrobial action, effects on bioenergetics of cardiac cells, cardioprotective action; Dietary risk factors of cardiovascular disease, genenutrients interactions; The main objective is to improve understanding, monitoring and control of lipid peroxidation in medicine and related biosciences and technologies. Very good transparent report. Involved in JPI. Industry involvement quite weak. Stress- and Nutrition-sensing Transcription Factors: Looking for Biomarkers in Atherosclerosis – A Medium Throughput Screening Prospective Study, plus quite a few other molecular projects Very much cellular lab work-no clinical trial work, medium level of molecular research overall, no JPI involvement and little industry involvement. Low level of research, low industry research and not involved in JPI. High level of molecular research programmes. Leading country of JPI, good industry involvement No research at the moment it seems but are plans to do some in the following areas1) health blood-vessel-health society; 2) genetic indicator in diagnostic and development of the new treatment methods 3) Stem cells in physiological and pathological conditions. Some industry involvement but low cooperation between private and public research. Good level of molecular research. Not involved in JPI. Good industry involvement. Some research in this area. Involved in JPI. Seems to be good public-private partnership. Not sufficient detail-looks like very little R*D activity despite being involved in JPI. And very little funding Very little research. Little industry involvement. Involved in JPI but only at a policy level. High level of molecular research projects but more could be done in nutrigenomics area. High industry involvement and good collaboration private-public. Involved in JPI. Good level of research-overall medium level of molecular research such as nutrigenomics so can be improved. There is alot of capacity building which is good. Involved in JPI. Good industry involvement and good public-private collaboration. High level of research. Not in JPI but lots of FP7 funded programmes. Very good industry involvement and very good private-public partnership 11 Turkey UK Childrens Hospital, University Hospital Zurich) R+D for Agroscope(Swiss research stations for agriculture, nutrition and environment) I Studies and individual projects have been carried out mainly by universities, public bodies and public research institutes and funded by their own budget. Government funded: Universities and Medical Research Council and Food standards agency Not sufficient detail. Appears the genetic engineering and biotechnology Institute may do some molecular work but overall low level. Overall low level of R&D in general. Involved in JPI. No integrated programme specific to the “food and health” research area to coordinate related projects. The majority of the research implemented by institutions has been supported by the Scientific and Technological Research Council of Turkey (TUBITAK) which is responsible for promoting, developing, organizing, conducting and coordinating research and development in line with national targets and priorities. High level of molecular research. Medium level of industry involvement and medium level of public-private partnership. Involved in JPI. 3.2 Overview 10 countries had a high level of molecular research with cutting edge research such as nutrigenomics. (UK, Switzerland, Netherlands, Lithuania, Ireland, France, Finland, Denmark, and Czech Republic). 8 of these are involved in the JPI These countries ad a lot of research programmes. 8 countries had a medium level of research –they had good molecular research but could improved particularly in cutting edge research; (Sweden, Spain, Portugal, Latvia, Luxembourg, Austria, Cyprus, Greece) 2 of these were involved in the JPI. 10 countries had a low level of molecular research both traditional and cutting edge. (Belgium, Croatia, Estonia, Poland, Romania, Slovenia, Turkey). However 8 of these were involved in the JPI.Countries with low level general had poor R&D overall (apart from Belgium) and poor industry involvement. 12 4. Reviewing the needs, gaps, overlaps: towards 2010 Food and health molecular research is progressing well to meet research challenges overall in Europe. The effort is concentrated in a third of the countries and cutting edge research is concentrated in a few countries. There has been a lot of work on micronutrients on an individual country level and on a cross-European and international level. The focus has begun to shift from micronutrients in the last 5 years due to micronutrient research not answering some key research questions and due to lack of positive results; for example trials of micronutrients in relation to cardiovascular and cancer outcomes. As epidemiological studies have always found a link between cardiovascular disease and fruit and vegetable intake it was thought that the micronutrient vitamins and minerals from this food groups was protective. But randomised controlled trials with vitamin supplements and with fruit and vegetables have shown no effect. The move is now towards looking at the whole diet/whole foods for example macronutrients and different dietary patterns such as Mediterranean diets. There is has also been recognition of the limitation of the current methods used for dietary methods and validating/trying to be innovative with current data to get the most out of it but also move to try and develop more accurate dietary assessment methods such as biomarkers. 4.1 Knowledge needs Epic and EURRECA are excellent programmes. A similar programme to EURRECA is needed for macronutrients. A similar programme to EPIC may be needed also for obesity as this is a big challenge. Further investment in needed on both national and cross-European levels on ageing – it is evident that is not covered sufficiently from a food and health perspective despite the European commissions ERA-AGE programmes- food and health in relation to ageing needs to be added to this. Only a few countries are looking at ageing. The New Dynamics of ageing programme which was funded by ERA-AGE 1 has a programme called HALCyon (www.halcyon.ac.uk) which includes a small bit on nutrition. This can be added to and built upon. More collaborative programmes are needed to ensure better and uniform methods of dietary assessment across Europe. A more concerted effort is needed across Europe to improve biomarker research. Perhaps a dietary assessment/biomarker development group can be put together as improved methodology lies at the base of future diet and health research. More collaborative programmes are needed so that data can be pooled for greater statistical power to overcome some of the methodological issues to do with dietary assessment. More national and cross-European level research in the area of Nutrigenomics is needed-it appears the area is progressing slowly. 4.2 Significant research questions Is the error involved in current dietary assessment methods obscuring diet-disease relationships? Are there statistical methods that can be used/developed to minimise the error involved? How does diet impact the new emerging markers of physical and cognitive ageing? How is gene expression and metabolic responses affected by foods? (Nutrigenomics) How can nutrigenomics enhance the predictive validity of assessing the genetic make-up for susceptibility to disease? (nutrigeneteics leading to personalised nutrition). How do macronutrients/dietary patterns relate to markers of disease? Following results from EURRECA, current existing databases can be revaluated in terms of micronutrients if the recommended amounts differ from the current recommendations. 13 4.3 Ways to organise research: priorities, developing agendas There are also some recommendations in section1.2 and 4.1. As there is a need for coordination and concerted European effort-methods that facilitate and enable this need to be put in place. An organisation similar to the European nutrigenomics organisation can be set up for biomarker/dietary assessment research. Networks such as those currently exist within FP6 and FP7 could also be good for molecular diet-health research. Another possibility is a virtual food and health institute which brings together a critical mass of researchers from all food and health areas and this could have the following aims: Develop European food and health research, set up joint European infrastructures, promote multi-disciplinary research and good practise, transfer research to policy. Cross-European post-doctoral programmes that are well coordinated with the fellowships being carried out in a minimum of two countries could be a way of ensuring uniform training and infrastructure building. Mid-career researchers could also be encouraged to do (European commission funded) fellowships in other countries that are doing similar research so that there is better collaboration between countries. This is a particularly important for the countries that have low and medium levels of research currently in the molecular area (see section 3.2). More capacity building is needed in the area of nutrigenomics as the area is moving relatively slowly, more researchers are needed and in more countries. 4.4 Interaction between public research and industry Public sector first needs to make the most of its own resources and increase research and output the areas of nutrigenomics and biomarker research as described in section 1.2. It can at the same time or following this try to engage the public sector based on partnerships that have already been successful as described in section 1.2. As nutrigenomics is a difficult area it is likely that only big companies would be able to invest in this area. But biomarkers/macronutrients and dietary patterns is an easier area and smaller companies should be able to invest here. It appears that where industry is not getting readily involved itself-it needs to be engaged by the public research area with the long benefit to industry being highlighted. Cellular/molecular mechanisms that can be used by industry should be highlighted to them early on in the research process so that can fund/provide expertise to get greater and quicker output. 5. Gaps and overlaps for further research 5.1 & 5.2 Structures & infrastructures Section 3.2 identifies the countries with low, medium and high levels of research. For low level countries in particular there needs to be an improvement in capacity building and more effective inclusion into networks (involvement in the JPI does not seem to be doing some countries any good). In some of these countries it appears that European funds are not being used effectively because of the countries government so this needs to be investigated. The structures available in the “high” countries need to be implemented in the other countries. Suggestions of how this can be done are made in sections 4.1 and 4.3 and below. 5.3 Ways to organise research This is described in sections 4.3 and 4.4. Research needs to be organised so that there is good collaboration between countries so that there can be a concerted effort but also so that infrastructures and methods can be made the same across Europe. Collaboration between 14 institutes and researchers in different countries is very important for this. If the European commission could fund fellowships for early and mid career researchers in other countries this would be an excellent way of forming links and sharing training and expertise. But also creates meetings/programs/networks where researchers can meet. Involving a critical mass of European researchers in research programs is also important. ERA-AGE being a good example of this-a network such as this can be set up for molecular dietary research. 6. Conclusions and proposals 6.1 Research fields & 6.2 Research organisation, structures and infrastructures There is a lot of duplication of research on a country level. Particularly in the micronutrients area. This can be avoided for future research by creating cross-European consortiums (and other recommendations made in sections 4 and 5) for the remaining key micronutrients of Vitamin D, Iron, polyphenols, B Vitamins and folate in relation to different disease areas. The same can be done for macronutrients and dietary patterns. As biomarkers and nutrigenomics are relatively new areas it will be even easier to set cross-European structures in place (as recommended in sections 4 and 5) to ensure a concerted European effort and to avoid duplication of research. 15