Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

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A Novel Approach to Improve the Estimation of a Diet Adherence Considering Seasonality and Short Term Variability – The NU-AGE Mediterranean Diet Experience
Giampieri, Enrico ; Ostan, Rita ; Guidarelli, Giulia ; Salvioli, Stefano ; Berendsen, A.M. ; Brzozowska, Anna ; Pietruszka, Barbara ; Jennings, Amy ; Meunier, Nathalie ; Caumon, Elodie ; Fairweather-Tait, Susan J. ; Sicinska, Ewa ; Feskens, E.J.M. ; Groot, C.P.G.M. de; Franceschi, Claudio ; Santoro, Aurelia - \ 2019
Frontiers in Physiology 10 (2019). - ISSN 1664-042X
In this work we present a novel statistical approach to improve the assessment of the adherence to a 1-year nutritional intervention within the framework of the NU-AGE project. This was measured with a single adherence score based on 7-days food records, under limitations on the number of observations per subject and time frame of intervention. The results of the NU-AGE dietary intervention were summarized by variations of the NU-AGE index as described in the NU-AGE protocol. Food and nutrient intake of all participants was assessed by means of 7-days food records at recruitment and after 10 to 14 months of intervention (depending on the subject availability). Sixteen food groups and supplementations covering the dietary goals of the NU-AGE diet have been used to estimate the NU-AGE index before and after the intervention. The 7-days food record is a reliable tool to register food intakes, however, as with other tools used to assess lifestyle dietary compliance, it is affected by uncertainty in this estimation due to the possibility that the observed week is not fully representative of the entire intervention period. Also, due to logistic limitations, the effects of seasonality can never be completely removed. These variabilities, if not accounted for in the index estimation, will reduce the statistical power of the analyses. In this work we discuss a method to assess these uncertainties and thus improve the resulting NU-AGE index. The proposed method is based on Hierarchical Bayesian Models. This model explicitly includes country-specific averages of the NU-AGE index, index variation induced by the dietary intervention, and country based seasonality. This information is used to evaluate the NU-AGE index uncertainty and thus to estimate the “real” NU-AGE index for each subject, both before and after the intervention. These corrections reduce the possibility of misinterpreting measurement variability as real information, improving the power of the statistical tests that are performed with the resulting index. The results suggest that this method is able to reduce the short term and seasonal variability of the measured index in the context of multicenter dietary intervention trials. Using this method to estimate seasonality and variability would allow one to obtain better measurements from the subjects of a study, and be able to simplify the scheduling of diet assessments.
Gender-specific association of body composition with inflammatory and adipose-related markers in healthy elderly Europeans from the NU-AGE study
Santoro, Aurelia ; Guidarelli, Giulia ; Ostan, Rita ; Giampieri, Enrico ; Fabbri, Cristina ; Bertarelli, Claudia ; Nicoletti, Claudio ; Kadi, Fawzi ; Groot, Lisette C.P.G.M. De; Feskens, Edith ; Berendsen, Agnes ; Brzozowska, Anna ; Januszko, Olga ; Kozlowska, Katarzyna ; Fairweather-Tait, Susan ; Jennings, Amy ; Meunier, Nathalie ; Caumon, Elodie ; Napoli, Alessandro ; Mercatelli, Daniele ; Battista, Giuseppe ; Capri, Miriam ; Franceschi, Claudio ; Bazzocchi, Alberto - \ 2019
European Radiology 29 (2019)9. - ISSN 0938-7994 - p. 4968 - 4979.
ObjectivesThe aim of this work was to examine the cross-sectional relationship between body composition (BC) markers for adipose and lean tissue and bone mass, and a wide range of specific inflammatory and adipose-related markers in healthy elderly Europeans. Methods A whole-body dual-energy X-ray absorptiometry (DXA) scan was made in 1121 healthy (65–79 years) women and men from five European countries of the “New dietary strategies addressing the specific needs of elderly population for a healthy aging in Europe” project (NCT01754012) cohort to measure markers of adipose and lean tissue and bone mass. Pro-inflammatory (IL-6, IL-6Rα, TNF-α, TNF-R1, TNF-R2, pentraxin 3, CRP, alpha-1-acid glycoprotein, albumin) and anti-inflammatory (IL-10, TGF-β1) molecules as well as adipose-related markers such as leptin, adiponectin, ghrelin, and resistin were measured by magnetic bead-based multiplex-specific immunoassays and biochemical assays. Results BC characteristics were different in elderly women and men, and more favorable BC markers were associated with a better adipose-related inflammatory profile, with the exception of skeletal muscle mass index. No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-β1, TNF-α, IL-6Rα, glycoprotein 130, TNF-α-R1, and TNF-α-R2.Conclusions The association between BC and inflammatory and adipose-related biomarkers is crucial in decoding aging and pathophysiological processes, such as sarcopenia. DXA can help in understanding how the measurement of fat and muscle is important, making the way from research to clinical practice.
Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults
Jennings, A. ; Berendsen, A.M. ; Groot, C.P.G.M. de; Feskens, E.J.M. ; Brzozowska, A. ; Sicinska, Ewa ; Pietruszka, Barbara ; Meunier, N. ; Caumon, Elodie ; Malpuech-Brugère, Corinne ; Santoro, Aurelia ; Ostan, Rita ; Franceschi, Claudio ; Gillings, Rachel ; O'Neill, C.M. ; Fairweather-Tait, Susan J. ; Minihane, Anne-Marie ; Cassidy, Aedin - \ 2019
Hypertension 73 (2019)3. - ISSN 0194-911X - p. 578 - 586.
We aimed to determine the effect of a Mediterranean-style diet, tailored to meet dietary recommendations for older adults, on blood pressure and arterial stiffness. In 12 months, randomized controlled trial (NU-AGE [New Dietary Strategies Addressing the Specific Needs of Elderly Population for Healthy Aging in Europe]), blood pressure was measured in 1294 healthy participants, aged 65 to 79 years, recruited from 5 European centers, and arterial stiffness in a subset of 225 participants. The intervention group received individually tailored standardized dietary advice and commercially available foods to increase adherence to a Mediterranean diet. The control group continued on their habitual diet and was provided with current national dietary guidance. In the 1142 participants who completed the trial (88.2%), after 1 year the intervention resulted in a significant reduction in systolic blood pressure (−5.5 mm Hg; 95% CI, −10.7 to −0.4; P=0.03), which was evident in males (−9.2 mm Hg, P=0.02) but not females (−3.1 mm Hg, P=0.37). The −1.7 mm Hg (95% CI, −4.3 to 0.9) decrease in diastolic pressure after intervention did not reach statistical significance. In a subset (n=225), augmentation index, a measure of arterial stiffness, was improved following intervention (−12.4; 95% CI, −24.4 to −0.5; P=0.04) with no change in pulse wave velocity. The intervention also resulted in an increase in 24-hour urinary potassium (8.8 mmol/L; 95% CI, 0.7–16.9; P=0.03) and in male participants (52%) a reduction in pulse pressure (−6.1 mm Hg; 95% CI, −12.0 to −0.2; P=0.04) and 24-hour urinary sodium (−27.1 mmol/L; 95% CI, −53.3 to −1.0; P=0.04). In conclusion, a Mediterranean-style diet is effective in improving cardiovascular health with clinically relevant reductions in blood pressure and arterial stiffness.
A Mediterranean-like dietary pattern with Vitamin D3 (10 μg/d) supplements reduced the rate of bone loss in older Europeans with osteoporosis at baseline : Results of a 1-y randomized controlled trial
Jennings, Amy ; Cashman, Kevin D. ; Gillings, Rachel ; Cassidy, Aedin ; Tang, Jonathan ; Fraser, William ; Dowling, Kirsten G. ; Hull, George L.J. ; Berendsen, Agnes A.M. ; Groot, Lisette C.P.G.M. de; Pietruszka, Barbara ; Wierzbicka, Elzbieta ; Ostan, Rita ; Bazzocchi, Alberto ; Battista, Giuseppe ; Caumon, Elodie ; Meunier, Nathalie ; Malpuech-Brugère, Corinne ; Franceschi, Claudio ; Santoro, Aurelia ; Fairweather-Tait, Susan J. - \ 2018
American Journal of Clinical Nutrition 108 (2018)3. - ISSN 0002-9165 - p. 633 - 640.
bone - Mediterranean diet - older adults - Osteoporosis - Vitamin D supplementation

Background: The Mediterranean diet (MD) is widely recommended for the prevention of chronic disease, but evidence for a beneficial effect on bone health is lacking. Objective: The aim of this study was to examine the effect of a Mediterranean-like dietary pattern [NU-AGE (New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe)] on indexes of inflammation with a number of secondary endpoints, including bone mineral density (BMD) and biomarkers of bone and collagen degradation in a 1-y multicenter randomized controlled trial (RCT; NU-AGE) in elderly Europeans. Design: An RCT was undertaken across 5 European centers. Subjects in the intervention group consumed the NU-AGE diet for 1 y by receiving individually tailored dietary advice, coupled with supplies of foods including whole-grain pasta, olive oil, and a vitamin D3 supplement (10 μg/d). Participants in the control group were provided with leaflets on healthy eating available in their country. Results: A total of 1294 participants (mean ± SD age: 70.9 ±4.0 y; 44% male) were recruited to the study and 1142 completed the 1-y trial. The Mediterranean-like dietary pattern had no effect on BMD (site-specific or whole-body); the inclusion of compliance to the intervention in the statistical model did not change the findings. There was also no effect of the intervention on the urinary biomarkers free pyridinoline or free deoxypyridinoline. Serum 25-hydroxyvitamin D significantly increased and parathyroid hormone decreased (P < 0.001) in the MD compared with the control group. Subgroup analysis of individuals with osteoporosis at baseline (site-specific BMD T-score ≤ -2.5 SDs) showed that the MD attenuated the expected decline in femoral neck BMD (n = 24 and 30 in MD and control groups, respectively; P = 0.04) but had no effect on lumbar spine or whole-body BMD. Conclusions: A 1-y intervention of the Mediterranean-like diet together with vitamin D3 supplements (10 μg/d) had no effect on BMD in the normal age-related range, but it significantly reduced the rate of loss of bone at the femoral neck in individuals with osteoporosis. The NU-AGE trial is registered at clinicaltrials.gov as NCT01754012.

Cross-Sectional Analysis of the Correlation Between Daily Nutrient Intake Assessed by 7-Day Food Records and Biomarkers of Dietary Intake Among Participants of the NU-AGE Study
Ostan, Rita ; Guidarelli, Giulia ; Giampieri, Enrico ; Lanzarini, Catia ; Berendsen, Agnes A.M. ; Januszko, Olga ; Jennings, Amy ; Lyon, Noëlle ; Caumon, Elodie ; Gillings, Rachel ; Sicinska, Ewa ; Meunier, Nathalie ; Feskens, Edith J.M. ; Pietruszka, Barbara ; Groot, Lisette C.P.G.M. de; Fairweather-Tait, Susan ; Capri, Miriam ; Franceschi, Claudio ; Santoro, Aurelia - \ 2018
Frontiers in Physiology 9 (2018). - ISSN 1664-042X
Methods for measuring diet composition and quantifying nutrient intake with sufficient validity are essential to study the association between nutrition and health outcomes and risk of diseases. 7-day food records provides a quantification of food actually and currently consumed and is interesting for its use in intervention studies to monitor diet in a short-term period and to guide participants toward changing their intakes. The objective of this study is to analyze the correlation/association between the daily intake of selected nutrients (collected by a 7-day food records plus a mineral/vitamin supplementation questionnaire) and estimates of energy expenditure as well as blood and urine biomarkers of dietary intakes in 1,140 healthy elderly subjects (65–79 years) at baseline of the NU-AGE intervention study (NCT01754012, clinicaltrials.gov). The results show that: the daily intake of energy correlated significantly with predicted total energy expenditure (pTEE) (ρ = 0.459, p < 0.001, and q < 0.001); protein intake correlated significantly with the ratio of 24 h urinary urea to creatinine excretion (ρ = 0.143 for total protein intake, ρ = 0.296 for animal protein intake, and ρ = 0.359 for protein intake/body weight, p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes correlated significantly with their serum concentrations (ρ = 0.151 and ρ = 0.363, respectively; p < 0.001 and q < 0.001 for each correlation); sodium and potassium intakes correlated significantly with their 24 h urinary excretion (ρ = 0.298 and ρ = 0.123, respectively; p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes were negatively associated with plasma homocysteine measure (p = 0.001 and p = 0.004, respectively); stratifying subjects by gender, the correlations between energy intake and pTEE and between potassium intake and its 24 h urinary excretion lost their significance in women. Even if the plasma and urinary levels of these nutrients depend on several factors, the significant correlations between daily reported intake of nutrients (protein, vitamin B12, folate, and sodium) and their blood/urinary markers confirmed that the 7-day food records (plus a supplementation questionnaire) provides reliable data to evaluate short-term current dietary intake in European elderly subjects and it can be exploited to guide and monitor NU-AGE participants through the shift of their diet according NU-AGE recommendations.
Short Telomere Length Is Related to Limitations in Physical Function in Elderly European Adults
Montiel Rojas, Diego ; Nilsson, Andreas ; Ponsot, Elodie ; Brummer, Robert J. ; Fairweather-Tait, Susan ; Jennings, Amy ; Groot, Lisette C.P.G.M. De; Berendsen, Agnes ; Pietruszka, Barbara ; Madej, Dawid ; Caumon, Elodie ; Meunier, Nathalie ; Malpuech-Brugère, Corinne ; Guidarelli, Giulia ; Santoro, Aurelia ; Franceschi, Claudio ; Kadi, Fawzi - \ 2018
Frontiers in Physiology 9 (2018). - ISSN 1664-042X
The present study aims to explore the potential influence of leucocyte telomere length (LTL) on both a single indicator and a composite construct of physical functioning in a large European population of elderly men and women across diverse geographical locations. A total of 1,221 adults (65–79 years) were recruited from five European countries within the framework of NU-AGE study. The physical functioning construct was based on the 36-item Short Form Health Survey. Handgrip strength was used as a single indicator of muscle function and LTL was assessed using quantitative real-time PCR. Women had significantly longer (p < 0.05) LTL than men. Participants in Poland had significantly shorter LTL than in the other study centers, whereas participants in the Netherlands had significantly longer LTL than most of the other centers (p < 0.01). An analysis of LTL as a continuous outcome against physical functioning by using linear models revealed inconsistent findings. In contrast, based on an analysis of contrasting telomere lengths (first vs. fifth quintile of LTL), a significant odds ratio (OR) of 1.7 (95% CI: 1.1 – 2.6; p < 0.05) of having functional limitation was observed in those belonging to the first LTL quintile compared to the fifth. Interestingly, having the shortest LTL was still related to a higher likelihood of having physical limitation when compared to all remaining quintiles (OR: 1.5, 95% CI: 1.1 – 2.1; p < 0.05), even after adjustment by study center, age, sex, and overweight status. Collectively, our findings suggest that short LTL is an independent risk factor that accounts for functional decline in elderly European populations. The influence of LTL on functional limitation seems driven by the detrimental effect of having short telomeres rather than reflecting a linear dose-response relationship.
Effect of the NU-AGE Diet on Cognitive Functioning in Older Adults : A Randomized Controlled Trial
Marseglia, Anna ; Xu, W. ; Fratiglioni, Laura ; Fabbri, Cristina ; Berendsen, A.M. ; Bialecka-Debek, Agata ; Jennings, A. ; Gillings, Rachel ; Meunier, N. ; Caumon, E. ; Fairweather-Tait, S. ; Pietruszka, B. ; Groot, C.P.G.M. de; Santoro, A. ; Franceschi, Claudio - \ 2018
Frontiers in Physiology 9 (2018). - ISSN 1664-042X
Background: Findings from animal and epidemiological research support the potential neuroprotective benefits from healthy diets. However, to establish diet-neuroprotective causal relations, evidence from dietary intervention studies is needed. NU-AGE is the first multicenter intervention assessing whether a diet targeting health in aging can counteract the age-related physiological changes in different organs, including the brain. In this study, we specifically investigated the effects of NU-AGE’s dietary intervention on age-related cognitive decline.
Materials and Methods: NU-AGE randomized trial (NCT01754012, clinicaltrials.gov) included 1279 relatively healthy older-adults, aged 65–79 years, from five European centers. Participants were randomly allocated into two groups: “control” (n = 638), following a habitual diet; and, “intervention” (n = 641), given individually tailored dietary advice (NU-AGE diet). Adherence to the NU-AGE diet was measured over follow-up, and categorized into tertiles (low, moderate, high). Cognitive function was ascertained at baseline and at 1-year follow-up with the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-Neuropsychological Battery and five additional domain-specific single cognitive tests. The raw scores from the CERAD subtests [excluding the Mini-Mental State Examination (MMSE)] and the single tests were standardized into Z-scores. Global cognition (measured with MMSE and CERAD-total score), and five cognitive domains (perceptual speed, executive function, episodic
memory, verbal abilities, and constructional praxis) were created. Cognitive changes as a function of the intervention were analyzed with multivariable mixed-effects models.
Results: After the 1-year follow-up, 571 (89.1%) controls and 573 (89.8%) from
the intervention group participated in the post-intervention assessment. Both control and intervention groups showed improvements in global cognition and in all cognitive domains after 1 year, but differences in cognitive changes between the two groups were not statistically significant. However, participants with higher adherence to the NU-AGE diet showed statistically significant improvements in global cognition [b 0.20 (95%CI 0.004, 0.39), p-value = 0.046] and episodic memory [b 0.15 (95%CI 0.02, 0.28), p-value = 0.025] after 1 year, compared to those adults with lower adherence.
Discussion: High adherence to the culturally adapted, individually tailored, NU-AGE diet could slow down age-related cognitive decline, helping to prevent cognitive impairment and dementia.
Effect Of The NU-AGE Individually Tailored Diet On Cognitive Function: A Randomized Control Trial
Marseglia, Anna ; Xu, Weili ; Santoro, A. ; Scurti, M. ; Berendsen, A.M. ; Pietruszka, B. ; Jennings, A. ; Meunier, N. ; Caumon, E. ; Fairweather-Tait, S. ; Brzozowska, A. ; Groot, C.P.G.M. de; Franceschi, C. - \ 2017
Nouvelles strategies alimentaires pour un vieillissement optimisé des seniors européens – Projet européen FP7 NU-AGE
Meunier, N. ; Caumon, E. ; Lyon, N. ; Caille, A. ; Berendsen, A.M. ; Groot, C.P.G.M. de; Feskens, E.J.M. ; Santoro, A. ; Franceschi, C. ; Pietruszka, B. ; Brzozowska, A.M. ; Jennings, A. ; Fairweather-Tait, S. ; Cano, N. - \ 2014
Reprint of: A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study
Berendsen, A.M. ; Santoro, A. ; Pini, E. ; Cevenini, E. ; Ostan, R. ; Pietruszka, B. ; Rolf, K. ; Cano, N. ; Caille, A. ; Lyon-Belgy, N. ; Fairweather-Tait, S. ; Feskens, E.J.M. ; Franceschi, C. ; Groot, C.P.G.M. de - \ 2014
Mechanisms of Ageing and Development 136-137 (2014). - ISSN 0047-6374 - p. 14 - 21.
cardiovascular risk-factors - mediterranean diet - vitamin-d - metabolic syndrome - older-adults - nutritional-status - blood-pressure - fatty-acids - weight-loss - life-style
Background The proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. Methods The NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium. C-reactive protein is measured as primary outcome. Discussion The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.
A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study
Berendsen, A.M. ; Santoro, A. ; Pini, E. ; Cevenini, E. ; Ostan, R. ; Pietruszka, B. ; Rolf, K. ; Cano, R. ; Caille, A. ; Lyon-Belgy, N. ; Fairweather-Tait, S. ; Feskens, E.J.M. ; Franceschi, C. ; Groot, C.P.G.M. de - \ 2013
Mechanisms of Ageing and Development 134 (2013)11-12. - ISSN 0047-6374 - p. 523 - 530.
cardiovascular risk-factors - mediterranean diet - vitamin-d - metabolic syndrome - older-adults - nutritional-status - blood-pressure - fatty-acids - weight-loss - life-style
Background The proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. Methods The NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium. C-reactive protein is measured as primary outcome. Discussion The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.
Combating 'inflammaging' through a Mediterranean whole diet approach: the NU-AGE project rationale
Santoro, A. ; Pini, E. ; Scurti, M. ; Palmas, G. ; Berendsen, A. ; Brzozowska, A.M. ; The NU-AGE Consortium, A. ; Groot, C.P.G.M. de; Feskens, E.J.M. ; Fairweather-Tait, S. ; Salvioli, S. ; Capri, M. - \ 2013
Free Radical Biology and Medicine 65 (2013)Suppl. 1. - ISSN 0891-5849 - p. S3 - S4.
The development of a chronic, low grade, inflammatory status named "inflammaging" is a major characteristic of aging which plays a critical role in the pathogenesis of age-related diseases. The NU-AGE rationale is that a one year Mediterranean whole diet (considered by UNESCO a heritage of humanity), newly designed to meet the nutritional needs of the elderly, will reduce inflammaging in fully characterized subjects aged 65-79 year of age, and will have systemic beneficial effects on health status (physical and cognitive). Before and after the dietary intervention a comprehensive set of analyses, including omics (transcriptomics, epigenetics, metabolomics, metagenomics) will be performed to identify the underpinning molecular mechanisms. NU-AGE will set up a comprehensive database as a tool for a systems biology approach to inflammaging and nutrition. NU-AGE is highly interdisciplinary, includes leading research centres in Europe on nutrition and aging, and is complemented by EU multinational food industries and SMEs, interested in the production of functional and enriched/advanced traditional food tailored for the elderly market, and European Federations targeting policy makers and major stakeholders, from consumers to EU Food & Drink Industries.
EURRECA-principles and future for deriving micronutrient recommendations
Claessens, M.M.A.E. ; Contor, L. ; Dhonukshe-Rutten, R.A.M. ; Groot, C.P.G.M. de; Fairweather-Tait, S. ; Gurinovic, M. ; Koletzko, B. ; Ommen, B. van; Raats, M.M. ; Veer, P. van 't - \ 2013
Critical Reviews in Food Science and Nutrition 53 (2013)10. - ISSN 1040-8398 - p. 1135 - 1146.
The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence (NoE) explored an approach for setting micronutrient recommendations, which would address the variation in recommendations across Europe. Therefore, a framework for deriving and using micronutrient Dietary Reference Values (DRVs) has been developed. This framework comprises four stages (defining the problem-monitoring and evaluating-deriving dietary reference values-using dietary -reference values in policy making). The aim of the present paper is to use this framework to identify specific research gaps and needs related to (1) knowledge available on specific micronutrients (folate, iodine, iron, selenium, vitamin B12, vitamin D, and zinc) and (2) the methodology presented in the framework. Furthermore, the paper describes the different outputs that support the process like protocols, guidelines, systematic review databases, and peer-reviewed publications, as well as the principal routes of dissemination of these outputs to ensure their optimal uptake in policy, practice, and research collaborations. The importance of ensuring transparency in risk assessment and risk management, systematic searching the literature, and taking into account policy options is highlighted
A randomized trial on the effect of a full dietary intervention on ageing in European elderly people: the Nu-Age study
Berendsen, A.M. ; Santoro, A. ; Pini, E. ; Cevenini, E. ; Ostan, R. ; Pietruszka, B. ; Rolf, K. ; Cano, N. ; Caille, A. ; Lyon-Belgy, N. ; Fairweather-Tait, S. ; Feskens, E.J.M. ; Franceschi, C. ; Groot, C.P.G.M. de - \ 2013
EURRECA: development of tools to improve the alignment of micronutrient recommendations
Matthys, C. ; Bucchini, L. ; Busstra, M.C. ; Cavelaars, A.J.E.M. ; Eleftheriou, P. ; Garcia-Alvarez, A. ; Fairweather-Tait, S. ; Gurinovic, M. ; Ommen, B. van; Contor, L. - \ 2010
European Journal of Clinical Nutrition 64 (2010). - ISSN 0954-3007 - p. S26 - S31.
dietary assessment - europe - network - food - framework - nutrition - quality - policy
Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned, http://www.eurreca.org) Network of Excellence is developing generic tools for systematically establishing and updating micronutrient reference values or recommendations. Different types of instruments (including best practice guidelines, interlinked web pages, online databases and decision trees) have been identified. The first set of instruments is for training purposes and includes mainly interactive digital learning materials. The second set of instruments comprises collection and interlinkage of diverse information sources that have widely varying contents and purposes. In general, these sources are collections of existing information. The purpose of the majority of these information sources is to provide guidance on best practice for use in a wider scientific community or for users and stakeholders of reference values. The third set of instruments includes decision trees and frameworks. The purpose of these tools is to guide non-scientists in decision making based on scientific evidence. This platform of instruments will, in particular in Central and Eastern European countries, contribute to future capacity-building development in nutrition. The use of these tools by the scientific community, the European Food Safety Authority, bodies responsible for setting national nutrient requirements and others should ultimately help to align nutrient-based recommendations across Europe. Therefore, EURRECA can contribute towards nutrition policy development and public health strategies
Prioritizing micronutrients for the purpose of reviewing their requirements: a protocol developed by EURRECA
Cavelaars, A.J.E.M. ; Doets, E.L. ; Dhonukshe-Rutten, R.A.M. ; Hermoso, M. ; Fairweather-Tait, S. ; Koletzko, B. ; Gurinovic, M. ; Moreno, L.A. ; Cetin, I. ; Matthys, C. ; Veer, P. van 't; Ashwell, M. ; Groot, C.P.G.M. de - \ 2010
European Journal of Clinical Nutrition 64 (2010)S2. - ISSN 0954-3007 - p. S11 - S18.
iodine deficiency - europe - nutrition - adequacy - health
Objectives: The EURRECA Network of Excellence is developing standardized methods that will guide the alignment of micronutrient reference values (RVs) across Europe. A consultation process to identify and prioritize the best practice, ‘tools’ or guidance for EURRECA was undertaken. Subjects/Methods: A questionnaire was sent to 90 individuals with experience of setting or using RVs. Respondents were asked to rank the usefulness of each type of possible guidance. Results: In all, 52% of individuals returned completed questionnaires. For the planning process, the most needed guidance was on the best way to assess the ‘status quo’ of RVs; what to cover, setting priorities, how to take into consideration the diverse needs of the users; and making the whole process transparent. The most needed guidance for the active stage of development was how to obtain valid and robust data on intakes and status to use as a base for RVs; how to account for food-related factors; how to incorporate results of systematic reviews; how to identify unbiased and independent reviews and make decisions if evidence is conflicting; methods to ‘weight’ the evidence; and formats or concepts to convert scientific requirements into RVs. Users of RVs required guidance on communication, codes of practice to raise professional and public awareness, making them easy to use in the intended way. Conclusions: The questionnaire responses provided views from a wide range of experts on the most needed ‘tools’ and standardized methodologies for the process of reviewing micronutrient RVs. This will help the EURRECA Network of Excellence to prioritize resources
EURRECA scientific triage to produce a transparent, evidence based, process for prioritising particular micronutrients for purposes of reviewing their recommended intakes
Cavelaars, A.J.E.M. ; Groot, C.P.G.M. de; Fairweather-Tait, S. ; Koletzko, B. ; Gurinovic, M. ; Moreno, L.A. ; Ashwell, M. - \ 2009
How we will produce the evidence-based EURRECA toolkit to support nutrition and food policy
Ashwell, M. ; Lambert, J. ; Alles, M.S. ; Branca, F. ; Bucchini, L. ; Brzozowska, A. ; Groot, C.P.G.M. de; Dhonukshe-Rutten, R.A.M. ; Dwyer, J.T. ; Fairweather-Tait, S. ; Koletzko, B. ; Pavlovic, M. ; Raats, M.M. ; Serra-Majem, L. ; Smith, R. ; Ommen, B. van; Veer, P. van 't; Rosen, J. von; Pijls, L.T.J. - \ 2008
European Journal of Nutrition 47 (2008)1. - ISSN 1436-6207 - p. 2 - 16.
europe - recommendations - values - energy
Background There is considerable variation in the recommended micronutrient intakes used by countries within Europe, partly due to different methodologies and concepts used to determine requirements and different approaches used to express the recommendations. As populations become more mobile and multinational, and more traditional foods become available internationally, harmonised recommendations based on up to date science are needed. This was recognised by the European Commission's (EC) Directorate-General (DG) Research in their 2005 call for proposals for a Network of Excellence (NoE) on 'nutrient status and requirements of specific vulnerable population groups'. EURopean micronutrient RECommendations Aligned (EURRECA), which has 34 partners representing 17 European countries, started on its 5-year EC-funded programme in January 2007. The programme of work was developed over 2 years prior to submitting an application to the EC. The Network's first integrating Meeting (IM) held in Lisbon in April 2007, and subsequent consultations, has allowed further refinement of the programme. Aim This paper presents the rationale for the EURRECA Network's roadmap, which starts by establishing the status quo for devising micronutrient recommendations. The Network has the opportunity to identify previous barriers and then explore 'evidence-based' solutions that have not been available before to the traditional panels of experts. The network aims to produce the EURRECA 'toolkit' to help address and, in some cases, overcome these barriers so that it can be used by those developing recommendations. Results The status quo has been largely determined by two recent initiatives; the Dietary Reference Intake (DRI) reports from the USA and Canada and suggestions for approaches to international harmonisation of nutrient-based dietary standards from the United Nations University (UNU). In Europe, the European Food Safety Authority (EFSA) has been asked by the EC's Directorate-General for Health and Consumer Protection to produce values for micronutrient recommendations. Therefore, EURRECA will draw on the uniqueness of its consortium to produce the sustainable EURRECA toolkit, which will help make such a task more effective and efficient. Part of this uniqueness is the involvement in EURRECA of small and medium-sized enterprises (SMEs), consumer organisations, nutrition societies and other stakeholders as well as many scientific experts. The EURRECA toolkit will contain harmonised best practice guidance for a more robust science base for setting micronutrient recommendations. Hence, in the future, the evidence base for deriving nutrient recommendations will have greater breadth and depth and will be more transparent. Conclusions The EURRECA Network will contribute to the broader field of food and nutrition policy by encouraging and enabling the alignment of nutrient recommendations. It will do this through the development of a scientific toolkit by its partners and other stakeholders across Europe. This will facilitate and improve the formulation of micronutrient recommendations, based on transparently evaluated and quantified scientific evidence. The Network aims to be sustainable beyond its EC funding period.
The usefulness of in vitro models to predict the bioavailability of iron and zinc: A consensus statement from the HarvestPlus expert consultation
Fairweather-Tait, S. ; Lynch, S. ; Hotz, C. ; Hurrell, R. ; Abrahamse, L. ; Beebe, S. ; Bering, S. ; Bukhave, K. ; Glahn, R. ; Hambidge, M. ; Hunt, J. ; Lonnerdal, B. ; Miller, D. ; Mohktar, N. ; Nestel, P. ; Reddy, M. ; Sandberg, A.S. ; Sharp, P. ; Teucher, B. ; Trinidad, T.P. - \ 2005
International Journal for Vitamin and Nutrition Research 75 (2005)6. - ISSN 0300-9831 - p. 371 - 374.
A combination of dietary and host-related factors determines iron and zinc absorption, and several in vitro methods have been developed as preliminary screening tools for assessing bioavailability. An expert committee has reviewed evidence for their usefulness and reached a consensus. Dialyzability (with and without simulated digestion) gives some useful information but cannot predict the correct magnitude of response and may sometimes predict the wrong direction of response. Caco-2 cell systems (with and without simulated digestion) have been developed for iron availability, but the magnitude of different effects does not always agree with results obtained in human volunteers, and the data for zinc are too limited to draw conclusions about the validity of the method. Caco-2 methodologies vary significantly between laboratories and require experienced technicians and good quality cell culture facilities to obtain reproducible results. Algorithms can provide semi-quantitative information enabling diets to be classified as high, moderate, or low bioavailability. While in vitro methods can be used to generate ideas and develop hypotheses, they cannot be used alone for important decisions concerning food fortification policy, selection of varieties for plant breeding programs, or for new product development in the food industry. Ultimately human studies are required for such determinations.
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