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Outlook:
The future of functional
carbohydrates
connecting nutrition and health
1st European BENEO
Scientific Symposium:
New findings about
energy metabolism of
functional carbohydrates
EDITION 1 | 2008
At a glance:
BENEO functional
carbohydrates
window to science 1|2008 – The Bord of BENEO-Group
The BENEO Group – a newly founded innovative,
scientific research-based ingredient manufacturer
We, Matthias Moser, Yves Servotte and Hildegard Bauer, are
Our customers profit from our effective and creative technical
the BENEO board.
application services, as well as our analytical and marketing ser-
May we introduce our new company?
vices. In addition the sound scientific basis of our ingredients is
supported by our consumer research and by our regulatory sup-
The BENEO Group unites the three individual speciality ingredient
port service. Our conviction is that this united expertise and
manufacturers of the SÜDZUCKER Group. All three companies
strength qualifies us as THE preferred partner in innovation for
are market leaders in their fields, namely BENEO ORAFTI, spe-
our customers.
cialising in inulin and oligofructose, BENEO PALATINIT, specialising in isomalt and Palatinose™ and finally BENEO REMY, focus-
The findings of our first European scientific conference, which
sing on rice starches, flours and bran. These three are now
was held in Brussels this year, are the main topic of the current
combined into one strong, research-oriented force, a pioneer in
issue of our new journal “Window to Science”. Our intention is to
functional ingredients from natural sources. BENEO offers unique
encourage and facilitate scientific networking.
building blocks for unique solutions, in line with today’s trend
We are looking forward to working with you!
towards a healthier lifestyle.
Sincerely yours,
BENEO acts globally in more than 70 countries, has a turnover
The Board of BENEO Group
of 350 mil €, 900 employees and a total of 5 production units in
Belgium, Germany, Chile and Italy. Our dedicated, experienced
team has the expertise to produce premium ingredients that add
to healthy nutrition and fit into a healthy lifestyle. A sound scientific basis is the key to successful product development and
Dr. Matthias Moser
Yves Servotte
Hildegard Bauer
we look back on a long history of nutritional research programs,
partnerships in large-scale international research projects and
intensive cooperation with numerous research institutes worldwide. We are constantly intensifying this scientific network.
From left to right: Yves Servotte, Hildegard Bauer and Dr. Matthias Moser.
window to science 1|2008 – Editorial · table of contens
WELCOME!
Welcome to our 1st edition of
BENEO “window to science”!
Dr. Gunhild Kozianowski, Vice president
Nutrition Science, BENEO-Group
Anke Sentko, Vice President Regulatory Affairs
& Nutrition Communication, BENEO Group
Dear Reader,
BENEO-Orafti, BENEO-Palatinit and BENEO-Re-
We want to share our research results, new
Connecting nutrition and health… this is the spi-
my have combined their expertise in life scien-
trends, interpretations and developments with
rit of the BENEO Group, our driving force. This is
ces, regulatory affairs and technical application
you. And we are keen to hear what you think!
our philosophy and the reason we chose to con-
services for the benefit of the BENEO Group as a
nect this key message to the name of our Group:
whole, whilst continuing their individual opera-
Finally, we hope you enjoy this, our 1st edition of
ting business as usual.
“WINDOW to Science”, in which you will find a
review of the latest scientific findings on energy
An enthusiastic team with more than 20 years of
metabolism and functional carbohydrates as
Connecting nutrition and health: This confirms
experience in nutrition science and application
presented at our 1st BENEO European Scientific
our commitment to science and technology, in-
services in projects all over the world is prepared
Symposium, held in April this year in Brussels.
novation and consumer health. If you have had
for the challenge – together with our partners in
This is sure to be of particular interest to those
contact with one of the Group Members of our
research and industry for everyone’s benefit.
who did not have the chance to attend. We are
looking forward to working with you all!
leading food ingredient companies: ORAFTI, PALATINIT or REMY in the past you will already be
This new BENEO “WINDOW to Science” is our
familiar with the quality of our work as your part-
voice to interested partners and friends in the
ners in business and science. United forces are
academic world, industry R&D, Health Authori-
stronger – that’s why the BENEO Group was
ties and health professionals as well as nutrition
founded in 2007. The three ingredient specialists
communicators and other interested partners.
Best regards,
Anke Sentko
Dr. Gunhild Kozianowski
Physiological diversities of carbohydrates
(G. Kozianowski)
New findings about energy metabolism of functional carbohydrates
The obesity epidemic and the role of dietary factors (A. Astrup)
4–7
9
10
Mechanisms and biomarkers of appetite regulation (J. E. Blundell)
10 – 11
Role of carbohydrates in appetite and glycaemic control: Their impact on obesity and health outcomes (C. J. Henry)
12 – 13
Postprandial energy metabolism of low glycaemic carbohydrates (D. König)
14 – 15
Effects of inulin and oligofructose on weight management and health (K.M. Tuohy)
15 – 16
Food intake regulation by inulin-type prebiotics: Mechanisms and animal data (N.M. Delzenne)
16 – 17
Appetite and food intake regulation: Human data (R.W. Welch)
17
Prebiotics, fibres and body weight management (D. Bosscher)
18
In conclusion…
19
Outlook: the future of functional carbohydrates
(M. Kunz)
20 – 22
window to science 1|2008 – BENEO ingredients
Physiological diversities
of carbohydrates
BENEO functional carbohydrates at a glance
Carbohydrates in human nutrition
scientific world until recently. Carbohydrates
first began to attract attention in the early
Carbohydrates are quantitatively the most im-
1980’s due to research of Jenkins and co-wor-
portant nutrients in the human diet. According
kers related to the different glycaemic respon-
to expert recommendations 50 to 60% of our
ses of carbohydrates (see Figure 2).
total energy intake should come from carbohydrates. Carbohydrates, if available to the body,
provide about 4 kcal/g. In the economically
Carbohydrates – their nutritive
and functional role
developed countries the actual intake of carboDr. Gunhild Kozianowski, Vice President
Nutrition Science BENEO Group
hydrates is around 40%, in some developing
Today more is known about carbohydrates
countries it is as high as 80% of the energy in-
that provide health benefits beyond nutritive
take. Traditionally, the main purpose of carbo-
functions, however, the ground for research
hicory roots, sugar beet and rice are
hydrates is to “provide energy” to the body
is still “young” and interest in this field of
the starting materials of BENEO in-
and to supply a source of carbon. Carbohydra-
research is growing. The term “functional
gredients. The natural carbohydrate stores in
tes are of key importance for metabolism. In
carbohydrates” is used to address this speci-
these plants are extracted and processed to
times of deprivation, humans are able to main-
fic group of carbohydrates.
obtain carbohydrates with specific phys-
tain a minimum level of glucose required for
Figure 3 illustrates the key characteristics of
iological characteristics. Figure 1 provides
certain body functions, such as the brain.
nutritive and functional carbohydrates.
and of the respective business units dealing
Surprisingly, there was little interest in the
Nutritive carbohydrates are characterised
with the specific ingredients.
physiological diversity of carbohydrates in the
by a rapid digestion that begins in the mouth,
C
an overview of the BENEO Group ingredients
Ingredients for food, feed and pharma
Chicory
Sugar beet
Rice
Inulin, oligofructose,
Isomalt,
Synergy1
PALATINOSE™ (Isomaltulose)
Starches, flours, proteins,
bran, syrup, concentrates
Ingredients for feed and pharma
Inulin, chicory fiber, gluten,
rice derivatives, isomaltulose
syrup and more
Figure 1: BENEO ingredients at a glance
galenIQ™
(Isomalt, pharmaceutical grade)
Glues, Inutec™ and more
(Adhesives, surfactants,
natural polymers)
Science based dietary guidelines aimed
at reducing the risk of chronic diseases
Prebiotic
definition
1850
Energy intake
1900
1950
Role of
Nutrition
essential nutrients; requirements
Deficiency diseases
Role of the diet in
chronic diseases
(CVD, Cancer)
Energy Supply
Nutrient, Vit & Mineral Supply
Passclaim
2000
2050
Glycemic response
measurements
of carbohydrates
Maintenance of health
Reduction of risk
Functional ingredients
Bioactive substances
Figure 2: Development of knowledge in nutrition
followed by a quick hydrolysis and absorption in the upper part of
• Non-digestible carbohydrates that are fermented in the large intesti-
the small intestine (providing 4 kcal/g). The digestion results in a
ne providing selective effects on the gut micro flora composition (e.g.
steep rise of blood glucose levels followed by a pronounced counter
prebiotic effects) and other gut health related aspects (short-chain
reaction, induced by the hormone insulin that is released to down-
fatty acid production and others) (e.g. inulin and oligofructose)
regulate the rapid increase in blood sugar.
Nutritional targets for functional carbohydrates are manifold and may
Functional carbohydrates have either specific digestive or fermentable
be related to the improvement of body functions or even the prevention
properties, or they have specific metabolic functions. What is the “physio-
i.e. risk reduction of nutrition- and lifestyle-related diseases:
logical functionality” of those carbohydrates? Here are some examples:
• No fermentation by the oral flora: If carbohydrates are not fermen-
(a) Improved body functions:
ted by the oral flora, acids are not produced. Acids are responsible
• Lipid or carbohydrate metabolism
for attacking the tooth leading to dental caries. Therefore, those
• Stool output regulation
carbohydrates that are not fermented by the oral flora do not pro-
• Gut health
mote dental caries. (e.g. Isomalt, Palatinose™)
• Immune function
• Slow and complete hydrolysis and absorption in the small intestine
(slow release carbohydrate, low GI, prolonged energy supply to
™
muscles and brain) (e.g. Palatinose )
• Partial/low digestible carbohydrates: limited absorption in the small
intestine, fermentation in the large intestine, low blood glucose
response, lower energy value, increased fermentation
activities in the large intestine (e.g. Isomalt)
• Mental and cognitive performance
• Physical performance and fitness
• Body weight regulation
• Satiety/appetite
• Well-being
Characteristics of nutritive carbohydrates
• Easily mobilisable plant storage materials
- (cooked) starches, maltodextrins
- glucose, fructose, sucrose
• Rapidly digestible (upper GI tract)
• Absorption/metabolism of monosaccharides
• 4 kcal/g
amylase
oral flora
Characteristics of functional carbohydrates
• Specific digestive properties
- lower rate (“prolonged energy”)
- undigestibility (“fibre-like”)
isomaltulose
PALATINOSE™
slow digestible
isomalt
acid
low digestible
inulin
undigestible
small intestinal
glucosidases
n
• Specific fermentation properties
- non-oral fermentability
- selective growth stimulation “prebiotic”
- short chain fatty acids (butyrate, propionate)
gut flora
Figure 3: Characteristics of nutritive carbohydrates and of functional carbohydrates
(b) Nutrition- and lifestyle-related diseases:
scientists and research institutes all over the world. We are grateful
• Obesity
• Dental Caries
and proud to be part of this network of expertise and intend to
• Allergies
continue and extend this collaboration. New ideas and challenges
• Constipation and other
are always welcome as innovation is the driving force of success!
• Type 2 diabetes and predisposition
(e.g. insulin resistance)
• Cardiovascular diseases
• Osteoporosis
chronic colonic diseases
• (Colon)cancer
•…
High quality scientific research is the basis for successful innovation – be it a new ingredient, the positioning of a functional carbohydrate in the context of a healthy and prevention-oriented diet
or the substantiation and communication of new physiological
What are the functional carbohydrates that were developed and
benefits in the interest of the consumer.
substantiated by the BENEO Group?
Table 1 gives a quick view of the BENEO ingredients and their key
On April 11, 2008 the BENEO Group organised its 1st European Scien-
physiological characteristics. Possible potential to contribute to a
tific Symposium in Brussels, Belgium. The focus of our symposium
healthy diet, specific body functions or disease prevention can be
was on energy metabolism and weight management from various
concluded from their physiology.
angles having the “Number One health threat” worldwide in mind
6
A number of claims related to the health-ingredient relationship of
and the debate on “Globesity”. The topic of the BENEO Symposium was
“Energy Metabolism of Functional Carbohydrates: New Findings”.
the BENEO ingredients have already been established and substantiated. This substantiation was made possible as a result of the many
In the following a summary of this interesting and successful day
partnerships and projects which the BENEO researchers had with
is given.
window to science 1|2008 – BENEO ingredients
Ingredient of
the BENEO Group
Classification
Physiological
properties
Health targets
Isomalt
• Polyol
• Hydrogenated carbohydrate of
a disaccharide type
• Nutritive or bulk sweetener
(sugar replacer)
• Tooth friendly
• Very low glycaemic
• Very low insulinaemic
• Reduced energy value
(2 kcal/g)
• Oral health/dental caries
• Glucose metabolism, diabetes,
metabolic syndrome
• Obesity, body weight
management
Isomaltulose
Palatinose™
• Disaccharide of
glucose and fructose
• Alpha 1-6 binding
• Novel (functional) dissaccharide
made from sucrose
• Tooth friendly
• Slowly and fully digestible in the
small intestine (4 kcal/g)
• Unique low glycaemic properties
• Prolonged glucose/
energy supply
• Promotes fat oxidation
• Satiety
• Oral health
• Diabetes, metabolic syndrome
• Physical performance
• Mental performance
• Body weight management /
obesity
Inulin
Orafti® Inulin
• GFn = 3-60
• (G)Fn = 2-8
• Fructans
• Beta (2-1) fructosyl-fructose
binding
• Food ingredients with sugar
replacer and/or fat replacer
functions
• Dietary fibre
• Undigested in the small intestine
• Completely fermented in the
large intestine
• Energy value 1.5 kcal/g
• Prebiotic – selectively
stimulating bifidobacteria
• Enhanced mineral (calcium)
absorption and bone mineral
density
• Appetite & food intake
regulation
• Short-chain fatty acid formation
• Stool regulation
• Improved intestinal transit
• Gut health/well-being
• Bone health
• Immune defence
• Body weight management/
obesity
• Starch from rice
• Highly digestible
• High nutritional value
• No known allergy (Caucasians)
• Gluten free
• No cholesterol
• Valuable amino acid composition of protein fraction
• Healthy diet
• Stabilised rice bran by extrusion
avoids rancidity and conserves
all valuable ingredients of a
whole grain (bran and germ)
• High fibre content (25%),
indigestible
• Vitamins, minerals,
phytochemicals, antioxidants
• Unsaturated lipids
• Body weight regulation
(low energy density, satiating)
• Cardiovascular diseases
• Digestive health
Oligofructose
Orafti® Oligofructose
Synergy1
Orafti® Synergy1
Rice starches
e.g. Remy®,
Remygel®
and rice flours
Remyflo®
Rice bran
and germ
RemyLiVe®
Table 1: Ingredients of the BENEO-Group, their classification, their key physiological
characteristics and their health targets
Reference: Kozianowski, G.; Physiological diversities of carbohydrates.
1st European BENEO Scientific Symposium: Energy Metabolism of Functional Carbohydrates:
New Findings. April 11, 2008, Bruessels, Belgium
window to science 1|2008 – 1st European BENEO Scientific Symposium
Highlights of the 1st European
BENEO Scientific Symposium
Energy Metabolism of
Functional Carbohydrates:
New findings
C
alories will count, but there are more aspects to consider when it comes to weight
9
management and weight control. Brussels was the setting for the first European
BENEO Scientific Symposium, chaired by respected weight management experts
Professor Arne Astrup (Copenhagen, Denmark) and Professor John Blundell (Leeds, UK).
The objectives of the symposium were to explore factors influencing energy balance and
showcase international human and animal research on the role of functional carbohydrates
in promoting weight management and metabolic control. This is a short review of the various
presentations given. A booklet with programme and abstracts is available upon request.
Please contact [email protected]
window to science 1|2008 – 1st European BENEO Scientific Symposium
The obesity epidemic and the role of dietary factors (A. Astrup)
by 2015. In countries, such as the USA and
When it comes to the treatments of obesity,
the UK, up to half of the adult population
it is difficult to find examples that provide
now has a body mass index (BMI) in excess
long-term benefits. Our obesogenic envi-
of 30. Obesity affects all age groups and all
ronment is too successful at minimising
parts of Europe. As longitudinal data show,
physical activity and encouraging food con-
certain countries (UK, Finland, Greece and
sumption, resulting in weight regain when
parts of Eastern Europe) have seen a rapid
people have previously lost weight. Suc-
increase in the proportion of the population
cessful interventions include energy-re-
affected by obesity, while the rise in others
stricted diets, trials that reduce the energy
has been slower. The health consequen-
density of the diet (e.g. by cutting fat con-
ces of this epidemic are clearly spelt out in
tent) and interventions that combine diet
literature. Obesity causes metabolic disor-
and physical activity. Bariatric surgery is
ders, such as dyslipidaemia, insulin resis-
also effective at reducing weight and chro-
he scene was set by Professor Arne
tance and hypertension which, in turn,
nic disease risk. Work from Professor
Astrup, from Copenhagen University’s
are risk factors for type 2 diabetes mellitus
Astrup’s own department and from the CAR-
Department of Human Nutrition, who de-
and heart disease. Prevalence rates for type
MEN study in which he was involved, sug-
scribed the size of the worldwide obesity
2 diabetes have increased by 25-50% across
gests that high protein foods and meals with
epidemic and its health consequences. The
the globe, particularly where obesity confla-
a low glycaemic index (GI) are useful for
International Obesity Task Force has esti-
tes with high waist circumference and ge-
weight management because they can help
mated that 704 million people will be obese
netic predisposition.
induce satiety1,2.
Professor Arne Astrup (Copenhagen University’s
Department of Human Nutrition, DK)
T
1
2
Skov et al (1999) Int J Obesity 23, 528-536.
Saris et al (2000) Int J Obesity 24, 1310-1318.
Mechanisms and biomakers
of appetite regulation (J.E. Blundell)
Professor John Blundell (Institute of Psychological
Sciences, Leeds University, UK)
‘energy-satiety ratio of all common foods’
to help people manage an energy balance.
Now this could become reality thanks to research on appetite and satiety.
Energy intake and expenditure are governed
by a complex array of factors; physiological,
psychological, societal and environmental.
While physiological factors, e.g. gut distension, gastric emptying, circulating hormones,
food composition, colonic fermentation and
substrate oxidation have an important influence on food intake, our behaviour has a
great share in influencing both intake and
T
he topics of appetite, satiation and
expenditure.
satiety were introduced by Professor
John Blundell from the Institute of Psycho-
It is clear from international data that main-
logical Sciences at Leeds University, UK. As
taining an optimum energy balance is a prob-
far back as 1981, the prominent UK resear-
lem for many people. At an individual level,
cher, Professor Ken Heaton, called for an
the reasons for this are complex, although a
Po
pt
or
e
iv
e
y
ve
iv
iti
st
gn
ge
bs
-in
-a
st
st
Po
Co
or
ns
Se
early
late
FOOD
Satiation
Satiety
Figure 4: Satiety Cascade (Adopted from Blundell et al 1987 in: Food Acceptance and Nutrition
(eds Solms, Booth, Pangborn, Raunhardt) London: Academic Press, 205-219.)
common thread is the relative ease at which
duce. Blundell’s ‘satiety cascade’ is a useful
than stimulating overconsumption, as many
calories can be consumed relative to the
tool for conceptualising how different foods
foods do at present. Professor Blundell con-
3
effort required to burn off calories. For ex-
influence energy intake (see Figure 4) . The
cluded by saying that energy density and tex-
ample, a person running for 60 minutes would
concept is used in research to identify senso-
ture are key factors in improving satiety. The
burn 600 calories, yet this could be consumed
ry and physical characteristics that are likely
challenge for new product development is to
in food and drink in around 6-10 minutes.
to optimise a food’s impact on appetite, e.g.
achieve the right balance between satiety
However, if foods could be designed to
portion size, macronutrient composition, sen-
and palatability and if possible to simultane-
have a stronger influence
over appetite and satiety,
the energy intake side of
the equation could be better controlled.
sory qualities, and pre-
“Energy density and
texture are key factors in
improving satiety.”
(Professor Blundell)
ously increase both.
sence of specific ingredients. He stated that, in
principle, manipulation of
all macronutrients can
modulate satiety including
Appetite is an umbrella term covering food
proteins, fats, carbohydrates (via Glycaemic
intake, selection, motivation and preference.
Index, Glycaemic Load) and fibres. Studies
Hunger is the driver for initiating eating,
using visual analogue scales, test meals and
whilst satiation represents the driver for ter-
dietary diaries have revealed that foods can
minating eating. Satiety, on the other hand, is
be developed to have different effects on sa-
the inhibition of eating between meals. If this
tiety. These methods can be utilised to produ-
could be prolonged, energy intake would re-
ce foods that help appetite regulation rather
3
11
Blundell et al (1987) in: Food Acceptance and Nutrition
(eds Solms, Booth, Pangborn, Raunhardt) London:
Academic Press, 205-219.
window to science 1|2008 – 1st European BENEO Scientific Symposium
Role of carbohydrates in appetite and
glycaemic control: Their impact on obesity
and health outcomes (J. Henry)
Professor Jeya Henry (School of Life Sciences,
Oxford Brookes University, UK)
on how quickly digestion and absorption
Tufts University in Boston shows that the vari-
takes places. The GI of a food is deemed to
ation in individual responses to GI is wide5. A
be high if it is greater than or equal to 70 and
consequence of this is that research studies
low if it is less than or equal to 55. A medium
must make a clear distinction between high
category of GI = 56-69 falls in between.
and low GI meals in order to elicit significant
Professor Henry suggested a need to re-
differences in response.
consider the old classification of GI in the
light of new developments (i.e. a GI of ⱕ 45
4
for low GI and of > 65 for high GI) .
Controlling the GI of foods and diets is beneficial for health. Studies in normal subjects show lower more balanced glucose
T
Whilst recognising the nutritional scope of
excursions when low GI foods and diets are
the GI, it is equally important to appreciate
consumed6,7. The study by Henry illustrates
and accept its limitations. Recent work from
that the choice of a low glycaemic multi-
he theme of appetite and glycaemic
control was taken up by Professor
Jeya Henry (School of Life Sciences, Oxford
2,0
Multiseed/All-in-One bread
White bread
Brookes University, UK) with focus on the
drates in diabetes and overweight. Having
already learned about metabolic differences
in proteins by Osborne and Mendel in 1919
and differences in fats by Burr and Burr in
1932, it took until the work of Jenkins and
co-workers in 1981 – which gave birth to the
concept of the Glycaemic Index (GI) – to
take a more differentiated look at carbohyd-
Change in blood glucose (mmol/l)
long-term effects of low glycaemic carbohy1,5
1,0
0,5
rates. This glycaemic index categorises
12
carbohydrates based on how they affect
0
06:00
9:00
12:00
15:00
18:00
21:00
00:00
blood sugar levels following consumption.
In the past, carbohydrates were described
as ‘simple’ or ‘complex’, yet both glucose
03:00
06:00
Time (hours)
24h blood glucose response in healthy subjects (n=10) on identical diets
except for the type of bread: low GL (Multiseed/All-in-One bread, GI: 41)
or high GI bread (white bread, GI: 71)
and starch can give a similar blood glucose
profile in the post-prandial period depending
Figure 5: Alteration of the day-long blood glucose profile by the choice of bread (adopted from
Henry et al 2006 Int J Food Sci Nutr 57, 273-278)
seed-type bread instead of a high glycaemic
is followed by low insulin release and con-
rable effect for body composition changes
bread for main meals, together with the
sequently higher levels of fat oxidation le-
and weight management indicated in first
choice of a lower glycaemic snack (apple vs.
vels as compared to high glycaemic carbo-
animal studies.
banana) can markedly modify the 24h blood
hydrate-based foods. This over time may
glucose response (see Figure 5). Studies in
have an effect on body composition. In an
Professor Henry concluded by stating that
people with type 2 diabetes (see review by
18-week study with rats on a controlled
the concept of GI is a real, observable pheno-
Augustin and co-workers , or the recent Cana-
weight maintenance diet with identical nut-
menon. As low GI foods also stimulate satiety,
dian trial9) indicate that a low GI diet helps
rients except for the starch type, those rats
as evidenced from a study from Professor
control glycated proteins, markers for long-
on a low GI diet developed less body fat and
Henry’s research work12, these are likely to be
term blood glucose control, and C-reactive
more lean body mass than the rats on high
useful for weight management as well as for
8
11
protein, a marker of inflammation linked with
GI diet . Such findings are an interesting
safeguarding metabolic health . The provisi-
heart disease risk. It has been hypothesised
field for further research.
on of low GI foods may be a useful strategy to
that repeated and high glucose and insulin
reduce food intake and thereby reduce the
excursions, following the regular consump-
A number of components influence GI which
risk of obesity. The type of carbohydrate con-
tion of high GI meals, over time may lead to
could be varied during food processing to
sumed may have a greater impact on weight
insulin resistance and increase the risk of
produce low GI products. Such components
gain than previously considered. A low GI
type 2 diabetes mellitus. Our routine prescrip-
include the starch type, presence of viscous
diet may be useful for modulating blood glu-
tion of a low fat diet (hence a diet high in high
fibre, particle size, ripeness, levels of protein
cose control in both healthy individuals and
glycaemic carbohydrates) may have inad-
and the addition of functional carbohydrates,
those with diabetes mellitus. In his view “the
vertently increased our risk of obesity. Consi-
notably inulin, oligofructose, isomalt and Pa-
inclusion of novel and new food ingredients
dering the wide-spread use of low fat diets
latinose™. Palatinose™ is a fully available
in foods to reduce their GI will emerge as a
for weight control, it would be additionally
carbohydrate with the generic name isomal-
growing market”.
beneficial to add high carbohydrate low GI
tulose (also found naturally in honey) which
elements in order to enhance the health-pro-
has a very low GI and produces a blunted glu-
moting effects of such diets.
cose response following test meals. Studies
with Palatinose™ have shown as well, that it
10
Ebbeling and Ludwig
proposed a model
increases fat oxidation, with a potential desi-
linking the macronutrient composition and
GI of a diet to body weight via alterations in
the endocrine profile (e.g. insulin) and portioning of metabolic fuels and subsequent
4
5
regulation of food intake. Indeed the intake
of carbohydrate based low glycaemic foods
6
7
8
9
10
11
12
Barclay et al (2008) Am J Clin Nutr 87, 627-37.
Vega-Lopez et al (2007) Diabetes Care 6; 1412-17.
Stevenson et al (2006) Am J Clin Nutr 84, 354-360.
Arai et al (2007) Metab Clin Experim 56, 115-121.
Augustin et al (2002) Eur J Clin Nutr 56, 1049-71.
Wolever et al (2008) Am J Clin Nutr, 87, 114-125.
Ebbeling, Ludwig (2001) Adv Pediatr 48, 179-212.
Pawlak et al (2004) Lancet 364, 778-785.
Warren et al (2003) Pediatrics 112, 414-419.
window to science 1|2008 – 1st European BENEO Scientific Symposium
Postprandial energy metabolism of
low glycaemic carbohydrates (D. König)
Dr. Daniel König (Division of Prevention, Rehabilitation and Sports Medicine at Freiburg University, DE)
Could carbohydrates with a low GI maintain
significantly promoted fat burning (by 26%)
or even promote fat oxidation? This question
in comparison with maltodextrin, both befo-
was pursued by the research team of Pro-
re and during exercise. A further study with
fessor Berg and Dr König. They found in ran-
a similar methodology, completed recently,
domised double-blind placebo-controlled
revealed a trend towards a prolonged exer-
studies that a low GI in test drinks had a sig-
cise endurance with Palatinose™, while po-
nificant effect on subsequent fuel metabo-
wer output was significantly greater at the
lism, both under resting and exercise condi-
end of the exercise period. This could be
13
tions. In the first study ,
the metabolic effects of
low GI drinks containing
Palatinose™ or high GI
drinks containing malto-
due to glycogen sparing
The ability to oxidise
fat stores is of great
importance not only to
overweight people,…
F
™
ning earlier in exercise.
Other implications from
the metabolic effects of
dextrin were investigated
urther evidence for the fat burning im-
at the expense of fat bur-
™
in a group of highly trained endurance athle-
Palatinose in comparison with high GI car-
pact of Palatinose was presented by
tes. The results showed that drinks supple-
bohydrates have been observed in obesity
Dr Daniel König (Division of Prevention, Reha-
mented with Palatinose™ produced a lower
and weight management. Excess weight
bilitation and Sports Medicine at Freiburg
blood glucose peak than maltodextrin drinks.
can induce insulin resistance which pre-
University, Germany). The ability to oxidise fat
Insulin levels were lower and circulating
vents further storage of fatty acids in adipo-
stores is of great importance not only to over-
levels of free fatty acids were higher with
cytes but leads to increased blood fat levels
weight people, but also to athletes. This is
the Palatinose™ drinks. Data on respiratory
and encourages storage in other types of
because enhanced fat oxidation spares vital
™
cells (i.e. intramuscular fat accumulation)
exchange ratios indicated that Palatinose
glycogen stores and helps to prolong physical endurance. Unfortunately, consuming high
glycaemic carbohydrate foods suppresses fat
55,0
Difference: 7.9g fat /7h
27.1g fat /day
9.8 kg fat /year
oxidation via the actions of insulin. Yet, athletes
and other consumers are encouraged to eat
50,0
diet. In sports nutrition guidelines, athletes are
advised to obtain 55-60% daily energy from
carbohydrates and to consume carbohydratecontaining sports drinks before, during and
Fat Oxidation (g)
high carbohydrate foods as part of a balanced
45,0
40,0
after exercise. With the exception of postexercise intake of carbohydrates, where high
GI carbohydrates are preferred to quickly
refill glycogen stores, little is known about the
35,0
PALATINOSE ™
sucrose/glucose
Fat Oxidation during a 7h test period in obese persons (n=20) receiving a test
breakfast and a lunch containing PALATINOSE ™ or a sucrose/glucose combination.
effect of GI before and during exercise.
Figure 6: Increase in fat burning by the choice of foods based on
Palatinose™ instead of conventional high glycaemic carbohydrates.
Effects of inulin and oligofructose on
weight management and health (K. M. Tuohy)
to the detriment of health14. A contributing
on prebiotics has progressed since the con-
Dr Kieran Tuohy (Food Biosciences,
University of Reading, UK)
factor to insulin resistance is the consump-
cept was introduced by Professors Glenn
tion of high GI diets which promote carbo-
Gibson and Marcel Roberfoid in 1995. Well-
hydrate oxidation and excess insulin re-
established prebiotics now include inulin and
lease but inhibit fat oxidation. While insulin
oligofructose, transgalacto-oligosaccharides
resistance is commonly associated with ob-
and lactulose.
esity, it can also occur in lean people. Data
from a study of healthy, lean subjects15
A considerable body of research has been
show that exposure to high carbohydrate
published confirming the impact of inulin and
meals elicited different insulin responses in
oligofructose in stimulating beneficial gut bac-
insulin resistant individuals compared with
teria. Some studies for example have also shown
normal controls. While blood glucose ex-
inhibitory effects on potential pathogenic bac-
cursions were similar in both groups, insu-
teria, e.g. clostridria or enterobacteria. Human
lin secretion and de novo lipogenesis in the
studies have identified key areas of health
resistant group were significantly higher.
I
n the later part of the symposium, the focus
where inulin and oligofructose can have a be-
shifted to low digestible carbohydrates,
neficial effect. These include (i) bone health,
However, insulin resistance can be impro-
in particular the role of dietary prebiotics in
where inulin and oligofructose promote mine-
ved by switching from a high to a low GI
weight management and health. Dr Kieran
ral (calcium) absorption and increase bone
diet. Data with Palatinose™-based foods
Tuohy (Food Biosciences, University of Rea-
mineral density; (ii) colorectal cancer, where
suggest that a low GI diet may help to re-
ding, UK) set the scene by defining a prebiotic
the release of short-chain fatty acids (SCFA) by
verse insulin resistance by lowering levels
as “a selectively fermented ingredient that
the microflora helps to reduce DNA damage;
of triglycerides in the liver and reducing ab-
allows specific changes, both in the com-
(iii) immuno-modulation, where oligofructose
dominal fat stores. New research from Professor Berg and Dr König’s research team
in obese subjects showed that meals with
16
Palatinose™ – in comparison with high GI
14
carbohydrates – resulted in lower insulin
period, while fat oxidation was enhanced
by an additional 8 g in seven hours (see Figure 6). In a theoretical extrapolation, this
12
Plasma endotoxin (EU/ml)
and glucose excursions in the post-prandial
8
6
4
equivalent to over 27,1 g fat per day or 9.8 kg
2
fat per year. This extrapolation should be
0
illustration purposes how small daily contri-
b
10
would result in an increase of fat oxidation
viewed as a highly simplified calculation for
b
a
a
Control
High-fat
High-fat
High-fat
cellulose
oligofructose
Modulation of plasma level of endotoxin by dietary treatment in mice.
Values are given as means ± SEM. Columns with different superscript letters
are significantly different, p< 0.05. n = 8, mice per group.
butions to energy balance could make a significant change over time. Further work is
needed to establish how Palatinose™ influ-
Figure 7: Modulation of endotoxaemia with oligofructose in mice on a high-fat diet
(adopted from Cani et al 2007 Diabetologia 50, 2374-2383).
ences fat oxidation and body fat over longer
time periods. However, at present it is pos-
position and/or activity of the gastrointestinal
has been found to increase resistance to-
sible to say that Palatinose™ as a low GI
microbiota that confers benefits upon host
wards respiratory infections and diarrhoeal
carbohydrate can have a role to play in ma-
well-being and health”. Basically, prebiotics
disease in children; and (iv) digestive health,
naging obesity and metabolic risk.
are carbohydrates that, post-consumption,
where inulin and oligofructose stimulate stool
remain intact until they reach the colon where
bulking and normal bowel regularity in adults
they are fermented by beneficial bacteria e.g.
and the elderly. Some studies have demonst-
lactobacillus and bifidobacteria. Research
rated lipid-lowering properties, particularly in
13
14
15
König et al (2007) AgroFood 18, 9-10.
König et al (2006) Dt Z Sport Med 57, 242-247.
Petersen et al (2007) Proc Natl Acad Sci 104, 12587-94.
window to science 1|2008 – 1st European BENEO Scientific Symposium
stimulation of indigenous beneficial bacteria
Food intake regulation by inulin-type
prebiotics: Mechanisms and animal data
and the release of metabolites (notably SCFA)
(N. Delzenne)
subjects with dyslipidaemia. The mechanisms
for all of these effects have their origins in the
through the bacterial fermentation of inulin
and oligofructose which have a wide range of
positive effects when taken up by the host.
Professor Nathalie Delzenne (Université Catholique
de Louvain, Brussels, Belgium)
ficial impact on dyslipidaemia.
A new twist to this hypothesis is how SCFA
Recent research has investigated how the gut
also appear to stimulate the release of a
microbiota has a role to play in regulating
peptide involved in the control of satiety,
energy homeostasis and glucose metabolism.
glucagon-like peptide 1 (GLP-1), which is
The theory is plausible because differences
produced in the ileum and the colon. Three
have been found in the balance of Bacteroide-
prebiotic-supplemented diets were fed to
tes and Firmicutes between obese and lean
Wistar rats for three weeks. Compared with
subjects, with the ratio between these two
the control diet, the oligofructose and Syn-
major phyla in obese adults favouring bacteria
ergy1 diets significantly increased levels of
that are capable of harvesting additional ener-
GLP-1 in the proximal colon (see Figure 8)
gy from the diet. Colonizing germ-free animals
and in the portal vein, while levels of an ap-
P
rofessor Nathalie Delzenne (from the
petite enhancer, ghrelin, were reduced19. In
Université Catholique de Louvain, Brus-
the colon, levels of proglucagon mRNA, the
Methodological techniques, such as FISH and
sels, Belgium) expanded on the theme of
precursor of GLP-1 were also seen to rise.
DGGE, assist with greater understanding by
food intake regulation and energy balance
The mechanism for the increase in GLP-1
enabling the identification of specific species
with examples from animal and human re-
can further be explained by histological re-
as well as the numbers present.
search. Fermentation, and thus prebiotics,
search showing that oligofructose feeding
with the microflora of obese ones was even
16,17
shown to promote body weight increase
are intricately involved with lipid metabo-
in rats promotes the differentiation of gut
Lower populations of bifidobacteria have also
lism, insulin sensitivity and glucose metabo-
endocrine cells capable of producing GLP-120.
been found in the colonic material from obese
lism due to the widespread effects of short-
Zucker rats and this has stimulated interest in
chain fatty acids (SCFA) which are released
These metabolic effects translate into re-
the potential role of inulin and oligofructose in
during the fermentation process. SCFA crea-
ductions in energy intake. Rats fed high-fat
weight management. The obesogenic lifestyle
te a gut-liver axis which decreases lipoge-
diets clearly demonstrated suppression of
is characterised by a high fat intake, low levels
nic gene expression, hepatic lipogenesis,
hyperphagia when oligofructose was added
of fibre and lack of physical activity. If this
and hepatic and seric triglycerides, accor-
to their food. This resulted in a lower body
could be altered by influencing fibre levels and
ding to animal research. This explains why
weight gain21. In an additional study, the
gut health, could a benefit be realised? Early
inulin and oligofructose can have a bene-
mechanism for appetite suppression was
work on animal models has revealed promising findings. A study in mice compared diffe-
250
rent high-fat diets, some with a non-fermenta-
*
ble fibre (cellulose) or oligofructose added. As
duced the level of bifidobacteria and bacteroides and increased endotoxaemia. When oligofructose was added to the diet, bifidobacteria
and endotoxin levels returned to normal (see
Figure 7), but a similar effect was not seen
16
Colonic GLP-1 (pmol/g)
expected, the high-fat diet alone markedly re-
*
200
150
100
50
with cellulose suggesting that fermentation
process played a key role in the observed
effects. The study suggests that oligofructose
counteracts the consequences of a high-fat
0
Control
Oligofructose
Synergy1
Inulin
Proximal colon glucagon-like peptide (GLP)-1 (7-36) amide concentration
of rats fed a control diet, or a diet supplemented with 10% oligofructose
(Orafti®P95), inulin (Orafti®HP) or oligofructose-enriched inulin (Orafti®Synergy1)
Values are given as means ± SEM., *p < 0.05.
diet on the gut microbiota18.
Figure 8: Effect of oligofructose, inulin and Synergy 1 on glucagon-like peptide 1 (GLP-1) levels in the proximal colon
(adopted from Cani et al 2004 Br J Nutr 92, 521-526).
Appetite and food intake regulation:
Human data (R. W. Welch)
proven to relate to the impact of GLP-1 by
using knock-out mice incapable of respon-
Dr Robert Welch (Northern Ireland Centre for Food
and Health, University of Ulster, Coleraine, UK)
sumed a placebo or the oligofructose/pea-fibre formula as enteral feeding for two weeks.
ding to GLP-1. In these experimental ani-
Energy intakes were around 3% lower in the
mals, oligofructose failed to alter energy in-
fibre group, and subjects lost more weight, alt-
take and weight gain, which suggests that
hough the results failed to reach statistical
the reducing effects of oligofructose on
significance. However, the fibre supplemen-
energy intake and weight gain are mainly
tation appeared to be successful at inducing
dependent on the action of GLP-122.
satiety. Similar changes in satiety and energy
intake were seen in a single-blind cross-over
Further research is needed to examine the
study where ten healthy adults received 8 g of
long-term impact of oligofructose supple-
oligofructose (Orafti® P95) twice daily for two
mentation, especially in obese subjects or
weeks. Reported satiety at breakfast and at
those with diabetes or dyslipidaemia who
dinner was significantly higher when subjects
P
could benefit particularly.
rofessor Dr. Robert Welch (from the Nort-
received oligofructose compared with the
hern Ireland Centre for Food and Health at
control diet. As a consequence, total energy
the University of Ulster, Coleraine, UK) described
intake during the day was reduced by around
four human studies that had examined the
5 % (see Figure 9)25.
satiating properties of non-digestible carbohy-
16
17
18
19
20
21
22
23
24
25
26
Backhed et al (2004) Proc Natl Acad Sci 101,
15718-15723.
Turnbaugh et al (2006) Nature 444, 1027-1031
Cani et al (2007a) Diabetologia 50, 2374-2383.
Cani et al (2004) Br J Nutr 92, 521-526.
Cani et al (2007b) Br J Nutr 98, 32-37.
Cani et al (2005) Obes Res 13, 1000-1007.
Cani et al (2006a) Diabetes 55, 1484-1490.
Piche et al (2003) Gastroenterology 124, 894-902.
Whelan et al (2006) Br J Nutr 96, 350-356.
Cani et al (2006b) Eur J Clin Nutr 60, 567-572.
Abrams et al (2007) J Pediatr 151, 293-298.
drates, of which inulin and oligofructose are key
Lastly, benefits in maintaining body weight and
examples. In a double-blind, placebo-controlled
body composition have been associated with
trial23, nine patients were given a low fibre diet
Orafti®Synergy1 supplementation. A 12-month
plus oligofructose or placebo (20 g/d). After a
double-blind, placebo-controlled trial in 97
week and a further test meal, plasma GLP-1 levels
non-obese adolescent boys and girls compa-
were found to be higher in the oligofructose group
red a daily placebo drink with one containing
suggesting stimulation of this satiety hormone.
8 g/d of the inulin-type fructan, Synergy1.26
Those in the supplemented group demonstra-
The effects of inulin-type fructans (10 g/d) + pea
ted a significantly smaller increase in body
fibre were examined in another double-blind,
weight, body mass index and total fat mass
24
cross-over trial . Eleven healthy adults con-
over the year compared with the unsupple-
% Energy intake (compared to placebo which equals 100)
mented adolescents.
105
*
100
95
**
Further human trials would be desirable to fully
investigate these promising results and examine the mechanisms by which inulin and
*
oligofructose impact beneficially on appetite,
satiety, energy intake, and body composition.
90
85
80
75
Breakfast
Lunch
Dinner
Total
The figure represents the % of energy intake relative to the placebo group
at breakfast, lunch and dinner and over the day in subjects supplemented
with oligofructose (8 g twice daily) for 2 weeks.
*p< 0.05, **p< 0.01, Values are given as means ⫾SEM, n =10 subjects
Figure 9: Effect of oligofructose on subsequent energy intake in humans
(adapted from Cani et al 2006 Eur J Clin Nutr 60, 567-572).
window to science 1|2008 – 1st European BENEO Scientific Symposium
Prebiotics, fibres and body weight
management (D. Bosscher)
Dr Douwina Bosscher
(BENEO Group, Tienen, Belgium)
D
r. Douwina Bosscher (Manager Nutrition
that Orafti®Synergy1 (BENEO brand name for
Science, BENEO Group) extended the
oligofructose-enriched inulin) supplementation
theme to the role of prebiotics and other dietary
resulted in a lower body weight evolution in
fibres in weight management. RemyLiVe® is an
male rats during the whole experiment (see
example of a complex fibre which in addition
Figure 10)27. As far as humans are concerned, it
also contains high levels of phytochemicals and
is evident that the composition of the gut micro-
antioxidants. Rice bran has been shown to
biota has a link with obesity, although cause
affect blood lipids beneficially and to modulate
and effect is unclear. Obese people display
postprandial blood glucose levels. With respect
differences in the relative proportion of certain
to the prebiotic fibres inulin and oligofructose:
bacterial phyla in their microbiota compared
animal studies have found that oligofructose
to lean people, although this can be altered by
supplementation attenuates weight gain and
weight loss and/or potentially by supplemen-
fat mass development, in normal rats, as well
tation with oligofructose. Dr Bosscher also
as in obese rats. In a recent study, beneficial
highlighted conditions associated with obesity,
changes in body weight and adiposity were
e.g. inflammation and dyslipidaemia that could
demonstrated to correlate with bifidobacteria
be addressed by oligofructose consumption,
levels in the colon, these later being increased
based on extensive animal research. In Apo-E
upon oligofructose feeding18. All of these effects
deficient mice for instance, atherosclerosic
have been observed in the long- and short-term.
plaque formation was reduced through supple-
A life-long intervention study in rats has shown
mentation with Synergy1 or long-chain inulin28.
850
800
-
-
*
*
-
750
*
700
*
Weight (g)
650
600
**
550
500
Control
Synergy1
450
27
28
Rozan et al (2008) Br J Nutr 11, 1-8.
Rault-Nania et al (2006) Br J Nutr 96, 840-844.
400
350
3
6
9
12
15
18
21
24
27
Age (months)
The figure represents the body weight evolution in male rats after feeding with a
standard diet with or without (control) Synergy1 (Orafti®Synergy1)
- is indicative for p<0.10, *: p<0.05 and **: p<0.01. Values are given as means ± SEM
Figure 10: Effect of Synergy 1 on body weight evolution in rats (adopted from Rozan et al 2008 Br J Nutr 11, 1-8)
In conclusion…
With obesity affecting increasing numbers
health benefits to consumers and are useful
of adults and children across the globe, a
tools in a healthy diet. A sound research
variety of diet and lifestyle solutions must
base has now been established to demon-
be developed in order to help consumers
strate the impact of these functional carbo-
maintain a healthy weight. From the evidence
hydrates on satiety, metabolic function and
presented at the 1st BENEO Scientific Sym-
appetite control. Additional studies have
posium in Brussels, it is clear that functional
revealed plausible mechanisms for such
carbohydrates have an important role to play
effects. The pursuit of knowledge will conti-
in a healthy weight managing diet. Characte-
nue in order to expand the body of evidence
rised by their low glycaemic index, high fibre
supporting the use of these functional carbo-
content, satiating effects and/or their support
hydrates in diets supporting a healthy life-
for normal glycaemia and lipid metabolism,
style. In the meantime, these benefits can be
the BENEO ingredients inulin, oligofructose,
enjoyed in a wide array of functional food
™
Palatinose and isomalt offer a number of
and beverage products.
window to science 1|2008 – Outlook
20
Prof. Dr. Markwart Kunz, Member of the Board, Südzucker AG
Prof. Dr. Markwart Kunz
OUTLOOK: The future of
functional carbohydrates
C
ompared with the old, traditional way of nutrient intake (use of locally available
agro crops/fruits/vegetables to cook meals at home), lifestyle has changed a lot:
we can see changes in food preparation habits (less time to prepare a meal, often less
cooking skills), changes in eating habits (e.g. preference for lean meat, wide variety of fruits
and vegetables, not only the locally available products) and changes in the supply chain
(in the past a high proportion of the ingredients was sold directly to the consumer, today,
up to 90% of food ingredients are used by packaged food producers). Whilst in the past
the main focus of the supply chain was to provide nutritive, safe, tasty food at a reasonable price, expectations today go beyond this. New food ingredients with non-nutritive
window to science 1|2008 – Outlook
functionalities are developed for the benefit of the consumer.
fibres, minerals, vitamins and phytochemicals of whole grains in
Functional carbohydrates belong to this group of new ingredients.
a concentrated form while still yielding high quality energy and
The aim of these ingredients is to support and improve a healthy diet
providing fibre for satiation.
and by doing so these ingredients can help in preventing diet related
diseases and improve body functions. Basis for these functional
Challenges for the future are the optimization and further scientific
ingredients is their safe use and the science based evidence of their
substantiation of health-related properties of existing products as well
physiological benefits.
as the development of ingredients with additional health benefits.
Targets for improved body functions comprise modulation of carbo-
The combined efforts of the academia, industry and regulators are
hydrate metabolism, gut health and gut function regulation, immune
required to obtain consumer acceptance and to implement any
modulation, mental and physical performance, as well as body
nutritional concept into practice:
weight management and appetite regulation. The ultimate challenge
• Scientists to provide the scientific basis for our nutritional know-
today is to reduce the risk of lifestyle-related diseases such as obe-
ledge and develop consensus on nutritional concepts as well as
sity, type 2 diabetes and predispositions, cardiovascular diseases,
methodology.
osteoporosis, dental caries or even some types of cancer. Widely
• Regulators to provide the regulatory environment to enable adequate
acknowledged nutritional concepts are fibres, whole grains, prebio-
communication of health properties to the consumer and industry
tics, low glycaemic or tooth-friendly carbohydrates.
with the necessary Intellectual Property protection.
• Food industry to develop tailor-made food and food ingredients and
Well established functional ingredients of the BENEO-Group today
their scientific substantiation, well tasting and at a price level
are inulin, oligofructose, isomalt, Palatinose™ and rice bran, the
acceptable to the consumer.
nutritional functions of which complement each other. Inulin and
oligofructose can be classified as low calorie functional fibres. Their
Only well-tasting, reasonably priced foods will ultimately survive on
uniqueness, however, relates to their prebiotic effect. In addition, it
the market and contribute to a healthier nutrition of the consumer
could be shown that they enhance mineral absorption and promote
and the desired health benefits.
satiety. Data from animal studies and adolescents indicate that they
can reduce energy intake and contribute to body weight control.
The BENEO Group, in close co-operation with scientists and health
Isomalt is a polyol; its nutritional characteristics are tooth-friendly-
professionals all over the world, regulators and our customers and
ness, a very low glycaemic response, and a low caloric value.
partners in industry, will help to connect nutrition and health.
Palatinose™ is a novel low glycaemic nutritive carbohydrate which
provides sustained glucose as energy to the body, increases fat
metabolism and promotes fat burning. Finally rice bran combines
Prof. Dr. Markwart Kunz
Imprint
Window to Science – The journal of the BENEO-Group
© 2008 by BENEO-Group, Mannheim (Germany)
All Rights Reserved
Publisher:
BENEO-Group
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Phone +49 621 421 150
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Responsible for content:
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Anke Sentko
[email protected]
Editorial board: Anne Frank
Anke Sentko
Antje Jungclaus
Hélène Alexiou
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