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Tackling Chronic Diseases: the
Potential of Preventive
Medicine through
Improvements to Diet
Cathie Martin, MA, PhD, Professor
Department of Metabolic Biology
John Innes Centre
Norwich Research Park,
United Kingdom
Niels Bohr Professor,
Department of Plant Biology and Biotechnology
Copenhagen University,
Denmark
May 2009
Leading causes of death worldwide, 2005
Injuries 9%
Respiratory 7%
Diabetes 2%
Other chronic disease 9%
Cancer 13%
Cardiovascular disease 30%
Communicable diseases
maternal and perinatal
nutritional deficiencies 30%
Source: World Health Organisation
2005
Facts:
• The total number of people dying from chronic diseases
is twice the number of people dying from infectious
diseases including HIV/AIDS.
• 80% of mortality from chronic disease occurs in low and
middle income countries
• The poor are more vulnerable to chronic disease
because of increased exposure to risks and decreased
access to health care
• Chronic diseases cause poverty
• Without action deaths from chronic diseases will
increase by 17% between 2005 and 2015 (WHO report
2005)
Chronic Conditions:
Cardiovascular disease (CVD)
Diabetes
Obesity
Cancers
Respiratory diseases
Chronic conditions, including cardiovascular diseases (CVD),
diabetes, obesity, cancers and respiratory diseases, account
for 59% of the 57 million deaths annually and 46% of the
global burden of disease.
Of those with chronic conditions 60% are between the
ages of 18 and 64. 90% of seniors have at least one
chronic disease and 77% have two or more chronic
diseases.
Globally, chronic disease is
projected to cause 388 million
deaths in the next 10 years
Socio-Behavioural Risk Factors for Chronic Disease
OBESITY
Obesity is a major emerging disease, particularly
afflicting the poor.
Obesity has a strong correlation with the incidence of
several degenerative diseases, such as type II diabetes,
glucose intolerance, cardiovascular disease, and cancer.
Obesity is reaching epidemic proportions
Even in Italy obesity is becoming a problem
particularly in the young
What can plant science do to
combat chronic disease?
Emphasise the good things in
food
EU: FP6
Objectives: To generate defined dietary material (model
foods) to test the impact of specific flavonoids on
cardiovascular and age-related degenerative diseases
in a whole food context using animal model systems.
To find out what foods are good for you
Control line (r1)
Flavo-enriched line (ACR)
Genotype: p1r1c1A1
Genotype: p1R1C1A1
Special diets
Introduction of 20% of corn
seeds powder in a standard
pellet formula
8-week treatment
(~15 mg/kg/day)
Effects on ex
vivo myocardial
infarction
Effects on vascular
reactivity
Example of TTC staining for infarct size determination
Non-ischemic Zone (blue)
Group r1
Infarcted zone
(white)
+
Ischemic
viable zone
(red)
=
Risk Zone
Group ACR
Marie-Claire Toufektsian, Michel de Lorgeril
Infarct Size
Marie-Claire Toufektsian, Michel de Lorgeril
Anthocyanins offer
cardioprotection against
ischaemia/reperfusion injury
National Cancer Institute and
National Research Council in the US
recommend:
5 servings of fruit and/or vegetables
per day
(www.5aday.org)
Out of 15,000 surveyed only 23%
Americans achieved this intake
More worryingly the numbers attaining
5-a-day have decreased over the
past 10 years
Using genetic engineering
techniques we can develop
healthier foods, rapidly
del/ros
(line N)
WT
del/ros
del/ros
(line C)
(line N)
Antioxidant capacity of purple compared to red tomatoes
Eugenio Butelli, Cathie Martin
Red tomato –
supplemented
pellets
Purple tomato –
supplemented
pellets
p53-/p53- knockout mice
Life span, pathology
Diet
Number
of mice
Average
Lifespan
(days)
Std
Error
Maximum
Lifespan
(days)
Standard diet
24
142.0
8.7
211
Diet supplemented with 10%
red tomato powder
15
145.9
12.6
213
Diet supplemented with 10%
purple tomato powder
20
182.2
8.6
260
Lucilla Titta, Marco Giorgio
So what can society do about
chronic disease?
Grand challenges in chronic noncommunicable diseases:
The top 20 policy and research priorities for
conditions such as diabetes, stroke and
heart disease.
Nature, 450, 494-496
Sponsored by the Oxford Health Alliance
22 November 2007
Many chronic conditions could be
prevented:
• 36 Million of the projected deaths from
chronic disease could be avoided by 2015
• 50% of avoided deaths would be in people
<70 years old
• Economic impact would be enormous:
calculated loss in national income to
chronic disease in UK is: $33Billion
Commentary posted by
Rachel Nugent
Alas, this Grand Challenge has no money,
no Foundation, no benefactor. Indeed, it is a
kind of reverse Grand Challenge, as it
consists of scientists telling us what needs
to be done to address chronic NCDs and
hoping that someone will pony up the money
to do it.
Increase the availability and
consumption of healthy food
We need to start by ensuring that children eat well
Jamie Oliver
…….we need second
generation GMOs
to help combat chronic
disease
One important feature of the tomato study
was that it showed that genetic modification
is not just a generic technology that is either
good or bad, but that very different things
can be done with genetic modification of
plants—including the development of
products that have very real advantages for
consumers.
This displaces the debate from ‘it is alright
for them’.
• Research on functional foods is best
undertaken by publicly-funded
organisations:
To promote consumer confidence in
the results
To access and assess the entire range
of health-promoting phytonutrients not
just those of commercial interest
• But the regulatory burden is too costly for ‘not-forprofit’ organisations to bring improved GMO
products to the consumer
• The social burden is also very heavy in undertaking
this research:
One really has to wonder exactly who this tomato
will benefit, asked VAS's biosecurity representative,
Simona Capogna. It will undoubtedly help those who
hold the patent, those firms that sell it (at an inflated
price) and those researchers who use it as a career
move or who buy shares in biotech firms……
Detractors do not believe it is possible to use GM
technology for the ‘common good’.
The Future?