Prehrana otrok in odraslih kot zaščitni dejavnik ali dejavnik zdravstvenih tveganj (Slovene)

Nutrition can present either a risk or a protective factor for the development of a series of non-communicable diseases. While such effects were established for during whole life cycle, the nutrition in early life is particularly important, because of its possible long-term impact on health in later life. Reliable scientific data on dietary intakes and nutritional status of the representative population sample present a predisposition for elucidate the specific role of nutritional factors in human health. The scientific background of the proposed applicative research project is based on two starting points: a) the studies that follow the link between the early nutrition, initial intestinal microbiota, and development of children over a longer time period are limited, and b) in Slovenia no epidemiological data is available about the nutritional status of adults population, particularly in relationship to those micronutrients, for which the status can be reliably established only using biomarkers in human biological samples. Therefore, a key scientific challenges addressed in this project are to investigate the effects of early life nutrition on growth and health of children, to provide epidemiological data on the nutrient intakes in adults (including intakes of key micronutrients), and to investigate their relationship with various markers of health. The work programme of this multidisciplinary applicative project will comprise two pillars: Pillar A is focused into children, and tightly linked with previous “My-Milk” project (SRA J4-3606; finished in the year 2013), in which the role of early nutrition in the development of breast fed children and their intestinal microbiota during the first year of life were investigated. A prospective study will be conducted with children included to “My-Milk” study, who will be at the time of the study aged 6-7 years. Study will characterize the key modifying factors in early life on nutritional status (dietary intakes, anthropometrics, body composition - bone density, % of fat and muscle tissue), health (blood pressure, blood cholesterol, frequency and severity of infections), and faecal microbiota of children. Pillar B is focused into adults, and tightly linked with the national dietary EU Menu study, which will conducted in 2017/2018 (funded by the European Food Safety Authority, EFSA). EU Menu project was launched by the EFSA in order to introduce standardised approach for assessment of the food intake evaluation across Europe. However, while its methodology enables the assessment of energy and macronutrient intakes, a number of key micronutrients could be only studied with examination of biological samples, such as blood and urine. The proposed project includes conduction of a cross-sectional study on adults included to EU Menu study, particularly focusing into women of childbearing age and the increasing population of elderly. In addition to standard validated dietary assessment method, biomarkers will be used to investigate the status of the key micronutrients, including vitamin D, folate, vitamin B12, iodine, and iron. Furthermore, epidemiology of some diet related diseases in Slovenia will be investigated, focusing on body composition and various other measurable markers of health, such as BMI, thyroid size, thyroid function, and thyroid disorders. We expect that the project results will significantly improve progress in research in the areas of public health and nutrition and provide epidemiological data, which will be indispensable not only for the creation of appropriate policies, but also for further research, particularly for identification of new links between nutrition, health and the development of non-communicable diseases.

The project results will significantly improve progress in research in the areas of public health and nutrition. Extensive research carried out in recent years strongly suggests that early nutrition modulates growth and functional development of the child and exert lifelong programming effects on health, disease, and quality of life in adulthood. However, the question whether early differences in the composition of the intestinal microbiota of children are associated with metabolic or systemic problems later in life still remains unanswered. So, the interactions within the axis nutrition in early childhood, gut microbiota composition and diversity and potential health problems in later life are still not fully explored. The conclusions of proposed studies will contribute to the scientific development in this field in global prospective. It should be noted that this study would gain many new data on dietary habits, the basic features of the intestinal microbiota, health status and the occurrence of certain diseases in Slovenian children. We believe that the results of our research will contribute to the production of more suitable nutritional interventions in order to prevent/treat certain chronic non-communicable diseases and their complications, including overweight and obesity. This information will be an excellent basis for further studies in other areas, and for developing new dietary guidelines for the population of children. The proposed applicative research project will also provide epidemiological data for Slovenian adult population, which will be indispensable not only for the creation of appropriate policies, but also for further research, particularly for identification of new links between nutrition, health and the development of non-communicable diseases. In Slovenia currently we actually have NO data about the status of micronutrients in the population. The proposed project will for example provide highly necessary information about the current iodine supply, and also about the prevalence of thyroid disorders in Slovenian population. Additionally, the project will provide results about the seasonal changes in vitamin D deficiency in our geographic region. Considering that vitamin D status of mother affects the development of new-borns, and also influence the risk for the development of osteoporosis in the latter life, we will particularly focus into women in childbearing age and the elderly population. Project will also contribute to the methodology in the area of the assessment of nutritional status. For example, particular focus will be addresses into assessment of vitamin B12 deficiency, where a number of methodological issues still exist (Hannibal et al. 2016). Previous research showed that serum vitamin B12 has limited diagnostic value as a stand-alone marker. Other biomarkers, which are connected with B12 deficiency will be therefore also investigated, including homocysteine and methylmalonic acid.

Project’s relevance for society is proven by the co­financing by the Government (Ministry of Health, 25%). The results of the project will be used by the Slovenian government as a scientifically credible basis for the adoption of appropriate health care and nutrition policies, guidelines and preventive programs. New epidemiological data will enable a preparation of national guidelines for the screening of population and establishing population groups, which deserve a special attention. The objectives of the project are consistent with the Resolution on the National Programme on Nutrition and Physical Activity for Health 2015-2025 (National Assembly, 15/07/2015). This resolution particularly focus into priorities of Horizon 2020 programme - Health, demographic change and food safety, and highlights the need to ensure the research and monitoring at the national level, especially the collection of data on dietary habits in different population groups. »Periodic cross-sectional surveys of qualitative and quantitative type, used to monitor the status and trends in the field of nutrition habits and dietary intake of the individual population groups" are mentioned as a specific objective. Education and training are also listed as priorities. The proposed project will contribute to better realisation of all these areas. The project’s objectives are also in line with the Slovenian strategic resolution on the development of Slovenian agriculture and the food industry until 2020 “Food for the future”, the WHO recommendations, and the European Food and Nutrition Action Plan 2015-2020 (EU FNAP) which states, that dietary factors are the most important factors that undermine health and wellbeing in every Member State in the European Region. Moreover, it is pointed out that malnutrition, including undernutrition, micronutrient deficiencies, overweight and obesity, as well as non-communicable diseases (NCDs) resulting from unhealthy diets have high social and economic costs for individuals, families, communities and governments. Project will be also important for the businesses / industry: Particularly, project results will support responsible food production decisions in the food industry. Currently a number of foods on the market are enriched with various nutrients (particularly nutrients) without any evidence about the needs for these nutrients in the populations. Many times micronutrients are added to foods just to enable various attractive health claims and for advertising. With relevant data about the dietary status, the industry will have the data needed in the product development.