The Scientific Challenge of Expanding the Frontiers of Nutrition
Biomarkers are the backbones of our daily medical decision making. They indicatethe malfunction of organ systems and efficacy of therapeutic interventions.However, only in a few areas related to human nutrition and metabolism, biomarkersplay important roles to predict health and functional outcome, and areroutinely used in clinical practice. Parameters indicating the lipid status/metabolismwhich predict long-term cardiovascular risk and efficacy of targetedinterventions have been included in routine patient management for a longtime.Biomarkers of lipid status have also shown the limitations of our presentnutritional intervention strategies. Iron deficiency and overload can be preciselydiagnosed and managed by biomarkers, and it has recently been shown thatthe best ‘biomarker’ to guide treatment may be the physiological ‘determinant’of iron utilization (hepcidin). Interestingly, out of the ‘big four’ global nutritionaldeficiencies (vitamin A, zinc, iodine, and iron) which are associated withsignificant morbidity and mortality in humans, three still cannot be preciselydiagnosed by employing (biochemical) biomarkers. Therefore, interventionstrategies are mostly still targeted at population level and biomarkers play a limitedrole in research and decision making. Satisfactory pediatric nutritional biomarkersof outcome must be predictive of later functional health and ideallyremain stable over the period from infancy to childhood and adult life. Currenttraditional biomarkers such as anthropometry and blood pressure are indicesthat best fulfill those criteria. They are important to monitor long-term healthof children who were born with low birth weight in terms of malnutrition orobesity.New biomarkers which have recently been developed by employing highthroughputmetabolomic, proteomic, and genomic technologies indicate thatinpiduals are genetically and biochemically distinct. Our epigenome and metabolomecan be influenced by dietary, lifestyle, and environmental factors,which contribute to the heterogeneity observed in humans. Therefore, the riskfactors determined for populations cannot be applied to the inpidual, one hasForeword XIto accept ‘inpidual variability’. New biomarkers which indicate the inpidualrisk or benefit must not neglect the complexity of foods, lifestyle, and metabolicprocesses that contribute to health or disease and are significant challenges forpersonalizing dietary advice for healthy or diseased inpiduals. The 84th Nestlé Nutrition Institute (NNI) Workshop focused on values andlimitations of traditional nutritional biomarkers and opportunities of new biomarkers.NNI would like to thank the three Chairmen, Prof. Emmanuel E.Baetge (Switzerland), Prof. Anil Dhawan (UK), and Prof. Andrew Prentice,(UK) for their challenging and interesting program together and all speakers fortheir significant contributions. We would also thank the Nestlé Health ScienceInstitute and the Nestlé Research Centre for cooperation and support.