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The Road to Evidence-based Dietary Recommendations for Flavonoids: How Do We Get There?

6 th International Conference on Polyphenols and Health University of Buenos Aires, Argentina 19 October 2013. The Road to Evidence-based Dietary Recommendations for Flavonoids: How Do We Get There? From Data to Databases to Adequate Intakes. Jeffrey Blumberg, PhD, FASN, FACN, CNS

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The Road to Evidence-based Dietary Recommendations for Flavonoids: How Do We Get There?

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  1. 6th International Conference on Polyphenols and HealthUniversity of Buenos Aires, Argentina19 October 2013 The Road to Evidence-based Dietary Recommendations for Flavonoids: How Do We Get There? From Data to Databases to Adequate Intakes Jeffrey Blumberg, PhD, FASN, FACN, CNS Friedman School of Nutrition Science and Policy Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston, MA USA

  2. Disclosures for: Jeffrey B. Blumberg

  3. Why Develop Reference Values for Flavonoids? • Provide consumers with guidance about healthy food choices via education and food product labeling • Provide the nutrition industry with definitions to guide innovative product development as well as truthful and non-misleading communications about products

  4. Knowing is not enough; we must applyWilling is not enough; we must do.- Johann Wolfgang von Goethe (1749-1832) IOM FNB. DRI Coverpage 2000

  5. From Data to Databases Data analytical methods experimental design nomenclature quality control reporting

  6. From Data to Databases Data Food Composition Analysis cultivar environment geography post-harvest preparation sample size replication

  7. From Data to Databases Data Food Composition Analysis Database Classification and Organization accuracy analytical methodology aglycone vs. glycone nomenclature incompleteness

  8. Flavonoid Databases USDA ARS Database for the Flavonoid Content of Selected Foods USDA ARS Database for the Proanthocyanidin Content of Selected Foods USDA ARS Database for the Isoflavone Content of Selected Foods European Food Information Resource (EuroFIR) Bioactive Substances in Food Plants Information System (BASIS) French National Institute for Agricultural Research Phenol-Explorer

  9. From Data to Databases Data Food Composition Analysis Database Classification and Organization Dietary Intake assessment tools bioavailability reliability

  10. Dietary Intake of Polyphenols in French AdultsSU.VI.MAX Pérez-Jiménez et al. Am J Clin Nutr 2011

  11. From Data to Databases Data Food Composition Analysis Database Classification and Organization Dietary Intake Validation of Exposure matrix (blood, urine) pharmacokinetics single vs. multiple exposures

  12. Urinary (not Dietary) Polyphenols AreAssociated with Decreased MortalityInCHIANTI Study Total Urinary Polyphenols Total Dietary Polyphenols Zamora-Ros et al. J Nutr 2013

  13. From Databases to Function Range of Intake usual national vs. international duration in cohort

  14. From Databases to Function Range of Intake Function maintenance of physiological function modification of intermediary biomarkers reduction of disease risk

  15. Cocoa Flavanols Reduce Prehypertension Systolic Blood Pressure RCT: • 15 trial arms • 2 wk • 18-70 y • 168-902 mg flavanols • 30-1008 mg polyphenols Diastolic Blood Pressure Ried et al. BMC Med 2010

  16. Anthocyanins Reduce the Riskof Incident Hypertension NHS II NHS I • n=156,957 • 25-75 y • 14 y F/U Intake mg/d • Q1= 5.7 • Q5= 21.9 Multivariate Relative Risk HPFS Pooled RR: 0.92 95% CI:0.86-0.98, P<0.03 Quintiles Cassidy et al. Am J Clin Nutr 2011

  17. Intake of Anthocyanins and PolymersReduce the Risk of Myocardial InfarctionNurses Health Study II * Polymers: proanthocyanidins, theaflavins, thearubigins • n=93,600 • 25-42 y • 18 y F/U Cassidy et al. Circulation 2013

  18. From Databases to Function Range of Intake Function Flavonoid Reference Value frameworks for reference and risk FAO/WHO Codex Alimentarius U.S. Institute of Medicine

  19. From Function to Reference Values IOM framework – DRI: EAR, AI, RDA, UL Codex framework – NRV Adequate Intake: When sufficient evidence is not available to set an EAR, the AI is a goal for the intake of individuals. The AI is expected to cover the needs of most all people.

  20. From Function to Reference Values IOM Tolerable Upper Intake Level (UL): The highest level of daily intake likely to pose no risk of adverse health effects to almost all individuals in the general population. FAO/WHO Highest Observed Intake (HOI): Where no toxicity has been observed, the highest dose tested that can be confidently concluded as safe.

  21. Le mieux est l'ennemi du bien The perfect is the enemy of the good - Voltaire (François-Marie Arouet) 1694-1778

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