Cascade funding call for collaborative projects: Spoke 06 - Tackling malnutrition, University of Pavia

The 2030 Agenda for Sustainable Development, adopted by all United Nations member states in 2015, outlines 17 Sustainable Development Goals (SDGs) to be achieved by 2030. In this context, the OnFoods project (Research and Innovation Network on Food and Nutrition Sustainability, Safety, and Security – Working ON Foods) was born.

OnFoods operates with a comprehensive approach within the food supply chains, bringing together and synergizing the strengths and expertise of various disciplines, ranging from social and legal sciences to agricultural economics, food chemistry, food technology and engineering, logistics, microbiology, marketing, nutrition under physiological conditions, and in the presence of pathology.

Furthermore, the connection between research institutions and industrial partners is crucial for promoting research and development activities that can have an impact on the market. One objective of this synergistic action is to make healthy and sustainable products available for purchase by the public, positively influencing individual well-being and combating malnutrition in vulnerable populations.

OnFoods is composed of seven spokes, among which Spoke 6 "Tackling malnutrition" is included.

The rationale behind the activities of Spoke 6 is based on the observation in recent years of a global dietary transition characterized by the shift from traditional and local diets to a uniform "Western" diet high in sugars, salt, saturated and trans fats, marked by a significant consumption of ultra-processed foods.

These changes in diet contribute to a significant increase in the incidence, across all age groups, of overnutrition (overweight and obesity) and non-communicable diseases, including type II diabetes and cardiovascular diseases. At the same time, an unbalanced and nutrient-poor diet like the Western diet, along with other factors, exposes individuals to the development of undernutrition due to micronutrient deficiency.

The simultaneous presence of these three types of malnutrition results in a condition defined by the World Health Organization (WHO) as the "triple burden of malnutrition."

In particular, population groups most at risk for the development of malnutrition include children and adolescents, the elderly, pregnant and lactating women, but also all individuals affected by a condition that exposes them to the risk of inadequate nutrient intake and/or absorption, such as gastrointestinal diseases. These vulnerable targets require the development of targeted public health interventions to combat malnutrition, tailored to individual needs and nutritional requirements.

In this scenario, a possible solution could be provided by implementing interventions aimed at promoting adherence to dietary models that meet nutritional and sustainable needs (FAO), ensuring not only a nutritionally adequate, safe, accessible, and culturally acceptable diet but also a low environmental impact.

The OnFoods project is developed through the coordinated activities of seven spokes, each focusing on specific issues related to the production, transformation, and final impact of food on consumers.

All the spokes carry out their research activities independently, even though they are deeply interconnected and operate in perfect complementarity to promote dialogue between disciplines and different approaches and amplify potential outcomes.

There are six general objectives that the OnFoods project commits to achieving over a span of 36 months:

1. Promote sustainable food production.
2. Foster sustainable food distribution.
3. Develop innovative technologies for the production and consumption of sustainable food.
4. Increase adherence to more sustainable dietary patterns.
5. Improve food and diet quality.
6. Ensure food safety for the general population and specific vulnerable targets.

In particular, Spoke 6 "Tackling malnutrition" aims to achieve general objectives 4, 5, and 6.

Specifically, the research activities of Spoke 6 are aimed at developing nutritional strategies for vulnerable population targets (children, adults, and the elderly with undernutrition or overnutrition) to restore adequate nutritional status, ensuring greater resilience and combating malnutrition. Malnutrition will be addressed through the development of sustainable dietary plans that meet the needs of the target population, the identification of functional foods, and new bioactive and sustainable molecules produced by the microbiota or plant matrices, as well as new biomarkers as early and reliable indicators of malnutrition.

These functional foods and bioactive molecules should have an impact on nutritional status and contribute to the improvement of malnutrition or intestinal dysbiosis, through the formulation of food products, dietary supplements, and nutraceuticals for human consumption, aimed at combating malnutrition in vulnerable population targets. As defined in the project, through the research and development activities of Spoke 6, it is expected to contribute to the achievement of two of the United Nations Sustainable Development Goals (SDGs):

• SDG 3. Ensure health and well-being for all at all ages.
• SDG 8. Promote sustained, inclusive, and sustainable economic growth, full and productive employment, and decent work for all.

To achieve the various general and specific objectives, Spoke 6 has promoted several Research and Innovation themes within the OnFoods project aimed at supporting the development of innovative solutions at various levels, also involving strong public-private connections and, in some cases, collaboration with other spokes. In this regard, one of the objectives of Spoke 6 is to promote strategic project activities that can increase the impact of research and innovation achievable in the three years of the project, stimulating the creation of new partnerships between businesses and research organizations for some of the core themes of Spoke 6.

Based on the premises previously outlined, the general objectives of the OnFoods project, and the specific objectives set out in Spoke 6, which is dedicated to combating malnutrition in vulnerable population targets, the following strategic research themes have been defined to enhance the expected results and impact of the research and development activities of Spoke 6.

Malnutrition has a significant impact on both physical and social health, as well as on the healthcare system, especially affecting vulnerable population targets such as children, adolescents, and the elderly. Specifically, overnutrition increases the risk of type II diabetes, cardiovascular diseases, and cancer.

Cardiovascular complications can be observed in individuals in the developmental stage, such as children and adolescents, with consequences for an individual's health into adulthood. Furthermore, non-communicable diseases often emerge in the elderly population (over 65), which according to the latest ISTAT data will represent more than one-third of the Italian population by 2050, increasing the impact of malnutrition on society. At the same time, the elderly population is vulnerable to the development of undernutrition due to changes in health, social, and economic factors, resulting in an increased risk of frailty, infections, cognitive decline, disability, hospitalization, and mortality.

For these reasons, the management of malnutrition is a globally significant challenge. In this context, diet plays a central role in the prevention and treatment of this condition: a balanced diet, based on individual needs with a careful consumption of plant-based foods such as fruits, vegetables, nuts, whole grains, and legumes (similar to the Mediterranean diet) is associated with increased longevity, better health, and greater sustainability. On the other hand, recent data from the Council for Agricultural Research and Economics (CREA) report low adherence of the population to the Mediterranean diet, corresponding to excessive consumption of animal-based protein sources at the expense of plant-based ones.

The goal is to develop high-protein plant-based products, such as legumes or similar products, in line with the specific nutritional needs of vulnerable population targets (as mentioned above) to combat malnutrition, increase adherence to sustainable dietary patterns, promote local heritage while preserving biodiversity, and improve the diet by promoting the consumption of quality products accessible to the population. Therefore, the required activities include the prototyping of these functional foods, including evidence of potential beneficial effects of the product on preclinical models (in vitro and in vivo), consumer acceptability through market analysis, as well as sustainability of the packaging.

The proposed research projects will result in various research outputs that will contribute to one or more of the deliverables specified within Spoke 6 (WP6.4 - https://onfoods.it/spokes/spoke-06/wp-64) of OnFoods.

Malnutrition is characterized by a compromise of nutritional status, often associated with alterations in intestinal function and its microbiota. In particular, the term "dysbiosis" refers to an imbalance in the composition of the microbiota that negatively impacts health, triggering a vicious cycle with significant repercussions on individual nutrition and health status. 

Indeed, given the demonstrated role of dysbiosis in obesity, it is important to restore proper eubiosis not only to prevent obesity but also to prevent the cardiovascular and metabolic diseases that result from it.

At the same time, the integrity of the intestinal barrier and the composition of the intestinal microbiota are factors that can influence the development and treatment of malnutrition. In recent years, the role of pre-, pro-, and post-biotics has generated great interest because they appear to promote both the restoration of proper intestinal barrier integrity and permeability and the return to a state of intestinal eubiosis. Therefore, the design and development of innovative products based on pre-, pro-, or post-biotics aim to combat malnutrition by restoring gut well-being in vulnerable population targets.

To ensure better food quality and safety, the activities should include the development of a prototype product based on pre-, pro-, or post-biotics and its application in preclinical models (both in vitro and in vivo), as well as the analysis of its impact on the intestinal microbiota to highlight potential benefits or side effects in vulnerable populations affected by or at risk of malnutrition.

The proposed research projects will result in various research outputs that will contribute to one or more of the deliverables specified within Spoke 6 (WP6.3 - https://onfoods.it/spokes/spoke-06/wp-63) of OnFoods