Research project
36 | monthsNCDS-MOTION

Dysbiosis and non communicable diseases (NCDs): toward a multidisciplinary approach to contrast malnutrition

Related toSpoke 06

Principal investigators
Gesualdo Loreto

Other partecipants Loredana Perla, Sebastio Perrini, Paola Pontrelli, Filomena Corbo, Giuseppe Palma, Valentina Annamaria Genchi, Ruggiero Francavilla, Roberta Tardugno, Gianvito Caggiano. Other people involved: Alessandra Stasi, Rosa Losapio, Maria Felicia Faienza, Fernanda Cristofori
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Highlights

Task involved

Task 6.1.1.

Profiling of vulnerable targets (in connection with SPOKE 5) through: a) analyses of existing data in children affected by obesity and ageing population at risk of malnutrition and non-communicable diseases (NCDs) b) screening of socioeconomic factors, lifestyle and dietary habits, environmental factors, food knowledge, nutritional status, body composition, functional status and disability, quality of life, genetic, metagenetic, phenotypic profiles, exposure to endocrine disruptors chemicals (EDCs), immune system functions in children and aging population with malnutrition c) human-derived biological samples analysis (including samples for the gut microbiome structure analysis and function).

Task 6.1.2.

Identification and application of biomarkers of malnutrition (including inflammatory, metabolic, microbiological, genetic and epigenetic ones) and biochemical pathways associated with diet and age-related diseases/ syndromes for early malnutrition detection and quality of life restoration in target specific categories.

Task 6.2.1.

Identification of sustainable tailored multidimensional approach including nutritional strategies aimed at reducing malnutrition in target specific populations by exploiting the interactions between environment, food, genotype and phenotype: a) analysis of the positive and negative interactions between lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment and diet for the implementation of sustainable dietary patterns; b) malnutrition biomarker validation; c) draft of sustainable nutritional protocols (in connection with Spoke 1 and 4).

Task 6.3.1.

Assessing microbiome–host interaction in malnutrition (in connection with Spoke 4 and 5). a) Evaluation of gut microbiome features in paediatric and ageing subjects affected by malnutrition and malnutrition-related conditions, with a focus on immune and metabolic pathways; b) Investigation of gut microbiome cell wall constituents on immune and metabolic pathways involved in human malnutrition; c) Investigation of the diet, environmental factors and drugs influencing human gut microbiome structure and function; d) Design of an algorithm to predict the risk of gut dysbiosis associated with malnutrition and malnutrition-related diseases.

Task 6.3.2.

Investigation of the preventive and therapeutic action of sustainable personalised nutrition and microbial-derived products on malnutrition-associated gut microbiome alteration and effect on specific targets with malnutrition.

Task 6.4.1.

Implementation of sustainable dietary patterns as nutritional treatment for target specific groups with malnutrition. The task includes the prototyping of foods, supplements, ingredients and nutraceuticals aimed at restoring resilience in specific targets with malnutrition (in connection with Spoke 4). In addition, it is implemented a friendly end user personalised web responsive application for remote promoting and monitoring of sustainable dietary patterns target specific.

Task 6.4.2.

Preclinical and clinical evaluation of new prototypes of functional foods, food supplements, ingredients and nutraceuticals for preventing and treating malnutrition (in connection with Spoke 4).

Task 6.4.3.

Dissemination, communication and food policy (in connection with Spoke 7).

Project deliverables

D6.1.1.1.

Systematic evaluation of existing data on nutritional status and critical issues for target specific groups with malnutrition (M8)

D6.1.1.2.

Identification and mapping of specific target groups with malnutrition (M24)

D6.1.1.3.

Creation of a biobank for biological samples in connection with Spoke 5 (M36)

D6.1.2.1.

New biomarkers of malnutrition specific for diseases and age and related to diet (M24)

D6.1.2.2.

Identification of biochemical pathways interconnected with biomarkers of malnutrition and immunological responses (M36)

D6.2.1.1.

Report on lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment, diet, cultural and environmental determinants of malnutrition in target specific populations (M24)

D6.2.1.2.

Evaluation and harmonisation of existing nutritional protocol, dietary guidelines for specific target groups with malnutrition (M10)

D6.2.1.3.

Validated biomarkers and reference ranges for specific target groups with malnutrition (M36)

D6.2.1.4.

Development of new, sustainable, easy to use diagnostic tools for early malnutrition assessment in specific target groups (M36)

D6.2.1.5.

New sustainable nutrition protocols for specific target groups with malnutrition (M20)

D6.3.1.1.

Revision of the literature on microbiome and diet (M4)

D6.4.1.2.

New prototypes of functional foods, food supplements, ingredients and nutraceuticals for malnutrition and malnutrition related diseases (n=5) (M36)

State of the art

Human gut microbiota is a dynamic-community of microorganisms of the digestive tract, whose composition is influenced by age, genetic background, diet habits, use of antibiotics, prebiotics and probiotics, malnutrition. Chronic exposure to stress factors can alter the relationship among microorganisms leading to dysbiosis, that has been often associated with several chronic non-transmissible diseases-NCDs, such as chronic kidney disease-CKD and obesity. The presence of dysbiotic gut microbiome is associated with enhanced production of harmful metabolites and uremic toxins with a negative impact on kidneys and other organs. Understanding the molecular mechanisms influenced by diet, could be a strategy for the management of NCDs. Within a multi-disciplinary approach to NCDs, the development of precision cooking approaches and patient-centered education for healthy eating, develop guidance addressing sustainability aspects and putting in the foreground subjectivity.

Operation plan

The aim is to create a biobank of biological samples by an aging population affected by obesity and CKD, including samples for the gut microbiome structure analysis and function. This biobank will implement the samples already collected in BIOMIS Biobank (PON BIOMIS, 2019-2022). These samples will be used to identify by multiscale technologies, new biomarkers of malnutrition and biochemical pathways associated with diet and age-related diseases. These biomarkers will then be validated and reference ranges will be assessed for specific target groups with malnutrition (patients affected by obesity and CKD). It will be also evaluated nutritional status of enrolled patients comparing them to the adherence to existing nutritional protocols, with the aim to improve those protocols enhancing sustainability and compliance. The project will design an educational programme to engage enrolled elderly people in adopting healthy eating behaviors by means of game-based learning tools, and by wearable technologies and friendly Apps, as well as train on new precision cooking methods to promote adherence to new sustainable nutrition protocols.

Expected results

Samples from NCDs subjects with obesity and CKD will be collected with clinical data. A multi-factorial analysis of the microbiota will be performed to better define the effects of diet for the modulation of the microbiota. The use of statistical algorithms and artificial intelligence approaches will be used to cluster patients according to the NCDs, frailty and progression risk. Data obtained from multiscale technologies will be leveraged to obtain patients’ frailty stratification and to personalize care management and nutritional protocols. Protocols of precision cooking will be developed to create pilot cooking labs, target specific, to implement sustainability and compliance to nutritional protocols. Wearable technologies and App will be used to interact with patients, retrieving data and facilitating the empowerment to develop best practices, and policy recommendations to fight malnutrition.