Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page R1
Workshop Summary
The Human Microbiome,
Diet, and Health
Leslie Pray, Laura Pillsbury, and Emily Tomayko, Rapporteurs
Food Forum
Food and Nutrition Board
OCR for page R2
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Govern-
ing Board of the National Research Council, whose members are drawn from the
councils of the National Academy of Sciences, the National Academy of Engineer-
ing, and the Institute of Medicine.
This study was supported by Contract Nos. AG-3A94-P-11-0081, FS-11-DC-01, and
CNPP/IOM-11-01 (U.S. Department of Agriculture), N01-OD-4-2139 ( ational N
I
nstitutes of Health), and HHSF22301020T (Food and Drug Administration) with
the National Academy of Sciences. Additional support came from Abbott Labo-
ratories, Cargill, Coca-Cola Company, ConAgra Foods, General Mills, Kellogg
Company, Kraft Foods, Mars, McDonald’s, Mead Johnson Nutrition, Monsanto,
Nestlé Nutrition, and PepsiCo. The views expressed in this publication are those of
the author(s) and do not necessarily reflect the views of the organizations or agencies
that provided support for this project.
International Standard Book Number-13: 978-0-309-26585-0
International Standard Book Number-10: 0-309-26585-1
Additional copies of this report are available from the National Academies Press,
500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202)
334-3313; http://www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page
at: www.iom.edu.
Copyright 2013 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost
all cultures and religions since the beginning of recorded history. The serpent
a
dopted as a logotype by the Institute of Medicine is a relief carving from ancient
Greece, now held by the Staatliche Museen in Berlin.
Cover credit: Image designed by Casey Weeks.
Suggested citation: IOM (Institute of Medicine). 2013. The human microbiome,
diet, and health: Workshop summary. Washington, DC: The National Academies
Press.
OCR for page R3
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
Advising the Nation. Improving Health.
OCR for page R4
The National Academy of Sciences is a private, nonprofit, self-perpetuating society
of distinguished scholars engaged in scientific and engineering research, dedicated to
the furtherance of science and technology and to their use for the general welfare.
Upon the authority of the charter granted to it by the Congress in 1863, the Acad-
emy has a mandate that requires it to advise the federal government on scientific
and technical matters. Dr. Ralph J. Cicerone is president of the National Academy
of Sciences.
The National Academy of Engineering was established in 1964, under the charter
of the National Academy of Sciences, as a parallel organization of outstanding en-
gineers. It is autonomous in its administration and in the selection of its members,
sharing with the National Academy of Sciences the responsibility for advising the
federal government. The National Academy of Engineering also sponsors engineer-
ing programs aimed at meeting national needs, encourages education and research,
and recognizes the superior achievements of engineers. Dr. Charles M. Vest is presi-
dent of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of
Sciences to secure the services of eminent members of appropriate professions in
the examination of policy matters pertaining to the health of the public. The Insti-
tute acts under the responsibility given to the National Academy of Sciences by its
congressional charter to be an adviser to the federal government and, upon its own
initiative, to identify issues of medical care, research, and education. Dr. Harvey V.
Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sci-
ences in 1916 to associate the broad community of science and technology with the
Academy’s purposes of furthering knowledge and advising the federal government.
Functioning in accordance with general policies determined by the Academy, the
Council has become the principal operating agency of both the National Academy
of Sciences and the National Academy of Engineering in providing services to the
government, the public, and the scientific and engineering communities. The Coun-
cil is administered jointly by both Academies and the Institute of Medicine. Dr.
Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of
the National Research Council.
www.national-academies.org
OCR for page R5
PLANNING COMMITTEE ON THE HUMAN
MICROBIOME, DIET, AND HEALTH1
GORDON L. JENSEN (Chair), Pennsylvania State University,
University Park
JENNIFER BRULC, General Mills, Inc., Minneapolis, Minnesota
SUSAN CROCKETT, General Mills, Inc., Minneapolis, Minnesota
CINDY DAVIS, National Institutes of Health, Bethesda, Maryland
ERIC DECKER, University of Massachusetts Amherst
MARGARET LEAHY, The Coca-Cola Company, Atlanta, Georgia
SARAH ROLLER, Kelley Drye & Warren LLP, Washington, DC
PAMELA STARKE-REED, National Institutes of Health, Bethesda,
Maryland
IOM Staff
LAURA PILLSBURY, Study Director
GERALDINE KENNEDO, Administrative Assistant
LINDA D. MEYERS, Senior Director, Food and Nutrition Board
1 Institute of Medicine planning committees are solely responsible for organizing the work-
shop, identifying topics, and choosing speakers. The responsibility for the published workshop
summary rests with the workshop rapporteurs and the institution.
v
OCR for page R6
FOOD FORUM1
FRANK BUSTA (Chair), University of Minnesota, St. Paul
MARK ANDON, ConAgra Foods, Inc., Omaha, Nebraska
PAUL M. COATES, National Institutes of Health, Bethesda, Maryland
DAVID B. COCKRAM, Abbott Laboratories, Columbus, Ohio
SUSAN J. CROCKETT, General Mills, Minneapolis, Minnesota
ERIC A. DECKER, University of Massachusetts Amherst
CAROLINE SMITH DEWAAL, Center for Science in the Public Interest,
Washington, DC
SAMUEL GODEFROY, Health Canada, Ottawa, Ontario
DAVID GOLDMAN, U.S. Department of Agriculture, Washington, DC
CINDY GOODY, McDonald’s Corporation, Oak Brook, Illinois
SONYA A. GRIER, American University, Washington, DC
BRENDA HALBROOK, U.S. Department of Agriculture, Alexandria,
Virginia
JERRY HJELLE, Monsanto Company, St. Louis, Missouri
KATE J. HOUSTON, Cargill Incorporated, Washington, DC
VAN S. HUBBARD, National Institutes of Health, Bethesda, Maryland
LEE-ANN JAYKUS, North Carolina State University, Raleigh
GORDON L. JENSEN, Pennsylvania State University, University Park
RENÉE S. JOHNSON, Congressional Research Service, Washington, DC
WENDY L. JOHNSON-ASKEW, Nestlé Nutrition, Florham Park,
New Jersey
GENE KAHN, Bill & Melinda Gates Foundation, Seattle, Washington
CAROL KELLAR, Kraft Foods, Glenview, Illinois
MICHAEL M. LANDA, Food and Drug Administration, College Park,
Maryland
MARGARET LEAHY, The Coca-Cola Company, Atlanta, Georgia
ERIK D. OLSON, Pew Health Group, Washington, DC
ROBERT C. POST, U.S. Department of Agriculture, Alexandria, Virginia
STEVEN W. RIZK, Mars Chocolate North America, Hackettstown,
New Jersey
SARAH ROLLER, Kelley Drye & Warren LLP, Washington, DC
SYLVIA B. ROWE, SR Strategy, LLC, Washington, DC
PETER VAN DAEL, Mead Johnson Nutrition, Evansville, Indiana
PARKE E. WILDE, Tufts University, Boston, Massachusetts
DEREK YACH, PepsiCo, Purchase, New York
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual
documents. The responsibility for the published workshop summary rests with the workshop
rapporteurs and the institution.
vi
OCR for page R7
Food Forum Staff
LAURA PILLSBURY, Director
EMILY TOMAYKO, Mirzayan Science & Technology Policy Fellow
(from August 2012)
GERALDINE KENNEDO, Administrative Assistant
ANTON L. BANDY, Financial Associate
LINDA D. MEYERS, Senior Director, Food and Nutrition Board
vii
OCR for page R8
OCR for page R9
Reviewers
T
his report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with
procedures approved by the National Research Council’s Report
Review Committee. The purpose of this independent review is to provide
candid and critical comments that will assist the institution in making its
published report as sound as possible and to ensure that the report meets
institutional standards for objectivity, evidence, and responsiveness to the
study charge. The review comments and draft manuscript remain confiden-
tial to protect the integrity of the process. We wish to thank the following
individuals for their review of this report:
Cindy Davis, National Institutes of Health, Bethesda, Maryland
Robert W. Hutkins, University of Nebraska, Lincoln
Artem Khlebnikov, The Dannon Company, Inc., White Plains,
New York
David Mills, University of California, Davis
Connie M. Weaver, Purdue University, West Lafayette, Indiana
Although the reviewers listed above have provided many constructive
comments and suggestions, they did not see the final draft of the report
before its release. The review of this report was overseen by Melvin Worth.
Appointed by the Institute of Medicine, he was responsible for making
certain that an independent examination of this report was carried out in
accordance with institutional procedures and that all review comments
were carefully considered. Responsibility for the final content of this report
rests entirely with the authors and the institution.
ix
OCR for page R10
OCR for page R11
Contents
OVERVIEW 1
Studying the Microbiome, 3
The Microbiome, Health, and Disease, 5
How the Microbiome Influences Host Diet Metabolism, 6
How Diet Impacts the Microbiome, 7
Probiotics and Prebiotics, 8
Understanding Consumer Behavior and Regulatory Challenges, 11
Moving Forward, 13
References, 14
1 INTRODUCTION 23
Organization of This Report, 24
Keynote Address: The Future Impact of Beneficial Microbes and
Gut Health, 25
Major Overarching Themes, 28
References, 31
2 STUDY OF THE HUMAN MICROBIOME 33
Defining the Human Microbiome, 33
Tools and Models for Assessment of the Microbiome, 40
Metabolome and Microbiome, 43
Open Discussion, 48
References, 50
xi
OCR for page R12
xii CONTENTS
3 INTERACTION BETWEEN THE MICROBIOME AND
HEALTH AND ENVIRONMENT 55
Overview of Pediatric Clinical Implications and Interventions, 55
Impact of Microbiome on Oral Health and Disease, 60
Impact of Microbiome on Gastrointestinal Health, 62
References, 67
4 INFLUENCE OF THE MICROBIOME ON THE
METABOLISM OF DIET AND DIETARY COMPONENTS 69
Diet, Obesity, and the Gut Microbiome, 69
Microbial Metabolites of Dietary Components, 74
Biogeography of the GI Tract, 77
References, 78
5 INFLUENCE OF DIET AND DIETARY COMPONENTS ON
THE MICROBIOME 81
Human Breast Milk, 81
Host-Microbe Interactions in the Perinatal Period, 83
The Resistome as a Driver of the Microbiome, 88
Probiotic Mechanisms of Action, 92
Prebiotic Mechanisms of Action, 96
Translation of Probiotic Science into Probiotic Foods, 100
Developing Delivery Systems, 105
How the Microbiome Revolution Fuels Functional Food
Research, 109
Discussion, 112
References, 115
6 SOCIETAL AND POLICY IMPLICATIONS 121
How Americans Eat and Drink to Improve Health, 121
Consumer Insights from the Industry Perspective, 125
Probiotic and Prebiotic Health Claims in Europe:
Scientific Assessment and Requirements, 129
Evaluation of Viable Microbes Using Regulatory Requirements
Developed for Nonviable Ingredients, 132
Health Claims and False Advertising, 137
Regulatory Frameworks: The Industry Experience, 140
The Regulatory Environment: A Synthesis, 142
References, 145
OCR for page R13
CONTENTS xiii
7 POSSIBILITIES FOR THE FUTURE 147
Moving the Science Forward: Studying Health Versus Disease, 148
Changing the Regulatory Framework for Food Claims, 149
The Microbiome, Environment, and Health: Future Research
Needs, 151
Reference, 154
APPENDIXES
A WORKSHOP AGENDA 155
B SPEAKER BIOGRAPHICAL SKETCHES 159
C WORKSHOP ATTENDEES 171
D ABBREVIATIONS AND ACRONYMS 179
OCR for page R14
