The Human Microbiome, Diet, and Health Workshop Summary (2013) / Chapter Skim
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Several major overarching themes emerged over the course of the 2-day dialogue: • The microbiome is integral to human physiology, health, and disease. • The microbiome is arguably the most intimate connection that hu mans have with their external environment, mostly through diet.
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• Dietary interventions intended to have an impact on host biology via their impact on the microbiome are being developed, and the market for these products is seeing tremendous success. However, the cur rent regulatory framework poses challenges to industry interest and investment.
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Nelson's talk prompted a lively discussion about methodology, mostly about the limitations of undersampling. JCVI researchers are credited with laying much of the conceptual and technological groundwork for contemporary research on the microbiome (e.g., Eckburg et al., 2005; Gill et al., 2006; Human Microbiome Jumpstart Reference Strains Consortium, 2010; Rusch et al., 2007; Venter et al., 2004; Wu et al., 2011a; Yooseph et al., 2007)
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. For example, mouse and rat studies have demonstrated what Nicholson described as a "massive effect of the microbiome on bile acid metabolism," with gut microbial activity impacting liver and colonic disease risk as a result (Martin et al., 2007; Swann et al., 2011)
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Researchers have made significant headway in understanding how the oral microbiome contributes to health and disease. Richard Darveau, professor and chair in the Department of Periodontics at the University of Washington Dental School, described evidence indicating that unlike many other human pathogens, the periopathogen Porphyromonas gingivalis triggers disease not by inducing inflammation but by intervening with host immunity in a more subversive manner.
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Growing evidence suggests that gut microbes influence what the human host is able to extract from its diet, including energetically. Peter Turnbaugh, Bauer fellow in the FAS Center for Systems Biology at Harvard University, summarized some of what is known about how the gut microbiome influences host energetics based on a series of mouse model studies demonstrating that gut microbes influence obesity (Backhed et al., 2004; Ley et al., 2005; Turnbaugh et al., 2006, 2008)
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German's quest to understand the preventive potential of diet led him to "the one thing" that evolved to promote a reduction in risk: human breast milk. He described work by Carlito Lebrilla, David Mills, and others on the association between human milk oligosaccharides (HMOs)
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. PROBIOTICS AND PREBIOTICS Workshop participants considered two major categories of dietary interventions intended to confer a health benefit: probiotics and prebiotics.
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Fahey urged more research on the effect of prebiotics on microbial metabolites, not just the microbiome taxonomic composition. There are some key scientific challenges to translating probiotic science into probiotic foods, according to Mary Ellen Sanders, executive director of the International Scientific Association for Probiotics and Prebiotics, beginning with the need for a more substantial evidence base that probioticmediated changes in the microbiome confer health benefits on the host.
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Despite the many scientific and other challenges to translating probiotic science into probiotic foods, the food industry already has seen tremendous success. Johan van Hylckama Vlieg, scientific director of gut icrobiology m and probiotics at Danone Research Center, discussed how Danone is l everaging the microbiome for health with a specific focus on prebiotics and probiotics.
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. The changing regulatory landscape around health claims for food products is arguably most visible in the European Union.
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Salminen commented on the difficulty in characterizing many of the strains being used in currently marketed probiotic products, let alone evaluating whether the evidence supports the proposed health claims. He acknowledged the difficulty in demonstrating a health effect in a generally healthy population but suggested that in many cases, small changes to standardize approaches and outcome measurements in study design would enable researchers to collect relevant data to demonstrate health effects more clearly.
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Finally, Sarah Roller, partner with the law firm Kelley Drye & Warren LLP, suggested that many of the regulatory challenges addressed by workshop speakers relate to the fact that "we are struggling to fit" an emerging science into an old legal paradigm. In the United States, the regulatory landscape for health claims on food products was codified in law in 1938, as part of the Federal Food, Drug, and Cosmetic (FD&C)
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All of this newfound knowledge about diet-microbiome-host dynamics is being used to develop probiotic and prebiotic food products intended to help build and maintain health. Indeed, probiotics are one of the fastest-growing sectors in the global functional food market.
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2011. Enterotypes of the human gut microbiome.
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2006. Metagenomic analysis of the human distal gut microbiome.
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2007. Glycoprofiling of bifidobacterial consumption of human milk oligosaccharides demonstrates strain specific, preferential consumption of small chain glycans secreted in early human lactation.
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2010. Consumption of human milk oligosaccharides by gut-related microbes.
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2011. Systemic gut microbial modulation of bile acid metabolism in host tissue compartments.
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2006. In vitro fer mentation of breast milk oligosaccharides by Bifidobacterium infantis and Lactobacillus gasseri.
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2007. The Sorcerer II Global Ocean Sampling Expedition: Expanding the uni verse of protein families.
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