The supply of nutrients such as vitamins, minerals and trace elements is directly related to the appearance of numerous metabolic diseases. In order to identify nutrient deficiencies in good time and counteract the development of diseases, the Institut für angewandte Biochemie (Institute of Applied Biochemistry; IABC) in Kreuzlingen has developed marker-based investigation methods that enable statements to be made on an individual’s personal nutrient requirements.
"We are very focused on quickly turning the latest research results into practical applications," explained Otto Knes, biochemist and managing director of IABC. This is one of the reasons why the institute is a member of the European EURRECA competence network funded by the European Commission. EURRECA's goal is to harmonise the identification and recommendations for the use of micronutrients on the basis of up-to-date science and to implement them in national regulations.
One particular focus area is the deviation of reference values in a person's metabolism. In contrast to traditional analysis methods, the IABC focuses on markers that provide information on developing diseases long before clinical disease symptoms become visible. "Rather than using the markers to diagnose a disease, we use them to provide information on any deviation from a person's normal state of health," said Otto Knes.
A standard example is the development of diabetes type II. Traditional medicine focuses on the monitoring of the blood glucose level. As long as the blood glucose level is ok, the patient will not be diagnosed as suffering from diabetes type II. However, it has been known for quite some time that diabetes type II develops over a longer period of time. Initially, elevated insulin requirements are compensated by the increased production of insulin. However, this process does not go on forever, as the target cells become more and more insensitive to insulin and require increasing concentrations of insulin. After a while, the insulin-producing cells are no longer able to supply insulin and diabetes manifests itself. Once this has happened, it is very difficult to reverse the process. IABC's goal is to be able to identify the development process of type II diabetes in order to assist in disease prevention.
Nowadays, there are known metabolic markers that provide information on the cells' insulin sensitivity. "We define these markers in order to be able to intervene in good time," said Otto Knes explaining that IABC scientists are investigating enzyme activities that correlate with micronutrients. The scientists are interested less in individual diseases and more in unspecific processes that might lead to a broad range of diseases. This relates to three areas in particular: chronic diseases (inflammatory stress), oxidative stress (surplus of free radicals) as well as metabolic stress (increase in metabolite concentrations, for example an increase in triglycerides caused by obesity, unbalanced nutrition, etc. Changes in the concentration of intermediary products, for example an increase in the homocystein level or a decreased level of production of thyroid gland hormones as a result of iodine deficiency are also examples of oxidative stress). All these areas are regulated by enzymatic processes, which in turn depend on the supply of sufficient nutrients.
The idea of consuming a varied range of non-specific vitamins or mineral tablets was largely discredited quite some time ago. In contrast to the previous belief that “more is better”, it has now become clear that the contrary is often the case: overdosing can be harmful. In addition, thanks to genetic investigations, it has become clear that different people not only have very different requirements due to different types of strain, such as physical or mental work, pregnancy or convalescence, but that individual nutrient requirements also depend on a person’s genetic composition.“We are looking to find markers that justify the supply of micronutrients,” explains Otto Knes. The determination of the micronutrient concentrations in the blood is not sufficient, because this does not necessarily provide information on the metabolic activity. For example, although a person might have a normal folate level, he or she might nevertheless be unable to effectively degrade homocystein, which is regarded as a risk factor for cardiovascular diseases. The researchers have found that people with a certain gene variant require more folate than others in order to be able to effectively metabolise homocystein.
The IABC has chosen to not only specialise in the definition and investigation of certain markers, but has for some time also been offering genetic analyses with the aim of identifying an individual’s personal risk in order to be able to intervene in good time. Otto Knes finds it important to point out that the aim of such investigations is not to frighten patients. The presence of a certain gene variant simply means that its carrier has a higher risk of contracting a cardiovascular disease or becoming overweight, for example.However, a person’s fate is not set and sealed. Early analysis helps people to take action to prevent a disease from occurring, for example by changing their lifestyle and/or substituting their diet with micronutrients. “We are very interested in the interaction between genetics and nutrition. Our goal is to be able to eliminate the risks that lurk in the genes by changing a person’s lifestyle,” explains the biochemist. The IABC has set up a comprehensive database consisting of more than 30,000 data sets, which can be used to compare the values before and after the substitution of an individual’s diet with micronutrients.