Leading digestive health experts and MEP Sarah Wiener address how healthy nutrition, starting from a young age, can help to reduce the risk of chronic digestive diseases and improve the health of our gut microbiome.
Chronic digestive diseases encompass a wide range of long-term health conditions and are becoming increasingly common across Europe. They include digestive cancers, which are responsible for 28% of cancer-related deaths in the EU, liver disease, coeliac disease, and inflammatory bowel syndrome.
Many digestive diseases are influenced by our dietary choices, with nutrition acting as a key preventive measure in the fight to reduce the burden of chronic digestive diseases.
A key nutritional recommendation includes limiting the intake of ultra-processed foods, which are foods high in added sugar, saturated fats, trans-fats, and salt. A recent report, ‘Nutrition and Chronic Digestive Diseases: An Action Plan for Europe’ states that our diets should include less than 10% of total required daily energy intake of sugar, less than 10% of total daily energy intake of saturated fats, less than 1% of total daily energy intake of trans-fats, and less than 5g of salt per day.
“Healthcare systems across Europe are under increasing pressure, driven by rising numbers of overweight and obese children and adults”, explains Professor Markus Peck, Chair of the United European Gastroenterology (UEG) Public Affairs Committee. “Over half of the EU adult population is now overweight or obese and for the foreseeable future these rates are only set to rise, leading to one of the greatest and most significant health challenges we face today.”
The importance of healthy nutrition starts at infancy and the first 1,000 days of life – the approximate length of time between conception and a child’s second birthday – is a unique period when the foundations of optimum health, a well-balanced immune system, growth and development are established.
“Breast milk contains both prebiotics and probiotics, both of which are essential for gut health”, explains Professor Gigi Veereman, representative of the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and member of the UEG Public Affairs Committee.
Breastfeeding should be encouraged, wherever possible, as research suggests that the non-digestible sugars of breast milk (the human milk oligo saccharides) provide a prime nutritional source for beneficial bacterial fermentation and the prevalence of Bifidobacteria. In comparison, infants fed formula milk in the first four weeks of life demonstrate no predominance of Bifidobacteria.
Professor Gigi Veereman added that “food products such as additives, fats and processed foods cause inflammation and plays a role in the management of chronic inflammatory bowel disease.”
Chronic digestive diseases and a healthy gut
The gut microbiome is now thought of as a vital organ of the human body and they are key to many aspects of human health, including digestive conditions. Approximately 100 trillion microorganisms live in the adult gut and incorporating prebiotics and probiotics in our diet helps to maintain its health. There are many foods that can be consumed to help with this, including foods that are rich in fiber, as well as fermented foods.
Although nutrition plays a significant part in maintaining a healthy gut, the environment also has an effect. Research in Israel has shown a socio-economic connection between citizens and their diets, with 17.4% of lower-paid citizens dying of obese-related diseases in 2018 due to heavy consumption of ultra-processed foods high in sugar and fats.
Dr Lucas Wauters, from the KU Leuven, comments how population-based studies clearly illustrate the effects of both the environment and lifestyle on the gut microbiome. “We have the possibility to study not only microbial composition but also function, including the degradation potential of substrates in the intestine such as sugars, fats and proteins. Until now, the majority of research has focused on the faecal microbiome and future studies should include the small intestinal microbiome, which is more relevant for immunity and nutrition.”
“With the Western diet predominantly consisting of refined sugar, processed foods and trans fats, it causes the gut to inflame which results in an alteration in the gut microbiome”, adds Dr Wauters. “In turn, this imbalance of the microbiome can increase the risk of digestive diseases and it is therefore important that governments authorise work to raise public awareness and introduce regulations on front of pack labelling (FOPL) schemes.”
Voluntary food labelling schemes are currently present in many EU Member States, resulting in a lack of adherence from food manufacturers who are able to direct and control what people eat. Countries that do have food labelling policies employ different schemes and regulations, resulting in a fragmented and inconsistent approach across the continent. The implementation of a simple, informative and uniform FOPL approach could help to educate the public, improve dietary patterns and promote healthy lifestyles.
With 40% of daily calorie intake amongst Israelis are coming from processed foods, Israel are one nation that has introduced measures to help regulate the consumption of processed foods through food labelling. This includes minimising the amount of ‘red’ (products high in sugar, salt and fats) foods that are being advertised via FOPL, as well as ensuring vending machines only sell products without red labels.
To promote optimal digestive health and to reduce the burden inflicted by obesity and chronic digestive diseases, UEG is calling for the adoption of mandatory FOPL across the EU. The implementation of a simple, informative and uniform FOPL approach could help to educate the public, improve dietary patterns and promote healthy lifestyles.
Professor Markus Peck said: “There is an urgent requirement across Europe for a considerable change in behaviours and attitudes towards food consumption and production. This cultural shift can only be achieved through coherent EU and Member State plans and a whole-of-society approach to create environments for people and communities that are conducive to limiting the consumption and production of unhealthy foods.
“We need the European Commission and national governments to act now on initiatives to change the way in which we buy and consume food. Our aim should be to achieve a European-wide transformation to healthy diets by 2050. This would require consumption of fruits, vegetables, nuts and legumes to double, and consumption of foods such as red meat and sugar to be reduced by more than 50% over the next 30 years.”
MEP Sarah Wiener, Member of the Committee on the Environment, Public Health and Food Safety, comments, “Encouraging an improved understanding of the association between chronic digestive diseases and poor nutrition amongst members of the public and political stakeholders is crucial in driving positive change for the benefit of citizens. The healthcare and economic burden of treating obesity is too great, so tackling unhealthy nutrition must therefore be an urgent priority, both at an EU and Member State level.”
Read UEG’s position paper on addressing unhealthy dietary patterns through mandatory FOPL
- Nam, S. Y. (2017). Obesity-related digestive diseases and their pathophysiology. Gut and liver,11(3), 323.
- Harmsen H et al. J Ped Gastroenterol Nutr 2000, 30: 61-67
- Stark PL, Lee A. J Med Microbiol 1982, 15(2):189-203
- Valdes, A. M., Walter, J., Segal, E., & Spector, T.D. (2018). Role of the gut microbiota in nutrition and health. Bmj, 361, k2179.
- Nutrition and Chronic Digestive Diseases: An Action Plan for Europe. Ueg.eu. Available at: https://ueg.eu/files/333/310dcbbf4cce62f762a2aaa148d556bd.pdf
United European Gastroenterology