Nutritional Genomics & Functional Foods Vol. 1, No. 1, pp. xx-xx, 2003
ISSN 1542-1821 print, Copyright © 2003 by New Century Health Publishers, LLC
All rights of reproduction in any form reserved
Printed in the USA by Hauser Printing
NEW ZEALAND - FERTILE GROUND FOR FUNCTIONAL FOODS AND
Lynnette R. Ferguson* and Martin Philpott
The University of Auckland, Auckland, New Zealand
[Received: April 30, 2003; Accepted: May 22, 2003]
ABSTRACT: Nutrition-related disorders including cardio-
ular biology and genomics, in order to study the interplay
vascular disease, diabetes and various cancers rank highly
between diet and the activity of an individual’s genes. Such
among the causes of death and disability in New Zealand,
ideals are moving into the commercial field. For example, the
with significant differences between racial groups in dis-
California-based company NutraGenomics, Inc.
ease susceptibility. While the bulk of the population are
(http://www.nutragenomics.com) advertise a customized
Caucasians, a significant proportion are of Polynesian ori-
workshop on nutritional genomics, which they base on 5
gins, including both Maori and Pacific Island groups, with
tenets, as follows:
an increasing Asian immigrant population. Maori have
• Improper diets are risk factors for disease
significantly lower colon cancer and significantly higher
• Dietary chemicals alter gene expression and/or change
stomach, breast, lung and pancreatic cancers in compari-
son with the rest of the population. Both diabetes and car-
• The influence of diet on health and disease susceptibil-
diovascular disease develop at an earlier age in both
ity depends upon an individual’s genetic makeup
Polynesian and Asian groups as compared with those of
• Genes regulated by diet play a role in chronic diseases
Caucasian origin. Thus, dietary manipulation has the
• Intelligent nutrition – that is, diets based upon genet-
potential to significantly affect health and disease-related
ics, nutritional requirements and status – prevents and
outcomes in the different racial groups of New Zealand.
mitigates chronic diseases.
However, major dietary changes within the population are
Whereas health and wellbeing are only one group of drivers
difficult to implement. Functional foods offer the solution
in the functional food industry, they become of major impor-
of modifying the nutritive properties of foods that people
tance in nutrigenomic studies, which focus on optimisation of
already consume. New Zealand’s high incidence of diet-
a health outcome and avoidance of disease. The rationale for
related diseases makes it an ideal testing ground for new
this approach is the recognition that health outcomes are not
developments in functional foods. The key to these devel-
only a function of either diet or genetics, but a complex inter-
opments is nutrigenomics, which offers approaches power-
play between them. Understanding can lead to the rational
ful enough to explore the complex interactions between
development of functional foods to target key medical issues
nutrients and biological systems, allowing the rational
such as cardiovascular disease, cancer and diabetes, or debili-
design of functional foods.
tating disorders such as osteoporosis or arthritis. We suggest
that the population mix, disease susceptibility and regulatory
KEY WORDS: : Cancer, Cardiovascular Disease, Diabetes,
environment make New Zealand an outstanding testing
Functional foods, Nutrigenomics
ground for such products.
DIET AND DIET-RELATED DISEASES IN NEW
Corresponding JDr. Lynnette R. Ferguson, Discipline of
Nutrition/ACSRC, The University of Auckland, Private Bag 92019,
A largely unpolluted environment, abundance of fresh food
Auckland, New Zealand; Fax: +64 9 373 7502; E-mail: l.fergu-
and agricultural-based economy in New Zealand has tradi-
tionally been assumed to provide the population with a
healthy lifestyle and diet. However, an analysis of New
Zealand food supply and consumption patterns in compari-
The relationship between diet and disease is well estab-
son with other OECD countries (Laugesen and Swinburn,
lished. The Human Genome Project provided the promise of
2000) suggests preferential eating patterns that coincide with
recognizing the genetic uniqueness of individuals, and its new
high risks of diet-related diseases. For example, these authors
challenge is to understand the nature of individual’s interac-
calculated that on 1995 figures, the high per capita consump-
tions with their environment, especially diet. The emerging
tion of butter and meat fats led to the New Zealand food sup-
field of nutrigenomics integrates concepts of nutrition, molec-
ply being ranked highest for thrombogenicity and third for
Plant estrogens, vascular reactivity, and age
atherogenicity among OECD countries. The high fat con-
that of the colon and prostate are higher (Tukuitonga et al.,
sumption makes the population susceptible to obesity, with
1992; Ferguson, 2002). Both diabetes and cardiovascular dis-
consequent increases in the risk of cancer and diabetes
ease develop at an earlier age and may be more severe in
(Hursting and Kari, 1999). While food preferences are slow
Polynesian groups as compared with those of Caucasian ori-
to shift, consumers have responded to health messages with
gin. For example, Simmons et al., 1996 surveyed residents
increases in fruit consumption, vegetable consumption and
from two districts of South Auckland, New Zealand, with a
fibre intake between 1961 and 1995, and changes in the fatty
high proportion of Maori and Pacific Islands people, as well as
acid profile of the diet (Laugeson and Swinburn, 2000).
interviewing patients with known diabetes. Their study
Cardiovascular disease includes all diseases of the circulato-
revealed significant ethnic differences in diabetes and its care,
ry system including acute myocardial infarction, ischemic
at least in South Auckland. Maori and Pacific Islands patients
heart disease, valvular heart disease, peripheral vascular dis-
were younger than Europeans at diagnosis, had a higher
ease, arrhythmias, high blood pressure and stroke. Although
chance of having had their diabetes diagnosed in pregnancy,
the incidence of deaths from this class of diseases has been
were less likely to be receiving antihypertensive or insulin
dropping somewhat over recent years (Capewell et al., 2000),
therapy, were more likely to be blind, and were more likely to
nevertheless it represented approximately 40% of all deaths
have received retinal photocoagulation.
between 1996-1997, and was the leading chronic disease
There also seems to be significant differences among sus-
cause of hospitalisation in New Zealand (New Zealand
ceptibilities to disease in different population members, inde-
Ministry of Health, in press). At an international level, it is
pendent of race. Metcalf et al., 1999 considered levels of
also a major cause of death and disability (Murray and Lopes,
modifiable risk factors of coronary heart disease (CHD) sur-
1997). Cancer leads to around 25% of all attributable deaths
vivors in a middle-aged New Zealand workforce. Their cross-
in New Zealand (New Zealand Ministry of Health, 1999).
sectional survey of 5,656 workers aged ?40 included 73 indi-
Obesity and diabetes are also very serious problems, and may
viduals with a history of hospitalisation for CHD. Compared
enhance the probability of complications or of fatality from
with those not showing evidence of disease, the CHD sur-
other diseases. Arthritis and depression are also at high levels
vivors reported higher total carbohydrate, dietary fibre,
in New Zealand, and both may be affected by diet.
polyunsaturated fat intakes and ratio of polyunsaturated to
saturated fat intakes. Total fat, saturated fat and monounsat-
POPULATION GROUPS AND FACTORS AFFECTING
urated fat intakes were lower than seen in the control group.
They ate less red meat and less salt, and more fruit and cere-
Maori people, of Polynesian origins, representing around
al, milk and margarine. Despite this group moving to dietary
14% of the population (Statistics New Zealand, 2001), are
measures considered beneficial for CHD, they had higher,
thought to have been in New Zealand for around 1000 years
similarly adjusted, mean serum total cholesterol, triglyceride
(Cambie and Ferguson, 2003). Although there is also a sig-
and lower HDL-cholesterol levels, suggesting that they were
nificant (and increasing) component of Pacific Island people
dyslipidaemic. The authors suggested that high-risk CHD
(7%), as well as Asian immigrants into the country (7%), the
survivors would benefit from more aggressive measures aimed
bulk of the population are Caucasians of European descent.
at correcting their lipid parameters.
There are differences between the groups in dietary intakes
Due to the rapid increase in the Asian population through
and food preferences (New Zealand Ministry of Health,
immigration in recent years, combined with the diverse ethnic
1999). Dietary surveys have generally suggested higher over-
makeup of this broad category (44% Chinese, 26% Indian,
all caloric intakes in the Polynesian groups. A National nutri-
8% Korean, 5% Filipino, 4% Japanese, 3% Sri Lankan, 2%
tion survey conducted in 1997 provided dietary data for
Cambodian, 2% Thai), there is, to date, little data on the eat-
Maori versus non-Maori (New Zealand Europeans and oth-
ing habits and disease susceptibilities of this population with-
ers) groups. In general, the intake of total energy, protein and
in New Zealand. Addressing this current lack of knowledge
fat was higher in men than in women, and higher for Maori
will be important for the development of functional foods in
than for non-Maori groups. The reasons for this may be part-
New Zealand and may have far reaching implications for all
ly economic. Food security is defined as “having enough,
Asian populations, who combined make up 60% of the
appropriate and acceptable food available”. Parnell and co-
workers (2001) found that New Zealand Europeans reported
the most food security, Maori somewhat less, and Pacific peo-
GENETIC FACTORS AND INTERPLAY OF GENO-
ple the least. This reduced food security led to the consump-
TYPE AND DIET
tion of lower cost, higher fat foods. They suggested that not
having enough food may be more prevalent in New Zealand
Well-cooked meats are a major source of the dietary car-
than in the US or Australia.
cinogens known as heterocyclic amines, thought to be risk fac-
The different population groups also have different risks of
tors in colorectal and other cancer types (Snyderwine et al.,
non-communicable disease. For example, cancer of the liver,
2002). The risk of cancer from heterocyclic amines may be
stomach and [possibly] breast appear lower for the European
modulated by host factors such as individual acetylator phe-
groups as compared with those of Polynesian descent, while
notype (Lang et al., 1994; LeMarchand et al., 2002). People
Plant estrogens, vascular reactivity, and age
who have the rapid acetylator phenotype and eat high
independent of birth size. Rush et al., 1997a and b showed
amounts of well-cooked red meats appear at significantly
significant differences between body mass index (BMI) crite-
higher risk of colon cancer than other groups (Lang et al.,
ria for obesity in Europeans as compared with Polynesians,
1994). It has been reported that approximately 93% of New
and also showed that the resting metabolic rate (RMR) was
Zealand Polynesians have a rapid acetylator phenotype, while
significantly lower in Polynesian compared to Caucasian
most groups of European descent tend to have around 40% of
women. They suggested that this lower RMR may predispose
individuals with this phenotype (McQueen, 1987)
Polynesian women to eventual onset of obesity.
Processed meats and N-nitroso compounds have also been
While the dietary association with CVD is clearly impor-
associated with colon cancer risk (Norat and Riboli, 2001).
tant, several genes and variants have been associated with
CYP4502D6 is a polymorphic human enzyme that is
increased CVD risk, including some encoding components of
involved in the activation of some, but not all, nitrosamines
the renin angiotensin system (Katsuya et al., 1995), mutations
(Crespi et al., 1991). Wanwimolruk and co-workers (1992;
in the gene encoding the hepatic low-density lipoprotein LDL
1998) compared genetic polymorphisms of debrisoquine
receptor protein (Jensen, 2002), apolipoprotein E, lipoprotein
(CYP2D6) in Polynesian compared with Caucasian groups
lipase and interleukin-6 (Stephens and Humphries, 2003) and
from New Zealand. The Polynesian groups appeared to
leptin (Shirasaka et al.,2003). There is also a strong genetic
extensively metabolize debrisoquine, and showed a lower inci-
component in diabetes, with at least 20 different chromoso-
dence of the poor metaboliser phenotype than New
mal regions linked to human type 1 diabetes (T1D) (Pociot
Zealanders of European descent. Again, there is likely to be a
and McDermott, 2002) and a sizable number of genes linked
strong interplay between genes and environmental factors in
to susceptibility to type 2 diabetes, including the calpain-10
this food safety issue.
gene (CAPN10) (Cox, 2002), the intestinal fatty acid binding
Stomach cancer is also likely to be susceptible to both
protein (FABP2) (Weiss et al., 2002) and others. Wong et al.
genetic polymorphisms and diet. The incidence of stomach
(2002) suggest that a locus on chromosome 20 q, close to
cancer is high in Polynesian groups, and this has been associ-
D20S32e, may contribute to both insulin secretion and action
ated with higher rates of Helicobacter infection and also a
in 12 members of a large Maori kindred with multiple affect-
unique type of Helicobacter in the Polynesian groups (Falush
ed members with type 2 diabetes. Therefore, cancer, obesity,
et al., 2003). Both the susceptibility to and virulence of
cardiovascular disease and diabetes would appear important
Helicobacter are susceptible to diet (Sivam et al., 1997).
candidates for investigation using nutrigenomic approaches in
Polymorphisms in DNA repair genes appear to be involved
in a range of different cancer types. Goode et al., 2002, con-
cluded that large, well-designed studies of common polymor-
PRIORITIES IN FUNCTIONAL FOOD DEVELOP-
phisms in DNA repair genes are important. These must also
consider relevant exposures to dietary and environmental car-
Functional foods are increasing in popularity worldwide,
cinogens likely to influence the probability of cancer in the
with increasing numbers of consumers seeking foods that they
presence of reduced DNA repair capacity.
perceive will deliver optimum health or better performance.
There is an increasing tendency to view food as medicines,
Obesity, cardiovascular disease and diabetes
and an increased variety of products available. The more
Obesity is a key factor in the development of many cases of
obvious ones provide low energy, fat, salt or cholesterol alter-
cancer, cardiovascular disease and diabetes, and is commonly
natives to regular food products, but some of the more inno-
attributed to lifestyle and dietary factors. However, it is
vative products rely on other properties. In particular, indi-
becoming increasingly recognised that susceptibility to obesi-
vidual consumers diagnosed with a disease or early disease
ty may be at least partially genetically controlled. For exam-
indicators, and who have consequently received specific
ple, Celi and Shuldiner (2002) suggest a central role of perox-
dietary advice, are highly motivated and will pay premiums
isome proliferator-activated receptor gamma (PPAR gamma)
for branded foods with specific health claims. Sloan (2002)
in fat cell biology and in the pathophysiology of obesity, dia-
identified what she considered the ten major functional food
betes, and insulin resistance. Leptin is the product of the ob
trends (table 1). Flavour and cost appear major motivators in
gene, and is a satiety factor secreted mainly in adipose tissue.
food selection, and functional foods may provide a realistic
As such, it is part of a signalling mechanism regulating the
alternative to major dietary changes that are often difficult to
content of body fat (Shirasaka et al.,2003). While genetic and
environmental effects to the individual may be important,
Given New Zealand’s strong background in agricultural and
there is also evidence that obesity may affect gene expression
horticultural research and the recent emphasis by local fund-
during foetal programming (Breier et al., 2001).
ing agencies on innovative foods (Foundation for Research
There is some evidence of racial differences in susceptibili-
Science & Technology, 2003), New Zealand is ideally posi-
ty to obesity in New Zealand. Simmons and Breier (2002)
tioned to be at the forefront of functional food development.
found that the offspring of Polynesian women are relatively
Functional foods already on the market include margarines
hyperleptinemic as compared with European or Asian groups,
with the potential to lower cardiovascular disease, “fibre-
Plant estrogens, vascular reactivity, and age
Table 1: Major classes of functional foods as identified by Sloan, 2002
1. Nutrient and speciality ingredient enhancement
7. Weight, satiety and appetite suppression
• Fibre, iron, antioxidants and B vitamins
• Low fat, low calorie
• Super satiating foods
2. Condition-specific marketing
8. Functional snacks
• Heart, head and joint health
• Moving toward medicine
• Obesity and diabetes
9. Mother nature knows best
3. Lifestyle enhancers
• Fresh whole foods with enhanced nutrients
• Soy-based foods
• Immunity, stress and sleep
• Fish oils and omega 3
• Mental performance and cognition
• Whey protein
4. Sports market crossover (mainstream)
• Pre and probiotics
• Health – active – athlete – hardcore
10. Non-traditional foods
5. Children’s health
• Eye health
• Obesity and diabetes
• Oral health, etc
• Whey protein
6. Gender, age and ethnic positioning
• Women’s and men’s health
• The over 50s
enhanced” breads and yoghurts, and an increasing range of
gets for nutritional intervention and establish suitable bio-
nutrient-enhanced fruits and vegetables. However, despite
markers for monitoring responses. Secondly, the characteri-
their potential health-enriching properties, they may not be
sation of single nucleotide polymorphisms (SNPs) promises
reaching the groups at highest risk of diet-related disease, per-
an understanding of the differences in response of individuals
haps either due to a lack of awareness, or to the difficulty in
to nutrients at the genetic level.
convincing individuals who are yet to manifest acute disease
As the field of nutrigenomics grows, it has been suggested
of the need to change.
that it will eventually be possible for an individual to be
In all these areas, proof of efficacy is becoming increasing-
genetically profiled, identifying foods they should be eating or
ly important (Hasler, 2002) and the regulatory environments
avoiding and which dietary supplements they should be tak-
need to be able to adapt to the developments in functional
ing (Peregrin, 2001). However, as the Western worlds
foods. However, responsiveness in developing appropriate
increasing obesity problem demonstrates, it can be extremely
test methodologies, and a willingness to think innovatively in
difficult to convince an individual to change their diet, even
new areas means that New Zealand could anticipate to be at
when specific causative foods have been identified. Therefore,
the forefront of setting the standards of the future.
the development of functional foods, guided by nutrige-
nomics research, offers a solution whereby people can contin-
ue to consume the foods they recognise and enjoy, which have
Despite the fact that good nutrition has long been recog-
had their nutritional content altered to better meet the needs
nised as perhaps the single most important factor in main-
of various identified subpopulations.
taining wellness, nutrition research has often been accused of
The diverse ethnic mix of the population with differing
lagging behind other fields of medical research (Trayhurn,
diet-related disease susceptibilities, the regulatory environ-
1998). However, nutrition research has embraced the grow-
ment, the strong background in innovative agriculture with a
ing field of genomics, recognising a tool at last powerful
new focus on the development of functional foods and the
enough to explore the complex interactions between nutrients
relative infancy of nutrigenomics combine to place New
and biological systems, spawning the field of nutrigenomics.
Zealand in the forefront of nutrigenomics research.
Nutrigenomics encompasses the understanding of how
nutrients affect health at the molecular level within the body
and how these effects vary between individuals. The key tech-
We thank the Auckland Cancer Society and The University of
nologies underlying nutrigenomics address these two overlap-
Auckland for their financial support.
ping areas. Firstly, genomics, including approaches such as
DNA-arrays and RT-PCR, which examine the interactions
between nutrients and gene expression, and proteomics,
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