Clinical Metabolomics and Nutrition: The New Frontier in Neonatology and Pediatrics

Abstract

In the pediatric clinic, nutritional research is focusing more and more on preventing the development of long-term diseases as well as supporting the repair processes important in the therapy of already fully developed diseases. Most children who are hospitalized or affected by chronic diseases could benefit from specific and careful attention to nutrition. Indeed, the state of nutrition modulates all body functions, including the different metabolic processes which, all together, have a profound effect on the development of the health and future of all individuals. Inappropriate food, even in the first periods of life, can accelerate the development of chronic metabolic diseases, especially in the pediatric age. To gain further insights into metabolic cycles and how they are connected with diet and health, nutrition and metabolomics interact to develop and apply modern technologies for metabolic assessment. In particular, nutritionists are evaluating the metabolomic approach to establish the single nutritional phenotypes, that is, the way in which diet interacts with individuals' metabolisms. This strategy offers the possibility of providing a complete definition of the individual's nutritional and health status, predict the risk of disease, and create metabolomic databases supporting the development of “personalized nutrition,” in which diet is attuned to the nutritional needs of individual patients.

Metabolômica: Definições, Estado-Da-Arte E Aplicações Representativas

“…156 A aplicação dessas novas áreas pode ser comprovada pela extensa compilação de trabalhos encontrados na literatura. [157][158][159][160][161][162] A nutrimetabolômica, que se refere à aplicação da metabolômica na área de nutrição, permite a caracterização de fenótipos individuais, por meio da medida de centenas ou milhares de metabólitos, após a exposição a uma dieta específica, por exemplo. De um modo geral, a nutrimetabolômica está focada na descoberta de biomarcadores por meio da avaliação do efeito de uma dieta, 163 estudos de intervenção de dieta em uma rota metabólica, 164,165 e estudo da relação dieta-doença 157 ou, mais recentemente, na busca de uma dieta personalizada.…”

Nutrition recommendations and science: next parallel steps

“…The individual responses to a given food and nutrient composition are mainly dependent on three components, as shown in Fig. : human genome, metabolome and gut microbiome . The knowledge on these has been evolving from the 1990s (genome), 2000s (metabolome) and 2010s (microbiome).…”

“…The metabolome (or metabolic profile) is the composition of low‐molecular‐weight metabolites . Metabolic analyses can be divided into targeted (predefined metabolite groups; hypothesis‐driven) or untargeted (identifying a metabolic ‘fingerprint’ or profile).…”

Metabolomics toward personalized medicine

“…Few laboratories in the world have adopted a comprehensive clinical metabolomics based approach in the evaluation of patients suspected of having a metabolic or multifactorial disease. Nutritionists and‐dietitians are re‐exploring metabolomics to identify novel ways to treat and prevent nutrition related diseases such as obesity, diabetes, and some inborn errors of metabolism (IEM) . Therefore, there is a strong need for a comprehensive metabolomic database that encompasses many physiological health and disease states identified in a large cohort of well‐phenotyped individuals …”

“…Nutritionists and-dietitians are re-exploring metabolomics to identify novel ways to treat and prevent nutrition related diseases such as obesity, diabetes, and some inborn errors of metabolism (IEM). 15,16 Therefore, there is a strong need for a comprehensive metabolomic database that encompasses many physiological health and disease states identified in a large cohort of well-phenotyped individuals. 17,18 FIGURE 1 Bibliographic search in PubMed containing the keyword metabolomics (as of November 2016).…”