Profiling of vulnerable targets (in connection with SPOKE 5) through: a) analyses of existing data in children affected by obesity and ageing population at risk of malnutrition and non-communicable diseases (NCDs) b) screening of socioeconomic factors, lifestyle and dietary habits, environmental factors, food knowledge, nutritional status, body composition, functional status and disability, quality of life, genetic, metagenetic, phenotypic profiles, exposure to endocrine disruptors chemicals (EDCs), immune system functions in children and aging population with malnutrition c) human-derived biological samples analysis (including samples for the gut microbiome structure analysis and function).

Task 6.2.1.

Identification of sustainable tailored multidimensional approach including nutritional strategies aimed at reducing malnutrition in target specific populations by exploiting the interactions between environment, food, genotype and phenotype: a) analysis of the positive and negative interactions between lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment and diet for the implementation of sustainable dietary patterns; b) malnutrition biomarker validation; c) draft of sustainable nutritional protocols (in connection with Spoke 1 and 4).

Task 6.3.1.

Assessing microbiome–host interaction in malnutrition (in connection with Spoke 4 and 5). a) Evaluation of gut microbiome features in paediatric and ageing subjects affected by malnutrition and malnutrition-related conditions, with a focus on immune and metabolic pathways; b) Investigation of gut microbiome cell wall constituents on immune and metabolic pathways involved in human malnutrition; c) Investigation of the diet, environmental factors and drugs influencing human gut microbiome structure and function; d) Design of an algorithm to predict the risk of gut dysbiosis associated with malnutrition and malnutrition-related diseases.

Task 6.3.2.

Investigation of the preventive and therapeutic action of sustainable personalised nutrition and microbial-derived products on malnutrition-associated gut microbiome alteration and effect on specific targets with malnutrition.

Project deliverables

D6.1.1.1.

Systematic evaluation of existing data on nutritional status and critical issues for target specific groups with malnutrition (M8)

D6.1.1.2.

Identification and mapping of specific target groups with malnutrition (M24)

D6.1.1.3.

Creation of a biobank for biological samples in connection with Spoke 5 (M36)

D6.2.1.1.

Report on lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment, diet, cultural and environmental determinants of malnutrition in target specific populations (M24)

D6.2.1.2.

Evaluation and harmonisation of existing nutritional protocol, dietary guidelines for specific target groups with malnutrition (M10)

D6.2.1.3.

Validated biomarkers and reference ranges for specific target groups with malnutrition (M36)

D6.3.1.1.

Revision of the literature on microbiome and diet (M4)

D6.3.1.2.

Identification of gut microbiome-derived biomarkers facilitating the prediction as well as the early diagnosis and the management of human malnutrition. (M24)

D6.3.1.3.

Definition of the modifiable factors facilitating malnutrition-related gut microbiome alteration (M16)

D6.3.1.4.

Definition of a set of gut microbiome-derived molecules able to tackle gut dysbiosis, modulate immune response and metabolic pathways in specific targets with malnutrition. (M24)

D6.3.1.5.

New algorithm supporting prediction of gut dysbiosis associated with malnutrition and related diseases (M24)

D6.3.2.1.

Profiling of gut bacterial constituents with potential applications as postbiotics aimed at restoring immune system and metabolic functions in vulnerable subjects with malnutrition (M36)

State of the art

Obesity can independently lead to loss of muscle mass and function, due to the negative impact of adipose tissue-dependent metabolic derangements, such as oxidative stress, inflammation, and insulin resistance. Additionally, individuals with obesity have a high prevalence of chronic non-communicable diseases that negatively impact muscle metabolism (both anabolism and catabolism).
On the other hand, sarcopenia may directly facilitate fat accumulation through reduced total energy expenditure, and obesity and sarcopenia may therefore synergistically enhance one another with vicious cycling of fat gains and muscle loss through reduced mobility, dependency and disability.
From a clinical standpoint, SO potentially leads to a cumulative risk derived from the two individual clinical situations.
At the moment profiling of SO subjects considering the etiological factors, the pathophysiological aspects and shared/validated therapeutic approaches are lacking.

Operation plan

Profiling of subjects with sarcopenic obesity (SO) based on ESPEN-EASO criteria: socioeconomic factors, lifestyle and dietary habits, food knowledge, nutritional status, body composition, functional status, quality of life.
Identification of tailored multidimensional approach a) malnutrition biomarker validation; c) draft of sustainable nutritional protocols.
Comparative evaluation of gut microbiome features in SO considering diet, environmental factors and drugs. Design of an algorithm able to predict the risk of gut dysbiosis associated with SO .
Investigation of the preventive and therapeutic action of sustainable personalized nutritional intervention together with physical activity protocol on SO-associated clinical and functional characteristics including gut microbiome alteration.
Prototyping, preclinical and clinical evaluation of functional foods/nutrients aimed at preventing and treating SO.

Expected results

Due to the high prevalence of SO and the important clinical and functional that characterizes SO, a better understanding of pathophysiological and socio-cultural determinants is of the outmost importance.
A special focus will be put on microbiota/oma.
These first information will allow a better identification of subjects with SO and the assessment of effective intervention protocols.
These latter will consider prototyping preclinical and clinical evaluation of functional foods, food supplements, ingredients and nutraceuticals aimed at preventing and treating SO.