Health professionals around the world are facing a profound crisis: despite advancements in pharmacology and tremendous personal and financial efforts in health care systems, chronic, so called non-communicable diseases (NCDs) cannot be treated adequately 1)Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, and Diabetes Prevention Program Research Group. (2002): Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” The New England Journal of Medicine 346,6:393–403.. More than 50% of all Disability-Adjusted Life Years (DALYs), expressing the number of years lost due to ill-health, disability and early death 2)Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, et al. (2012): Disability-Adjusted Life Years (DALYs) for 291 Diseases and Injuries in 21 Regions, 1990–2010: A Systematic Analysis for the Global Burden of Disease Study 2010. The Lancet 380,9859: 2197–2223. and almost 70% of the 55 million deaths per year globally 3)Benziger CP, Roth GA, Moran AE. (2016): The Global Burden of Disease Study and the Preventable Burden of NCD. Global Heart 11,4: 393–97. can be attributed to NCDs.

Health Professional with Mask

Cardiovascular diseases, diabetes, obesity and cancer are undiminished and on the rise: in the last three decades, deaths from cardiovascular diseases alone have risen over 40% 4)Roth, GA, Forouzanfar MH, Moran AE, Barber R, Nguyen G, Feigin VL, Naghavi M, Mensah GA, Murray CJL. (2015): Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality. New England Journal of Medicine 372,14: 1333–41., while deaths related to diabetes have increased by a staggering 93% 5)Lozano, Rafael, Mohsen Naghavi, Kyle Foreman, Stephen Lim, Kenji Shibuya, Victor Aboyans, Jerry Abraham, et al. (2012): Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study 2010.” The Lancet 380,9859: 2095–2128..

In addition to the deteriorating effect that NCDs have on people’s lives, they are also a major economic concern. By the year 2040, it is estimated that global spending on health will increase from US $9 trillion to $24 trillion per year 6)Dieleman, JL, Campbell M, Chapin A, Eldrenkamp E, Fan VY, Haakenstad A, Kates J, et al. (2017): “Future and Potential Spending on Health 2015–40: Development Assistance for Health, and Government, Prepaid Private, and out-of-Pocket Health Spending in 184 Countries.” The Lancet 389,10083;2005–30., with up to half of this spending due to NCDs 7)Garg CC, Evans DB (2011): What is the impact on non-communicable diseases on national health expenditures: a synthesis of available data. Discussion Paper No 3, World Health Organisation, Geneva..

A Longer Life in Good Health

While NCDs are on the rise worldwide, there are populations that are an exception to these frightening dynamics.

Populations in the so-called blue zones live healthier and longer than average, showing an exceptionally high number of healthy and active people above the age of 90.

The five blue zones are located in Sardinia (Italy), Okinawa (Japan), Loma Linda (California, USA), Nicoya Peninsula (Costa Rica), and Icaria (Greece). Despite their various geographical distribution, the blue zones’ populations share similar lifestyle habits 8)Buettner, D. (2009) The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest (First Paperback ed.). Washington, D.C.: National Geographic. p. vii. ISBN 978-1-4262-0400-5. OCLC 246886564.. One of the most influential habits they share is what they eat.

The traditional diets are essentially whole food, plant-based, centered around lots of fruits, vegetables, legumes, whole grains, and potatoes or other starchy vegetables. Many spices and herbs are used as well, for example turmeric, ginger, and mugwort in Okinawa. Meat is consumed very sparingly, e.g. as a celebratory food or a small side dish once or twice a week. This pattern creates a diet generally low in caloric density, fat, and sodium with relatively few proteins and rich in micronutrients, phytochemicals, and complex carbohydrates.

But can nutrition really be the main reason for the exceptional health and longevity in the blue zones?

Your Food Builds and Fuels You

Every bodily function depends on the adequate intake of the right substrate, i.e. nutrients, and the metabolism, i.e. the correct processing of the substrate. Proteins, for example, serve as structural elements and constituents of enzymes, the engine of our metabolism. Carbohydrates are primarily used for processes that require energy, and fatty acids fulfill both functions and are, for example, also needed for cell communication. But it’s not only energy that comes from our food; it also supplies us with essential substances like vitamins and minerals that function as cofactors for our metabolism to work properly.

Taking all of this into consideration, one can easily imagine how the amount and the composition of our food that we consume can influence our development and our bodily functions in a powerful way. The excess or the lack of one or more specific kinds of substrates an individual needs might lead to symptoms of deficiency, to an accelerated decline (i.e. aging) or to one of the many non-communicable diseases.

Your Food Influences Your Genes

But food and its components are far more than a mere substrate for our hardware and energy supply. Studies show that diet also has an impact on our genes, even beyond generations.

This is called epigenetics – heritable changes in gene expression due to environment and lifestyle, which are not accompanied by alterations in DNA sequence itself. Various studies in humans, animals, and cell cultures have demonstrated that food nutrients regulate gene expression. The influence is quite enormous and even starts in the fetus. The nutrition of the mother determines not only the development of the fetus, but also its health outcomes in later life, such as obesity, insulin resistance, type 2 diabetes, and even food preferences 9)Lumey, L. H., et al. (2007b). “The Dutch Famine of 1944-1945 as a Human Laboratory: Changes in the Early Life Environment and Adult Health.” Int J Early Life Nutrition and Adult Health and Development 3: 1196-1204.. Methylation of the insulin-like growth factor 2 (IGF2) gene is a modulator of a newborn’s fetal growth and development, and it could be seen that poor diet during pregnancy leads to less methylation of the IGF2 gene 10)Roseboom, T. J., et al. (2011). “Hungry in the womb: what are the consequences? Lessons from the Dutch famine.” Maturitas 70(2): 141-145.. In contrast, a calorie dense maternal diet leads to obesity and epigenetically alters fetal chromatin structure in primates via covalent modifications of histones, which allow for heritable gene regulation without altering the nucleotide sequence 11)Aagaard-Tillery KM, Grove K, Bishop J, Ke X, Fu Q, McKnight R, Lane RH. (2008): Developmental origins of disease and determinants of chromatin structure: maternal diet modifies the primate fetal epigenome. J Mol Endocrinol. 41(2):91-102.. Similarly, maternal obesity during pregnancy increases the risk of obesity in the offspring of mice via altered methylation and gene expression of dopamine and opioid-related genes, and thus increases preferences for foods high in fat and sugar 12)Vucetic Z, Kimmel J, Totoki K, Hollenbeck E, Reyes TM. (2010): Maternal high-fat diet alters methylation and gene expression of dopamine and opioid-related genes. Endocrinology. 151(10):4756-64. . Not only does macronutrient intake during pregnancy influence metabolic changes in the human’s adult life, but micronutrients do as well. A deficiency in vitamin B12 and folate concentrations during pregnancy were found to lead to insulin resistance in the offspring 13)Yajnik CS, Deshpande SS, Jackson AA, et al. (2008): Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: the Pune Maternal Nutrition Study. Diabetologia. 51(1):29-38. . Another clinical study could show that the underlying mechanism of periconceptional folic acid use is associated with epigenetic changes in the IGF2 gene in the child that may affect intrauterine programming of growth and development, influencing health and disease throughout life14)Tserga A, Binder AM, Michels KB. Impact of folic acid intake during pregnancy on genomic imprinting of IGF2/H19 and 1-carbon metabolism. FASEB J. 2017;31(12):5149-5158. doi:10.1096/fj.201601214RR.

Kid with Raspberries

Your Food Choices Matter

While we do not have an influence on our mother’s diet, the good news is that we seem to be able to induce epigenetic changes ourselves. Various studies in humans, animals, and cell cultures have demonstrated that macronutrients, e.g. fatty acids, micronutrients such as vitamins, and secondary plant compounds (such as flavonoids, carotenoids, coumarins, and phytosterols) naturally occurring in foods, are directly involved in metabolic reactions and even regulate gene expression. Some of the biochemicals in foods, such as genistein found in soy or sulforaphane, an isothiocyanate produced by cruciferous vegetables such as broccoli, are ligands for transcription factors and thus directly alter gene expression and influence pathways within the cell cycle. They were found to regulate the expression and activity of important enzymes activating and silencing specific genes which are, for example,. involved in aging and cancer formation 15)Sundaram, Madhumitha Kedhari; Ansari, Mohammad Zeeshan; Al Mutery, Abdullah; Ashraf, Maryam; Nasab, Reem; Rai, Sheethal et al. (2018): Genistein Induces Alterations of Epigenetic Modulatory Signatures in Human Cervical Cancer Cells. In: Anti-cancer agents in medicinal chemistry 18 (3), S. 412–421. DOI: 10.2174/187152061766617091814211416)Fernandes, Guilherme Felipe Santos; Silva, Gabriel Dalio Bernardes; Pavan, Aline Renata; Chiba, Diego Eidy; Chin, Chung Man; Dos Santos, Jean Leandro (2017): Epigenetic Regulatory Mechanisms Induced by Resveratrol. In: Nutrients 9 (11). DOI: 10.3390/nu9111201.17)Ali Khan, Munawwar; Kedhari Sundaram, Madhumitha; Hamza, Amina; Quraishi, Uzma; Gunasekera, Dian; Ramesh, Laveena et al. (2015): Sulforaphane Reverses the Expression of Various Tumor Suppressor Genes by Targeting DNMT3B and HDAC1 in Human Cervical Cancer Cells. In: Evidence-based complementary and alternative medicine : eCAM 2015, S. 412149. DOI: 10.1155/2015/412149..

It’s Not Only About Your Genes

Nutrition not only influences OUR genes, but it also has an impact on the occurrence and genes of the trillions of microbes inhabiting our body, especially our gut. These microbes influence our metabolism, our immune system, and our brain function, and also have an impact on our genes. Interestingly, the gut microbiota in patients with certain diseases, such as Alzheimer’s, depression, diabetes, rheumatoid arthritis and inflammatory bowel diseases, has been found to differ from healthy controls18)Wang B, Yao M, Lv L, Ling Z, Li L. The Human Microbiota in Health and Disease. Engineering. 2017;3(1):71-82. doi:10.1016/J.ENG.2017.01.008. It was found that we can influence the composition of our gut microbes through diet. A diet low in plant derived fiber and high in animal products leads to a reduction in microbes that produce short chain fatty acids (SFCA), and these changes have been suspected as one of the triggers for inflammatory diseases 19)Cresci, Gail A.; Bawden, Emmy (2015): Gut Microbiome. What We Do and Don’t Know. In: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition 30 (6), S. 734–746. DOI: 10.1177/0884533615609899.. In contrast, eating more fiber-rich plant foods increases those bacteria responsible for forming short-chain fatty acids from those fibers. SCFA in turn affect lipid, glucose, and cholesterol metabolism and serve as an energy substrate for the brain and the gut mucosa cells. This way they keep the gut wall healthy and build the link in the brain/gut axis as they can pass the blood-brain barrier. Also, it was shown that the SCFA butyrate can protect the brain and enhance plasticity in neurological disease models 20)Bourassa MW1, Alim I1, Bultman SJ2, Ratan RR3, Butyrate, neuroepigenetics and the gut microbiome: Can a high fiber diet improve brain health?, Neurosci Lett. 2016 Jun 20;625:56-63. doi: 10.1016/j.neulet.2016.02.009. Epub 2016 Feb 8..

So feeding ourselves and our gut microbes the right foods has a great potential to beneficially influence our health.

Looking at these powerful effects of food on our metabolism, our genes and our microbiome,– can we translate them to a certain diet? Let us have a look at the epidemiological and clinical data existing so far.

Epidemiological Evidence

A diet that has been the focus of research regarding overall health over the last decades is the Mediterranean diet, which is high in fruits, vegetables, whole grains, legumes and nuts, includes some olive oil, fish and very little meat. The data from prospective studies showed that adherence to the Mediterranean diet was associated with 23% reduced risk of developing type 2 diabetes 21)Koloverou E, Esposito K, Giugliano D, Panagiotakos D (2014): The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. Metabolism. 2014 Jul;63(7):903-11., more than 50% lower cardiovascular risk 22)Martínez-González MA, García-López M, Bes-Rastrollo M, Toledo E, Martínez-Lapiscina EH, Delgado-Rodriguez M, Vazquez Z, Benito S, Beunza JJ. (2011): Mediterranean diet and the incidence of cardiovascular disease: a Spanish cohort. Nutr Metab Cardiovasc Dis. 21(4):237-44., and almost 50% reduction in the risk of all-cause mortality 23)Zazpe I, Sánchez-Tainta A, Toledo E, Sánchez-Villegas A, Martínez-González MÁ. (2014): Dietary patterns and total mortality in a Mediterranean cohort: the SUN project. J Acad Nutr Diet. 114(1):37-47. and a potential protective role with regard to the prevention of depressive disorders 24)Sánchez-Villegas A, Delgado-Rodríguez M, Alonso A, Schlatter J, Lahortiga F, Serra Majem L, Martínez-González MA. (2009): Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry. 66(10):1090-8.. Interestingly, within the Mediterranean population, a high fruit and vegetable intake was inversely associated with BP levels despite a high intake in fat 25)Alonso A, de la Fuente C, Martín-Arnau AM, de Irala J, Martínez JA, Martínez-González MA. (2004): Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study. Br J Nutr. 92(2):311-9..

Another dietary pattern that promotes the consumption of fruits, vegetables, legumes, whole grains and nuts, containing some low-fat dairy products, poultry and fish, while attempting to reduce the intakes of red meat, sweets, sugar-containing beverages, total fat, saturated fat and cholesterol, is the DASH diet. In a prospective study, evidence for the cardioprotective effects of the DASH diet was found: accordance to a DASH resulted in a 20% lower risk of stroke, a 13% lower risk of total incident CVD, and CVD-related mortality also showed strong inverse associations with DASH accordance in a UK context 26)Jones NRV, Forouhi NG, Khaw KT, Wareham NJ, Monsivais P. (2018): Accordance to the Dietary Approaches to Stop Hypertension diet pattern and cardiovascular disease in a British, population-based cohort. Eur J Epidemiol. Feb;33(2):235-244..

So obviously plant foods seem to play a big role when it comes to health and prevention. This was underpinned by further observations from large cohorts, such as within the Nurse Health Study and the EPIC Oxford Study or Adventist Health Study, which gave insights into different diet forms that people were following, as well as certain foods and their correlation with specific diseases.

It was found that lacto-ovo vegetarians and vegans had lower total and LDL cholesterol levels ​​27)Thorogood M, Carter R, Benfield L, McPherson K, Mann JI. Plasma lipids and lipoprotein cholesterol concentrations in people with different diets in Britain. Br Med J (Clin Res Ed). 1987 295(6594):351-3., lower blood pressure 28)Orlich MJ, Fraser GE. (2014): Vegetarian diets in the Adventist Health Study 2: a review of initial published findings ; Am J Clin Nutr. 100(1): 353S–358S29)Pettersen, B.J., Anousheh, R., Fan, J., Jaceldo-Siegl, K., and Fraser, G.E. (2012). Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr 15, 1909– 1916., and a reduced mortality rate for cardiovascular disease when compared to people who ate meat 30)Fraser, G.E., and Shavlik, D.J. (2001). Ten years of life: Is it a matter of choice? Arch. Intern. Med. 161, 1645–1652.31)Orlich, M.J., Singh, P.N., Sabaté, J., Jaceldo-Siegl, K., Fan, J., Knutsen, S., Beeson, W.L., and Fraser, G.E. (2013). Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Intern Med 173, 1230–1238..

Vegans and vegetarians also had a significantly reduced risk (12-15%) of all-cause mortality 32)Orlich MJ, Fraser GE. (2014): Vegetarian diets in the Adventist Health Study 2: a review of initial published findings ; Am J Clin Nutr. 100(1): 353S–358S, approximately 16%-19% lower cancer risk 33)Key TJ, Appleby PN, Spencer EA, Travis RC, Roddam AW, Allen NE. Cancer Incidence in Vegetarians: results from the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr. 2009;*89*(suppl):1S–7S. 2009 May;89(5):1620S-1626S.34)Tantamango-Bartley, Y., Jaceldo-Siegl, K., Fan, J., and Fraser, G. (2013). Vegetarian diets and the incidence of cancer in a low-risk population. Cancer Epidemiol. Biomarkers Prev. 22, 286–294., and a 60% reduction in the risk of type 2 diabetes mellitus 35)Orlich MJ, Fraser GE. (2014): Vegetarian diets in the Adventist Health Study 2: a review of initial published findings ; Am J Clin Nutr. 100(1): 353S–358S36)Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R.P., and Fraser, G.E. (2013). Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis 23, 292–299. than non-vegetarians.

When the researchers looked into specific foods, it could be seen that meat and cheese consumption were positively associated, and fiber intake was inversely proportional to the total cholesterol concentration in both men and women 37)Appleby PN, Thorogood M, McPherson K, Mann JI. (1995): Associations between plasma lipid concentrations and dietary, lifestyle and physical factors in the Oxford Vegetarian Study. J Hum Nutr Diet. 8(5):305–14.. Specifically, nuts and whole grains seem to reduce the risk of cardiovascular diseases, while refined carbohydrates and trans-fat increased the risk. Also, a higher intake in vegetables, especially green leafy vegetables, reduced the risk of coronary artery disease and cognitive impairment 38)Kang JH, Ascherio A, Grodstein F. (2005): Fruit and vegetable consumption and cognitive decline in aging women. Nurses Health Ann Neurol. 2005 May;57(5):713-20.39)Campbell TC1, Parpia B, Chen J., Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study, Am J Cardiol. 1998 Nov 26;82(10B):18T-21T..

Infusion Stand

Clinical Evidence

Of the many study designs, the gold standard level of proofing treatments and therapies are Randomized Controlled Trials (RCTs). So let us have a look and see if diet can pass this test too.

In fact, recent clinical studies confirm the power of nutrition in the context of disease: In a RCT, adherence to a Mediterranean diet was associated with the methylation of the genes related to inflammation, which seems to be related to the diet’s favourable effects on cardiovascular risk, blood pressure, inflammation, and other complications related to excessive adiposity 40)Arpón A, Riezu-Boj JI, Milagro FI, Marti A, Razquin C, Martínez-González MA, Corella D, Estruch R, Casas R, Fitó M, Ros E, Salas-Salvadó J, Martínez JA. (2016): Adherence to Mediterranean diet is associated with methylation changes in inflammation-related genes in peripheral blood cells. J Physiol Biochem. 73(3):445-455.. Several clinical studies on the DASH diet showed that adherence also improved cardiovascular risk factors and appeared to have greater beneficial effects in subjects with an increased cardiometabolic risk 41)Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC. (2015): Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr. 14;113(1):1-15..

But is it the reduction of meat or the increase in plant fiber that is responsible for the beneficial effects?

It might be both: In randomized controlled trials, substituting animal protein with plant protein decreased LDL cholesterol and apolipoprotein B 42)Li SS, Blanco Mejia S, Lytvyn L, Stewart SE, Viguiliouk E, Ha V, de Souza RJ, Leiter LA, Kendall CWC, Jenkins DJA, Sievenpiper JL. (2017): Effect of Plant Protein on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 20;6(12). pii: e006659.. And the same was seen for fiber. While it plays an important role for our gut bacteria, it also influences blood lipids, and the polysaccharide β-glucan, found in barley and oats had a significant effect on LDL and total Cholesterol 43)Ho HV, Sievenpiper JL, Zurbau A, Blanco Mejia S, Jovanovski E, Au-Yeung F, Jenkins AL, Vuksan V. (2016): A systematic review and meta-analysis of randomized controlled trials of the effect of barley β-glucan on LDL-C, non-HDL-C and apoB for cardiovascular disease risk reduction. Eur J Clin Nutr. 70(11):1239-1245. 44)Whitehead A, Beck EJ, Tosh S, Wolever TM. (2014): Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 100(6):1413-21..

Looking at other non-communicable diseases like obesity, diabetes, and rheumatoid arthritis, specifically plant-based diets showed a great therapeutic potential. A low-fat vegan diet improved β-cell function and insulin resistance within 16 weeks 45)Kahleova H, Tura A, Hill M, Holubkov R, Barnard ND. (2018):  A Plant-Based Dietary Intervention Improves Beta-Cell Function and Insulin Resistance in Overweight Adults: A 16-Week Randomized Clinical Trial. Nutrients. 9;10(2). . Also, body weight could be significantly reduced in obese subjects through a plant-based diet intervention 46)Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard ND. (2013): A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr. 67(7):718-24., even when there was no caloric restriction 47)Wright N, Wilson L, Smith M, Duncan B, McHugh P. (2017): The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes.  20;7(3):e256.. Patients with rheumatoid arthritis, who fasted initially for 7-10 days and were then put first on a vegan and then a vegetarian diet, improved their symptoms significantly in comparison to a control group 48)Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Laerum E, Eek M, Mowinkel P, Hovi K, Førre O. (1991): Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis.Lancet. 12;338(8772):899-902..

Conclusion

Considering that only a few lifestyle risk factors account for up to 80% 49)McGinnis JM1, Foege WH., Actual causes of death in the United States, JAMA. 1993 Nov 10;270(18):2207-12. of premature death, each of us has the power to take care of our health. More specifically: Nutrition has the potential to prevent and reverse many of the most pressing health issues of our time as the major risk factor for life quality and life years lost is poor diet 50)Forouzanfar MH, Alexander L, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287-323..

Food’s different mechanisms of impact on our metabolism, our genes, and our microbiome, as well as epidemiological and clinical evidence, are pointing heavily in the same direction. The more whole plant foods a diet includes, the better people’s health, and the lower the chances for chronic disease.

By using this power of nutrition as health professionals in prevention and therapy, we increase the likelihood of truly restoring health and stopping our crisis of chronic diseases.

Together we can empower our patients, save and improve their lives and those of their families. We can reduce health care costs significantly to redirect financial resources towards medical fields, where those resources are needed badly. Last but not least, we can reduce the tremendous pressure that we know health professionals have and create a more satisfying environment for both patients and ourselves.

This is the introductory article of our series “The Power of Nutrition”. Please find all related articles here:
Part #1: The Power of Nutrition
Part #2: The Global Burden of Non-Communicable Diseases
Part #3: The Blue Zones
Part #4: Epigenetics
Part #5: The Human Microbiome
Part #6: How Does Nutrition Work?
 

Niklas Oppenrieder

Niklas Oppenrieder

Niklas Oppenrieder is a physician specializing in pediatrics at Aschaffenburg Hospital in Germany. As PAN’s Medical Director, he heads the development of the organization, applying his medical and scientific expertise as a pediatrician as well as his first-hand technical knowledge as a member of several different medical associations.
Niklas Oppenrieder

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