1. New concepts for the evaluation of food supplements By Derek Shrimpton Scientific Adviser to the EHPM

2. Current methods of evaluation: an enigma? Micronutrient food supplements are widely recognised as safe and beneficial Neither have been proven by conventional epidemiology – i.e. human clinical trials that are double blind, large scale and long term

3. Supplementation, health and life Current nutritional advances indicate the significance of nutrition in early life to secure health in later life. e.g. vitamin D and multiple sclerosis, Ramagopalan S V et.al., PLoS Genetics, February 6, 2009

4. Conventional proof of efficacy and safety Human trials “Healthy” subjects Free living Large scale (‘000’s) Randomised for allelic variation (in the MHC class 11 region for MS) Long term – at least 4 decades Double blind. Could this be envisaged? Who would be able to undertake it?

5. Need for a New Approach Working hypothesis: Convergence Of Conclusions from a Multidisciplinary Approach COCoMA

6. Potentially relevant disciplines Biochemistry Physiology Epidemiology Genetics Sociology – lifestyle, socio-economic

7. Emerging disciplines The border regions between disciplines could lead to new levels of understanding e.g. nutrition and genetics - Nutrigenics nutrition, genetics, economics. - Nutrigenomics

8. Optimal Health The goal What is it? How is it defined? Could COCoMA be used to give it meaning and even define it?

9. Strategies for Optimal Health Are different strategies required for different: socio-economic groups metabolic groups physiological groups genetic groups

10. A Prospect for the Future Using the tool of COCoMA to: recognize the opportunity in relation to nutrigenomics to achieve “optimal health” for individuals with the associated need to provide comprehensive product information particularly in respect of realistic expectations currently called “Health Claims”