Limburg fruit battles diabetes

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21 June 2021

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World-wide, the number of adults with diabetes is estimated by the International Diabetes Federation (IDF) to be 415 million. This number is expected to rise to 642 million by 2040. A healthy lifestyle is essential in preventing (severe) diabetes. Scientific research shows that about 90% of people with type 2 diabetes are overweight or obese.

Mireille Sthijns is Assistant Professor at the Centre for Healthy Eating & Food Innovation, part of Maastricht University. She does research on fruit. Or rather, the contents of fruit. "We are looking for components in fruit that have an effect on glucose metabolism in humans. I am trying to discover the mechanisms behind this: which substances are involved, what do they do and what ensures that precisely this substance has a positive effect on health? If we know these mechanisms then we can help people with type 2 diabetes or pre-diabetes to improve their health, for example by recommending certain fruits that are full of these substances and by developing a new food product based on these substances."


In diabetes, there is too much sugar (glucose) in the blood. Type 2 diabetes is the most common type of diabetes: nine out of ten people with diabetes have this type. With this disease, also known as diabetes or old-age sugar, the body no longer responds properly to the hormone 'insulin'. Normally, insulin allows glucose to go from the blood into the cells, but in type 2 diabetes the body becomes insensitive to the action of insulin. This can be due to obesity or lack of exercise, but hereditary predisposition also plays a role.

The glucose stays in the blood and the blood sugar level rises (insulin resistance). The pancreas starts to produce more insulin to compensate, but this eventually decreases. As a result, blood sugar levels become dysregulated and symptoms such as fatigue and shortness of breath to kidney failure or even blindness develop. Patients often receive nutritional and exercise advice and sometimes have to take medication or inject insulin. Prediabetes is a preliminary stage of type 2 diabetes. In this phase, the body already responds less well to insulin. As a result, the body has more difficulty processing blood sugar. In prediabetes, the blood sugar levels are already slightly higher, but not yet so high that you have diabetes.


Mireille is doing this research together with fellow researcher Associate Professor Freddy Troost, where she focuses on the mechanistic research in the laboratory (in vitro) and he deals with the clinical studies, the research with test subjects (in vivo). The ultimate goal is to develop interventions and innovations in nutrition. "Every fruit has different substances and concentrations. We are looking at the bioactive substances: in which type of fruit are they high and how can we use them? We have now found three substances that we see have a positive effect. Unfortunately I cannot say which substances they are, because commercial products will be made from them in a later phase. I'm mainly concerned with discovering the mechanisms and finding new ways to combat diabetes. If you consider that 1 in 4 of the Dutch people aged 45 years and older is expected to develop type 2 diabetes in the future, then we can really make a contribution to improving human health with this research."


Companies are involved in this research at an early stage. "When we know which substances work, we need to make a food product out of them. We need the companies for this: it is up to them to develop the product. You can think of a drink, bar or gel. But perhaps also a food supplement. All options are interesting, but the preference is for a food product, because a capsule or supplement still has the association with a medicine. Changing a lifestyle is not easy, but a nutritional product for better glucose management can help." But fruit growers themselves are also sorely needed in this research. They are the suppliers of the research topic: the Limburg fruit. There are now two fruit growers involved, but according to Mireille, interested growers can still come forward.

Gut and gut

Within this research, we are also looking at how the substances work when processed. They may work perfectly well in a piece of fruit, but what happens to these substances when you heat or pressurize them, for example? "It is possible that the functionality of the substance then decreases and of course we do not want that. It is also important to know the extent to which these healthy substances are also absorbed by the body: for this we use the gastrointestinal simulator in our laboratory that mimics the human digestive system and cellular systems that simulate absorption from the intestine to the blood."

Clinical trials

The next step is clinical trials, in which the effects of the substances are studied with test subjects. A request for this is before the medical ethics committee. "As soon as we have permission, we will start. Hopefully that will be around the summer. In this twelve-week trial, we want to measure the uptake of one - or more substances - and see if the mechanism we have investigated actually produces an actual effect at the cellular level."


Within the research, there is intensive collaboration between the Netherlands and Belgium. According to Mireille, the parties complement each other well in terms of knowledge and processing of the fruit substances. "Diabetes is a global problem, it doesn't stop at the border. Cooperation is only logical. Brightlabs is an expert in measuring ingredients. At our institute, it's all about the absorption and metabolic effect of content substances in the human body and the psychological and behavioral aspects of food. Hasselt University does a lot of research on the neurological effects of nutrients and Proefcentrum Fruitteelt has a lot of knowledge of cultivation and nutrients in fruit. You really need all these different expertises to achieve a good result."


Within this research, the focus is on the fruit of Limburg. But it is of course not the case that the Limburg apple or pear is a lot healthier than the one from Utrecht or Geldermalsen. "Dutch and Belgian Limburg are strong in growing fruit: from apples, pears, cherries and blueberries to strawberries and raspberries. But fruit growers in the region are having a hard time. The sector is under pressure and sales are declining. With the knowledge from this research, new products can be developed with good health values. This will create new revenue models and markets, with which the Limburg grower can strengthen his position."


In the coming years, Mireille wants to unravel the mechanism even further. "We are making great strides. But developing a whole new food product is no mean feat. I hope that in three years' time we will have a product that can really contribute to the health of people with type 2 diabetes and pre-diabetes and with which we can perhaps even prevent people from contracting this disease."

About the pilot 'Value of Limburg Fruit'

The pilot 'Value of Limburg Fruit' started in 2020. Through this project, Brightlands Campus Greenport Venlo, Maastricht University and Brightlabs BV together with Hasselt University and the Proefcentrum Fruiteelt will put their expertise to work to give the Limburg fruit industry a big boost. The focus is on developing new insights into the content of fruit in Limburg, the effects of cultivation on this and the health value for consumers.

Source: Brightlands Campus Greenport Venlo