Dear Sandra, please tell us about your career, how did you combined your academic and industrial experience?

I am passionate about science and innovation and like to assist our customers by bringing their products to market more efficiently, more sustainably, with benefits based on science, and with a clear story enduring success.

I was born and brought up in Maastricht, a city founded by the Romans in the South of the Netherlands. I feel privileged to come from Maastricht because it is rich in history and of cultural importance. Due to Maastricht’s proximity to several other countries, it differs from the rest of the country and is often said to be the ‘most European’ place in the Netherlands. After spending my youth there, I moved to Amsterdam to study chemistry at the Free University and did my PhD at another university in Amsterdam. As a molecular biologist with expertise in yeast fermentation and DNA modification I obtained my PhD in Biomedicine. Amsterdam is well known for its beautiful canals, quirky architecture, and lively nightlife, but I actually liked living in Amsterdam the most because the people are open-minded and Amsterdam offers plenty of opportunities for students and young professionals to express and develop themselves. In Amsterdam I also met my partner, who studied Biology at the time, and in February 2023 we will be married for 25 years.

Although I started my career as a chemist, I gradually specialized in molecular biology, life science and nutrition. I was lucky to be appointed Assistant Professor so early in my career and soon after became associate professor in Rotterdam. In these two academic hospitals, I was working closely together with Prof Hans Büller, a famous pediatrician, and an intelligent biochemist, Dr Jan Dekker. Together we pioneered with a small team of scientists and doctors doing pediatric research in Amsterdam, and we built a complete and very successful Pediatrics laboratory in Rotterdam. This was an exciting time during which I learned a lot and gained a lot of knowledge in life science, especially gut and immune health, food and pharma. We collaborated with a lot of big pharmaceutical and food companies. These collaborations were very exciting and actually triggered me to switch to the food industry at a certain timepoint to be able to apply the knowledge I had gained over the years in academia.

First, I started working as Nutrition and Health Director at Lipid Nutrition which was at that time part of Loders Croklaan, based near Amsterdam. This was a B2B type of business developing lipid ingredients for the food and supplements markets mainly. With a small R&D team we worked on the development of several different lipid ingredients for health with omega-3 and beta-palmitate being the most famous and successful ones. However, also many other, innovative ingredients were developed and several patents filed. Thereafter, I was offered a very nice position in a brand new innovation center in France and started to work for Tate & Lyle ingredients as their Health and Nutrition Director. During this international phase of my career, I learned a lot about the diversity in people, their cultures and habits as Tate&Lyle is a big multinational with R&D centers across the world.  I was responsible for the management of a team working on product development and nutrition and leading R&I programs to bring new food ingredients to the market with scientifically proven benefits yielding several patents. After a couple of years, an opportunity at Danone came along and I was appointed as their Scientific Program Director. This step really gave my career an extra boost as this is an extremely dynamic and successful B2C company with the development of health and nutrition products being at the core of their business.

Over the years, I have gained experience in (infant/medical/senior) nutrition, food science & technology, life sciences, health claim substantiation, GRAS and novel food applications. I led multidisciplinary teams focusing on innovative programs involving (pre)clinical research, product development, quality & safety of different foods and food/feed ingredients like prebiotics, lipids, plant-based ingredients among others. I have set-up up many international collaborations and has a large international network in industry and academia.

Tell us how you ended it up being recruited by Presans? What are your topics of interests?

I am active as Fellow of Presans, a Paris-based open innovation service provider. Together with Presans, I provide companies the world’s leading talents and experts on demand. Companies can tap into our comprehensive network of 6 million talents, scientists and technologists to tackle the most complex industrial challenges.

I became interested to work for Presans while I was still working for Danone. I already had in my mind to start my own consultancy when Darko Jesic, the current COO contacted me and told me about the capabilities of Presans. I immediately got excited and wanted to work for Presans as Fellow and Explorer. I saw this as a great opportunity to be able to work with many different multi-national food and pharma companies on big challenges in the research and innovation space. Being passionate about innovation, I am always eager to find experts on the topic that can help our clients on their needs. With my broad background and experience in academia and industry, I can help a wide range of clients on their needs in the areas of food, pharma, biotechnology, life science and nowadays also on sustainability.

Over the years, I worked on many different projects and one of the last ones was focusing on the Future of Food. Nowadays, projects are more and more focusing on sustainability matters and finding alternatives for the traditional meat and dairy. This is an exciting area I am currently working on. For more detailed biography, please have a look at my linked-in or research gate site.

Introduction

Since the start of the pandemic in December 2019, coronavirus SARS-Cov2 has killed 6.4 million people and infected at least 570 million people worldwide while the numbers are still continually increasing¹. The population most vulnerable are seniors, especially those who are obese and/or have an underlying disease like diabetics or cardiovascular disease.

Why are they so susceptible to COVID-19 and what do they have in common? This as yet isn’t completely clear. However, it seems seniors with/without the abovementioned disease suffer from an ongoing low grade inflammatory process (called inflammaging) and a gut microbiota disbalance, which unravels potential targets for prevention or treatment.

Therefore, the main objective of this paper is to explore seniors’ increased vulnerability to COVID-19 in terms of the function of their aged immune system (inflammaging) and their gut microbiota imbalance, and to suggest a few ways to intervene in order to lower the risk of coronavirus infection in seniors with or without underlying disease.

The latest science suggests that interventions with probiotics, omega-3, vitamin D and multivitamins, that target these mechanisms, might be successful.

Ageing population

The world is rapidly ageing. One in five people worldwide will be over 60+ in 2050. Although we all live longer nowadays, unfortunately the quality of life as we age hasn’t improved in recent years. The prevalence of diseases like heart disease, arthritis and osteoporosis are still very high in senior people which drastically impacts their mobility and quality of life. Also the susceptibility to infection increases with age. Therefore, developing and promoting adequate nutrition for the senior people is extremely important in order to help them maintain health for as long as possible.

Ageing population and susceptibility to infection

Seniors represent the group most vulnerable to COVID-19, with underlying age-related health issues, such as hypertension, diabetes and cardiovascular disease, being risk factors that can lead to complications in the case of infection. Further, the inevitable natural deterioration of the immune system makes it harder for older adults to fight off infection. Obesity, smoking and malnutrition also weaken the immune system and are thus associated with increased risk. Generally, there are nutritional deficiencies in for instance calcium, vitamin D, folate, and zinc among the senior population. A poor nutritional status is widely considered one of the significant risk factors for severe COVID-19². According to a study in Wuhan, where the outbreak started, the prevalence of malnutrition is elevated in seniors with COVID-19³.

Ageing and inflammageing

During ageing, chronic, low-grade inflammation — called inflammageing — develops, which contributes to the pathogenesis of age-related diseases. It is associated with a decline in the effectiveness of the immune system termed immunosenescence. A variety of stimuli sustain inflammageing, including viruses, pathogenic bacteria, a poor diet, psychological stress, pollutants, damaged cells or specific drugs (Figure 1). Across the lifespan, people have to constantly adapt to these harmful stimuli. The balance between pro- and anti-inflammatory parameters may shift to a more pro-inflammatory state, and, consequently, age-related diseases may emerge and ability to responds effectively to viruses and other pathogenic organisms decreases. In some COVID-19 cases the immune system even overreacts, which is known as the cytokine storm, damaging the cells more than the virus it targets.

Figure 1. The ageing process: a lifelong adaptive response to harmful stimuli leading to inflammageing and gut dysbiosis.

Ageing and a microbiota disbalance

The gut is a key contributor to our immunity, with more than 80% of the immune cells residing in the gut. The functioning of the immune system is closely linked to the functioning of the gut microbiota and vice versa. With age, the microbiota becomes less diverse and disbalanced. Many factors influence the microbiota including viruses, diet, pathogenic bacteria and antibiotics (Figure 1).

In seniors, a decrease in beneficial bacteria (e.g. Bifidobacteria and Bacteriodes) in the gut microbiota is observed. It is believed that perturbations in the gut microbiota in seniors trigger the innate immune response and may lead to chronic low-grade inflammation (inflammageing), leading to frailty and unhealthy aging⁴. This results in a microbiota that it less able to protect against pathogens, support the immune system, and digest food to supply nutrients (e.g. vitamins) and energy (e.g. short chain fatty acids) to the body. Ultimately, this leads to an increase in the transit time and constipation and susceptibility to various gut-related diseases such as gastroenteritis, infection and inflammatory bowel disease.

It is therefore not surprising that a disbalanced microbiota might increase the COVID-19 risk. COVID-19 has indeed been found to correlate to a difference in composition of the intestinal microbiota⁵. For instance, the anti-inflammatory bacterium Faecalibacterium prausnitzii among others is correlating negatively with COVID-19. Furthermore, a disbalanced gut microbiota together with intestinal inflammation, increases levels of angiotensin-converting enzyme 2 (ACE2), a cell surface receptor that serves as a target of SARS-CoV-2 thereby increasing the risk of COVID-19 infection.

The Mediterranean diet: A rich source of inspiration to target Covid-19 in seniors?

To date, considerable evidence has demonstrated that food and nutrients affect immune system and the microbiota. Especially, the Mediterranean diet is a powerful tool to promote healthy ageing by counteracting inflammaging and stimulating a healthy microbiota. As this diet is high in vegetables, fruits, nuts, fish and olive oil, it can provide seniors with the necessary macro- and micronutrients, polyphenols, anti-oxidants, pre-, pro-, post- and synbiotics to restore and maintain immune cell function and restore the microbiota balance. Therefore, this diet is a good source of inspiration when looking at ingredients that can decrease the risk of COVID-19. Recently, several reviews have appeared describing the potential of ingredients like curcumin, lactoferrin, pre- and probiotics, omega-3, vitamins B₁₂, C, D, and minerals iron and zinc^6–14. However, a very limited number of observational and intervention studies have been carried out in Covid-19 patients and therefore to date, the most promising candidate micronutrient is Vitamin D^15–17 (Figure 2). Also emerging science indicates promises for probiotics, omega-3, and multi-vitamins^18,19.

Figure 2. Potential nutritional interventions targeting COVID-19 in seniors.

Vitamin D targeting Covid-19

From observational studies it is clear that a poor vitamin D status in seniors prior to infection is associated with increased SARS-CoV-2 infection risk²⁰. This is not surprising as low vitamin D status predisposes for respira
tory tract infections in general. Several clinical studies on vitamin D are currently ongoing and four have been published already. One showed that a high-dose of vitamin D supplementation led to increased viral clearance indicating vitamin D had a therapeutic effect¹⁶. Another study reported that vitamin D supplementation taken during or just before COVID-19 was associated with less severe COVID-19 and better survival rate among frail elderly residents^15,17. Vitamin D supplementation also produced decreases in indicators of muscle damage in an elderly population, which may ultimately contribute to improving the health status and quality of life of elderly patients recovering from COVID-19²¹. However, vitamin D did not significantly reduce hospital length of stay in moderate to severe COVID-19 patients¹⁹. Therefore, Vitamin D so far seems a promising nutritional intervention to prevent COVID-19 or treat especially mild/early phases of the disease (Figure 2).

Probiotics, Omega-3, Multivitamins and magnesium targeting Covid-19

Recently, a large, app-based survey among more than 300.000 UK consumers showed a modest but significant association between use of probiotics, omega-3 fatty acid, multivitamin or vitamin D supplements and lower risk of testing positive for SARS-CoV-2 in women¹⁸. Another cohort study showed that a combination of vitamin D, magnesium and vitamin B12 in older COVID-19 patients was associated with a significant reduction in the proportion of patients with clinical deterioration requiring oxygen support, intensive care support, or both²².

A randomized clinical trial recently showed that a specific probiotic combination improves symptomatic and viral clearance in Covid-19 outpatients²³. Another trial specifically showed that in an elderly population the administration of a probiotic may enhance the specific immune response against COVID-19 and may improve the COVID-19 vaccine-specific responses²⁴. Therefore, specific probiotics seem promising candidate nutraceuticals to prevent or ameliorate symptoms of senior patients suffering from COVID-19 (Figure 2), but clearly future studies are needed to show which probiotics work best and what mechanisms are behind.  

The two mechanisms of actions described earlier (counteracting inflammaging and balancing the gut microbiota) may explain why the supplements had a beneficial effect on reducing the risk of COVID-19 infection. Specifically, vitamin D can modulate the innate and adaptive immune responses because immune cells (B cells, T cells, and antigen-presenting cells) express the vitamin D receptor and can thereby respond to vitamin D²⁵. Deficiency in vitamin D is associated with an increased susceptibility to infection. Probiotics are known to stimulate beneficial microbes in the gut and thereby interact with the gut-associated immune system, resulting in improved immunity and superior responses to vaccines. Omega-3s are demonstrated to be anti-inflammatory, but if they reduce the risk of SARS-CoV-2 infection is not yet clear. Multivitamins often contain micronutrients with antioxidant properties and roles in supporting the immune system.

Conclusion

Although observational studies shows promising results for the use of omega-3, and multivitamins, so far only specific probiotics and vitamin D have been tested in a clinical setting in seniors making these to date the most appealing nutritional supplements for seniors both at risk of, and suffering from COVID-19. Nevertheless, several nutritional intervention studies are ongoing making it likely that other candidates might appear on the horizon soon.

Author Bio

Sandra is Fellow at Presans since 2015. She is also consultant in strategy and innovation focusing on nutrition and health. She chairs the Nutrition Consultants Cooperative (NCC) and heads Einerhand Science & Innovation, recently receiving the Luxlife Food and Drink award for being the best European Early Life Nutrition Consultancy. In March 2021, Sandra Einerhand had the opportunity to present her activities on the National TV. Since april 2015, she is a member of the scientific advisory board of TNO Triskelion. Before, she worked in academia as associate professor in Life Science and in industries as Global R&D Director with Danone Nutricia Research being her last employer. She has experience in implementing an open innovation strategy, leading multidisciplinary teams focusing on innovative (pre)clinical  research, program management, product development, quality/safety of different food (ingredients) and neutraceuticals. Sandra Einerhand started her career as a molecular biologist with expertise in yeast fermentation and DNA modification and obtained her PhD in Biomedicine. She is co-inventor on several patents and is author of >100 international scientific papers, editorials, and chapters in international books and has given lectures at >50 international conferences and exhibitions.

EDUCATION

• Msc in Chemistry at the Free University in Amsterdam, NL
• PhD in Biomedicine focusing on fatty acid oxidation in health and disease (1992), Academic Medical Centre, Amsterdam University, NL

This article, written by Sandra Einerhand, was originally published in Nutra Horizons in 2020 but updated with the most recent science.  

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This article is the third in a series about the Disruptive digital tsunami, after Global shortage of digital skills.

Digital, smart, data, software, services, command, and control are words that express the revolution business world. Key to this digital transition is that it also effects our daily life: entertainment, health, energy, transportation, tourism, and on and on.

Digital is valuing data. It starts with data acquisition, data transmission via networks, and ends with data interpretation. It includes production chain automation and user communities. Step-by-step, all businesses are generating data about their processes and about customer usage of their products and services.

This data has tremendous value, because it follows along the production, distribution, and use of the product or service. It enables the company to redesign the product or service, for enhanced features and quality management, by a continuous, real-time adaptation. Digital is a means for all businesses to optimize their processes and become therefore more efficient and more profitable. Germany has taken the lead in this movement by setting up the Industry 4.0 program. The target of the program is to support German industry by helping companies to interconnect all of their machines to facilitate more agile production processes and improved quality management. This revolution, initiated in 2013 at CeBIT, the world’s largest and most international computer exposition, intends to put Germany on the top of industrial countries despite its very high labor cost.

Access to digital data is also a way for a company to reinvent its business model. For example, Michelin was selling tires, a pure product. The company had optimized the design of its product, and its relationship with its customer had been stable for many years. Michelin has been able to take the risk of reinventing itself by no longer selling the product alone but instead as part of a bundle that includes a service component. The transformation from selling a product to providing a service bundle changes the entire company. Data exploitation is the tool that can help a company make this kind of transition. The company must analyze its product, gathering and managing the acquired data to ensure that the product provides the quality of service required by its customers. This movement from product to service is inexorable. Companies that do not make the transition will be attacked on the cost front by the countries that have low labor costs and on the composition of the offering (quality, features, and service) by companies such as the participants in the Industry 4.0 program. The digital wave is not a choice but rather an opportunity, which can become a killing threat to companies that don’t move.

Digital data also provides an opportunity to continuously invent new businesses. Google, Apple, Facebook, and Amazon.com (GAFA) analyze industries looking for any that generate good profit margins but have weak relationships with their customers (for example, music, video, banking, retail, telecommunications, utilities, and other traditional industries have been attacked by these digital giants). GAFA focus on user demands and reinvent a high-value service for the user. They then often provide this service to the user for free in order to acquire the associated data. Because they have a rich understanding of the users, they are then in a good position to become intermediaries, providing customers with access to the more traditional industries in exchange for a portion of the profit margin (such as the 30% revenue share earned by Apple’s iTunes Store) and oftentimes even setting the price of the product or service such as streaming a song or owning an e-book (note, however, the price battle between Hachette and Amazon, which was settled in November 2014). Such a business transformation represents both a risk and an opportunity—at least, for the companies that take the lead. This transition is not a single step but rather a series of revolutions. By enabling companies to focus on users and gather information about them, digital opens the door to any kind of imagination. By tracking and analyzing user demands, creative people can develop new offerings tailored to the user feedback. For example, Pascal Nègre, CEO of Universal Music France, explains that the company is managing its fourth digital revolution in recent years: piracy, ringtones, the iTunes Store, and now streaming. The music production company hopes it has found the solution after experiencing a 65% decrease in value in less than fifteen years!

Digital transition is associated with a major social trend. Companies were accustomed to advertising their products to consumers who were waiting for this information so that they could consume even greater quantities. The reality of this digital era is the proliferation of communication channels. The Internet gave people the opportunity, and therefore the desire, to access information from various sources: the community effect. In some case, the customers are now more informed than the sales associates. These community tools have demonstrated an important consumer demand: people want to have deeper relationship with a product, service, or the company providing it. An advertisement is no longer sufficient. This customer preference is clear to retailers when their customers have already searched on Internet for information on their products before going to the store. It is also clear to companies that no longer have to be the lone voice boasting about their brand; they can now foster direct communication among consumers on the brand’s social networks (Facebook, Twitter, and so forth). The consumer demand for a deeper relationship forces companies to reinvent their communication strategies. Doing so often strengthens the value of the brand.

Digital is characterized by continuous innovation and access to the crowd. Some of the digital barbarians have become digital giants, pervading society. Google was founded in 1998; Apple, the most profitable company of all the time, was founded in 1976; Facebook, with more than a billion users, was founded in 2004. The digital transition is not a game we can just check on later. It is a challenge which can affect all businesses—and, indeed, everyday life—now, and when a company’s position is taken by a digital barbarian, it is already too late.

From a technology point of view, we are confronted by a series of waves: analog to digital information, compression, digital transmission and watermarking, pattern recognition, matching and statistics, service bundling, cloud computing, Big Data, high-performance computing, and real-time computing. We cannot master all of these new technologies. That is why platforms, open source, and reusability are so crucial in the digital era. They allow companies to follow and catch up to the technology waves. In this new world, the key is speed. The developer community has created new tools around reusability, agility, and test automation that enable companies to deliver continuously new versions of their products and services. In this digital world is has become more and more difficult to follow the traditional V-model process, because  the specifications themselves cannot be stable if no one by the market itself knows exactly what the product should be.

The most recent hacker attack on Sony (data on forty-five thousand employees was published), the hacker attack on Target (it cost the company $1 billion and the CEO his job), and many other cyber attacks have put pressure on companies’ security and opened the door to additional investment in R&D in pursuit of more effective methods of cybersecurity..

The digital economy has spurred innovation by start-up firms. The digital giants that have had incredible success were created as start-ups. In addition, many successful start-ups have been integrated into more traditional companies and have continued to innovate from th
e position of insider (this is particularly true inside companies like Cisco Systems and Facebook, as well as Dassault Systems, a French software company). Many of the large industrial companies are now creating their own venture capital firms, incubators, or accelerators (examples include Orange, Alcatel-Lucent, Novartis, and Qualcomm) to manage innovation inside their own structures. It is not always easy for them to attract the key people, since such people typically have entrepreneurial spirit and a desire for freedom. This movement is not a cycle but rather a structural shift. Innovation requires freedom and risk. Because the digital economy has made innovation possible for everybody, the large players must adapt in order to remain on the forefront of innovation.

Digital transition is a risk for a sleeping company, but it is an incredible opportunity for an agile one—it opens up opportunities to reinvent the business and thus create new value.

Be optimistic—innovate!

This section was written by Philippe Letellier. Philippe was R&D General Manager at Technicolor before becoming the Innovation Director of the Institut Mines-Télécom. He is currently Digital Fellow at Presans, Vice Chairman of the ITEA3 EUREKA program, and is launching an innovation accelerator. His perspective is balanced between technology and business.

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This article was initially published in the book Innovation Intelligence (2015). It is the third section of the fourth chapter.