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And how does this relate to our overall health?


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These questions are at the heart of a developing area of science called nutrigenomics. Before we can really dig into the details, a little Genetics might be helpful I know, I know…. Nutrigenomics studies how our individual genetic makeup contributes to how we process what we eat and drink, and how this may affect health outcomes like obesity or cardiovascular disease risk.

It looks at the interaction between nutrients and other dietary compounds with the human genome — all the way down at the molecular level. Work in nutrigenomics began about 15 years ago after the conclusion of the Human Genome Project , where we learned that while This includes our response to diet. But when it comes to disease prevention or treatment, a nutrigenomics approach has most often been applied in the study of obesity.

MIS2017: Feeding your Genes: The Science and Business of Nutrigenomics

While obesity is a complex condition with no one specific cause, there are several obesity-associated genes whose expression can be altered by dietary choices. For example, one variation of the gene that codes for the fat mass and obesity-associated protein FTO is connected to having a higher BMI and increased risk for type 2 diabetes.

Latest Research and Reviews

October Issue. Dietitians know genes and diet interact, but is nutrition counseling based on genetic makeup ready for prime time? Why have public health efforts to prevent obesity and metabolic diseases been relatively unsuccessful? It's likely because making one-size-fits-all nutritional strategies often miss the mark.

It's clear that not all people respond to diet equally, and it's becoming more and more clear that, as nutrition science evolves, nutrition professionals need to consider how genes interact with an individual's diet and physical activity patterns. Nutrigenomics may have the potential to prevent and treat diet-related chronic disease and conditions in a way that nutrition recommendations based on epidemiologic research and physiology can't by using genetics and molecular biology to predict individual risks, explain why those risks are present based on genotype, and allow personalization of nutrition therapy.

What Is Nutrigenomics? Nutrigenomics and nutrigenetics fall under the umbrella of nutritional genomics—so what's the difference between the two? Both study how individual genetic makeup contributes to observed differences in response to diet and how that gene-diet interaction contributes to predisposition to disease.

Ahmed El-Sohemy, PhD, Canada research chair in nutrigenomics in the department of nutritional sciences at the University of Toronto, says that if you ask five different experts in the field to define nutrigenetics vs nutrigenomics, you'll get five different answers.

1. Introduction

Personalized Nutrition: Is the Future Here? Once the Human Genome Project published the full sequence of the human genome in , the push for personalized or precision medicine and nutrition began. On a molecular level, nutrients transmit signals that can be translated into changes in gene, protein, and metabolite expression.

In other words, nutrigenomics looks at what happens in our cells when we eat, don't eat, or eat too much. At the end of the day, El-Sohemy, who's founder, president, and chief scientific officer of Nutrigenomix, a biotechnology company that works with dietitians to offer testing for nutrition-related genetic variants, says nutrigenomics is about consumer genetic testing for personalized nutrition. Do we have scientific evidence that can tell us, based on your genes, how you should eat?

News and Comment

Genetic variation likely explains why there are inconsistencies in research investigating the role of diet in disease, and why some individuals don't have "average" responses to nutrition interventions. Nutrigenomics and Obesity CVD, type 2 diabetes, and obesity are major public health focus areas. Accordingly, they're also points of focus for nutrigenomic research. Many cellular functions related to energy balance are regulated by gene expression and gene-environment interactions.

Genetic variation may affect appetite, calorie intake, and macronutrient preference,5,6 as well as insulin signaling, inflammation, adipogenesis the formation of fat cells , and lipid metabolism. Ginger Hultin, MS, RDN, CSO, a spokesperson for the Academy of Nutrition and Dietetics and dietitian at Arivale, a biotechnology company that incorporates genes and blood data into nutrition and health assessments, says there are two different sets of evidence, one for genes related to obesity risk and another for genes that help establish links between dietary factors and body weight.

Diet-Gene Interactions and Weight Loss Diet interventions in clinical trials universally see variation in response between participants. Why do certain individuals respond differently to diet or physical activity interventions? Why do some people lose weight on a high-protein diet, while others regain? The same question can be asked of low-fat and low-carb diets, and that's a question that Christopher Gardner, PhD, a professor of medicine at Stanford University, has been working hard to answer.

Ten years ago, Gardner had just completed the A to Z study—which compared the Atkins, Zone, Ornish, and LEARN diets and found huge variation in weight outcomes within each12—when a company that was working on genetic testing contacted him and asked if he wanted to look at the participants genotypes. Grouping the three SNPs as a multilocus genotype, Gardner got usable samples from of the original women in the study.

Nutrigenomics

The question was who fit a low-carb genotype, who fit a low-fat genotype, and who fit neither? Most participants fit one of the two genotypes, nearly a split, but because there were four diet groups, some of the specific diet-genotype subgroup sample sizes were small. To explain the variability Gardner and his colleagues were seeing, they needed to replicate it.

Gardner's National Institutes of Health-funded DIETFITS study enrolled more than people to test the primary hypotheses that whoever did best on a low-fat or low-carb diet would depend on insulin resistance and genotype. Not only that, but in the newer study, fewer of the participants fit as neatly into the two main genotype patterns.

El-Sohemy disagrees: "We're not trying to predict obesity, we're trying to look at what is a marker that's actionable," he says. One BMI-related gene can have many mutations, with different effects,17 and this has been demonstrated with the FTO gene.


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A meta-analysis published in The American Journal of Clinical Nutrition found that individuals with the obesity-predisposing variation of the FTO gene were more likely to lose weight through diet and lifestyle interventions than noncarriers. For example, one SNP is associated with increased risk of type 2 diabetes if there's low adherence to a Mediterranean diet and with obesity if a high-fat diet is consumed.

SNPs affecting other genes can reduce resting metabolic rate21 or determine whether an individual will lose weight on a low- to moderate-fat diet,22,23 or a diet that includes more monounsaturated fats. Another SNP is associated with enhanced weight loss on a high-fiber diet. Does Knowing Your Genotype Matter?

NuGO » An Association of Universities and Research Institutes

Hultin points out that standard recommendations for dietary macronutrients that encourage weight loss are based on practitioner or client preferences since there's often no clear evidence for when to use a low-fat or low-carbohydrate diet for a specific patient. As more nutrition-related SNPs are identified, we can move beyond generalized recommendations.


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As every dietitian knows, motivation is key. El-Sohemy says that while simply telling someone they're at increased risk of developing a disease or health condition isn't helpful, there's evidence that when an individual has that information—and there's a defined action they can take—it increases motivation. State of the Science It's becoming increasingly clear that the traditional assumption of nutrition research—that the influence of diet on disease risk is universal—isn't accurate.

As technology improves, GWAS and large meta-analyses are making it possible to examine the interactions between millions of SNPs, dietary factors, and specific phenotypes observable traits based on gene-environment interactions.

In spite of that, El-Sohemy constantly hears from skeptics that it's too soon to offer personalized nutrition. We can drag our feet, but at the end of the day we have to give nutrition advice today, because we eat today. Why not do that? While several SNPs have been identified that can more accurately guide recommendations for specific micro- or macronutrients, the research isn't at the point where nutrition professionals or other health care practitioners can precisely tailor someone's entire diet to their genes. Researching gene-diet interactions generally requires large sample sizes, compared with GWAS simply looking for association, because collecting accurate measures of diet and physical activity is difficult.

Nutrition, Metabolism and Genomics

We are getting better tools. Other factors in personalizing nutrition recommendations for weight and health include not just genotype and phenotype but also the microbiome—there are genetic factors that regulate the gut microbiome, which in turn affects how we respond to diet—gender, and other aspects of the individual's environment. Genes play a role, but we can't underestimate the potential impact of a person's lifestyle and environment," Hultin says.

Even though the ability to give actionable nutrition recommendations based on genotype—say, for example, sugar intake—may be powerful, dietitians also know that excessive sugar intake isn't good for anyone. So in some ways, nutrition counseling will be the same. I don't care what your genotype is. You're going to have to address those three things," Gardner says.