Nutrigenetics: Applying the Science of Personal Nutrition

397 Pages·2012·9.24 MB·English

by  Martin Kohlmeier

Nutrigenetics
Applying the Science
of Personal Nutrition
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Nutrigenetics
Applying the Science
of Personal Nutrition
Martin Kohlmeier
UniversityofNorthCarolina,ChapelHill,NC,USA,
andUNCNutritionResearchInstitute,Kannapolis,NC,USA
Gabrielle Z.Kohlmeier, JD, WashingtonD.C. (Chapter8)
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The contributions of Olivia Dong are noted with great appreciation.
Foreword
Nothingwill change howwethink about nutrition more than the new knowl-
vi edge that is developing in the area of how nutrients interact with genes e the
fieldofnutrigenetics.Beforewebegantounderstandtheimportanceofthisarea,
nutritionresearchresultswereoftenconfusing.Wethoughtthatallpeoplewere
metabolically similar, and when we studied their response to a nutrient and
found responders and non-responders, we attributed this variation to weak-
nesses in the scientific design of the study. News articles would trumpet
a discovery one week, only to have another research study find the opposite
result the next week. It was hard for the public to act on this information to
improvetheirhealth.
Now,weknowthatpeoplecanbemetabolicallyverydifferentbecausetheyhave
differences in genetic and epigenetic coding and we explain why investigators
observedthatsomepeoplerespondedtoanutrient,whileothersdidnot.Using
modern genetic methods, it is often possible to accurately predict who the
responders will be. Scientists are now developing a comprehensive catalog of
genenutrientinteractionsthatpredictrequirementsandresponsestonutrients;
todaytherearehundredsknown,butsoontensofthousandswillbeidentified.
This catalog will be the foundation for developing individualized recommen-
dationsforoptimalnutrientintake.Infivetotenyears,Iamcertainthatdoctors,
nurses and dietitians will be using this nutrigenetic catalog to change their
clinical practice.
Genetics,epigeneticsandnutritionarecomplexscientificareasandpeoplewho
want to be ready to use nutrigenetics to develop customized nutrition inter-
ventionsneedtomasteragreatdealofnewinformation.Dr.Kohlmeier’sbookis
anexcellent place tobegin this learning adventure.
Steven H. Zeisel MD, PhD
Kenan Distinguished University Professor of Nutrition and Pediatrics
University of North Carolina at Chapel Hill
Director, UNC Nutrition Research Institute
500 Laureate Way Kannapolis, NC 28081
July5,2012
Contents
FOREWORD........................................................................................ vi
PREFACE........................................................................................... ix
vii
CHAPTER1 Hasthe Time Come for Genotype-BasedNutrition 1
Decisions?.....................................................................
CHAPTER2 HowGenetic Transmission Works................................... 17
CHAPTER3 Where Nutrigenetic Differences Come From.................... 57
CHAPTER4 HowNutrients are AffectedbyGenetics.......................... 103
CHAPTER5 HowdoesNutrigenetics InfluenceLong-Term Health?...... 223
CHAPTER6 HowCan weKnow WhattheLatest Findings Mean?........ 273
CHAPTER7 Practical Uses ofNutrigenetics...................................... 307
CHAPTER8 Keeping Genetic Information Safe................................... 335
GENOMEGLOSSARY...........................................................................355
RESOURCES.......................................................................................365
INDEX................................................................................................369
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Preface
WHY HEALTH CARE PROFESSIONALS NEED TO LEARN
ABOUT NUTRIGENETICS
ix
Nutrigenetics investigates inherited differences in nutrient metabolism and
exploreshowtouseindividualgeneticinformationformakingbetternutrition
choices.The development ofthescienceand practice ofnutrigeneticshasbeen
going on since the early 1900s. The large and growing number of well-
established nutrigenetic conditions leaves little doubt that adjusting personal
nutritionpatternstoinheritedpredispositioncangreatlyimprovethehealthof
many people. The question is whether dietitians, nutritionists, physicians, and
otherhealthcareprofessionalsarepreparedtorecognizenutrigeneticproblems
indailypractice.Willtheybeabletousegenetictestsappropriatelyandprovide
nutritional guidance that helps the individual they are working with? Nutrige-
neticsisnotasciencewitheasyanswersandonestandardprescriptionforeach
genotype. The interactions of the inherited genome and nutritional factors are
verycomplex and not easily understood. We need competent nutrition profes-
sionals who can guide patients and clients effectively through the maze of
nutritionalandgeneticinformation.Learnerswillneedtoworkhardtoachieve
thenecessarylevelofcompetency,makesenseofthemoleculardifferencesthat
define each of us, and fine-tune nutritional interventions for one genetically
distinctindividual at atime.
The science of nutrigenetics can be traced back to Archibald Garrod’s seminal
description in 1908 of inborn errors of metabolism, conditions that were
defined early on as genetic disruptions of food metabolism. The new
biochemicalknowledgeslowlygaverisetotheverysuccessfulpracticeoftreating
some of these metabolic diseases with nutritional interventions. The discovery
by Asbjørn Følling in 1934 that defective metabolism of a dietary amino acid
(phenylalanine) causes severe mental impairment was followed in 1953 by
Horst Bickel’s demonstration that nutritional treatment of the condition is
effective. Many countries now routinely screen newborn infants for this meta-
bolic defect (phenylketonuria, PKU) and prevent devastating consequences by
starting nutritional treatment of affected children within days after birth. The
same is true for a growing number of once untreatable inherited diseases
(biotinidasedeficiency,maplesyrupurinedisease,andothers)thatrespondwell
to early nutritionalintervention.
Anothergroupofgeneticconditionswithalteredresponsestonutritionarethe
iron storage diseases. The discovery of disease-causing variants in the