Webinar: Nutrigenomics and Federal Dietary Guidelines?

In this webinar and interview, Bobbi Kline MD, Joe Veltmann PhD, of Genoma International,  and Amanda Archibald, RD of Genomic Kitchen, discuss the recently released 2015 Dietary Guidelines. These three globally recognized experts in nutrition, medicine and genomics bring a much needed perspective to what is missing from the guidelines. They believe the future of wellness lies in an integrative approach that melds nutrition education, genomics and culinary genomics. 

Nutrigenomics Webinar by Genoma International

What Good Are the Federal Dietary Guidelines?

Answers by Bobbi Kline, MD (blueberry ink), Joe Veltmann PhD (plum ink), Amanda Archibald, RD (leafy green ink).

Q: In an era of personalized medicine, why are the US 2015-2020 dietary guidelines still recommending the same ole stuff – cut intake of sugar, trans and saturated fat, and increase intake of fiber, fruits and vegetables.  It appears that strategy is not working when one looks at the rising rates of obesity and diabetes.

BK: The dietary guidelines do not reflect much of current science, and did not include many of the recommendations put forth by the scientific committee. Between strong pressure from special interest groups representing beef, dairy, and processed food industries, and lingering false beliefs that all fat is alike and obesity is just about calories in-calories out, the attempt to create something that is not controversial results in a very flawed guideline report.

JV: The stakeholders at the dietary guideline table included nutrition scientists from academic institutions, representatives from the food industry and government officials from the Food and Drug Administration. It is pretty obvious that the stakeholders missing from decision making were clinical nutritionists. They are on the front lines of the obesity and diabetes epidemic.  They would have told anyone who wanted to listen that these one-size-fits-all platitudes don’t work. 

Each person has a unique genotype and a seasoned clinical nutritionist tries consciously or intuitively to match a set of dietary and lifestyle recommendations to a person’s genes to hopefully create a phenotypic change to lose weight, manage blood sugar levels and even prevent a heart attack. 

Academicians still rely on epidemiological data to make recommendations for the masses.  That strategy may have worked 50 years ago, when there were fewer grocery stores, fast food outlets, all-you-can-eat buffet establishments, and children walked or biked to a friend’s house rather than be driven 2 blocks by a parent.  The fact is that food (usually high in fat, sugar and sodium) is cheap, accessible and does not require a lot of work to get.  Our genes are still very prehistoric. The abundance, and convenience of packaged food, ingredients that promote food addictions along poor lifestyle choices have created the “perfect” storm.  Dietary guidelines that only tweak the previous dietary recommendations by “shifting” away from unhealthy food choices will not cut it. 

Q: In your work you frequently mention that foods “talk” to your genes?  Please share a specific example of what this means. 

AA: From both a culinary and nutrition translation perspective, food is the raw material of our innate biochemistry. It is the substance that fuels our physiology, similar to the binary code for computers. Viewed in this light, food is the “talking” mechanism we use to drive or support health outcomes (positively, and for some people, negatively depending on their food choices!). When we look in the scientific literature, particularly at longevity and centenarians, we see possible links between food-derived bioactives and health outcomes. Specific to some parts of the Mediterranean, consumption of wild herbs, greens and foods rich in the bioactives:  quercetin, apigenin and luteolin,  are an important part of the daily diet. These bioactives have demonstrated nutrigenomic activity in human cells, including the upregulation of the NrF2 pathway which influences both antioxidant activity as well as stage II detoxification enzymes. When we can demonstrate nutrigenomic activity, then by definition we have a relationship between a food-derived component (bioactive), a subsequent signaling activity (event) which activates gene transcription to encode for a protein. In other words a conversation. 

JV: Let’s define “talk.”  Talk can mean to communicate, speak or dialogue.  Research is showing that our bodies and cells sense the presence of foods at mealtime, when we snack or drink a beverage.  Foods initiate a Christmas trees effect– the lights on a Christmas tree light up when plugged into an electrical outlet–so too, do our genes light up in response to food.  Genes are the blueprint for proteins needed by the body to function, to digest the food we consume, absorb nutrients from the small intestine into the blood stream and nourish cells in our extremities, transport nutrients across a cell membrane and communicate with genes in the nucleus of a cell to optimize the function of a collection of cells (tissue), a collection of tissues (organ) and finally the entire body.  So, each time you have meal, think of all the genes that are “lighting up” and how the food in the meal is contributing to your well-being.  For example, a high carbohydrate meal initiates a “conversation” with the genes that regulate blood sugar, insulin production, cell membrane receptors, fatty acid production, hormones that play “traffic cop” with the many biochemical processes associated with the intake of a donut, slice of pizza, or sugar-rich beverage.

Q: What (other) evidence do you have that genomics can improve the dietary requirements of a person?

RK: Genes code for the receptors and enzymes needed to absorb, metabolize, and utilize nutrients. When a person has a SNP on one or more of those genes, it can impact how much or what form is optimal for that person. For example, most people know to get their vitamin A through foods rich in beta-carotene. What they may not know is that beta-carotene has to be converted by enzymes to the active form, retinol. The rate-limiting step of that process is controlled by a specific gene, BCMO1, and SNPs can decrease the efficiency of that enzyme by up to 70%. That means this person has a much higher risk of vitamin A deficiency if he or she is relying on beta-carotene as their main or sole source of vitamin A. Therefore, knowing a person’s genomic makeup can help guide food choices to include those that contain retinol.

Q: Culinary genomics sounds like the best of both worlds in getting people to eat healthier?  Can you give me an example of how you this concept could be integrated into clinical practice and nutrition education?

AA: Yes, culinary genomics is not only the “best of both worlds,” but also the most personalized and strategic nutrition intervention that we can provide for patients. Culinary genomics allows the practitioner to integrate both food-derived bioactives and nutrient cofactors (vitamins and minerals) to influence signaling pathways and biochemistry that together impact health outcomes. A classic example might be how we can positively influence estrogen metabolism to favor the benign 2-OH pathway versus the (carcinogenic) 4-OH or 16-OH pathways. Culinary genomics considers which pathways and genes we need to influence, and then dials those strategic ingredients into simple recipes and meal concepts.  So shorthand culinary genomics comprises two phases. Nutrigenomics and then Culinary Translation of Nutrigenomics  (Culinary Genomics).  These two phases look something like this:

Nutrigenomics for Estrogen Metabolism

• MnSOD: Manganese
• COMT: Magnesium, Methionine
• P 450 (Inhibit): Raw crucifers/sulforaphane (assuming good gut health)
• GST: Crucifers/alliums, bioactives to upregulate NrF2
• NQO1: Crucifers, bioactives to upregulate NrF2

Practice Integration

From a practice perspective, we move from more generic advice (all foods fit, or eat your fiber, or eat your veggies) to a strategic intervention based on the genomic blueprint. This is less about “tasty recipes” and a solid meal plan, to teaching people about how specific foods work in their body and we simply integrate them onto the plate. So more coaching, and less recipe compendiums! In the above scenario, the patient conversation strategically focuses on raw cabbage or crucifer-based slaws, animal proteins (or specific nuts/seeds/seaweed for plant based sources) for methionine, legumes and specific nuts and seeds for manganese and magnesium. Culinary genomics is less about recipe perfection, and more about the integration of very specific ingredients into simple meal concepts. 

Q: If you were asked to rewrite the dietary guidelines based on a genomic footprint, how would they read?

RK: Ideally, everyone would have his or her genomic blueprint and use that as a guide. That said, if I had to issue revisions to the new 2015 guidelines, I would better define sources of fats to help reduce saturated fats and increase mono-and polyunsaturated fats, eliminate all added sugar, add in herbs and spices that have concentrated bioactive compounds, eliminate the dairy (and clarify that soy and almond milk are not dairy!), increase the vegetables (especially green leafy and cruciferous), reduce the meats, eliminate refined grains.

JV: I would like to see the government get out of the business recommending dietary guidelines.  Their message is lost in dietary “noise” powered by profit driven food companies whose goal is to sell you more food without considering the consequences on the healthcare system or a person risk for obesity, diabetes or heart disease.  People would be better served if the money used to generate these dietary guidelines went into genomic testing and then personalized dietary and lifestyle coaching by trained professionals along with programs to sustain a person’s progress over the long-term.  A paradigm shift is absolutely necessary by government, industry, medical doctors and other healthcare professionals instead of dietary guidelines that encourage a person to shift away from unhealthy foods. For once, let’s get real about the health problems in US population and speak truth to power!

If there is something that I have learned over the past 15+ years unzipping DNA, is that we all carry different genotypes (even identical twins have different genomes) and therefore, one set of dietary guidelines suitable for everyone is a waste of time.  Everyone needs to have their genome evaluated for predisposition for diabetes, obesity, heart disease, and osteoporosis just to name a few and then be given personalized dietary recommendations based on these interlacing factors: lifestyle, exercise, microbiome, emotional health, inflammation, environmental toxins, etc.  I have witnessed that a patient is more likely to comply with personalized dietary recommendations if they are unique to each individual. 

There is so much dietary “noise” on social media, the internet, infomercials, print media, books and internet-based summits that the average person is confused and often times has given up about the dos and don’ts of health eating. What is needed is not a government sponsored program that is abstract, which recommends “shifting” away from unhealthy foods.  Half-measures do not work.  People need to hear the truth (you have metabolic disability and therefore you cannot have simple carbohydrates of any kind) and be told the potential consequences if you continue to eat the way you do. It is a wake-up call and if you heed the advice you can change your life forever.  If not, then you are more than likely destined for debilitating chronic illnesses. 

AA: When you view food through the lens of genomics, how we understand nutrition, and its impact on health is entirely different. For me, we focus on foods that ramp up support the methylation cycle, drive antioxidant defense, facilitate detoxification pathways, tamp down pro-inflammatory pathways and importantly, support a beneficial gut microflora. Genomic short hand for practitioners is as follows:

Upregulate the antioxidant master gene NrF2 to put out the fires of inflammation, and support detoxification. Focus on crucifers, alliums, turmeric, cloves, cinnamon, cardamom, Mediterranean herbs, grapes, red wine, orange citrus, green tea.

Downregulate the pro-inflammatory pathway master gene Nf-KB to exit off the inflammation super highway. Similar focus as NrF2 (above) for foods and bioactives.

Support methylation (Support the central operating system of your body). Choose foods rich in methionine and folate.

Choose foods that seed and feed the gut to build the best immune defense. Choose or prepare a variety of naturally cultured and fermented foods.

Recorded Webinar: Do the 2015 Dietary Guidelines Talk to Your Genes?