We live in a wonderful (and scary) world of rapidly advancing technology and medical breakthroughs, and as practitioners it sometimes feels like not a day goes by without there being a new ‘cure all’ therapy or treatment approach to learn about (cue PSNI, FM, The Bredesen Protocol, methylation ….). The current ‘craze’ is rightly focused on the field of genetics and personalising nutrition and medical regimes. In the last week alone headlines have reported the potential for a blood test to identify the type of anti-depressant a person should take, as well as using viruses to modify our own genetic code and potentially eliminate, or modify, the genes associated with disease susceptibility and progression.
Nutrigenomics, personalised medicine and epigenetics is everywhere right now and with so many companies offering talks and training events about how to understand and use genomic testing, it’s easy to feel a little overwhelmed, like you might be getting left behind, with no idea where to start.
Even with a background in biomedical science and developing genetic cancer therapies, as well as having just spent the last few months with my head buried in materials from the wonderful courses by Anne Pemberton and Angela Bailey, and Caroline Hansen I still have a lot to learn. My endeavours of recent months have taught me a number of valuable things and it is these that I want to share with you today – a practitioner’s survival guide, if you will, to genetics and nutrigenomics.
The terminology (in plain English, as this alone can lead to confusion):
Genes: Instructions written in your DNA sequence (the alphabet being A,C,T,G) for making the proteins that carry out all biological functions.
Note – not all of your DNA is made up of genes, some is nonsensical and used for spacing purposes – much like re-ordering the letters on a typewriter so the buttons don’t get tangled up – and some act as instructions for the instructions – similar to that of a contents page before each chapter in a book signposting us to which bits to read.
Genetics: The study of the inheritance of genes, how they vary from person to person and are passed on to subsequent generations.
Genome: The collective term for all of our genes and the nonsensical bits of DNA together.
Genomics: A field of genetics that looks at and analyses the sequence of our genome (e.g. the human genome project)
Nutrigenetics: Concerns how our genetic variations affect our response to nutrients (e.g. SNPs in FLOR2 affect your ability to use folic acid).
Nutrigenomics: The study of how food and nutrients affect our gene expression (e.g. omega-3 fatty acids switch off NF-ƘB to prevent inflammatory cytokine production.)
Note – frustratingly, many people, including those in the nutrition practitioner world seem to have ditched the term nutrigenetics in favour of nutrigenomics alone. Therefore, whilst technically inaccurate, nutrigenomics has come to be associated with both how we react to and metabolise foods as well as their potential impact on our health and wellbeing as a result of altered gene expression.
Epigenetics: The modification to the expression of genes, not involving changes in the genetic code itself (mainly via histones and methylation), that occurs in response to environmental factors. This results in genes being switched ‘on’ or ‘off’.
Nutrigenomics is a branch of Epigenetics whilst, technically, nutrigenetics is not.
Applying genetic health support in clinic
If there is one thing the past few months has taught me, it’s that having someone’s genetic code at your fingertips should not change your approach to the support you will give. Nutritionists had been practicing, with great success, for many years before genomics came along and so we should take confidence and reassurance that applying the tools and support that are known to benefit clients, is still a perfectly valid approach.
Treating SNPs is not and should not be the aim; instead, knowing someone’s genetic code can help you better understand some of the intricacies and complexities of a case and guide your recommendations in line with their genetic requirements. Bear in mind: knowing someone’s SNPs does not tell you if a gene is switched ‘on’ – only functional testing and the case history can do that. So genomic testing is still only one part of the picture and with research growing and changing daily, much of what we ‘know’ today, about which genes may be implicated in disease risk and progression, may in fact change.
So here are my top tips for ensuring you are supporting genetic health, before you’ve even embarked on any genomic testing.
1) Support the HPA-axis and address historical traumas
Much of the recent epigenetic press has focused on how stress, throughout our lives, can lead to significant epigenetic changes and increase our risk for numerous negative health outcomes. As practitioners we are all too familiar with the role stress plays in health; identifying and supporting HPA-axis dysfunction remains a key priority in any genetic support plan.
Historical emotional and physical trauma, also known as adverse childhood events (ACEs), can significantly modify the accessibility of our genes for transcription. Encouraging clients to acknowledge and accept their ACEs can be a powerful tool in the healing process and reduce the likelihood of passing these epigenetic alterations on to our children.
2) Support methylation with low-dose B Vitamins
Methylation is a vital process for healthy DNA and epigenetic modification. Having too much or too little methylation can be very problematic and leaves us susceptible to a range of health issues such as fatigue, poor cognitive function, reduced detoxification and diseases such as cancer and cardiovascular conditions. The B vitamins, in particular folate, vitamins B12 and 6, with the help of B2 and 3, are the most important when it comes to a healthy methylation cycle and high homocysteine levels may indicate low levels of these nutrients, or a block somewhere in the process.
Eating a range of B vitamin-rich foods and supplementing with a low dose pre-methylated B complex (such as Igennus’ Super B-Complex), and slowly titrating the dose to your client’s needs, will help provide gentle support without overstimulating the pathways and sending your clients off into a methylation storm.
3) STOP taking folic acid – opt for QuatreFolic instead
Unfortunately those of us with issues throughout our methylation pathways often struggle to use folic acid, which is still the most common form of folate used in supplements. Research now links folic acid use with a range of adverse effects, from increased cancer risk to autism. Certain SNPs mean people are less able to absorb and process folic acid and it can therefore accumulate, causing toxicity. Without testing, switching your clients’ folic acid for folate rich foods and supplements containing Quatrefolic (such as Igennus Super B-complex) is the safest way to avoid the risks of folic acid use.
4) Remove toxins and check for heavy metals
We are regularly exposed to dietary and environmental factors that have the potential to change our epigenetic markers and even encourage DNA breaks. Removing exposure to chemicals and toxins is an important step in protecting genetic health. Swapping to natural cleaning and cosmetic brands, storing fatty foods away from plastics and aluminium foil, choosing organic or home grown foods where possible, and reducing exposure to airborne toxins is essential to protect DNA integrity and reduce potentially negative modifications. Heavy metal toxicity has also been shown to disrupt our genetic expression and so testing can be useful.
5) Control inflammation
High levels of inflammation can not only lead to epigenetic changes but also increase the risk of subsequent disease developing in the presence of existing SNPs and histone modifications. Inadequate cellular capacity to resolve inflammation (high AA:EPA ratio), or the presence of persistent inflammatory triggers (chronic infection, high stress, food intolerance, autoimmunity) can lead to long-term health issues and further unwanted DNA modifications. Recommending clients follow an anti-inflammatory diet and testing their AA to EPA ratio, as well as supplementing with EPA and DHA at the doses they need to resolve imbalances in the omega 3 to 6 ratio, is also essential.
6) Make movement an essential part of your support plan
Exercise is a very powerful therapy and even better when conducted outside in nature. Studies show that exercise elicits many of its health-enhancing benefits (beyond getting fitter and leaner) via epigenetic mechanisms, many of which are linked to improved cellular processes, enhanced metabolism and longevity. Recent studies have shown exercise to be more powerful than a second round of chemotherapy in the treatment of cancer!
Being familiar with all the different ways in which clients can add movement to their day (that is realistic and achievable for that client) will really help in keeping their DNA healthy.
These are just a few starting points; of course there is much, much more to think about, but the key is not to get bogged down. Get out there, do some reading, research and get involved with all the amazing CPD, webinars and online support there is; all safe in the knowledge that you are already doing a lot of the right things necessary to build an effective nutrigenomic support protocol.
Here are just a few links to help you get started:
Webinars and videos:
CPD and courses: