Changing the Model for Nutrition and Health Assessment
by Toni Tarver
Eating for health and wellness has become very important to consumers. Yet most people’s diets are deficient in nutrients and lead to high cholesterol, obesity, and diabetes. This reality has led researchers to rethink the conventional one-size-fits-all approach to nutrition and health. In Tuesday morning’s scientific session “Nutrigenomics, Nutritional Phenotype, and Delivery of Personalized Nutrition,” presenters provided logic for personalizing nutrition and health assessments.
Ben van Ommen, Executive Director of the Nutrigenomics Organisation, presented the European perspective on research in nutrition and health. According to van Ommen, nutrition is not about curing disease; rather, it is about optimizing health. Thus, a group-study approach to nutrition is not conducive to optimizing individual health. For example, for most people, a high intake of polyunsaturated fatty acids (PUFAs) yields an increase in HDL (the good cholesterol). But for approximately 10% of the population, a high intake of PUFAs causes a decrease in HDL. For those people, consuming foods high in PUFAs would not benefit their health and could lead to adverse outcomes. Van Ommen advised that while genetics plays a role in nutrition and health studies, aspects of an individual’s environment are equally important.
James Kaput, Director of the U.S. Food and Drug Administration’s Division of Personalized Nutrition and Medicine, agreed with many of van Ommen’s revelations. Expounding on the concept of a personalized approach to nutrition, Kaput defined nutrigenomics as the integration of the study of genotypes with nutrition science and lifestyle variables. Most studies on nutrition and health are missing detailed reviews of each subject’s diet and lifestyle. Kaput advised researchers to follow subjects over time, carefully observing the environmental factors that drive diet, nutrition, and exercise: for example, cigarette-smoking, cultural influences, athleticism, etc. Genes may be integral for determining functionalities, but nutrition and lifestyle choices modify gene expression.
J. Bruce German, Professor at University of California, Davis, bridged nutrition and health assessment with food choices. “We should be enjoying the greatest health in the history of humans, but we are not,” German said. One of the greatest successes of the 20th century is that every essential nutrient for human life has been identified. That along with advancements in hygiene and medicine have combined to extend the average human lifespan to three lifetimes, German said. But because of poor dietary choices, more often than not, the quality of that extended lifespan is poor. Humans are not instinctive eaters: They don’t innately detect when they are missing nutrients, and they certainly don’t know what to eat to achieve proper nutrition. As a result, humans eat whatever they want. According to German, humans need to learn proper nutrition, diet, and exercise—beginning at a young age. Instead of offering classes in calculus and philosophy, perhaps schools should have mandatory classes on food and nutrition.
Clearly, with a more personalized approach to nutrition and health, what’s good for the goose isn’t necessarily good for the gander.
Polymorphisms could potentially change everything. It will certainly challenge current assumptions on nutrition policy. If a subpopulation can be identified that has increased requirement for essential vitamins and minerals (think folic acid or haptoglobin polymporphisms where an increased intake of folic acid or antioxidants like vitamin E and/or C may attenuate risk), what is the advice beyond eat more of foods x and Y which are good/excellent sources of Z? Should genotyping be used to guide advice on dietary supplementation? Or should fortification be increased across a variety of foods and beverages to meet the needs of this subpopulation? Congratulations to the speakers and to IFT for this very important session which raises more questions than answers.