Fresh Wrap Ep 01: Food and our Genome: International Society of Nutrigenetics/Nutrigenomics (ISNN)

MELISSA ADAMSKI: Hi, everyone. This is a wrap up of the
2019 International Society of Nutrigenomics and
Nutrigenetics Conference in Cambridge in the UK. And these are some of
the takeaway messages that we thought you
might find interesting from that conference. So first of all, the
conference mainly was situated around
two main themes. So the first one was
around genetics and weight. And the second one was
around the microbiome. So two very interesting
and topical areas in genetics and ones that are
very relevant for practicing health care
professionals and ones that we usually get a lot of
questions about at this time. Because the microbiome–
there’s lots of information out there online and
in the media about how the microbiome might affect our
health, similarly around how genetics may affect our weight. And as health care
professionals, is there something that we
can do about that if someone is predisposed or has a
genetic influence in regards to their weight? So just a couple of
take-home messages that I took away
from the conference that you might like to
go and research further. And it will be
definitely something that I’ll be going to
research further as well. So first of all, an interesting
point that I took away was not just around obesity or weight
that is influenced by genetics, but also around eating
behaviours as well. So there were a couple of talks
that talked about the genetic influence of eating behaviours. And I guess what it
really highlighted to me was just the
complexity of the role that genetics plays
in regards to weight. And so when we’re
talking to patients, we can’t distill it
down into such simple, black-and-white messages because
every one of our patients will be different. So one of the points made
was that biology really encodes for food cravings. So it’s not just around our
body shape and weight gain in general. But it was distilling it down
even going into the genetics of food cravings as well and
that human eating behaviours are underpinned by
biological mechanisms. And so that’s something
that I’ll definitely consider when patients are
describing their habits. We’re not at that stage yet. I don’t think that we can
actually use that genetics when counselling patients. But really in, I think our
research or our conversations around what might be influencing
a person’s weight is making sure that we’re not just
blaming someone’s behaviours and saying, it’s all your fault.
You lack willpower, et cetera, et cetera. We must recognise that there
is something deeper going on and much more complex
mechanisms at play, and that it partly might
be genetics that may be influencing their
eating patterns there. So that was a very
interesting point. Secondly, it’s
interesting to see that genetics are
now starting to come into national guidelines more. So I found out that the
Endocrine Society in the UK actually has clinical
guidelines that were released in 2017 that
do have a panel of genes that are recommended– so not SNPs, sorry, a gene
sequence that is actually recommended for
very young children who gain weight very, very
quickly in that early age. So a genetic test is actually
one of those options that can be done in clinical practise to
actually understand what might be underlying that weight gain
and if it is actually a genetic component rather than a purely
environmental component there. And that was just interesting
to see that, once again, clinical guidelines are starting
to recognise that genetic influence that can
happen with weight. So once again, it’s
not for everyone. And it’s for very specific
cases for very young children but still, once again,
an interesting thing. Also, there was discussion
around genetic risk scores regarding weight
because in the past there has been suggestion or
the development of genetic risk scores that have tried
to explain weight gain. And in the past this
has not been reflected in the literature as being
something that could be used in clinical practise. But what was mentioned
at the conference is that these past genetic
risk scores were only on a limited number
of genetic variants. I think it was about 100 or so. Whereas a newer
paper that came out in Cell around three months
prior to this conference looked at around 2 million
variants which did actually suggest or predict weight,
which I found very interesting. And once again, this
was a brief comment made within a talk
and so something that I need to go and research
myself more to understand. But it is a hint that you might
also like to start researching around that point
because, once again, it highlights that complexity
in what information we might actually need before we could
start using this area well in practise to actually
inform what we do. So that was just interesting–
the difference between the 100 variants versus the 2 million
variants and the difference that that had with regards to
that genetic risk score there. Another point that
was made as well was that just because
genetics might make it easier to gain
weight with influences– for example, the association
of weight with the FTO gene– it doesn’t necessarily mean
that it’s harder to lose weight. And I really found
this interesting because there is the danger
that when people learn about their genetics that
they might think, oh, well, there’s nothing I
can do about it. It’s in my genes. And so I’ll just be this weight. I won’t be able to
make a difference. However, it was summarised
in this conference. The research was summarised that
currently the research suggests that just because people
have genetic variants that may be associated with
weight or having more weight, it doesn’t necessarily
mean they can’t lose weight like people without those
risk variants there. So that was interesting as well
and something that I think we should watch this space with
so we can take away to clinical practise to say that
even if someone, say, has genetic tests done and they
do find out that they do have genetic variants associated
with weight gain or more weight, et cetera, it doesn’t
necessarily mean they won’t respond to
weight loss efforts. Now, in saying
that, yes, we need to look at the research and
literature around perhaps gene-diet interactions
and different diets and how people respond to them. But I think that’s
a separate point. Just in general, when looking at
the FTO gene and the AMY1 gene, the research suggested that
people with those risk variants could still lose weight
similar to people that didn’t have those risk variants. So that was interesting
there as well. And there was also discussion
around a bit of an update around different variants
associated with weight and around eating behaviours. And it was reported that there
are approximately about 25 loci associated with eating
behaviours that are known at the moment and over 800
associated with weight gain. So once again, just showing
the incredible breadth of variations that
are currently known or currently being researched
and how you can see how complex that gets so quickly, especially
if we start testing them all and then trying to understand
or put all that information together to then come up with
recommendations for patients there. So needing some
assistance with that will definitely be
something that’s key in the future, such
as some bioinformatic help perhaps, et cetera,
to help us put all that information together. So once again, that was just
a little checkpoint for me to check in and just say, wow,
this is an interesting space. And it is quite complex. So we need to learn more about
how genetics affects weight to be able to tailor
recommendations. And that’s probably the
overall take-home I took away– that once again, using this
in practise at the moment, we might be able to use little
snippets of information. But overall, we still need a lot
more research to be able to get a much better picture of how our
genes are affecting weight from a practical point of view in
practise in front of a patient. Also, there is a textbook
that is being released by the International
Society of Nutrigenetics and Nutrigenomics. It’s been a number of
years in the making. But it will hopefully be
one of those go-to resources that as dietitians
and doctors, et cetera we’ll be able to use
to be able to get a good grasp on this space. So they announced that at
the conference and that it will be released
in September 2019. It’s 73 chapters, so
quite a large one. And it will cover topics of
nutrigenetics, nutrigenomics, ethical, legal,
and social issues, and other practical
aspects of this space. So once again, nice to see
a resource being developed to help us health care
professionals out there understand the evidence. And then finally, looking
at the second half of the conference, which really
touched on the gut microbiome. So once again, a very
interesting space and very topical here. Just a couple of take-home
points I took away. The microbiome is not
my space of expertise. So some simple ones that
I thought were interesting was that 80% to 90%
of the gut microbiome is not yet explained or
understood– so once again, back to those complex messages. And I know just hearing
myself say “complex,” I’ve said it quite a
few times in this video. But it really highlighted
to me that, once again, we still don’t know a whole lot. And that’s really
resonated with me because when I’m in
front of a patient and they have a lot of
questions about the microbiome, it does come back to a
lot of the time me saying, we don’t really know yet. We know a lot. We’ve come a long way. But there’s still so
much we can learn. So even though it was
mentioned that there over 30,000 papers
in the literature around the microbiome, we still
don’t understand 80% to 90% of it, which is interesting. Now, I’ve heard
this figure before– and I’m sure many of
you have as well– that we have a couple of
kilos of bacterial mass in our bodies. And it’s something that you
see quite a bit online– that point being thrown around. However, it was suggested
in one of the talks that this figure is
actually not correct and that we only have around
200 grammes of bacterial mass. And it was, once again,
an interesting point, just highlighting to me as well just
to always go back and check where figures have come
from to make sure that they have been reported correctly. But it is a very common one that
I think a lot of even health care professionals and
scientists we talk about. But apparently there, yes,
is only around 200 grammes of bacterial mass. And that diet actually
has a small impact on microbial diversity. I thought that was
an interesting point. And that we must also remember
the importance of the GI, or the Gastrointestinal,
tract physiology when we are giving meaning
to microbiome data. So we must always take
it back to physiology as well and not just
forget about how our gastrointestinal
tract works when we are looking at microbiome results. So we must always
interpret that in terms of the gastrointestinal
tract, including transit time, what affects
transit time, et cetera. So there was a bit of
discussion around the microbiome or the samples of faecal
mass and the microbes that may be found in that. We must also remember
that transit time may have affected those results there. And this may be
forgotten sometimes. And lastly, there
was also some talk around lactose intolerance. Now, this is an example that’s
used a lot in nutrigenetics around– it’s quite a simple one– around lactose tolerance and
genetic variation around who is lactose tolerant and
who is lactose intolerant. And it was suggested that
acquired lactose tolerance may actually have a
frequency of around 24% and that this may be a result
of the microbiome or certain– I think it was Bifidobacteria
in the microbiome might be influencing this
acquired lactose tolerance in
lactose-intolerant individuals. So once again, it’s
highlighting the importance of learning how the
microbiome may impact on not just our health,
but how we respond to diet and other lifestyle factors. So there were just
a few snippets that I took away
from the conference, once again, the
areas that I will be going to research further
and to clarify further. And if any of those
interested you as well, I suggest that you do the
same because we always like to try and get the
latest updates around what’s happening in this space and
pass them on to you as well. So that’s it for me. And I hope you found the
video enjoyable and relevant to your professional practise.

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