Personalised healthcare
GENES VARIANTS
Cheong says there are genes that have been identified to have direct or indirect effect on weight gain — FAB (fat absorption), PPAR, PPARgC1A (fat storage) and LEPR-1, LEPR-2, FTO and MC4R (appetite control).
“A person with variant genes on this panel is at higher risk of food cravings and preference especially for fatty foods, carbohydrates and energy dense foods.
“For example, if he has a variant fat absorption genes, he would absorb twice the amount of fat, making him more susceptible to weight gain. Similarly, if someone has unfavourable appetite control genes, he eats more.
“When the person has these variants, he needs to be more cautious about the quantity and the type of food and put in more effort in exercising to manage his weight.”
Beacon Laureate dietitian and nutrigenomics practitioner Edna Loh says when broken down, food contains macro and micronutrients. Macronutrients are carbohydrates, proteins, fatty acids and fibre while micronutrients consist of vitamins, minerals, phytochemicals and food metabolites. These nutrients can up or down-regulate gene expressions.
“For example, the gene PPAR-y is a hormone receptor linked to obesity. Coupled with living in an obesogenic environment, the person can be at higher risk of being obese and may need lower energy intake to keep weight stable.”
“However, your genes does not mean you are predisposed to a certain conditions. A person with genes that predispose him to weight gain does not mean he will become obese. He needs to be more aware of his diet and exercise to control his condition. This is where the genetic profiling helps.”
The balanced meal guideline is probably applicable to some people but it may not work for others. For these people, a dietary pattern that suits their genes is better at helping them manage their weight and health.
Cheong Yuen Khai
PERSONALISED DIET PLAN
Loh says there is a team of doctors, dietitians and nutrigenomics practitioners to assist in planning personalised healthcare interventions. The dietary pattern recommended is based on the latest nutritional guidelines and evidencebased practice.
She says her role is to integrate food and nutrition knowledge into practice, making sure it is precise and based on the clients’ needs, readiness to change, and socioeconomic factors.
“I have recommended healthy balanced diet for vegetarians, low fat diet, carbohydrate counting for diabetes and low purine diet for people suffering from gout. It is also important to consider the person’s tradition, religion, culture and personal food preferences.”
“The DNA panels also discuss about the positive effects of exercises. Some genes work better with aerobic exercises, strength training or high-intensity training so we will recommend types of exercises as well.”
Although the person is following dietary pattern that suits his genes, it does not mean the effect can be seen immediately.
“A diet can be precise, but it can never be perfect. There is no fixed timeline as to when one can see results because the interventions recommended are for long term changes. The expected improvement should be slow but sustainable, and ultimately the individual can manage his or her health goals with confidence.
“Some people may be ready to change
and others may not. This is where the challenge lies, and nutrition interventions can either work very well or not at all.”
Loh says a person can rarely follow the same dietary recommendations for life as his needs change according to life stages, changes in physical activity and medical condition.
“That means at different points in life, there will be changes to dietary recommendations as well. That is why I always advocate the importance of following up with a dietitian or healthcare professional to reassess your nutritional needs.”
Cheong says while diet alone may not be
able to prevent diseases, it is an important factor that can directly or indirectly contribute to disease progression.
“For example, a low fibre diet and high red meat intake are known risk factors of colorectal cancer. Diet also plays a role in type 2 diabetes and hypertension, because over a period of time, uncontrolled carbohydrates and salt intake could heighten the risk.
“Of course, other factors such as stressors in life, family history, and sedentary lifestyle can also increase the risk of these chronic diseases.”
The expected improvement should be slow but sustainable, and ultimately the individual can manage his or her health goals with confidence. Edna Loh