Textbook of Personalized Medicine - Second Edition [2015]

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A central theme of the research will be to consider whether or not there should
be regulations governing the nutrigenomics and what such regulations should
look like. ESRC also plans to investigate what the public is being told by commer-
cial kit providers.


Genomics of Vitamin D and Calcium Supplementation


Inter-individual response differences to vitamin D and Ca supplementation may be
under genetic control through vitamin D and estrogen receptor genes, which may
infl uence their absorption and/or metabolism. Metabolomic studies on blood and
urine from subjects supplemented with Ca and vitamin D reveal different metabolic
profi les that segregate with genotype. Genotyping was performed for estrogen
receptor 1 gene (ESR1) and vitamin D receptor gene (VDR) in postmenopausal
women some of whom were classifi ed as low bone density as determined by a heel
ultrasound scan and others had normal bone density acting as controls (Elnenaei
et al. 2011 ). Those with low bone density (LBD) were supplemented with oral Ca
and vitamin D and were classifi ed according to whether they were ‘responders’ or
‘non-responders’ according to biochemical results before and after therapy com-
pared to controls receiving no supplementation. Metabolomic studies on serum and
urine were done for the three groups at 0 and 3 months of therapy using NMR spec-
troscopy with pattern recognition. The non-responder group showed a higher fre-
quency of polymorphisms in the ESR1 (codons 10 and 325) and VDR (Bsm1 and
Taq1), compared with to the responders. The wild-type genotype for Fok1 was more
frequent in those with LBD (70 %) compared with the control group (10 %).
Distinctive patterns of metabolites were displayed by NMR studies at baseline and
3 months of posttreatment, segregating responders from nonresponders and con-
trols. Identifi cation of potential non-responders to vitamin D and Ca, before therapy,
based on a genomic and/or metabolomic profi le would enable targeted selection of
optimal therapy on an individual basis.


Nutrigenomics and Functional Foods


Functional foods are nutrients that benefi t human health beyond the effect of fulfi ll-
ing essential physiological needs. Many claims have been made for the benefi ts of
functional foods but there are no consistent and proven results, partly because
human responses are variable. Polymorphisms in genes for the absorption, cir-
culation, or metabolism of essential nutrients, such as n-3 polyunsaturated fatty
acids, would affect the effi cacy of that nutrient. However, functional foods often
incorporate bioactive compounds, such as epigallocatechin-3-gallate, without con-
sidering the interaction with genetic polymorphisms. There are individuals whose
genotype precludes their deriving signifi cant benefi t from an increased intake of
such foods. Although large-scale, whole-genome association studies are providing


Personalized Nutrition

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