584
and information from the building blocks of metabolism-based nutrient-gene inter-
action can lead to future individualized dietary recommendations to diminish cancer
risk (Go et al. 2005 ).
Application of genomics in nutrition is important in nutritional management of
obesity and special diets for certain diseases such as hypertension (low salt diet). At
least one company, NutraGenomics Inc, is using a systems biology approach involv-
ing nutrition and the latest molecular and genomic technologies. NutraGenomics
will identify diet-regulated genes and nutritional interventions that will allow indi-
viduals to better manage their health and well-being. It is anticipated that such a
service might be integrated in diets prescribed by physicians as personalized medi-
cines approach is established in medical practice by the end of the fi rst decade of the
twenty-fi rst century. Individualized diet prescriptions, based on DNA and protein
analysis of a blood sample, may be provided.
Personalized nutrition, however, faces more challenges for implementation than
personalized medicine. Whereas drugs are designed to interact with specifi c targets
and the knowledge of sequence of a single gene may be enough to determine
whether a person will respond to a drug. In contrast, the diet contains thousands of
nutrients, vitamins, and other compounds that can have subtle but signifi cant effects
on numerous targets and genes. It may take decades to test the effects of changes in
diet, making it diffi cult to design and conduct well-controlled clinical trials. Simply
knowing the sequence of an individual’s genes is not enough; there is also a need for
understanding how different genes interact as well as of epigenomics – transient
modifi cations in the genome.
Personalized Physical Exercise
Physical exercise is generally considered to be important for maintaining health and
is an important consideration in preventive medicine. However, individuals differ in
their responses to physical exercise.
Variations in Response to Aerobic Exercise
Physiological responses to exercise and likelihood of aerobic benefi t varies consid-
erably among individuals. Low maximal oxygen consumption (VO2max) is a strong
risk factor for premature mortality and endurance exercise training increases
VO2max with a very wide range of effectiveness in humans. A study has used RNA
expression profi ling to produce a molecular classifi er that predicts VO2max training
response to predict gains in maximal aerobic capacity following endurance exercise
training in humans (Timmons et al. 2010 ). The study concluded that combining
RNA profi ling with single-gene DNA marker association analysis yields a strongly
validated molecular predictor with meaningful explanatory power. VO 2max responses
to endurance training can be predicted by measuring a 30-gene RNA expression
19 Personalized Non-pharmacological Therapies