Articles

Digital Nutrition - Making Athletics Safer

HEREDITY AND SUGAR CONSUMPTION
Fredric Abramson, Ph.D., S.M., Esq. Copyright 2018

Summary: Turns out that the folk myth that some people are simply wired to eat more sweets, is true! Researchers found a genetic difference in the amount of sugar people eat each day. Which means that there’s more to what we put in our bodies than simply blaming fast food, soft drink and candy companies.

Overview: The gene is the glucose transporter type 2, or GLUT2, and different versions of the GLUT2 gene impact the amount of sugar we eat. Researchers used food records collected over three days to identify the amount of sugar people ate. Two specific versions of the GLUT2 variant (rs5400) were studied: the “C” type and the “T” type. The study found that[1] the TT and TC persons ate 30% to 35% more sugar each day than the CC persons. This translates to roughly 4 ounces of sugar each day, which amounts to about 7 pounds per month. The CC persons on the other hand ate roughly 3 ounces a day, or five and a half pounds a month. In other words, those with one or two copies of the T gene consume between 1.1 and 1.9 extra pounds of sugar each month.

Age did not appear to be a factor as sugar consumption was essentially the same in younger and older adults. In addition, there were no differences in sugar consumption in younger and older adults when the amount of fat, protein or alcohol consumed was taken into account.

Using Genetic Information

Weight Management: These results may be useful for dieters who snack, have a “sweet tooth”, or who find it difficult to lose weight in general. For example, TT and TC persons who are dieting may inadvertently be eating more sugar than they need to. If a person knows that genetic programming may play a role in increased sugar consumption, then it is possible to look more closely at what is in the foods, to reduce the amount of sugar for possible diet success. (Is the sugar consumption also related to a dopamine reward system which results in craving a little more sugar?)

Parenting: Consider the possibility that one child may be more disposed to eating sweets than another child. One can imagine an impact on their weight, and their self-image. Being aware of a possible genetic effect can help with better meal planning for a child, without being arbitrary.

Relationships: Many relationships become strained because of changes in physical appearance. In fact, many people go on weight loss diets to look better to their partner, and feel better too. Differences in sugar craving can create challenges in terms of deciding what foods are bought, prepared and served. Understanding these differences can produce more effective shared strategies.

[1] Genetic variant in the glucose transporter type 2 is associated with higher intakes of sugars in two distinct populations, Karen M. Eny, Thomas M. S. Wolever, Bénédicte Fontaine-Bisson and Ahmed El-Sohemy, 2008, Physiol. Genomics 33: 355-360Type your paragraph here.

Unlocking the Promise of Personalized Nutrition

By Fredric Abramson, Ph.D., S.M., Esq.

People wonder why one dish can be so appealing to one person and turn off another person? Or why their neighbor’s weight loss diet didn’t work for them. These reflect the fact that people metabolize the same food at different rates. Just as our physical capabilities are individualized, so it is with nutrition. So what can happen when consumers have insights into what nutrients best match their genetic needs?

There’s a growing commercial interest in DNA testing, and consumers are increasingly fascinated by what a swab of saliva can reveal. But there’s more to genetics than simply ancestry. Unwinding and translating one’s genetic makeup can also unlock a path toward peak health, helping consumers make more informed food choices for improved fitness, mental and physical performance, weight management, and overall well-being.

The emergence of genetically-personalized nutrition, also known as nutrigenomics or nutrigenetics, represents a huge potential, not just as it relates to the improved health of consumers, but also for food landscape and healthcare as we know it. Consumers will be using their genetic data to better understand nutrient profiles that best match their genetic map.

The adage “you are what you eat” will now be “you eat what you are.” Personalized nutrition represents potential. The potential for consumers to make smarter nutritional choices for themselves and for their family. The potential to transform the customer experience in the process restaurant and the food service areas. Food companies can increase brand loyalty with new and improved products that dovetail with their customers’ genetic makeup. Imagine smartphone-friendly QR codes or barcodes on restaurant menus that customers can scan to identify better choices. We are entering a new dimension in food and nutrition that is as revolutionary as refrigeration was a century ago

Increasing customer control over their nutrition choices can change the face of healthcare as we know it. Genetics empowers consumers to be proactive about their health and well-being, rather than reactive. Everyone will have the potential to find the nutrient mixes that let their bodies perform more optimally, and that meet their personal metabolic profiles and nutritional needs.

Major food companies have started moving into the space. Campbell's initiated a project in San Francisco where they use a person's DNA profile to prepare customized meals delivered to the customer’s door. Nestle is investing millions in nutrigenomic research to create foods configured around persons genetic profile.

The shopping experience itself is changing. Amazon Go knows what shoppers pull off the shelf and automatically charges it to their Amazon account. The Internet of Things technology can have food products and the store “talking” to shoppers as they shop. Food companies are experimenting with 3-D printing to produce customized foods, possibly opening a whole new chapter to take out ordering.

Thousands of scientific studies document the relationships linking genetic variations with how the body processes and uses nutrients. Everyone knows that people react differently to foods, and their nutrient content. Here are a few examples that highlight some common differences.

Sugar content and obesity is a hot topic. Some people seem to have a sugar craving. But is this craving DNA driven, or learned? Researchers found that the variations in the GLUT2 gene (glucose transporter type 2) impact sugar consumption.[1] Those with one or two copies of one variant consume 1.1 and 1.9 more pounds of sugar each month than those with no copies. Interestingly, there was no effect of age, and no differences in the amount of fat, protein or alcohol consumed. In our own pilot study, one participant, when told she did not have the gene for increased sugar consumption, grasped that her “sweet tooth” was probably learned because her parents didn’t let her eat sweets when she was a child.

Another obesity related area related is dietary fat. The Framingham heart study found that a variant of the APOA5 (apolipoprotein A5) gene was associated with increased BMI when the dietary fat intake exceeded 30% of total calories.[2] Below 30%, there was no difference in the risk of being overweight.

Appropriate vitamin and mineral levels are important to maintain good health. The HFE gene helps regulate the amount of iron in the body. One variant is associated with the condition known as hemochromatosis (excess iron) when the person carries both copies. The heterozygous person, with one copy, has high normal iron levels. For this person, providing high levels of iron supplementation could elevate iron levels above normal. The impact of excess iron on athletes can be negative, and lower their performance.[3]

These examples highlight the opportunity for each person to have her/his own “best” nutrient profile, based in part on their genetics. Of course other factors play a role, such as activity levels, age, medications, and overall health status. Genes don’t operate in a vacuum.

Still skeptical about genetically-personalized nutrition’s potential? It’s worth remembering that every day, people listen to weather forecasts, knowing that weather forecasting is far from perfect but better than simply waiting for the weekend to find out if it’s going to rain.

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Fredric Abramson is an adjunct professor of Biotechnology at Johns Hopkins, and is founder of Digital Nutrition. His Ph.D. in Human Genetics and Population Planning is from the University of Michigan, and his Masters of Management is from MIT where he was an Alfred P. Sloan Fellow.

[1] Genetic variant in the glucose transporter type 2 is associated with higher intakes of sugars in two distinct populations, Karen M. Eny, Thomas M. S. Wolever, Bénédicte Fontaine-Bisson and Ahmed El-Sohemy, 2008, Physiol. Genomics 33: 355-360
[2] APOA5 gene variation modulates the effects of dietary fat intake on body mass index and obesity risk in the Framingham Heart Study, Dolores Corella et al, Journal of Molecular Medicine, Volume 85, Number 2 / February, 2007 119-128
[3] Iron supplementation in athletes – first do no harm, Heinz Zoller and Wolfgang Vogel, Nutrition, Volume 20, Issues 7-8, July-August 2004, 615-619.

Sports, Genes and Concussions
Nisha Batta ©March 2019

Genetic research identified certain genetic variants that are linked to the risk of a concussion injury. One of these variants (different versions of a gene) involves the APOE gene. This gene contributes to plasticity and repair. Basically, it allows the brain to recover from an injury, like a concussion. The research showed that one APOE variant increases concussion risk.

What follows is an interview with a high school athlete that illustrates how knowledge about one’s genetic makeup can help an athlete identify specific strategies to lower his/her concussion risks.

My brother Mark and I both play sports. I am a cheerleader at Silver Mill High School. Mark plays club soccer and for the Silver Mill varsity soccer team. Mark had been having a tough time recovering from an ACL tear and our doctor suggested that it might be a good idea to try out genetic testing. The purpose was to see if we tested positive for any genetic markers of injury. For me, he wanted to look at certain genes that might put me a higher risk of concussion. He’d been seeing a lot of cheerleaders coming in with concussion injuries. He explained the example of a gene called APOE. APOE might predispose me to a higher risk of concussion and cause issues in my recovery if I were to have a concussion.

The APOE gene, and specifically the e4 version, was what my doctor examined. This gene, he explained, provides the directions for your body to make a protein called Apolipoprotein E. The Apolipoprotein E protein in turn forms lipoproteins. Lipoproteins are molecules that carry fats through the bloodstream and help keep cholesterol at normal levels. The reason this gene seems to relate to the risk of concussion is that Apolipoprotein E plays a role in nervous system growth and recovery. It also has a role with communication within the nervous system. It appears that specific variants of the e4 allele can extend post-concussion symptomology, cause decreased performance, and reduce information processing.

When the results came back I was mortified. My doctor told me that I in fact have this genetic variant in the APOE gene – which meant that part of my gene wasn’t acting the right way and it might be harder for my brain to recover from injury. I had heard the stories about how cheerleading is the number one concussion injury activity in girls and is called “the world’s most dangerous sport.” But cheerleading had never hurt me. Hearing this news though, I thought I would have to stop cheering and stop doing what I loved. After I talked to my doctor and he calmed me down, I was given some options on how to modify my cheering so that I could still participate. Some of these options were:

Limit my level of height in pyramid stunts.
Not participate in stunts where I might be thrown into the air or participating as a flyer.
Limiting participation in stunts in general.
Making sure proper mats are always used when performing stunts.
To stop when I get tired and fees like my form is being compromised, or when I am ill or injured.
Consider training outside of just cheering, to build up my strength and stamina to decrease the probability of things going wrong.
Do not participate in stunts unless a qualified, trained coach is present.
Focus on my technique over everything else when in practice.

Another interesting piece of advice he gave me was regarding my diet. He suggested that I should increase my intake of EPA/DHA also known as omega-3s to help decrease my risk of injury. Specific genes, like APOE, have been seen to impact omega three processing. Certain omega three foods he recommended were mackerel, salmon, cod liver oil supplements, flaxseeds, chia seeds, and walnuts.

Thankfully I was not a flyer on the team. But taking these considerations into actual practice was hard especially since my coaches were so tough. I was most scared of how to talk to my them about my risk since their motto was usually, “Unless you are actually injured, you’re not sitting out.”

My mom and I set up a meeting to talk to them about it. I was freaking out. Surprisingly, they were not the tough coaches I usually saw during practice, but they were actually interested in the genetic information we had gotten and were as concerned as we were. They wanted all of my teammates to do genetic testing so they could structure practices and the team positions better. They thought that knowing this information would decrease the amount of injuries we were having on our team – which were a lot. For example, I had sometimes been a flyer but mostly was a base. So, it was easier for me to modify my involvement in stunts. I was given more parts cheering on the floor than participating in stunts. I found this to actually be way better since I was a dancer on a competitive dance team too. I had to quit because cheer practices were getting more demanding. I was so excited with the news that I could combine my dance technique with cheer!

My brother Mark had a different diagnosis and he didn’t have the same variant I had. This was good news for him because most of his soccer strategy relied on his ability to perform “header-shots” into the goal. Since this was the case, concussion was still a risk for him. It’s not like he was immune to concussions or anything. So, our doctor advised him on some normal safe play guidelines like:

Try to avoid collisions with equipment and other players especially head to head contact.
Make sure goal posts are padded and in good condition.
Practice heading technique with a softer ball of the same size during practices when possible.
Make sure he is training for stamina and strength outside of just practice so he can play better and sacrifice form best.
Try to head the ball as little as possible and start working on other techniques to improve them to be as good as heading.
Making sure you know the proper heading technique according to the National Soccer Coaches Association of America (NSCAA)

Sources: https://www.stopsportsinjuries.org/STOP/STOP/Prevent_Injuries/Cheerleading_Injury_Prevention.aspx
https://kidshealth.org/en/teens/cheerleading.html
https://www.cdc.gov/headsup/basics/concussion_prevention.html
https://ghr.nlm.nih.gov/gene/APOE#conditions
https://www.ncbi.nlm.nih.gov/pubmed/28541413
https://www.ncbi.nlm.nih.gov/pubmed/8820179

December 2018

Gymnastics is tough on a person’s body. Of course, this is true of many sports. Gymnastics, though, has some special risks.

I grew up as a gymnast. I saw many of my teammates injured. And I unfortunately was no exception.

Every gymnast has pains that they try to live and work with. Sometimes though they experience pain so severe that they have to get help. That happened to me. My knees gave out. The pain was incredible. I went to doctor after doctor. I spent huge amounts of time trying to find out what was wrong. I spent two years doing gymnastics on knees that constantly hurt, all while struggling to get some real clarity about what was wrong.

Finally, one doctor nailed it immediately. He said it was about my genes. I have a genetic condition that was causing my knee pain. One reason it took so long to figure out is that most people don’t experience this problem until later in their life. In my case, I started getting symptoms at the age of eight. Because gymnastics has high impacts on the legs and body.

With the reason identified, I was given exercises to help relieve the pain.

This is true of most injuries and pains. The sooner they are caught and treated, the better off the person is. More important, when you know what parts of your body have a higher risk of being hurt, you can take steps to avoid injury and reduce their severity when they occur. In case, a genetic test early in my gymnastics career would have identified this risk. And I would have been able to start preventive exercises to lower the risk and pain severity.

I also would have saved all that time spent at doctors trying to figure out what was wrong, while continuing to suffer. If I had it to do over again, I would hope my parents would get the genetic test. That way, we could have been doing the right things from the beginning!

Perhaps you have a similar story. I'd like to hear it. You can contact me at leighannleslie4@gmail.com