A Diet Customized to Your DNA

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

It seems like it couldn’t get any better: a nutrition plan truly tailored just for you, created using your genetic blueprint.  Is this the answer to fad dieting, weight cycling and frustration?  Unfortunately, it appears that the science just isn’t quite there yet, and the promises from “DNA diet” companies might be too good to be true.

The premise behind the DNA diet makes sense.  Your genes hold information about your chance of getting certain diseases, such as obesity, diabetes, or high cholesterol.¹ You can influence whether or not your body expresses certain genes by becoming more physically active or making different food choices.  There are even genetic markers that suggest whether you may be better able to metabolize fat or carbohydrates,² which in theory would determine whether you should eat a high-fat or high-carbohydrate diet. 

A recent study called DIETFITS examined this theory by placing 600 participants on either a high-fat or high-carbohydrate diet.  The participants got regular instruction about weight loss strategies while following their assigned diet.  During the course of the study, the researchers categorized participants as “low-fat genotype,” “low-carbohydrate genotype,” or “sensitive to neither genotype” depending on whether their DNA contained any of three different variations. After one year, participants on the high-fat diet had lost about the same amount of weight as the people on the high-carbohydrate diet, regardless of their genotype, and whether they followed the diet that “matched” their genetic sensitivity to fat or carbohydrates.² 

The DIETFITS study also gave participants a glucose tolerance test to see whether their insulin sensitivity was related to their success with weight loss on a low-carbohydrate vs. low-fat diet.  Researchers believed that people who were insulin resistant would do better on a low-carbohydrate diet.  After one year, however, researchers found that glucose tolerance had no impact on weight loss for people in either the low-carbohydrate or low-fat group.²

Part of the reason it’s so difficult to accurately match a person’s genes to their ideal diet is that many different genes are associated with weight, and your environment and behaviors influence how these genes will be expressed.¹ For example, a high activity level is associated with a stronger immune system, possibly because being active triggers small amounts of inflammation, and as a result the body makes more copies of the proteins needed to fight inflammation.³ In order to say for sure whether DNA diets are truly the thing of the future, there will have to be more, well-designed research studies that evaluate the expression of more than just three genes, and follow participants for longer than just one year.  This way, researchers will be able to say whether the diets support both weight loss and weight maintenance over time.

In the meantime, if you’re still curious about the DNA diet, there are many companies that can perform this service for you.  The cost ranges from about $50 to $200, depending on the depth of information and amount of support you receive.  Most of the tests ask you to send in a saliva sample so they can map your DNA.  Some also measure your insulin sensitivity and other markers of disease risk like cholesterol and triglycerides to help you create a meal plan that will maximize your overall health in addition to promoting weight loss.  For example, if a test measures your insulin sensitivity, they send a glucose tolerance test, in which you would drink a high-carbohydrate beverage, wait about 30 minutes, prick your finger and collect a blood sample to send back and be analyzed.  If your cells are sensitive to insulin, you will have less glucose remaining your blood.  If you are insulin resistant, your blood sugar may be higher.  Insulin resistance is a precursor to diabetes, so if you have a family history or other risk factors for this disease, you’ve probably had a glucose tolerance test at a doctor’s visit.

These companies’ websites do not include many specific details of how the test results inform their recommendations (they’re probably trade secrets!).  Most likely, if someone’s test indicates they’re insulin resistant, they will be given a low-carbohydrate meal plan to help reduce their chances of getting diabetes.  Along the same lines, if someone’s blood test suggests they have high triglycerides, that person will likely be given a low-fat meal plan.  These findings would be used in combination with the results of the saliva sample DNA test.  Marcia is ordering a test kit to learn more about the process and will be able to provide more information about this in the near future.

It’s important to note that even without a personalized DNA diet plan, you can still make healthy diet and lifestyle choices that will impact your overall health and reduce your risk of disease.  In one study, men with low-risk prostate cancer adopted a low-fat diet, increased their activity level to be active for about 4 hours per week, and spent time prioritizing stress reduction.  After 3 months, genetic evaluation showed that they were producing fewer of the genes associated with tumor development.¹ In the DIETFITS study, all of the participants were told to eat more vegetables, eat less added sugar and refined grains, and focus on whole, unprocessed foods whenever possible.² You will likely see similar health benefits and reduce your risk of disease by practicing stress reduction, getting active, eating more fruits and vegetables, and eating fewer refined grains.  For support with this, contact a Registered Dietitian who will give you evidence-based recommendations that work with your lifestyle to reduce your risk of disease over the long-term and reach any other nutrition-related goals you might have.

References:

1.         Camp KM, Trujillo E. Position of the Academy of Nutrition and Dietetics: Nutritional Genomics. J Acad Nutr Diet. 2014;114(2):299-312. doi:10.1016/j.jand.2013.12.001

2.         Gardner CD, Trepanowski JF, Gobbo LCD, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. JAMA. 2018;319(7):667-679. doi:10.1001/jama.2018.0245

3.         Gjevestad GO, Holven KB, Ulven SM. Effects of Exercise on Gene Expression of Inflammatory Markers in Human Peripheral Blood Cells: A Systematic Review. Curr Cardiovasc Risk Rep. 2015;9(7). doi:10.1007/s12170-015-0463-4

Protein Needs Change with Age

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Starting at age 50, your muscle mass begins to decrease each year.  This age-related muscle loss is called sarcopenia.  It's normal and it happens to everyone to some degree.  However, extreme loss of muscle mass can lead to frailty, fatigue, falls, fatigue, and even insulin resistance, all of which can result in a loss of independence for the older adult.¹ Because of this, maintaining muscle mass is crucial for promoting health and longevity as you age.  One of the most important factors in slowing the rate of muscle loss is consuming enough protein on a day to day basis.^2,3

Dietitians used to believe that adults over the age of 18 only needed 0.8 grams of protein per kilogram of their body weight each day.  Recent research, however, suggests that adults over the age of 65 actually need between 1 and 1.3 grams of protein per kilogram of their body weight to support muscle maintenance.  In fact, one study found that adults’ muscle mass still decreased when they were meeting the general recommendation by eating 0.8 g protein per kilogram of their weight every day.³ In more practical terms, this means, once they reach the age of 65 …

·      An adult weighing 130 lb would need 60-76 g protein per day

·      An adult weighing 150 lb would need 68-88 g protein per day

·      An adult weighing 170 lb would need 77-100 g protein per day

·      An adult weighing 200 lb would need 90-118 g protein per day

In addition to getting enough protein on a daily basis, it is also important to be aware of the quality of protein you eat.  All protein molecules are made up of amino acids that link together and determine the protein’s final structure.  There are nine amino acids that your body can’t make, and have to be provided by the food you eat; these are considered essential amino acids.  The other amino acids are considered non-essential, and can be produced in your body.  High-quality sources of protein provide all of the essential amino acids, and some studies show that people don’t need to eat as much protein each day if all of their protein comes from high-quality sources.³

Animal products, such as meat, fish, eggs, and dairy products, provide all of the essential amino acids.  A few plant products, such as soy, quinoa, hemp seeds, buckwheat, and pumpkin seeds, also contain all of the essential amino acids.  You can also combine sources of whole grains with legumes or nuts to create meals that provide all of the essential amino acids.  People used to believe it was necessary to combine these foods within the same meal to absorb all of the amino acids.  Dietitians now know that this isn’t true, and as long as you eat a mix of these foods throughout the day you will meet your essential amino acid requirement.

Studies also suggest that spreading protein intake throughout the day will be most effective for preventing muscle breakdown and maintaining muscle mass. It appears that the ideal protein distribution is about 30 grams of protein at each meal; studies have shown that there is no additional increase in muscle growth when people eat much more than 30 grams of protein at once.^2–4 This means that many adults need to increase the amount of protein they eat at breakfast and lunch, and decrease the amount they eat at dinner.  For example, a day that includes 30 grams of protein per meal would be:

·      Breakfast sandwich with 2 scrambled eggs, 1 oz Cheddar cheese, spinach, and tomato on 2 slices whole grain bread, with an 8-oz glass of milk on the side

·      Lunch: green salad with 2 cups vegetables, 3 oz tuna canned in water, 1 cup canned white beans, and a 6-inch whole grain pita on the side

·      Dinner: stir fry with 1 cup cooked quinoa, ½ cup cooked lentils, 2 oz grilled chicken, and 1 cup mixed vegetables

Lastly, engaging in strength training exercise at least twice per week will also help you maintain a high muscle mass.³ If you aren’t already doing regular resistance exercise, start slowly and work your way up as you build your strength, and consider working with a trainer who will make sure you’re doing the exercises correctly.  This regular activity is crucial for stimulating your body to increase your muscle mass. 

If you're concerned that you aren’t eating enough protein each day or would like support to make sure you're distributing your protein evenly throughout the day, make an appointment with a Registered Dietitian who can determine your unique protein needs and help you create a plan that will fit with your lifestyle.  An ideal plan will allow you to maintain your muscle mass, strength and independence as you get older.

References:

1.         Walston JD. Sarcopenia in older adults. Curr Opin Rheumatol. 2012;24(6):623-627. doi:10.1097/BOR.0b013e328358d59b

2.         Nowson C, O’Connell S. Protein Requirements and Recommendations for Older People: A Review. Nutrients. 2015;7(8):6874-6899. doi:10.3390/nu7085311

3.         Baum JI, Kim I-Y, Wolfe RR. Protein Consumption and the Elderly: What Is the Optimal Level of Intake? Nutrients. 2016;8(6). doi:10.3390/nu8060359

4.         Protein for Fitness: Age Demands Greater Protein Needs. https://www.todaysdietitian.com/newarchives/040715p16.shtml. Accessed October 1, 2018.