Personalised, population and planetary nutrition for precision health

Martínez‐González, Miguel Ángel; Kim, Hyun‐Sook; Prakash, Vish; Ramos-López, Omar; Zotor, Francis; Martínéz, J. Alfredo

doi:10.1136/bmjnph-2021-000235

Cited by 11 publications

(4 citation statements)

References 25 publications

(30 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…The horizontal approach to the provision of dietary recommendations has been questioned ( 52 ) as it often fails to address particularities at the individual patient level. Approximately 70 years ago, Williams ( 53 ) was the first to envisage personalized nutritional recommendations that take into account “genetic patterns” and suggested that patients are “far from standardized specimens.” Although this concept remained dormant for several decades, the potential of precision nutrition in health and disease management is nowadays increasingly recognized ( 11 , 13 , 14 , 54 ) and corroborated by several observational studies linking dietary outcomes to genetic variants ( 55 – 59 ).…”

Section: Discussionmentioning

confidence: 99%

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Genetically-Guided Medical Nutrition Therapy in Type 2 Diabetes Mellitus and Pre-diabetes: A Series of n-of-1 Superiority Trials

Gkouskou

Grammatikopoulou²,

Lazou³

et al. 2022

Front. Nutr.

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Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder of multifactorial etiology that includes genetic and dietary influences. By addressing the latter, medical nutrition therapy (MNT) contributes to the management of T2DM or pre-diabetes toward achieving glycaemic control and improved insulin sensitivity. However, the clinical outcomes of MNT vary and may further benefit from personalized nutritional plans that take into consideration genetic variations associated with individual responses to macronutrients. The aim of the present series of n-of-1 trials was to assess the effects of genetically-guided vs. conventional MNT on patients with pre-diabetes or T2DM. A quasi-experimental, cross-over design was adopted in three Caucasian adult men with either diagnosis. Complete diet, bioclinical and anthropometric assessment was performed and a conventional MNT, based on the clinical practice guidelines was applied for 8 weeks. After a week of “wash-out,” a precision MNT was prescribed for an additional 8-week period, based on the genetic characteristics of each patient. Outcomes of interest included changes in body weight (BW), fasting plasma glucose (FPG), and blood pressure (BP). Collectively, the trials indicated improvements in BW, FPG, BP, and glycosylated hemoglobin (HbA1c) following the genetically-guided precision MNT intervention. Moreover, both patients with pre-diabetes experienced remission of the condition. We conclude that improved BW loss and glycemic control can be achieved in patients with pre-diabetes/T2DM, by coupling MNT to their genetic makeup, guiding optimal diet, macronutrient composition, exercise and oral nutrient supplementation in a personalized manner.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Genetically-Guided Medical Nutrition Therapy in Type 2 Diabetes Mellitus and Pre-diabetes: A Series of n-of-1 Superiority Trials

Gkouskou

Grammatikopoulou²,

Lazou³

et al. 2022

Front. Nutr.

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“…To fully apprehend nutrition —clinically, socioeconomically, politically, locally and globally… we must, as an example, incorporate and navigate the potential benefits of agritech, to reduce poverty on one hand; and the fatal consequences of eating disorders (anorexia and bulimia) on the other, assuring parity of esteem (physical and mental health)?39 As shown, Hodges’ model can complement ongoing work in nutrition and recognition of the planetary scale 38. The best way to ‘Leave No One Behind’ is to ensure individuals have the requisite literacies, so they can advocate for self, family and community; and ‘not be pushed behind’ 33 40…”

Section: Discussionmentioning

confidence: 99%

Hodges’ model: the Sustainable Development Goals and public health – universal health coverage demands a universal framework

Jones¹,

Wirnitzer

2022

BMJNPH

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Background to issue Future sustainable healthcare delivery and systems need reflective practitioners and critical thinkers to engage the public to achieve health policy aims and objectives. Therefore, this descriptive review introduces a generic conceptual framework, adopting a specific theme to illustrate and demonstrate a model of care or any other context. Whatever the purpose, context or philosophical stance in healthcare and health literacy, there is no standardised generic conceptual framework to structure reflection and critical thinking. This work presents a pragmatic solution focused on the oneto-one relationship of learner-mentor, patient-clinician, public health professional-public and groups. Methods The method is constructivist, an educational exercise, practical and the target group can be defined/ viewed as student, teacher, patient, carer or member of the public in a health promotion campaign, for example. The building blocks are health and care concepts that arise clinically in practice, or for a student writing an assignment. As will be explained, concepts (including the Sustainable Development Goals) are assigned by the subject(s)-in this instance the authors-to a domain of knowledge. Results As two-by-two tables, the results represent the structure of the conceptual framework, framing the content in a series of four knowledge (care) domains. The contents, ultimately the Sustainable Development Goals, may then be linked and relationships discussed. Results are produced gradually, building a cognitive or mind-map. The results, it must be stressed, are therefore qualitative. Conclusion Drawing on educational theory and practice, the results are explored and justified using the theme of nutrition, and the often stated desirability in education of reflective practice and critical thinking abilities. Providing a series of cross-disciplinary, the reader will gain insight into the potential of Hodges' model to facilitate integrated, person-centred and care that improves parity of esteem, supporting students and qualified personnel in their learning careers.

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“…Different frameworks have emerged to: evaluate the evidence generated from nutrigenetic practice and research [ 27 ]; investigate precision nutrition [ 28 ]; apply nutrigenetics in personal, population, and planetary health [ 29 ]; guide health care providers in the practice of personalised nutrition [ 30 ]; collect genetic and environmental data from the Malaysian population by the `Malaysian Node of the Human Variome Project’ (MyHVP) [ 31 ]; predict the perceived risks and benefits of stakeholders towards the implementation of nutrigenetics in Malaysia [ 32 ]; and represent the aetiological complexity of obesity in a dynamic framework that includes genetics [ 33 ]. Moreover, stakeholders in Malaysia have shown interest in adopting nutrigenetics in the decision-making for health and wellbeing [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation of Nutrigenetics and Nutrigenomics Research and Training Activities for Developing Precision Nutrition Strategies in Malaysia

et al. 2022

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Nutritional epidemiological studies show a triple burden of malnutrition with disparate prevalence across the coexisting ethnicities in Malaysia. To tackle malnutrition and related conditions in Malaysia, research in the new and evolving field of nutrigenetics and nutrigenomics is essential. As part of the Gene-Nutrient Interactions (GeNuIne) Collaboration, the Nutrigenetics and Nutrigenomics Research and Training Unit (N2RTU) aims to solve the malnutrition paradox. This review discusses and presents a conceptual framework that shows the pathway to implementing and strengthening precision nutrition strategies in Malaysia. The framework is divided into: (1) Research and (2) Training and Resource Development. The first arm collects data from genetics, genomics, transcriptomics, metabolomics, gut microbiome, and phenotypic and lifestyle factors to conduct nutrigenetic, nutrigenomic, and nutri-epigenetic studies. The second arm is focused on training and resource development to improve the capacity of the stakeholders (academia, healthcare professionals, policymakers, and the food industry) to utilise the findings generated by research in their respective fields. Finally, the N2RTU framework foresees its applications in artificial intelligence and the implementation of precision nutrition through the action of stakeholders.

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Personalised, population and planetary nutrition for precision health

Cited by 11 publications

References 25 publications

Genetically-Guided Medical Nutrition Therapy in Type 2 Diabetes Mellitus and Pre-diabetes: A Series of n-of-1 Superiority Trials

Genetically-Guided Medical Nutrition Therapy in Type 2 Diabetes Mellitus and Pre-diabetes: A Series of n-of-1 Superiority Trials

Hodges’ model: the Sustainable Development Goals and public health – universal health coverage demands a universal framework

Implementation of Nutrigenetics and Nutrigenomics Research and Training Activities for Developing Precision Nutrition Strategies in Malaysia

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