Nutrigenomics: Food as Precision Medicine

Imagine a world where you don’t need to count calories or obsess over food. Imagine a world where you’re not caught between retreating to the couch or spending hours at the gym. Finally, imagine a world where you’re not feeling shame, punishment or restriction when it comes to the food you eat. This is the world of nutrigenomics.

In this short blog, I’m going to share how I’ve transformed my relationship with food and radically improved my health, happiness and sanity along the way.

The Promise of Nutrigenomics

Nutrigenomics is the science that studies the interaction between your nutrition and genes, especially with regard to the prevention or treatment of disease. In my opinion, as nutrigenomics develops, it will unlock the secrets to living longer and healthier lives. Once you understand how your DNA interacts with what you eat and drink, you can move beyond a love/hate relationship with food

Twenty years ago I had a love/hate relationship with food. I was an intern at UCSF, 27 years young. After a 36 hour shift, I would come home, open the freezer and pull out a pint of ice cream. Can you relate to that? Sometimes it was Haagen Daz coffee flavor, other times it was Ben & Jerry’s Super Fudge Chunk. I would sit in front of the television, pint in one hand, spoon in the other and then I would space out and at some point, find myself scraping the bottom of the pint. That was a lot of calories, certainly not the best nutrigenomics.

Food As Medicine

Our food is meant to have a positive effect on the activity of our DNA. It is meant to be like a shield protecting our health but that is not what I was doing. For me, food used to be more like a bad boyfriend – even though I knew better, I’d keep going back to those foods that made me feel lousy.

I’ve searched high and low to understand how food interacts with DNA. This is one of the fundamental themes connecting my work and my books: how to use food as medicine, as information for your DNA.

If you don’t know what to eat, I get it, it can be super confusing. One day eggs are good, the next day they are the worst thing. Same thing with coffee and wine. Now we are putting butter in coffee (I doubt this trend will extend to wine). But when I was growing up, low calories and low fat were the important thing. The idea that people would be putting butter and MCT oil into their coffee would have been ludicrous.

But times change as our knowledge and insight into our DNA grows. Now, I know that what is more important than overall calories is what those calories do to your hormones, especially insulin.

A Crisis of Nutritional Confusion

No wonder we are confused about nutrition. Not only does the media change the messaging when it comes to nutrition, but we also have Bad science, Big Food, and even our own government’s BAD advice that has led to a crisis of nutritional confusion.

My goal here is to share with you three powerful ways to use all we know about BIG DATA and the latest research to change your relationship with food. I am going to talk about the genome and illuminate how food talks to the genome. Remember, your genome is your complete set of DNA. It contains all the information needed to build and maintain your body.

#1. Know Your Genomics: One Person’s Superfood Is Another Person’s Poison

Let’s take coffee. Coffee is delicious, a morning ritual for millions, and highly addictive. Is coffee good for you? It depends. In functional medicine, we know that the jolt is in your genes. So your response to coffee depends on how your genes talk with your environment. Specifically, how your caffeine gene interacts each morning with your daily cuppa Joe.

Example: Slow vs Fast Caffeine Metabolizers

Half of the people in the US have the fast caffeine metabolism gene. They process a cup of coffee three times faster than me. These are the lucky ones who won the genetic lottery. They get all the benefits: they live longer, have lower risk of heart disease, and even enjoy protection against diabetes and Alzheimer’s.

Then there’s the other half of the population, people like me, who have the slow gene. We drink an afternoon latte and get jittery, TENSE (think cortisol spike), can get elevated blood pressure and go into fight-flight-freeze mode. For those like me, caffeine is too stimulating because we cannot break it down. One or two cups, and we can’t sleep. With this gene, we slow metabolizers get all the risk with none of the benefits.

The way to determine if a food will trigger your DNA in a good or bad way is to measure your genotype and phenotype. Your genotype is your set of genes that you inherited from your parents—such as whether you are a fast or slow metabolizer of caffeine. Your phenotype is your set of characteristics, the ones that make you, you. The phenotype represents your genes interacting with your environment.

#2. Consider the Genetic Environment

The second way that Big Data has helped us understand what to eat is the concept that genes load the gun but food pulls the trigger. This phrase was coined by Francis Collins, the director of the Human Genome Project.

Knowing your genomics is just the first part of the story. You also really need to consider your environment.

Let’s use one of my patients as an example: “Julie” who is age 46. Her mother developed early onset Alzheimer’s disease so she came to me to check for the gene, called APOE4.

The good news is that Julie did not have the gene. But the gene/environment interaction is not as simple as… do I have the gene, yes or no? You see, Julie ate in ways that increased her risk of Alzheimer’s. Sixty percent of cognitive decline is due to problems with blood sugar. And like me in my early 30s, Julie had a sweet tooth, and that was activating 10 other blood sugar and insulin genes that caused her to poke holes in her shield of health. We tested her blood sugar, and she was in the prediabetes range, putting her at much greater risk dementia and Alzheimer’s.

Over six weeks we optimized Julie’s blood sugar by changing her food. She started eating one pound of vegetables per day plus fish and anti-inflammatory meats. I advised her to eat real food, that matches the way our DNA evolved. No more donuts and diet soda but plants, nut, seafood, the occasional wild game. Eat foods that grow in the ground and roam the planet.

The good news: it worked. Julie now eats in a way that matches her DNA. She turned off the naughty genes that promote Alzheimer’s, and as a result, dramatically reduced her risk.

Did you know that reducing your fasting blood sugar reduces your risk of cognitive decline by 60%? That is a pretty dramatic statistic.

#3. The Context In Which We Eat

The third aspect we need to take into consideration is the CONTEXT, i.e. WHEN you eat your food.

BIG DATA shows that the human genome is not stable across time or situations—it changes dramatically depending on what you’re eating, feeling, thinking, and whom you’re with at any given moment in time. For instance, when I eat a meal with my stressed out teen, my body processes those foods very differently than on a romantic date night with my husband.

When we eat and feel stress or under pressure, our bodies naturally release stress hormones such as cortisol, adrenaline, and noradrenaline.  These literally produce physiological responses in our system that cause us to have the fight or flight response. If we choose to go with the “fight,” we likely end up eating more than we would or should which causes other problematic symptoms within the body.  If we were to go with the “flight” response, we may not eat enough, digest properly, and try to get out of the situation as fast as possible. This often leaves our nutritional balance lacking and sending out stress response hormones as we internally and externally desire to flee the situation.    

Stress hormones also affect our respiratory and cardiovascular systems at varying levels.  When the body responds to a surge of stress hormones, our breathing is often increased in an effort to divert more oxygen-rich blood throughout the body.  This is oxygen is diverted specifically to your muscles responding to the survival instinct to take flight. At low to medium levels, we may feel a slight pain in our chest or shortness of breath due to our blood vessels constricting.  At high levels, stress hormones can lead to cardiac arrest with detrimental outcomes. Eating in peace is actually of very high importance.

Social Genomics

Our brains have evolved over time and learned to scan the environment looking for evidence of danger where you have a greater risk of physical injury. There are three situations that make your brain set off an alarm: social conflict, social rejection, and social isolation.

When the brain perceives potential danger of this type, it triggers the immune system to prepare for potential physical injury- which sets off a cascade of inflammation. Unfortunately, that’s a double-edged sword. Inflammation can be healing and reparative right after an injury.

But if it doesn’t turn off, you get chronic inflammation. Chronic inflammation is bad – the fire that keeps burning past the point of utility, damaging DNA, distorting proteins, making you age way too fast. It may also lead to chronic disease—everything from stroke to cancer and depression.  

Therefore, the goal is to avoid these situations that trigger the immune system to make you inflamed.

One of the worst situations is eating in the car. In fact, 80% of Americans eat in the car, and 20% of Americans REGULARLY eat a meal in their car at high speed on the freeway.

Why is this is bad? You’re isolated from your herd, have no protection, you’re in traffic, stressed, and the chance of an accident especially when eating is high! Your brain tells your immune system to prepare for injury, and you become inflamed.

Your Prescription For Your Next Meal

In conclusion, here are the three things to consider when you eat your next meal.

  1. Consider your genotype: Many of you probably have learned about the right fit of foods to your DNA through trial and error, but that can take a lot of sleepless nights before you start making the right connections. Testing just gets you there faster. Use genetic and biomarker tests like 23andme or consider working with a functional medicine doctor.

  2. Look at the environment and how it is interacting with what you eat: If you’re not sure what to eat, perform an elimination diet and cut out sugar, dairy, caffeine, and gluten. Add them back slowly one by one after 4/6 weeks, and see how you feel. This will help you determine which foods trigger your DNA in a bad way.

  3. Look at the context: Eat in a calm, soothing social environment that doesn’t tell your immune system to prepare for the worst.

Food — the right quality, dose, and eaten in a positive social atmosphere—is the foundation of your best health now and well into the future. Food is precision medicine, adjusted for your own DNA. All you need to do is to put the right medicine for you on a fork. Personalized medicine can change your relationship with food and transform your health.