As a naturopathic doctor, I believe in the concept of biochemical individuality. Personalized, holistic interventions based on the unique needs of an individual is a naturopathic medicine principle I espouse.
Heading into the new year, I am concerned about the current bombardment of diet-culture messages and body shaming. For this reason, I have dedicated a series of articles to help prevent the harms that can result from this form of healthism.
In my first article, Personalized Medicine: Why A One Diet-Fits-All Approach to Food Goes Against Naturopathic Principles, I discussed how food can be medicine. I also explained the concepts of personalized medicine and nutrigenomics which emphasize the dangers of approaching nutrition using generalized dietary trends.
In this second article, I will discuss in more detail the importance of individualized nutritional approaches. Specifically, I will explore how variations in genetic sequences can affect how the body processes and metabolizes certain nutrients.
If one is consuming foods or supplements that are not in alignment with their body’s innate chemical makeup, they could be experiencing uncomfortable symptoms and potential mood imbalances. On the flip side, if one is eating in harmony with their genetic predispositions, they could be optimizing their wellness potential.
Biochemical Individuality and Nutrients
Everyone has their own unique genetic blueprint and its variations are based on epigenetic imprinting. Taking this analogy to a technical comparison, health status is based on variations of one’s specific DNA (the hardware), how well it functions (the software) and environmental influences (updates or viruses). Nutrigenomics is the science that explains how our diet (source, source), as a lifestyle intervention, impacts our genes.
Speaking on this concept of biochemical individuality and, more specifically, on how food influences brain functioning, Dr. Walsh states:
Each of us has innate biochemical factors which influence personality, behavior, mental health, immune function, allergic tendencies, etc. Scientists tell us that the number of different genetic combinations possible in a child from the same two parents exceeds 42 million. It’s interesting to note that we do not possess a combination of characteristics from our parents, but instead have a diverse collection of characteristics from many ancestors on both sides of the family.
Because of genetic differences in the way our bodies process foods, most of us are quite deficient in certain nutrients and overloaded in others. Even with an ideal diet, most of us have certain nutrients that are at very low levels with many times the RDA required to achieve a healthy balance.
Naturopathic or functional medicine doctors skilled in these aspects has the ability to implement a more personalized approach. They can suggest different macronutrient categories that can nourish their client’s body as part of their overall wellness protocol. I started this discussion a bit in part one.
Now, I will discuss this concept in more detail.
Can You Personalize Dietary Interventions Based on Genetic Variations?
As technology advances and headlines continue to proclaim the benefits of lifestyle changes on disease processes, researchers now accept that genes alone have very little to do with chronic disease outcomes. It is the combination of our genetics and how that DNA is “read,” based on the influence of everyday choices, including diet, that determines health. In other words, everyone has a unique “wellness epigenetic imprint.”
A few weeks ago, I spent several hours watching and re-watching a webinar that reviewed how some of the most common genetic variations in enzymes (related to the processes of methylation and sulfation) affect mood and mental health. Based on these specific markers, correlated with clinical symptoms, the presenters discussed how dietary factors can be adjusted to impact how these genes function to address health outcomes. This is an example of one biochemical application based on using nutrigenomics to alter mental and emotional health.
Let’s take a few examples with two of my clients.
(The names have been changed to protect the awesome!)
1. Suzy – A Powerful Female with Poor Sulfation and Methylation Function
Suzy came to me fatigued and with many symptoms she related to her diet. Using data from a genomic printout, we were aware that Suzy had several genetic variations in sulfur metabolism. She also had a backup in methylation pathways, including the most common one, a MTHFR mutation.
Suzy has a very “healthy diet,” that is highly plant-based. However, based on how her genes function, if she takes a folate supplement and eats a diet full of broccoli, cruciferous vegetables for addressing methylation, she could experience some major gas, digestive issues, joint pain, histamine responses, brain fog, and/ or exacerbation of mental health symptoms. This is related to the fact that her body has a hard time clearing all that sulfur due to her “sluggish enzymes.” In this case, her “healthy” diet may have been contributing more to her symptoms rather than alleviating them. It was likely increasing histamine responses and creating overmethyation.
I recommended that Suzy go a little easier on the cruciferous veggies and replace them with some other foods that are lower in sulfur and histamine for a little while. I also suggested some nutrients to help her body process the sulfur, such as molybdenum.
Along with some other lifestyle shifts, this supported her body in removing the stinky gas and ammonia buildup that was creating some wonky symptoms.
2. Linda- A Poor Methylation and Estrogen Metabolizer
On the other hand, someone like Linda, who had low methylation and problems with estrogen metabolism, did great when implementing more methyl-rich foods with folate, like broccoli. Furthermore, she felt was her “saving grace for mood and hormonal health” were a specific form of B12 and folate supplementation that I suggested.
Over-and-Under Methylation, Microbiome Impact, and Beyond Genetic SNPs
This strategy I used with “Suzy” and “Linda” can be helpful for most people, but it can also backfire.
One needs to be familiar with the concept of overmethylation and undermethylation, especially in relationship to mental health. Furthermore, treating SNPs is still a bit short-sided, as we have to look at biochemistry and genetic variations within the concept of epigenetics, lifestyle factors, not separated from it.
Along with diet, toxins, stress, and social relationships also come into play on how these SNPs “show themselves.” Furthermore, gut health will impact digestion. Also, an individual’s micobiome makeup impacts how they react to certain foods, such as oxalates (source, source) and carbohydrates. In fact, the same food can create different blood sugar responses based on the bugs in our bellies. (Check out the podcast, A Microbiota Test to Personalize Your Diet from Dr. Ruscio Radio: Health, Nutrition and Functional Medicine, for more information on this.)
If you want more detail on just how complicated putting all of these factors together can be, listen to this 75-minute interview with Dr. Walsh and Mike Mutzel.
Summary: Using Genomics as Part of the Puzzle for Personalizing Nutrition
The concept of personalized nutrition is still evolving in its definition. (source, source) The overall theme is to optimize health through nutrition that is based on the needs for the individual using a variety of indicators. Although genetic information can be helpful, it is not yet routinely used in clinical practie due to lack of long-term studies. According to a December 2019 article in BMJ:
The overall goal of personalised nutrition is to preserve or increase health using genetic, phenotypic, medical, nutritional, and other relevant information about individuals to deliver more specific healthy eating guidance and other nutritional products and services (table 1). Personalised nutrition is equally applicable to patients and to healthy people who may or may not have enhanced genetic susceptibilities to specific diseases.
Personalised nutrition has raised expectations similar to the excitement that has surrounded other scientific developments in their early stages. Scientists working in this area have expressed concerns about overpromising,29,30 individually31,32 as well as through institutional guidelines and statements.33,34,35,36,37,38 Highest expectations arise from the suggestion that genetic information might be used to define personalised dietary recommendations. For example, the Academy of Nutrition and Dietetics states that “nutritional genomics provides insight into how diet and genotype interactions affect phenotype. The practical application of nutritional genomics for complex chronic disease is an emerging science and the use of nutrigenetic testing to provide dietary advice is not ready for routine dietetics practice.” The consensus is that much research is needed before personalised nutrition can deliver the expected benefits.36
I never treat genetic variations in my practice based solely on a genomic report. As indicated above, diet and nutrition interventions are much more nuanced than that. I keep in mind one’s genetic information together with lifestyle modifications, and mind-body medicine. I utilize all these factors in combination with clinical symptoms and lab work to guide me in suggestions. If appropriate, I will then discuss with my client supporting genetic pathways that may be “stuck.”
In other words, I take genomic information as one piece of the puzzle and introduce a therapeutic healing plan that incorporates food as medicine as part of it.
Implementing Personalized Approaches to Nutrition as a Naturopathic Doctor
If one’s body has certain trigger foods, ceasing them for a short time may bring about symptom relief. However, I am not a fan of long-term elimination diets. I feel they mess with our microbiome and trigger disordered relationships with food, especially if one is so predisposed.
For this reason, with any elimination, I reintroduce foods as quickly as possible once the underlying symptoms, triggers, and supportive products have helped to rejuvenate the body’s sluggish pathways. Sometimes, some foods need to be avoided and some foods need to be eaten on a regular basis to help one stay at optimal functioning. This needs to be delicately balanced with someone’s emotional issues around food as well as their social health. Sometimes, one may choose to use supplements on a regular basis rather than reinforce a restrictive pattern of eating.
(Click here to read about “The Dangers of Subscribing to the Morality of Eating.”)
I wrote more about the dangers of trading dietary adherence for relationships here.
The good news is that when one embraces intuitive eating and begins to trust their body’s feedback again, clinical symptoms and genomic data can merge into a nurturing practice, not a militant one.
In the next post, I will expand on this topic and how to be more holistic in your approach with eating for the new year.
This material is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness. You should check with your doctor regarding implementing any new strategies into your wellness regime. These statements have not been evaluated by the FDA. (Affiliation link.)
Disclaimer: This information is applicable ONLY for therapeutic quality essential oils. This information DOES NOT apply to essential oils that have not been tested for purity and standardized constituents. There is no quality control in the United States, and oils labeled as “100% pure” need only to contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin. The studies are not based solely on a specific brand of an essential oil, unless stated. Please read the full study for more information.
For additional safety and medical information, visit my essential oils database. It includes a full category on how to use essential oils safely and potential drug interactions that can occur.
Please be extra cautious and be sure to check with your doctor if you have a seizure disorder. The Epilepsy Society of the UK lists certain essential oils implicated for their antiseizure effect as well as those that have stimulating properties.
If you and/or your physician are interested in consulting with me to assist with supporting the integration of essential oils safely into a therapeutic protocol, essential oils consultations are available.