Diet, genes and health: towards

effective personalised nutrition advice

John Mathers
Human Nutrition Research Centre
Institute for Ageing and Health
Newcastle University
 John Mathers
“Diet, genes and health: towards
effective personalised nutrition advice”
Presenter Disclosure Information:
Conflicts of interest/
This speaker has no conflicts of interest
Musculoskeletal disorders are major
causes of years lived with disability

Murray CJ et al. (2013)

Lancet 381, 997-1020
 Poor diet and physical inactivity
account for much DALYs in UK

Murray CJ et al. (2013) Lancet 381, 997-1020

 Nutrition
interacts with
genotype to
influence
health

Mathers JC (2002) Br. J. Nutr.

88, (Suppl. 3), S273-S279
Health is plastic: Importance of diet-
gene interactions

Phenotype = Σ[(environmental exposure) * genotype]

Diet
 Obesity ↓ health and wellbeing
throughout the life-course and ↑ risk
of age-related diseases
↑ Physical activity ↓ risk (age of onset)
of chronic diseases

More
PA

Handschin C & Spiegelman BM (2008) Nature 454, 463-469

Behaviour change is the key
Interventions ↑ fruit and veg. intakes

Lara J et al. (2014)

BMC Medicine 12: 60
Personalised lifestyle-based
interventions .1
Personalised lifestyle-based
interventions .2
 64,000 dollars questions
Will personalised nutrition produce:

 Bigger, more appropriate, more sustained, behaviour

change?

 Bigger gains in health and wellbeing?

than can be achieved by conventional dietary advice?

 How useful is genotype-
based dietary advice?

© MARK GABRENYA/ISTOCKPHOTO.COM
 Views of
genotypic
analysis
among
readers of
Nature

Maher B (2011) Nature 478, 11

 How will people respond to genotype-
based information?

Bouwman L (2009) Ph.D. Thesis, University of Wageningen, The Netherlands

 Systematic
review of
effectiveness of
DNA-based
advice in
changing
behaviour .1

Marteau TM et al. (2010)

Cochrane Database Syst. Rev.
Oct. 6 (10): CD007275
 Systematic review of effectiveness of
DNA-based advice in changing
behaviour .2
Conclusions:
“Mindful of the weak evidence based on a small number of
studies of limited quality ... communicating DNA-based
disease risk estimates ... may have a small effect on self-
reported diet and on intentions to change behaviour.

Claims that receiving DNA-based test results motivates

people to change their behaviour are not supported by the
evidence.

Larger and better-quality RCTs are needed.”

Marteau TM et al. (2010) Cochrane Database Syst. Rev. Oct. 6 (10): CD007275
 Food 4Me Proof of Principle
(PoP) Study

Is it possible to deliver personalised

nutrition (PN) and is it effective?

• Is PN advice more effective than general

healthy eating guidelines?

• What is the best basis for personalisation?

• Is the internet a successful delivery platform?

 Recruitment for Food4Me Study

 Partners from 7 countries

1. University College Dublin (Ireland)

2. Maastricht University (The Netherlands)

3. University of Navarra (Spain)

4. University of Reading (UK)

5. National Food and Nutrition Institute Warsaw (Poland)

6. Harokopio University Athens (Athens)

7. Technische Universitaet Muenchen (Germany)

 Coordinated by Newcastle
University
 Study Design

 Randomised Controlled Trial

 Adults

 Recruitment target (1540) 220

220
220 220
220
 4 Treatment groups

 Intervention lasted 6 months

220 220
Internet-based format
 Study Design
Is PN advice more effective than general healthy
eating guidelines?
Total Participants
Level 0: Non-Personalised dietary advice (Control group) Level 0 n=385
 Study Design
Is PN advice more effective than general healthy
eating guidelines?
Total Participants
Level 1: Personalised DIETARY Advice Level 1 n=385
 Study Design
Is PN advice more effective than general healthy
eating guidelines?
Total Participants
Level 2: Personalised DIETARY + PHENOTYPE Advice Level 2 n=385

+
 Collection of Phenotypic Data

Anthropometrics measurement:
(self-reported)
• Height
• Weight
• Waist circumference
• Hip circumference
• Thigh circumference
 Collection of Phenotypic Data

Physical Activity Measurement:

• Physical activity (PA) measured

objectively using Phillips PA
accelerometers

• PA data collected continuously

throughout 6 months of intervention

• Self-reported using an International PA

questionnaire.
 Collection of Phenotypic Data

Metabolic and Nutritional Markers

Measurement :
• 2 Dry Blood Spot Card (DBS)
• DBS card were posted back to each
Study Centre
• 35 metabolic & nutritional markers
measured (including Glucose,
Cholesterol, Vitamin D, Carotenoids
and Fatty acids)
 Study Design
Is PN advice more effective than general healthy
eating guidelines?
Total Participants
Level 3: Personal DIETARY + PHENOTYPE + GENOMIC advice Level 3 n=385

+
 Collection of Genomic Data

Genetic Markers:

• Buccal cells collected for DNA

extraction

• 32 nutrient-related genetic variants

genotyped for the food4me Study

• Personalised nutritional advice for

the PoP Study is based on 5
nutrient-related genetic variants
How do we integrate these complex data and
develop personalised nutritional advice?
Providing feedback and advice
Validation

Novel aspects of
food4me PoP Study:

 Internet-based

 Remote collection of
data and biological
samples
 Validation

Two major issues:

 Validation

10% validation sample:

1. Identity

2. Measurements
+
Study completed – March 2014
 Personalised nutrition?

• Promising
• Too early for implementation
• Outcomes of Food4Me Proof
of Principle Study awaited

Kevin Clarke (1989) ‘Self portrait in Ixuatio’

Acknowledgements

Carlos Celis
Jose Lara
Marianne Walsh
Mike Gibney