ABSTRACT
Introduction: Managing nutrition and lifestyle practices, nutrition phenotypes, and the genome forms the foundation of precision nutrition. Precision nutrition focuses on metabolic variability among individuals, and one approach to achieving its goals is to integrate gene-based nutrition and lifestyle recommendations in nutrition practice. However, scientific evidence proving the effectiveness of such recommendations is limited. This study will examine whether providing nutrition and lifestyle recommendations based on individual genotype can lead to better weight loss, along with reduction in body mass index (BMI), waist circumference, and body fat percentage among overweight and obese adults. Methods and analysis: A parallel group, single-blind, randomized controlled trial will be conducted. Sixty-two overweight/obese individuals aged 19-59 years old will be recruited. Participants will be randomly allocated to either the intervention (n = 31) or the control arm (n = 31). Participants in the intervention group will receive the MyGeneMyDiet® Recommendation for Weight Management, a gene-based nutrition and lifestyle recommendation that was developed based on existing evidence of the effects of FTO rs9939609 on body weight, BMI, and physical activity; UCP1 rs1800592 on calorie intake; and TCF7L2 rs7903146 on dietary fat intake. Participants in the control group will receive the standard recommendations for weight management. The primary outcomes will be the differences in weight, BMI, waist circumference, and body fat percentage between arms in both the active phase (6 months) and inactive phase (last 6 months) of the trial. Participants in both arms will be evaluated at baseline and in months 3, 6, 9, and 12. Discussion: To the best of our knowledge, this will be the first gene-based intervention that will adopt a phase of intensive nutrition counseling, followed by a simulation of a free-living state to determine adherence to a gene-based recommendation. This study will contribute to the future implementation of precision nutrition interventions by providing evidence on the effectiveness of a gene-based nutrition and lifestyle recommendation for weight loss. Clinical trial registration: clinicaltrials.gov, identifier [NCT05098899].
ABSTRACT
Preventive strategies for hypertension and its sequelae require an understanding of their predisposing conditions and recognition of at-risk individuals. Several factors, both genetic and nongenetic, are influential, and likely vary in their effects across ethnicities. This study aimed to identify dietary, lifestyle-related differences and genetic variants associated with hypertension in Filipinos. The study included 147 adult Filipino respondents of the 2013 Philippine National Nutrition Survey living in the National Capital Region. Data on the socio-demographic profile and selected lifestyle factors were obtained via face-to-face interviews. Blood pressure, anthropometric and biochemical indicators of health were determined using standard procedures. Hypertension incidence was determined following American College of Cardiology/American Heart Association guideline. Genotyping utilized the customized Illumina Golden Gate genotyping array, with subsequent allele and genotypic association analytics. Genetic variant effects were adjusted to clinical parameters via logistic regression. Between those with and without hypertension, there was relatively higher intake of dietary protein, fat but not carbohydrates in the latter (P<.05). Of note, other established risk factors for hypertension, such as high lipid levels and fasting blood sugar, were consistently frequently seen among hypertensive respondents. Of the gene markers, 3 SNPs (rs10492602 of APOC [3' UTR], rs12721054 of CYP2C19 [exon] and rs4244285 [intergenic between PCDH17-DIAPH3 locus]) remained significant after multivariable logistic regression. The study highlights that both nutrition and genetic information may contribute to hypertension among Filipinos. This could guide public health initiatives to identify Filipinos susceptible to hypertension and recommend control strategies in lowering its morbidity rate.
Subject(s)
Hypertension , Adult , Humans , Essential Hypertension , Philippines/epidemiology , Nutrition Surveys , Hypertension/epidemiology , Hypertension/genetics , Risk FactorsABSTRACT
Advances in nutritional genomics are intended to revolutionize nutrition practice. A basic understanding of nutritional genomics among nutritionist-dietitians is critical for such advancements to occur. As a precedent to the development and integration of gene-based nutrition advice, this study aimed to assess hospital-based nutritionist-dietitians' perceptions of nutritional genomics. A total of ten focus group discussions (FGDs) with sixty-one registered nutritionist-dietitians (RNDs) from hospitals in the National Capital Region (NCR), Philippines, were conducted from October to November 2019. Data were collected using a pretested semistructured discussion guide, and thematic analysis was subsequently performed. Diverging perceptions about nutritional genomics were noted among the FGD participants. Five themes emerged relating to the enablers and barriers of gene-based nutrition advice: training and capacity building, the extent of information to be disclosed, cost, ethical considerations, and government support. Themes related to the desired features of the gene-based nutrition advice included being consent-driven, cost-effective, technology-oriented, and guided by standards. The results of this study suggest that training and continued learning will equip RNDs to provide nutrition advice based on genetic information. However, other factors, such as cost and ethical considerations, are critical dimensions that need to be acknowledged and addressed before integrating gene-based advice into nutrition practice.
ABSTRACT
This study was undertaken to determine the effect of medium-chain triglyceride (MCT) oil supplementation on the duration and episodes of diarrhea attacks, and specifically its effect on the clinical manifestations of patients. Seventeen children aged 6 months to 47 months old with a mean age of 19.6 months, suffering from acute diarrhea at the Pediatric Ward of the Philippine General Hospital Medical Center and other neighboring health centers were studied. A double-blind randomized design was employed. Physical and clinical assessment was performed by a physician prior to enrolment in the study. Dietary, anthropometric, and biochemical assessment were undertaken by clinical investigators before and after the supplementation. The subjects were randomly assigned to either the MCT oil- supplemented diet or the non-MCT oil diet. Daily monitoring of food intake and the frequency or episodes of diarrhea attacks was done. Subjects were closely monitored for any possible adverse reactions. The baseline characteristics of the subjects were not significantly different for any of age, height, weight, cholesterol or triglyceride concentrations between the two groups. Nutrient intakes at baseline and during intervention were also not significantly different. There were no differences in cholesterol and triglyceride between the two groups after supplementation. Stool frequencies of the MCT group and the non-MCT group at baseline, after the 6th hr, and at 12th hour, were not different. No subject developed fat malabsorption during the intervention, as assessed with Sudan Black stain. There was statistical significant difference in the rate of weight gain among subjects in the MCT group compared to subjects in the non-MCT group , but a trend in this direction (0.22 + 0.22 kg/day vs -.048 + .26 kg/day), (p=.042). MCT oil may promote weight gain (although what this constitutes in body compositional terms is uncertain) and shows a trend towards shorter duration of intervention among children with acute diarrhea. Limited sample size precludes conclusions on these possibilities. MCT oil did not cause vomiting, dehydration, or fat intolerance. MCT oil did not cause an elevation in cholesterol and triglyceride levels. More studies, with larger sample size, and longer duration will be worthwhile to assess the effect of MCT oil on childhood diarrhea.
