Frontier Lifeline Nutrigenetics ClinicApril 9, 2019
She is cute and brilliant. The 15-year-old Tess Katungi’s favourite food is fried chicken and finger chips. It’s her second visit to Chennai’s well-known heart specialty hospital, Frontier Lifeline Hospital, and most of the doctors and staff members at this hospital have already become her friends as she has been here with her mother for some days now after a successful open-heart surgery. Her first visit to this hospital was almost six months ago to consult the chief surgeon Dr K M Cherian after she was diagnosed with a type of congenital heart disease in Uganda, her home nation.
Tess’s surgery was a great success. She needs to have physiotherapy and a couple of post-surgery check-ups now at the hospital, and she will be back at her school in Kampala in the next few weeks.
But what makes Tess most happy is that she can again have her favourite food, chicken, which had been a strict no-no for her since she was diagnosed with the heart disease at a Kampala hospital last year.
“Her nutrigenetic assessment allows her to include chicken in her diet, though there are a few more things we are adding to her diet with a personalised diet plan that will keep her well and healthy, now as well as in future, with no recurring health issues,” says Tess’s dietitian at Frontier Lifeline Hospital, which started the country’s first nutrigenetics clinic fully integrated with a specialty hospital setup.
Nutrigenetics, which evaluates and analyse gene-diet interaction status from patients’ DNA samples to deliver a personalised DNA-DIET, helps to enhance treatment outcome as well as boost and maintain desired immunity levels to prevent diseases in future.
Many of us still do not have much idea about genetics in India. Thus, the biggest challenge that this Chennai nutrigenetics centre had to undertake was to create awareness.
“Through genetic counselling, we give basic introduction about the subjects of genetics and nutrigenetics. We explain the process involved and what all one can expect to see as the outcome. We also collate the incidence of genetic diseases through family history and the patent’s current life-style, including his or her BMI and medical history,” says Beula Daniel, Chief Dietitian and Head – Nutrigenetics Clinic, Frontier Lifeline Hospital.
The patients enrolled in the clinic for nutrigenetic assessment are also asked to do a blood test that measures levels of lipids or fats, including cholesterol and triglycerides. These data would be utilised for assessing the individual’s current health portfolio, added Beula Daniel.
In recent times, with the advancement of molecular tools, the two branches of nutritional genomics — namely Nutrigenetics and Nutrigenomics — have become the front-runners in the field of nutritional research. Both these concepts stem from the fact that the genetic makeup of every individual is different. In other words, no two individuals react exactly the same way to a food substance, and at the same time, no single food substance has exactly the same impact on the gene expression patterns of two individuals.
According to Dr C N Ramchand, Scientific Advisor for Frontier Lifeline Nutrigenetics Clinic and an Adjunct Professor, Faculty of Science, Engineering and Technology at Swinburne University of Technology, Australia, Nutrigenetics aims to identify genetic susceptibility to diseases and the ways in which very small difference in our genes can alter the effects that nutrient intake has on the body. By understanding and analysing these variations, specific dietary and disease prevention advice can be given, based on personal genetic makeup.
For example, Apolipoprotein A1 (ApoA1) plays an important role in serum cholesterol metabolism. Studies clearly indicate that a polymorphism close to the ApoA1 gene determines how polyunsaturated fatty acid (PUFA) intake affects plasma HDL cholesterol levels. In this context, it would make sense for some people to consume higher amounts of PUFAs than others, depending on genotype, to reduce the risk associated with cardiovascular disease (CVD).
More specifically, Eicosapentaenoic acid (EPA) is a PUFA which is abundant in fish oils and is prescribed as a dietary supplement to prevent CVD.
On the other hand, Nutrigenomics initially concerned itself with the effects of nutrients on the expression of an individual’s genetic makeup.
Of late, this definition has been broadened to encompass nutritional factors that protect the genome from damage. Thus, nutrigenomics is concerned with the impact of dietary components on the genome, proteome and metabolome, added Dr Ramchand.
Hospital Integrated Functioning
While several technology providers have recently entered this novel healthcare segment in the country, most of them still cater to the consumer as service aggregators and are not attached with a hospital where all the assessment and treatment components are integrated for better patient outcome.
In this context, the Frontier Lifeline initiative is unique.
“After the enrolment, we first collect the recommended volume of blood sample for DNA isolation (around 3-5 ml). While the nutrigenetics report would take 45 to 60 days, including shipping of samples, processing and the design of diet plans, once the genetic interpretation is delivered, the patients would be referred to the inhouse cardiologist, physiotherapist and dietitian.” said Ramya Koshi, Genetics Counsellor at the clinic.
The assigned cardiologist would assess the patients’ lifestyle record and genetic results to recommend any medical advice. Simultaneously, the hospital’s physiotherapist would recommend physical activities which would be beneficial according to the patent’s genetic result and the dietitian would assess his or her current lifestyle and food intake pattern to recommend a personalised diet plan as per the genetic result, evaluating the nutrition requirement.
This first, integrated centre in nutrigenetics also offers health supplement products made in-house, on a case to case basis, if required.
“Our food and nutrition department has formulated and introduced multigrain, multiprotein and golden milk mix from 36 grains and other natural sources. These products are helping diabetic and cardiovascular patients by reducing bad cholesterol, normalising glucose levels and boosting antioxidants and immunity levels,” added Koshi.
The improvements from these recommendations could be assessed after 6 months with a blood test and BMI analysis, she added.
While patients suffering from cardiovascular diseases, obesity, hypertension and diabetes can do the test to find the right diet, healthy individuals of any age group can also enroll in such clinics as nutrigenetics is emerging as a trend towards precision diet. More importantly, individuals having a strong family history of genetic diseases can test themselves to prevent the onset of such diseases by enrolling for a genetic diet plan.
For instance, dietary components can selectively activate or deactivate gene expression by inducing changes in DNA methylation, histone modifications and alteration in microRNA (miRNA) expression, without any change in the DNA sequence (called as ‘epigenetic regulation’). The best and most well-studied example is Curcumin (diferuloylmethane), a component of the golden spice Curcuma longa, commonly known as turmeric. It has been determined to induce epigenetic changes, thereby preventing various kinds of cancer. Hence, it is quite vivid that approaching a disease condition with a molecular vision definitely helps in an adjuvant treatment modality in addition or conjunction with the mainstream therapy for a given condition. Also, gaining knowledge about the genetic makeup of every healthy individual will undoubtedly help in preventing diseases through the prescription of a customized diet regimen, says Dr Ramchand.
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