Making nutrigenomics simple and accessible

Practitioners often struggle putting genetic and genomic data into clinical practice, said David Brady, ND, DC, CCN, DACBN, IFMCP, FACN, director of the Human Nutrition Institute, at the 2020 Integrative Healthcare Symposium in New York City.

Human physiology is influenced by various biochemical processes, which is in part influenced by one’s genotype, Brady said. Biochemical individuality is a major pillar in the practice of precision functional medicine Single nucleotide polymorphisms (SNPs) largely influence our biochemical individuality.

Complex systems are messy, and human being make errors trying to understand them, but that’s okay, Brady said. Artificial intelligence (AI) has the potential to significantly impact healthcare delivery and outcomes, he said. However, most healthcare providers feel unprepared to deploy AI in their organizations, according to a new HIMSS Analytics survey.

Data is an invaluable tool for healthcare practitioners, and for personalized lifestyle medicine, useful data includes genetics and genomics. Genetics is the study of genes and inheritance. It often assesses single genes within congenital disorders. Genomics, on the other hand, is the study of genes, their functions, and interactions with each other and the environment. This includes epigenetics, epistatic relationships, and pharmacogenomics.  

Epistasis is an interaction between different genes, the biological interaction between proteins. Epigenetics is the interaction between genes and the environment. Epistasis and epigenetics are, in part, why practitioners don’t always see the same outcomes in genomics and various disorders.

Brady said genetics loads the gun and lifestyle fires it. By aggregating data in a way that is meaningful and usable, practitioners can make better recommendations to improve their patients' lives. 

Brady focuses his approach to personalized medicine on genomic data. The clinician is essential in contextualizing data, he said. When clinically apply genomic testing, Brady said to keep in mind that the practitioner’s curation is to fit within the context of the patient:

• Chief concerns
• Medical history
• Family history
• Medications and supplements
• Environmental exposures

Consumer genetic and genomic data is not presented in a usable format, Brady said. Therefore, he suggests exploring tools and applications that take genomic data and translate it into information the clinician can contextualize and utilize, such as:

• Single-nucleotide polymorphism (SNP) navigator
• Multi-SNP macros
• Network mappings
• Complex templates
• Prescriptive tools
• Curation

“The landscape for healthcare is going to dramatically change rapidly,” said Brady. “There’s a lot of talk about personalized medicine and precision medicine, but it’s not put into practice in an effective way. We need to figure out how to make integrative medicine models more precise and more personalized, and genomics is how we can truly make an impact.”