Use genetic testing to enhance, customize patient care

Science is beginning to support what integrative professionals have done for years, empowering patients and recognizing that we are all very unique. One trend in line with this thinking is the use of precision medicine, care customized to the patient based on a number of individual factors including genetics. Genetics and genomics can help practitioners find better ways to treat patients, said Jennifer Stagg, ND, owner of the Whole Health Wellness Center, during a presentation at the Integrative Healthcare Symposium pre-conference session earlier today.

Precision medicine can be applied in integrative medicine, Stagg says, specifically with genomics and epigenetics, which go beyond pharmacogenomics and oncogenomics. One method is genomic wellness testing, which Stagg said she uses regularly in her patient practice.

The method Stagg uses is known as PathwayFIT Testing, which assesses 80 of a patient's genetic markers, or single nucleotide polymorphisms (SNPs), to deliver a personalized  diet, nutrition, and exercise plan. Applying this method in the integrative setting removes guess work, leading to better care and patient outcomes, Stagg said. This will, in turn, help practitioners gain referrals and grow their practices. "Modern patients have high expectations and this is one way we can deliver high quality care," said Stagg.

Other types of genetic testing include telomere length testing and global DNA methylation, which Stagg encouraged attendees to keep an eye on.

 

Stagg presented a case study, which looked at a 42-year-old, caucasian, stay-at-home mom. Pre-existing conditions included hypothyroidism, stable irritable bowel syndrome (IBS), depression and anxiety, and diabetes. She was on a Paleo diet, which is about 20 percent carbohydrate, 40 percent protein, and 40 percent fat. The results were not great, and she experienced extreme cravings for sweets and sugar.

Working with the patient, Stagg performed a genomic wellness profile, which broke down into seven categories:

1. Matching diet type
2. Eating behavior traits
3. Nutritional needs
4. Food reactions
5. Exercise (anaerobic versus aerobic exercise)
6. Body and weight
7. Metabolic health factors

The results revealed a low carbohydrate genetic marker, meaning the patient requires a higher carbohydrate diet, says Stagg. In addition, the test noted a monounsaturated fat marker, and the patient would benefit from more olive oil, avocado, and healthy fats in their meals.

The findings also showed genetic tendencies to overeat, known as eating disinhibition, as well as food reactions—the patient is a slow caffeine metabolizer and a bitter taster. Bitter tasters, says Stagg, tend to over-salt foods and not like vegetables, something practitioners will need to address and help patients identify alternatives, such as roasting vegetables. The tests also revealed the patient's specific vitamin needs, which included B12 and vitamin A.

The profile also looks at how a patient responds to different types of exercise—in this case study, enhanced endurance, meaning the patient would benefit from cardio beyond what others would have, and strength training impairment, shown shown to lead to increased fat deposition in weight training, Stagg says.

Other factors the genetic profile looked at revealed the patient has enhanced insulin sensitivity and weight loss and regain, which means low calorie diets with incorporated "cheat meals" will not help the patient lose weight.

Stagg reviewed the profile with her patient and developed a customized diet and exercise plan based on her unique genetic responses. After four weeks, the patient's appetite had decreased significantly, she was snacking less, and eating fewer carbohydrate in the afternoon. She also lost nine pounds, two inches off of her waist circumference, and lowered her cholesterol.

"Genomic testing can provide actionable data," said Stagg. "We can use this data to customize the care we give our patients and improve long-term health and wellbeing."

Editor's note: This article is part of live coverage from the Integrative Healthcare Symposium. Click here to learn more.