Research and News October 2018

Genomics as Only One of Multiple Precision Medicine Methods
Within the overarching trend towards personalized medicine, many corners of medicine have fast-embraced genomics. However, it is only ONE piece of the puzzle when it comes to truly individualizing patient care. Too often, I see patients who have been told that they have a certain gene mutation and that it alone has responsibility for certain health outcomes. The reality is most often much more complex and multifactorial. The New England Journal of Medicine tackles this tension in its most recent issue, in the context of public health personalization (historically a dichotomous head scratcher!): “The more tightly defined and individually focused conception (of personalized public health), anchored in genomics, has gained greater momentum – and poses a greater threat.” Read more at the NEJM and here: The New Nutrigenomics – Embracing Complexity, Moving Upstream.

Scientists Argue for Microbiota ‘Vault’ to Protect Long-Term Human Health
Should we be creating a human microbiota ‘vault’ to protect our long-term microbial diversity and health? Scientists at Rutgers University think so. Underscoring just how important our microbiome(s) are – digesting food, producing nutrients, strengthening our immune system, protecting against pathogens, balancing our metabolism, producing cancer-protective compounds, and more – this ‘global repository’ would be akin to the Svalbard Global Seed Vault, the world’s largest collection of crop diversity created in case of natural or human-made disasters.

Correlation Between Epigenetic Methylation and Osteoporosis
Osteoporosis is a complex disease. New research shows that epigenetic methylation plays a role by altering gene expression in many pathways related to bone integrity. In fact, DNA methylation pattern analysis could in the future be used to predict the risk for osteoporosis. Group gene + methylation marks are much more likely to provide answers to disease risks than single gene polymorphisms alone. It also means that balanced, healthy methylation, as we support in our Methylation Diet & Lifestyle, can be a helpful approach for bone health. Check out our previous article on Methylation and Bone Health for more.

Flaws in the Lancet Meta-Analysis of Vitamin D for Bone Health
Classical scientific research models aren’t perfect when it comes to assessing nutrition. A recent Lancet meta-analysis (an analysis of many different trials) concluded that vitamin D has no benefit for bone health. But, as this rebuttal explains, looking at nutrients in isolation misses the vitally important fact that nutrients work together for health outcomes. Vitamin D is needed for calcium absorption, but you also have to be consuming enough calcium in the first place, and you also need vitamin K to ensure that the calcium is deposited into bones (instead of soft vascular tissue). Other nutrients are involved too. While we continue to need good scientific study of nutrients, we need a more comprehensive way to assess real-life nutrient interactions. Combination studies may prove more valuable.

Benefits of Ketogenic Diets Mediated via Gut Microbiome
Supervised ketogenic diets can be an incredibly powerful therapeutic tool. Several mechanisms are at work with ketogenic diets, but not all are well understood. New research highlighted in the JAMA news networks indicates that the gut microbiome may be pivotal in mediating some of the beneficial effects of the diet. Yes, gut microbes are altered with a ketogenic diet – most notably an increase in Akkermansia species. These microbial changes are associated with decreased gamma-glutamyl amino acids and elevated GABA/glutamate levels in the hippocampus, and reduced seizures in mouse epilepsy models. It’s reasonable to think that these microbially-mediated effects may be behind some of the benefits seen for other disease status such as cognitive decline.

Proceeds from Health Data Sales Could Soon Come to You
If you, like many of us and our patients, have paid for your own 23andme genetic report, you will have clicked-to-agree that 23andme can sell on your anonymized data and reap the proceeds from that. In other areas, other deidentified medical data is also brokered to third parties from health care providers, pharmacies, insurers and clinical labs. To who? Pharmaceutical companies and other businesses who use that aggregated data for research, product development and marketing purposes. Eric Topol, from the Scripps Research Institute, thinks that data ownership (and payment flows) will change in the future, allowing consumers to get in on reaping the proceeds from health data markets too. He points to a growing group of health data brokering startups, called ‘biobrokers’, who’s goal is to shake up the industry and transfer data control (and a share of the profits) back to the individual. Do you believe you should own your data?

Large Prospective Study Supports Organic Foods Choices to Lower Cancer Risk
Choosing organic foods “most of the time” may reduce your risk for breast cancer by up to 33%, according to a broad study of nearly 68,946 individuals. Risk of lymphoma (blood cancer) may be reduced by up to 76%. This is huge! Making smart buying (and growing) choices means that choosing organic doesn’t have to break the bank.

Liverwort Cannabinoids May Be Therapeutically Superior to Cannabis
Liverwort contains perrottetinene, with very similar properties to cannabidiols from cannabis and that may have superior therapeutic utility, according to new animal research from scientists in Switzerland. Perrottetinene readily crosses the blood brain barrier and activates endocannabinoid receptors, inhibiting inflammation-promoting prostaglandins, but with a weaker psychoactive effect. Learn more about our endocannabinoid system here.

Do ApoE4 Brains Have a Harder Time Utilizing Glucose?
ApoE4 gene variants are associated with an increased risk for Alzheimer’s Disease. New animal research suggests that this gene variant may impair the brain’s ability to utilize glucose, since it is associated with a reduction of a key glucose-metabolizing enzyme, hexokinase. It makes an interesting potential argument for the use of ketogenic diets in Alzheimer’s disease, especially since, in this study, ApoE4 carriers retained normal levels of ketone utilization proteins. ApoE3 carriers, meanwhile, had lower level of ketone utilization proteins. More on preventing and reversing cognitive decline here.