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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EGenetic variations can affect how nutrients are metabolized, while nutrient deficiencies can have an effect on genetic variation. This article discusses the future challenges and present ethical considerations in the use of personalized nutrition based on genetic polymorphisms that increase an individual\u0027s risk for developing, or susceptibility to, marginal nutritional deficiency.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDeficiency Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrigenomics\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDeficiency Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrigenomics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENutrition\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EGenetic variations can affect how nutrients are metabolized, while nutrient deficiencies can have an effect on genetic variation. Carl L. Keen, PhD, University of California, Davis, Davis, California, USA, discussed the future challenges and present ethical considerations in the use of personalized nutrition based on genetic polymorphisms that increase an individual\u0027s risk for developing, or susceptibility to, marginal nutritional deficiency.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EOver time the benefits expected from a healthy diet have evolved from prevention of illness due to deficiencies in essential nutrients (eg, rickets, scurvy), to the reduction in the onset\/progression of select cancers and age-related diseases, to concepts such as the Barker Hypothesis, which proposes an association between maternal diet generational health, and most recently to the belief that healthy diets promote \u201coptimal health\u201d. Although the exact definition of optimal health remains elusive, it has been variously characterized as a sense of well-being, achievement of one\u0027s genetic potential, the absence of disease, and the ability to retain excellent visual acuity, reaction time, and fine motor control well into old age. The success of nutritional genomics will be defined by the targets that are set.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003ESingle-nucleotide polymorphisms (SNP) can determine how nutrients are processed in the body and may be useful in determining which foods to consume and in what quantities. The enzyme 5, 10-methylenetetrahydrofolate reductase (MTHFR) is involved in folate metabolism. Polymorphisms of the MTHFR gene are associated with higher rates of neural tube defects [Kirke PN et al. \u003Cem\u003EBMJ\u003C\/em\u003E 2004], which can result in a higher risk of infants born with spina bifida in women who have these genetic defects [De Wals P et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2007]. Food fortification with folic acid has been shown to significantly reduce the rate of neural-tube defects in newborns.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOther nutrient-gene interactions that reduce manganese and copper have been identified that lead to ataxia prolonged bleeding, lysosomal dysfunction, cardiomyopathy, and lung failure in mice and sheep, scoliosis in chickens [Voglis S et al. \u003Cem\u003EAm J Respir Crit Care Med\u003C\/em\u003E 2009; Yoshida M et al. \u003Cem\u003ELab Invest\u003C\/em\u003E 2009; Huang L et al. \u003Cem\u003ENat Genet\u003C\/em\u003E 1999; Opsahl W et al. \u003Cem\u003EScience\u003C\/em\u003E 1984], and conditions such as Menkes disease, occipital horn syndrome, and Wilson\u0027s disease, in humans [Kodama H et al. \u003Cem\u003EBrain Dev\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003ELow levels of vitamin C are linked to increased risk of heart disease, type 2 diabetes, and cancer. The utilization of vitamin C can be affected by variations in the glutathione S-transferases (GSTs) T1 gene that protects against serum ascorbic acid deficiency. Individuals with the GSTT1 deletion gene variant have an increased risk of ascorbic acid deficiency if they do not meet the Recommended Dietary Allowance for vitamin C (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Cahill LE et al. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2009].\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022GSTT1 Genotype, Vitamin C Adequacy and Ascorbic Acid Deficiency\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1712197672\u0022 data-figure-caption=\u0022GSTT1 Genotype, Vitamin C Adequacy and Ascorbic Acid Deficiency\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13430\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EGSTT1 Genotype, Vitamin C Adequacy and Ascorbic Acid Deficiency\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003E*Relative risk of deficiency for those with the \u201cdeletion\u201d variant who do not meet the RDA for vitamin C compared with those who do meet the RDA.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EDel=deletion; INS=insertion; RDA=recommended daily allowance.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003EReproduced from Cahill LE et al. Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. \u003Cem\u003EAm J Clin Nutr\u003C\/em\u003E 2009;90(5)1411\u20131417. With permission from the American Society for Nutrition.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-8\u0022\u003EIt is generally accepted that sodium intake is associated with hypertension; however, the impact is not the same for everyone. Blood pressure response to high salt intake is greater in individuals with ACE I\/D and 11\u03b2HSD2 G534A polymorphisms (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E) [Poch E et al. \u003Cem\u003EHypertension\u003C\/em\u003E 2001].\u003C\/p\u003E\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Salt-Sensitive Hypertension by ACE Genotype\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1712197672\u0022 data-figure-caption=\u0022Salt-Sensitive Hypertension by ACE Genotype\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13433\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003ESalt-Sensitive Hypertension by ACE Genotype\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-4\u0022\u003E*Relative risk of salt-sensitive hypertension with the GA or AA genotype compared with the GG genotype.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-5\u0022\u003EReproduced from Poch \u0026amp; et al. \u003Cem\u003EHypertension\u003C\/em\u003E 2001. With permission from the American Society for Nutrition.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EThe Costa Rica Heart Study [Cornelis MC et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2006] looked at the association between coffee intake and the risk of myocardial infarction (MI), and whether the polymorphic cytochrome P450 1A2 (CYP1A2) enzyme modifies this association. Caffeine intake was associated with an increased risk of nonfatal MI, but only in individuals with AC or CC CYP1A2 genotype (slow caffeine metabolizers; \u003Ca id=\u0022xref-fig-3-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F3\u0022\u003EFigure 3\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F3\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F3.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Coffee Intake, MI, and CYP1A2 Genotype\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1712197672\u0022 data-figure-caption=\u0022Coffee Intake, MI, and CYP1A2 Genotype\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 3.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F3.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F3.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 3.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/21\/9\/F3.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13435\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 3.\u003C\/span\u003E \n            \u003Cp id=\u0022p-11\u0022 class=\u0022first-child\u0022\u003ECoffee Intake, MI, and CYP1A2 Genotype\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-6\u0022\u003E*p\u0026lt;0.05.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-7\u0022\u003EReproduced with permission from Cornelius MC et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2006. With permission from the American Society for Nutrition.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-12\u0022\u003EAdding to the complexity of gene-nutrient interactions is the human microbiome, which contains 100 times as many genes as the human genome. The microbiome produces vitamins, maintains intestinal structure, protects from pathogens, helps maintain immune function, and affects host metabolism and secretion of hormones from the gut. It is significantly impacted by mode of infant feeding (formula vs breast feeding), host genotype, diet, and gut biotics.\u003C\/p\u003E\u003Cp id=\u0022p-13\u0022\u003EMajor issues for the future will be the identification of more genetic polymorphisms that increase an individual\u0027s risk for developing, or susceptibility to, marginal nutritional deficiency, as well as toxicity, states. Once this information is obtained, attention will need to be paid to the determination of the epigenetic, or persistent, consequences associated with mild micronutrient deficiencies during early development and how these persistent effects contribute to the risk of age-related chronic diseases.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/21\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzl5hq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl5hq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}