(P10-025-23) Nutrigenetic Rules Look-Up for Clinical Practice: A Precision Nutrition in Medicine Tool

Objectives: Physicians need practical tools to start using genetic information to select the most effective nutritional guidance for their patients’ individual needs. We aimed to develop an evidence-based chart for efficient reference of genotype-based nutrition patient guidance.

Methods: Genotype-specific nutrition rules with adequate evidence that apply to a significant percentage of patients seen in clinical practice were collated from multiple literature searches. These rules were compiled on a single page to be used as a clinical tool with genotype in the left-hand column, the nutrition intervention for that genotype in the column next to it, and an outline of the specific counseling instructions for patient guidance on the right. 

Results: The guidance tool covers 16 genotype-specific rules relating to five types of conditions: abdominal distress, cardiovascular risk, excess body fat, NASH, and vitamin deficiency.

For instance, patients with the CYP7A1 rs3808607 GG genotype can effectively lower elevated cholesterol by consuming 2-3 g B-glucan while TT genotype carriers benefit little from this intervention. Counseling instructions for patients with G alleles are therefore to eat 1.5 cups oatmeal, 1 cup pearl barley, or 2 teaspoons of psyllium husks daily.

Another example guides patients with the FGF21 rs838147 AA genotype to keep carbohydrate consumption low when they need to lose excess body weight. Those with the GG genotype, on the other hand, need to be guided in the opposite direction and follow a caloric reduction with emphasis on whole grains, sweet potatoes, legumes, and non-starchy vegetables.

A third example directs patients with the TCF7L2 TT genotype towards a Mediterranean Diet (fruits, vegetables, whole grains, legumes, nuts, extra virgin olive oil) to lower cardiovascular risk, while those with the CC genotype usually benefit less from such guidance. And, hypertensive patients with the SLC4A5 rs7571842 genotype AA should hear that keeping daily sodium intake under 2300 mg is likely to help lower their blood pressure.

Conclusions: This nutrigenetic reference table helps look up dietary interventions that are most likely to be effective in patients with selected genotypes and provides specific counseling instructions.

Funding Sources: Supported by the UNC Nutrition Research Institute