It is now four years since the passing of Mike and Ray Mentzer, and therefore bringing to my mind the updated movie version of “The Time Machine.” The title character Alexander Hartdegen loses his girl friend Emma, struck down by a small time crook from a mugging attempt during the late 19th century Victorian era in England. As Alexander stands in disbelief, he later asks himself the defining question --“what if?” He withdraws into himself to invent a time machine, taking several years, and travels back in time to prevent the incident from reoccurring. No matter how many times Alexander travels back to the past, Emma is destined to die by the hands of the mugger or trampled under the wheels of a horse and carriage.
I ask myself the same question about Mike and Ray, “what if.” What if a health practitioner was to have examined their DNA and targeted their faulty genes in order to have recommended foods and supplements that would have attenuated or prevented their disease states. Is it possible they still would be with us today?
The genesis of this question was sparked during the fall of 2004. I went to see Dr. Judith Lukaszuk, Ph.D., at Northern Illinois University in Dekalb, Illinois while she was making her presentation on nutrition and customized diets of the future. She called it, “Nutritional Genomics.” I must admit the title sounded more like a higher education geometry course involving fruits and vegetables than cutting edge nutrition, at ay rate I listened intently. I took notes at this continuing education session and seemed to remember more than most of my colleagues about this particular presentation. However, I wanted to probe deeper and petitioned Dr. Lukaszuk to grant me an interview on this subject, she accepted. (Note: To read more about Dr. Lukaszuk, refer to my articles Supplements - Part 1 and Part 2 - The Good, Useless and Dangerous)
I asked, “What is Nutritional Genomics?” Dr. Lukaszuk responded in an erudite fashion, “It is the ability to alter your gene expression through food consumption. It might be eating broccoli, cauliflower, and brussels sprouts for one individual to prevent them from expressing the gene for colon cancer throughout their life. If, however, one does not eat these foods they may likely express this gene for colon cancer, because they do not have the protective effect from the above mentioned foods.”
I noted three very important concepts in Nutritional Genomics. They were “basic support,” “additional support,” and “maximum support”. I asked Dr. Lukaszuk to explain each. She stated in a precise manner, as follows:
I brought Dr. Lukaszuk an anonymous genetic profile for her analysis. This individual will be known throughout the article as “Subject X.” “Subject X, she stated in her usual meticulous manner, requires both basic support for certain SNPs and maximum support for others. Nutrients or supplements (maximum support) are required for Subject X to prevent those expressed genes from causing long-term complications. In this case, their profile reveals high risk for hypertension, inability to anti-oxidize, because they have SOD present. SOD present means that they have a gene expressed, and this individual would be better off eating organic foods, because they have problems getting rid of chemicals and pesticides. Supplements that would be beneficial, include fish oil, alpha lipoic acid, and glutathione (all help in detoxification of the body) all in their highest dosage. Once again the maximum support of each is required to prevent free radicals from building up in the body.”
- “Basic support tells you that there is no Single Nucleotide Polymorphism (SNP) present. In fact, 99.9 % of our DNA is the same. Where we differ is when we have SNPs in our DNA and that makes us genetically susceptible to chronic diseases. In accordance with the Journal of the American Medical Association (JAMA) and the Council for Responsible Nutrition, basic supplementation is recommended. This means eat well-balanced and healthy, and you won’t likely need any additional support or lifestyle interventions.
- Additional support describes a person that has received a defective SNP from at least one parent and will only benefit from moderate amounts of nutritional support and lifestyle interventions.
- Maximum support means the individual received genetic characteristics (ineffective SNPs) from both parents, and therefore, those particular genes have been expressed. They will benefit from maximum levels of nutritional support and lifestyle intervention.”
I examined the profile much closer and stated, “I see a lot of supplement recommendations for this person’s nutrition support. Some of them I am familiar with and some I am not.” I explained further to illustrate my point, “I have asked my general practitioner about taking some of these supplements, and he tends to know little about them by saying, “you probably know more about these than I do.” Dr Lukaszuk replied, “You probably do know more than the doctor does, because you are the nutritional professional. There is a booklet that comes with one’s profile describing each supplement and why they are required. All the supplements recommended are backed up by scientific and peer reviewed journals.”
I put forth a challenge to Dr. Lukaszuk by discussing the issue of cholesterol. I wanted her best analysis of cholesterol as an indicator for heart disease. I stated, “In the genetic profile, I noticed a SNP for (APOB) cholesterol control, and whether it being high or low was a factor for requiring nutrition support. The current issue of the Journal of the American Dietetic Association (JADA) makes reference to the Framingham study and using this as an indicator for heart disease. The reason I bring this up is that Swedish physician Uffe Ranskov stated that if Ancel Keys (the one who purported the lipid hypothesis for heart disease) had included data from 22 countries instead of 6 in the study that Key’s hypothesis would be weak. In other words, Ranskov was saying that the lipid-cholesterol hypothesis was a fallacy. How would you respond to Ranskov’s statement?”
I could tell Dr. Lukaszuk had her act together and answered my rather lengthy question without hesitation. “Well, I think we have found better techniques to assess somebody’s risk of plaque formation and inflammation in the arteries. All artery plaque formation starts with inflammation. Once low density lipid cholesterol (LDL) starts to oxidize that’s when the plaque formation starts to begin. One can assess degree of inflammation by getting hs-CRP levels checked. If checked and high that means you have a lot of inflammation in your body and are at risk for heart attack or stroke unless you do something to bring the inflammation down, i.e. taking fish oils everyday, eating a Mediterranean diet and exercising. Your MD may choose to place you on a medication to bring your inflammation down as well, such as, baby aspirin or statins. There are also more modern forms of herbals, such as Cholestin (Red yeast rice).
My next question involved the controversy over refined and simple carbohydrates and their role in heart disease. I stated my long winded description of biochemistry that Dr. Lukaszuk knew backwards and forwards. “Cholesterol biosynthesis is governed primarily by the hormone insulin. The secretion depends on the blood glucose level. Isn’t it true that the amount of glucose in the blood dictates the amount of insulin produced by the pancreas, and this in turn directs Acetyl CoA to go to cholesterol and body fat? I guess what I am saying is a diet that causes high blood cholesterol promotes insulin resistance, and chronic inflammation, all of which are powerful risk factors for heart disease. In other words, wouldn’t a “high sugar/high starch” diet promote these types of problems versus a “low starch/low sugar” one?”
She replied to my somewhat tortuous question, “Yes, this would apply to certain people that have Syndrome X based on their waist circumference. The bigger their waist circumference, the more apt they are to be insulin resistant and then they would be carbohydrate intolerant. In people with a waist circumference measuring greater than 37 inches for men or 31.5 inches for women, they are in fact at risk of taking their blood sugar higher and subsequently, a higher insulin level by consuming a high carbohydrate diet. The fatter one is around the middle, the more problems they have tolerating carbohydrates, and thus, need to temporarily restrict carbohydrates to 40%, fat 35-40% (1/2 from monounsaturated fat), and protein 20%. Gerald Reaven, who wrote Syndrome X the Silent Killer, stated that once their waist gets so big that not only do they have problems with their blood sugar but also have problems with insulin resistance, increased risk for breast cancer, increased risk for fatty liver, because it is all around their vital organs. The bottom line is that blood sugar levels will be high, and subsequently insulin will be high and this drives lipogenesis (fat production). This will play havoc with your ability to lose weight, your ability to lose fat percentage, and your ability to lose inches off your waist. Once your waist size decreases and tolerance to carbohydrates increases, you can increase carbohydrates to 50-55% total Calories and cut back on the fat.”
I continued along the lines of the cholesterol track to once again ask if it was truly a risk factor for heart disease. “Isn’t it true that arteriosclerosis has no relationship to blood cholesterol level? Doesn’t cholesterol deposition occur in arteriosclerotic lesions regardless of how low the blood cholesterol is, and it does not deposit in healthy vessels no matter how high the cholesterol is?” Dr. Lukaszuk gave a rather terse reply, “Total cholesterol doesn’t seem to be as good an indicator as LDL cholesterol.
Another factor I noted in the genetic profile of Subject X was Homocysteine. I asked, “Homocysteine is an indicator as far as the Nutritional Genomic profile is concerned. What causes high levels of homocysteine and does it damage the artery walls? If so, what does it do to them?” Dr Lukaszuk explained this rather stealth problem. “If you are not clearing the build up of homocysteine, it increases your risk of myocardial infarction. This was discovered when people with normal cholesterol and normal lipid profile had died in their early forties and mid-fifties of heart attack with no other risk factors involved. Then they checked their homocysteine levels and they were sky high. Yes, homocysteine is strongly linked with plaque formation in the arteries. Fortunately, taking additional supplements which allow homocysteine to be adequately metabolized in the majority of the population would also protect Subject X, and include Folic Acid, B-12 and B-6. This individual should visit their doctor to get their homocysteine level checked and find out what dosages of vitamins he or she would recommend.”
I asked, “Do many cardiologists typically test for homocysteine levels?” “No,” she replied. I went the medical route in my next question, “Are their any drugs that can lower homocysteine?” “There is a certain population that needs medication for homocysteine management called Betaine,” she stated with careful deliberation. “This medication would be given to a person that does not have a vitamin deficiency, but they simply have the inability to excrete homocysteine,” she further added.
“You spoke earlier of the B-complex vitamins,” I asked. “Are you talking about those found in a multivitamin?” She answered in a rather discerning tone, “Probably not the dosages Subject X would need. So we’re talking about someone with high homocysteine that would need to take at least 1 milligram of Folic acid, 10-25 milligrams of B-6 and 400 mcg of B12.”
I brought up the subject of Statin drugs such as Lipitor, Zocor, and others that lower blood cholesterol by inhibiting the biochemical conversion of HMG to mevalonic acid (MVA), which in turn is converted by series of biochemical reactions to cholesterol. I brought one rather interesting side affect to Dr. Lukaszuk’s attention by stating, “Now one reaction of the statins is the inhibition of the body’s ability to manufacture Coenzyme Q10. What is the potential harm in this, if any?” I noted her concern as she answered, “Because there is a deficiency of Coenzyme Q10 this affects the contractility of the heart. What I recommend is that anyone who is on a statin should take 150 mg of Coenzyme Q10 daily. It also attenuates some of the aches and pains as side effects from the statins.” I probed further, “Do you think most physicians are telling their patients to go on Coenzyme Q10?” She replied, “Probably not, and the New England of Journal of Medicine printed the benefits of Coenzyme Q10 for people on statins.
“Where is the trend of nutritional genomics going?” I asked. “They are currently doing nutritional genomics in California,” she replied. “We have a small 12 or 26 SNP panel that we can do right now. Certainly, the sky is the limit and from this feedback, we can prescribe specific foods and supplements to attenuate any deleterious affects of the expressed gene for a particular disease process. It is a very nice way to personalize your nutrition plan based on your genetic makeup. Also it is good to know that even though you have this factor present, it won’t cause that much problems if you treat it. We know statistically that the odds are it will cause some problems.”
I stated, “In the world of nutrition one could argue that researchers write love letters to each other and the information does not filter down to the mainstream public. Are researchers communicating this new science of nutritional genomics to the public? The reason I ask is because the supplement industry is growing and the lay person is dosing themselves obtaining their information from an infomercial or fitness guru. What is your response?” She replied, “This is not a main stream thing at this point. We are on the cusp of discovering this and the genetic tests came out in only the last year.”
Before I completed our interview I wanted to touch on the drug companies. “Pharmaceutical companies do a lot of advertising for drugs on television,” I stated. They give the impression that whether you are taking a statin drug, allergy medication, or male performance enhancement drug, you will experience some form of nirvana.” She replied, “The pharmaceutical industry is extremely lucrative, and so they have the money to spend on advertising using T.V., radio, and billboards. How often do you see commercials on fruits and vegetables? That is not the rich industry. The nutrition industry is not a rich industry and does not have the money to spend.” She joked, “The beer industry is a rich industry.” After having a chuckle myself, I thanked her for the interview.
This article that you have just read is about cutting edge nutrition science. It is also a tribute to Mike and Ray Mentzer. Mike had spoken of supplementation only if one is deficient in a particular nutrient. Now, we have the science to identify many of these nutrients. The ability to explore the DNA will allow nutrition scientists to perhaps identify other ineffective SNPs, and the nutrition support for diseases such as Parkinson’s or Multiple Sclerosis. The question concerning Mike and Ray may be “what if”, but because Mike was a great believer in logic and western medicine the answer could be “what was.”
Master of Science Degree - Registered Dietitian,
Licensed Dietitian Nutritionist,
Certified Personal Trainer (NSCA)*
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* This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is written with the understanding that neither the Website owner nor the Copyright owner(s) are engaged in rendering medical advice or services. Before starting this or any exercise and nutritional program, you should always consult with your doctor and obtain a thorough check up. Mention of the NSCA does not mean this Website owner endorses or recommends that organization or any other certification organization.