functional medicine and nutritional genomics - American Association ...

AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS
Additionally Chinese licorice root, tienchi ginseng root,
and astragalus root may have a role in addressing
heartburn and mild indigestion (100).
Promoting gastrointestinal health through this type of
program may have significant impact, not only on
localized intestinal inflammatory risk, but also on
systemic inflammatory processes associated with the
loss of intestinal mucosal integrity.
Future Strategies
The application of nutritional genomics can create a
better understanding of IBD pathology and has focused
attention on the interaction between genetic factors and
bacteria within the gut.
Whether through any of the above genes discussed,
increasing scientific evidence supports the notion that
inflammatory bowel disease results from a genetic
predisposition to abnormal interaction with an
environmental stimulant – most probably part of the
normal luminal bacterial flora – which in turn leads to
excessive immune activation and chronic inflammation.
There are many putative bioactive molecules that are
being identified every day that can help modulate
genetic expression of inflammation, however, many of
these components still need to be further tested with in
vivo animal models of human disease. A combination
of food fractionation, testing in tissue culture models
and validation through animal models has been
discussed by Sutton as a rationale for developing
‚nutrigenomics‛ based foods (102).
Although there is growing wealth of nutritional and
medical information to guide an understanding of which
nutrients or nutraceuticals should be used for
personalized nutritional recommendations, it is an area
that still requires much more intercommunication
between various medical disciplines in order to obtain
a more holistic and global perspective of a patient’s
medical and nutritional status and needs. In the past
decade, nutrition research has undergone a shift in
focus from epidemiology and physiology to molecular
biology and genetics. This shift has resulted in a
growing realization that we cannot understand the
effects of nutrition on health and disease without
determining how nutrients act at the molecular level.
Muller and Kersten pointed out ‚There has been a
growing recognition that both macronutrients and
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2012
micronutrients can be potent dietary signals that
influence the metabolic programming of cells and have
an important role in the control of homeostasis‛
(103). As a result, adequately trained health
professionals who possess an authentic and
experienced understanding of the interconnectedness of
the biological systems in the human body, as well as
the common underlying mechanisms that cut across
many diseases, syndromes, conditions and organ
systems, will be required particularly to interpret and
communicate this information both to the public and
with regulatory officials to responsibly develop, apply
and progress this new field.
Additionally, this solid background and training will
allow for far more personalized preventative care that
incorporates a client centered approach, tailored to the
patients’ unique needs, (as compared to the current
disease centered model which revolves around
dissecting the body to arrive to a quick diagnosis,
pharmacology and identifying ICD-9 codes), and will
help to achieve tremendous success with ‚healing‛ our
patients rather than just ‚treating‛ their symptoms.
Searching for root cause solutions will be the focus
rather than ‚band-aid‛ symptom management.
However, the complexity of chronic illness, similar to
layers of an onion, will require time, patience and a
willingness to ask the questions that will lead us to
the answers and understanding of how various human
systems function interdependently as well as influence
each other.
Nutrition-focused practitioners are at a pivotal point in
the history of their practice. Kauwell recently stated,
‚Armed with the findings of the Human Genome
Project and related research, dietetics practitioners will
have the potential to implement more efficient and
effective nutrition intervention strategies aimed at
preventing and delaying the progression of common
chronic diseases.‛ (104)
Additionally, because beliefs, attitudes, and motivations
can all play a major role in overall wellness, it will be
very important to examine and include not just the
physical, but the mental, and emotional aspects, at
least to a certain extent, of our patients in order to
make a more holistic and accurate assessment and
care plan of their nutritional needs.