Should 'Omics' education be a part of allied health profession curricula?

Sequencing of human genome followed by monumental progress in omics sciences within last two decades has made personalized nutrition for better health is a reality for near future. The complexity of underlying science in making personalized nutrition recommendation has led to the need for training of health care providers. The International Society of Nutrigenetics/Nutrigenomics (ISNN) has mission to increase the understanding among both professionals and the general public of the role of genetic variation and nutrients in gene expression. To bring this mission to fruition, we need trained healthcare professionals ready to educate public. With this in mind, we have surveyed allied health students for their omics knowledge, desire to learn more and their perception of the need of omics education. The results show a need for training in omics in all allied health disciplines and desire of the students to learn more.

Resistant starch lowers postprandial glucose and leptin in overweight adults consuming a moderate-to-high-fat diet: a randomized-controlled trial.

BACKGROUND: High-amylose maize resistant starch type 2 (HAM-RS2) stimulates gut-derived satiety peptides and reduces adiposity in animals. Human studies have not supported these findings despite improvements in glucose homeostasis and insulin sensitivity after HAM-RS2 intake which can lower adiposity-related disease risk. The primary objective of this study was to evaluate the impact of HAM-RS2 consumption on blood glucose homeostasis in overweight, healthy adults. We also examined changes in biomarkers of satiety (glucagon-like peptide-1 [GLP-1], peptide YY [PYY], and leptin) and body composition determined by anthropometrics and dual-energy x-ray absorptiometry, dietary intake, and subjective satiety measured by a visual analogue scale following HAM-RS2 consumption. METHODS: Using a randomized-controlled, parallel-arm, double-blind design, 18 overweight, healthy adults consumed either muffins enriched with 30 g HAM-RS2 (n = 11) or 0 g HAM-RS2 (control; n = 7) daily for 6 weeks. The HAM-RS2 and control muffins were similar in total calories and available carbohydrate. RESULTS: At baseline, total PYY concentrations were significantly higher 120 min following the consumption of study muffins in the HAM-RS2 group than control group (P = 0.043). Within the HAM-RS2 group, the area under the curve (AUC) glucose (P = 0.028), AUC leptin (P = 0.022), and postprandial 120-min leptin (P = 0.028) decreased independent of changes in body composition or overall energy intake at the end of 6 weeks. Fasting total PYY increased (P = 0.033) in the HAM-RS2 group, but changes in insulin or total GLP-1 were not observed. Mean overall change in subjective satiety score did not correlate with mean AUC biomarker changes suggesting the satiety peptides did not elicit a satiation response or change in overall total caloric intake. The metabolic response from HAM-RS2 occurred despite the habitual intake of a moderate-to-high-fat diet (mean range 34.5% to 39.4% of total calories). CONCLUSION: Consuming 30 g HAM-RS2 daily for 6 weeks can improve glucose homeostasis, lower leptin concentrations, and increase fasting PYY in healthy overweight adults without impacting body composition and may aid in the prevention of chronic disease. However, between-group differences in biomarkers were not observed and future research is warranted before specific recommendations can be made. TRIAL REGISTRATION: None.

Advanced Glycation End Products, Inflammation, and Chronic Metabolic Diseases: Links in a Chain?

Advanced glycation end products (AGEs) are a diverse group of compounds produced when reducing sugars react with proteins or other compounds to form glycosylated molecules. AGEs may form endogenously, and glycation of molecules may negatively affect their function. AGEs may also be consumed in food form with dietary AGEs reported to be particularly high in foods treated with high heat: baked, broiled, grilled, and fried foods. Whether dietary AGEs are absorbed in significant quantities and whether they are harmful if absorbed is a question under current debate. The American Diabetes Association makes no recommendation regarding avoidance of these foods, but many researchers are concerned that they may be pro-inflammatory and way worsen cardiac function, kidney function, diabetes and its complications and may even contribute to obesity.

Contribution of dietary advanced glycation end products (AGE) to circulating AGE: role of dietary fat.

The purpose of this pilot study was to determine whether macronutrient content (low-fat v. high-fat diet) influences an indicator of advanced glycation end products (AGE), N(ε) carboxymethyl-lysine (CML), in the context of a 1-d, high-AGE diet. The effect of the diets on inflammatory markers was also assessed. A total of nineteen overweight and obese adults (nine men and ten women) without known disease were recruited to participate in a crossover challenge of a high-fat, high-AGE (HFHA) and low-fat, high-AGE (LFHA) diet. In each phase patients had fasting blood drawn, followed by consumption of a high-fat or low-fat breakfast test meal, then three postprandial blood draws at 1, 2 and 3 h after consuming the test meal. After consuming high-AGE meals for the remainder of the day, participants returned the next day for a follow-up analysis. A different pattern in the 3-h post-meal CML and soluble receptor for AGE response to the two diets was observed (P=0·01 and 0·05, respectively). No change in serum CML was observed following consumption of a LFHA breakfast (535 (25th-75th percentile 451-790) to 495 (25th-75th percentile 391-682) ng/ml; P=0·36), whereas a rise in CML occurred after the HFHA breakfast (463 (25th-75th percentile 428-664) to 578 (25th-75th percentile 474-865) ng/ml; P=0·05). High sensitivity C-reactive protein and high molecular weight adiponectin were not affected by either diet. These findings suggest that dietary CML may not be as important in influencing serum CML as other dietary factors. In addition, acute exposure to dietary CML may not influence inflammation in adults without diabetes or kidney disease. This is contrary to previous findings.

Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification.

Advanced glycation end products (AGEs) are a family of compounds of diverse chemical nature that are the products of nonenzymatic reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs bind to one or more of their multiple receptors (RAGE) found on a variety of cell types and elicit an array of biologic responses. In this review, we have summarized the data on the nature of AGEs and issues associated with their measurements, their receptors, and changes in their expression under different physiologic and disease states. Last, we have used this information to prescribe lifestyle choices to modulate AGE-RAGE cycle for better health.

"Omics" Education in Dietetic Curricula: A Comparison between Two Institutions in the USA and Mexico.

BACKGROUND/AIMS: The completion of sequencing of the human genome and a better understanding of epigenomic regulation of gene expression have opened the possibility of personalized nutrition in the near future. This has also created an immediate need for trained personnel qualified to administer personalized nutrition education. Of all the allied healthcare personnel, dietitians are the most likely to undertake this role. However, dietitians and dietetic students are still deficient in their knowledge of nutrigenomics and other "omics" technologies. Therefore, with the eventual goal of dietetic curriculum reorganization, the International Society of Nutrigenetics/Nutrigenomics (ISNN) has set out to evaluate nutrigenomic knowledge among dietetic students from different countries. In this study, we compared nutrition and dietetic students from Texas Woman's University (TWU) and the Universidad Autónoma de Nuevo León (UANL) for their perceived need for, interest in, and knowledge of different topics within nutritional genomics. METHODS: Students from both universities were sent an e-mail link to the survey which was located at psychdata.com. One hundred twenty-seven students completed the survey. The survey assessed the students' knowledge of, perceived need for, and interest in different omics technologies, as well as their basic knowledge of basic nutrition and genetic topics. Differences were assessed using the χ2 test for homogeneity and Fisher's exact test. RESULTS: Students from TWU and UANL exhibited differences in their knowledge, desire to learn more, and perceived need for omics science in some but not all categories. CONCLUSIONS: Undergraduate nutrition students from both the USA and Mexico lack a high level of knowledge in different omics topics but recognize the role that omics will play in their future as dietitians. There were differences between the 2 universities in terms of the desire to learn more about different omics technologies and to take more classes covering different topics with nutritional genomic components. In order to make personalized nutrition a reality, future dietitians will need to become fluent in different omics technologies.

Association between serum uric acid and metabolic syndrome components in prepubertal obese children (Tanner Stage I) from Nuevo León, Mexico - a preliminary study.

BACKGROUND: Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease and diabetes. Previous studies in obese children demonstrating a positive association between serum uric acid (sUA) and components of MetS are confounded by lack of uniformity in age and pubertal status of children. Therefore, we have examined the role of sUA in MetS and its components in pre-pubertal children (Tanner Stage I, age ≤ 9 years). METHODS: Pre-pubertal obese children (32 boys, 27 girls, age 6-9 years) were recruited from Nuevo Leon, Mexico. For comparison, an equal number of children with normal body mass index (BMI) in the same age range (22 Boys, 39 girls, age 6-9 years) were also recruited from the same community. Presence of MetS and its components was defined according to the criteria of International Diabetes Federation. Fasting blood was analyzed for lipids, glucose, insulin, and uric acid. RESULTS: Among the obese children, sUA was positively associated with insulin resistance and hypertriglyceridemia and negatively associated with high density lipoprotein-cholesterol (HDLc). Subjects were three times more likely to have a MetS diagnosis per one unit (md/dL) difference in sUA. Of the 59 obese pre-pubertal children, 20 were classified as having MetS defined by the presence of abdominal obesity and two or more of other components described under methods. Of these, 57.1% (20/61) had sUA between 5.1 and 7.1 mg/dl. CONCLUSIONS: The findings of this study clearly indicate a positive relationship between uric acid and MetS and its components in pre-pubertal obese children with Tanner stage I and ≤9 years of age.

Vitamin E and prostate cancer: is vitamin E succinate a superior chemopreventive agent?

There is convincing evidence that vitamin E succinate significantly reduces human prostate cancer growth in experimental models compared with alpha-tocopherol or tocopheryl acetate. Its intact delivery to cancer cells is questionable when administered orally; however, a study in transgenic mice showed a synergistic inhibitory effect of dietary vitamin E succinate, selenium, and lycopene on prostate cancer incidence. Clinical trials have yet to confirm this effect.

Bioactive Plant Metabolites in the Management of Non-Communicable Metabolic Diseases: Looking at Opportunities beyond the Horizon.

There has been an unprecedented worldwide rise in non-communicable metabolic diseases (NCDs), particularly cardiovascular diseases (CVD) and diabetes. While modern pharmacotherapy has decreased the mortality in the existing population, it has failed to stem the rise. Furthermore, a large segment of the world population cannot afford expensive pharmacotherapy. Therefore, there is an urgent need for inexpensive preventive measures to control the rise in CVD and diabetes and associated co-morbidities. The purpose of this review is to explore the role of food bioactives in prevention of NCDs. To this end, we have critically analyzed the possible utility of three classes of food bioactives: (a) resistant starch, a metabolically resistant carbohydrate known to favorably modulate insulin secretion and glucose metabolism; (b) cyclo (His-Pro), a food-derived cyclic dipeptides; and (c) polyphenol-rich berries. Finally, we have also briefly outlined the strategies needed to prepare these food-bioactives for human use.

Lower bone mass detected at femoral neck and lumbar spine in lower-weight vs normal-weight small-boned women.

Sixty-one nonsmoking, healthy, young, menstruating women aged 18 to 30 years generally considered at peak skeletal bone mass were screened for diseases and drugs known to adversely affect bone mineral density (BMD). Anthropometric measures, BMD of the lumbar spine (LS) and femoral neck (FN), exercise time, selected nutrient, and energy intake were compared. The women were categorized by frame size and body mass index (BMI), with the upper range for normal weight (NW) being BMI 23.0 to 25.9 (n=30) and lower weight (LW) being BMI 16.0-19.9 (n=31). Multivariate t tests, Pearson correlations, and independent sample t tests were used for statistical analysis. Ten of 21 in the LW group, all with small frames, had varying degrees of low BMD of the LS and/or FN. The amount of exercise time was greater in the NW group. Energy and nutrient intakes did not differ significantly between groups.

Prescribing personalized nutrition for cardiovascular health: are we ready?

Of all chronic metabolic diseases, cardiovascular disease (CVD) is the leading cause of death worldwide. Most research over the past 100 years show a link between CVD and lifestyle, including diet; thus, public health messages have focused on modifications of the diet to better manage this disease. Despite this effort, the CVD mortality rate continues to rise. Therefore, is it possible that this failure may be due to individual variability in response to dietary recommendations? The elucidation of the structure of the human genome combined with the knowledge that nutrients are capable of modifying gene expression and genetic variability regulates how individuals respond to a diet have led to the possibility of personalized nutrition for disease prevention. While this possibility is real for the future, our current understanding of nutrient-gene interactions for CVD is limited, making personalized nutrition therapy difficult at this time. With advances in nutritional genomics, in the near future, dietitians and nutritionists will be able to give personalized nutritional advice based on a combination of lifestyle factors and genetics.

Serum soluble receptor for advanced glycation end products correlates inversely with measures of adiposity in young adults.

Advanced glycation end products (AGEs) may promote inflammation by interacting with the receptor for advanced glycation end products. Serum soluble receptor for advanced glycation end products (sRAGE), a form of receptor for advanced glycation end products thought to mediate AGE's inflammatory properties, is decreased in diabetes mellitus and coronary artery disease. Evidence in older adults suggests that sRAGE is depressed in individuals without current disease who are obese; however, 2 studies have failed to find this correlation. We hypothesized that sRAGE would be inversely correlated with adiposity and positively correlated with inflammation, even in apparently healthy, young adults. By considering adults of body mass index (BMI) varying from normal weight to overweight and obese, we aimed to define how closely AGEs and sRAGE correlate with adiposity and other indicators of metabolic stress. Anthropometric measurements and fasting blood samples were obtained from participants (n = 69). Sera were analyzed for sRAGE, n-epsilon carboxy-methyl-lysine, a measure of AGEs, and high sensitivity C-reactive protein. High molecular weight adiponectin, glucose, insulin, total cholesterol, high-density lipoprotein, and triacylglycerol were also assessed (n = 32). Spearman rank correlations were used to evaluate the relationship among indicators of adiposity and biochemical indicators of metabolic health and inflammation. Factors inversely correlated with sRAGE include weight (Rs = -0.397; P = .001), waist circumference (-0.291; P = .015), and BMI (-0.3338; P = .004). High molecular weight adiponectin was positively correlated with sRAGE, and predictors of sRAGE included BMI and total cholesterol. This is the first time these associations have been found in a diverse population of young adults.

Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging.

Uncontrolled continued exposure to oxidative stress is a precursor to many chronic diseases including cancer, diabetes, degenerative disorders and cardiovascular diseases. Of the many known mediators of oxidative stress, reactive oxygen species (ROS) and advanced glycation end products (AGEs) are the most studied. In the present review, we have summarized current data on the origin of circulating AGEs, discussed issues associated with reliable assessment of its steady state level, and changes in its level with age and select metabolic diseases. Lastly, we have made recommendations about life style changes that may decrease AGEs burden to promote healthy aging.

Measurement and validation of the nature of salivary adiponectin.

Adiponectin (Ad) is an adipocyte-derived hormone that plays an essential role in regulating insulin sensitivity, inflammation, and atherogenesis. Levels of some hormones in saliva change in a fashion similar to that in plasma in response to a disease or physiological condition. Since saliva is an easy to obtain biological fluid, measurements of salivary hormonal changes are preferred in diagnoses and treatments. Therefore, it was of interest to examine the nature of salivary Ad. While there have been two publications in the literature reporting presence of Ad in human saliva, the nature of salivary Ad has not been characterized. To this end, we investigated the effect of sample dilution on the measurement of Ad in saliva. To our surprise, we observed an increase in measurable level of Ad in saliva on sample dilution. One explanation for this paradoxical observation may be the presence of inhibitor(s) of Ad/anti-Ad binding in saliva that following dilution relieves the inhibitory effect. Working with this hypothesis, we were able to demonstrate the presence of an inhibitor in saliva that co-eluted with the dimeric form of Ad and was capable of inhibiting Ad assay. The presence of such inhibitor(s) may lead to underestimation of Ad in saliva.

Sensory characteristics of high-amylose maize-resistant starch in three food products.

Type 2 resistant starch from high-amylose maize (HAM-RS2) is considered a functional ingredient due to its positive organoleptic and physiochemical modifications associated with food and physiological benefits related to human health. The sensory characteristics of three types of food products (muffins, focaccia bread, and chicken curry) with and without HAM-RS2 were evaluated using a 9-point hedonic scale. The HAM-RS2-enriched muffins, focaccia bread, and chicken curry contained 5.50 g/100 g, 13.10 g/100 g, and 8.94 g/100 g RS, respectively, based on lyophilized dry weight. The HAM-RS2-enriched muffin had higher moisture content and was perceived as being significantly moister than the control according to the sensory evaluation. The addition of HAM-RS2 to muffins significantly enhanced all sensory characteristics and resulted in a higher mean overall likeability score. The HAM-RS2-enriched focaccia bread appeared significantly darker in color, was more dense, and had the perception of a well-done crust versus the control. A grainer texture was observed with the chicken curry containing HAM-RS2 which did not significantly affect overall likeability. We concluded that the addition of HAM-RS2 may not significantly alter consumer's acceptability in most food products.

Consumption of a diet rich in cottonseed oil (CSO) lowers total and LDL cholesterol in normo-cholesterolemic subjects.

Animal data indicates that dietary cottonseed oil (CSO) may lower cholesterol; however, the effects of a CSO-rich diet have not been evaluated in humans. Thirty-eight healthy adults (aged 18-40; 12 males, 26 females) consumed a CSO rich diet (95 g CSO daily) for one week. Anthropometric measurements were obtained, and blood was drawn pre- and post-intervention. Serum lipids (total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), and free fatty acids (FFA)) were assayed. There was no change in weight or waist circumference among participants. There was no change in HDL (Pre: 1.27 ± 0.4 mmol/L; Post: 1.21 ± 0.3 mmol/L) or TG (Pre: 0.91 ± 0.6 mmol/L; Post: 1.06 ± 1.0 mmol/L). Total cholesterol and LDL were reduced (TC Pre: 4.39 ± 0.9 mmol/L; Post: 4.16 ± 0.8 mmol/L; LDL Pre: 2.70 ± 0.8 mmol/L; Post: 2.47 ± 0.6 mmol/L). When data were grouped by sex, total cholesterol was reduced in female participants (Pre: 4.34 ± 0.9 mmol/L; Post: 4.09 ± 0.8 mmol/L). Consumption of a high fat, CSO-rich diet for one week reduced total cholesterol in female participants without reducing HDL.

Effect of blueberry polyphenols on 3T3-F442A preadipocyte differentiation.

Today obesity is an epidemic, and its prevalence has increased significantly over the last few decades. To avoid excessive accumulation of fat, optimum energy intake along with regular exercise is mandatory. Polyphenols present in green tea, grape seeds, orange, and grapefruit combat adipogenesis at the molecular level and also induce lipolysis. However, very little is known regarding the role of blueberry polyphenols on adipocyte differentiation. Hence we tested the dose-dependent effects of blueberry polyphenols on mouse 3T3-F442A preadipocyte differentiation and lipolysis. 3T3-F442A preadipocytes were incubated with three doses of blueberry polyphenols (150, 200, and 250 µg/mL [BB-150, BB-200, and BB-250, respectively]), and intracellular lipid content, cell proliferation, and lipolysis were assayed. Blueberry polyphenols suppressed adipocyte differentiation determined by Oil Red-O staining and AdipoRed assay. Intracellular lipid content in control (11,385.51±1,169.6 relative fluorescence units) was significantly higher (P<.05) than with the three doses of blueberry polyphenols (8336.86±503.57, 4235.67±323.17, and 3027.97±346.61, respectively). This corresponds to a reduction of 27%, 63%, and 74%, respectively. Cell proliferation was observed to be significantly higher in the control (0.744±0.035 optical density units) than with BB-150 (0.517±0.031), BB-200 (0.491±0.023), and BB-250 (0.455±0.012). However, when tested for lipolysis, there was no significant difference observed among the groups. We conclude that blueberry polyphenols may play an effective role in inhibiting adipogenesis and cell proliferation.

Introducing nutritional genomics teaching in undergraduate dietetic curricula.

Nutritional genomics offers great promise to personal health management based on the understanding of the relationship between diet, gene expression and health outcomes. Our readiness to deliver nutrigenetic-based nutrition education has been slow due to the complexity of gene-nutrient interaction and interplays between many disciplines such as genetics, nutrition, biostatistics, sociology, law and philosophy in the process. To make a public impact, we must prepare future allied health professionals with knowledge necessary to provide nutrigenetic and nutrigenomic education. We have described here a plan to introduce nutrigenetic and nutrigenomic education in dietetic curricula that may serve as an example for other allied health programs.