Mariette Abrahams is an award-winning Registered Dietitian, Business Consultant and spokesperson for the British Dietetic Association (BDA). She has over 20 years experience in the clinical nutrition and medical nutrition industry and currently works with businesses in the biotechnology, functional food and digital health industry and has expertise in the field of nutritional genomics and personalised nutrition.
I have seen Mariette speak passionately about nutritional genomics at a nutrition conference a few years ago which inspired me to complete her British Dietetic Association (BDA) endorsed webinar on this topic; so I am delighted to have the chance interview Mariette about this interesting area!
Maeve: So first things first, what is personalised nutrition?
Mariette: Personalised nutrition has been around for a long time where we, as nutrition experts, would take various factors into account such as an individual’s preferences, religious beliefs and intolerances. This also includes measurable characteristics of a person such as blood markers to more recently including genotype information as well.
Maeve: That’s a good point since personalised nutrition is often referred to as a new area of nutrition. How would you describe nutritional genomics and epigenetics in simple terms?
Mariette: Nutritional genomics is the overarching term that is the study of the interplay between genes and nutrition. This involves looking at which genetic variations have been inherited and what functions they play in the body for example in relation to nutrient metabolism, detoxification or requirements.
Epigenetics is the study of how genes respond (called gene expression) to environmental factors such as diet, lifestyle and pollution. This is where the genes are expressed without there being a change in the DNA sequence such as mentioned above.
Maeve: Are there any specific genes which have been found to be related to nutritional health?
Mariette: A number of gene-nutrient interactions have been studied and some replicated. This area is still emerging and so I think the important message to take away considering nutrigenetics, is that single genetic variations have a small effect on the development on chronic diseases.
Also that are still learning a lot about how genes interact with each other as well as the environment. Keep in mind that genes are part of the story, but lifestyle choices have a big impact on our final destination, not just the DNA that we have inherited from our parents.
“Genes are part of the story, but lifestyle choices have a big impact on our final destination”
Maeve: So genes are only part of the overall nutritional puzzle! Do you feel that the evidence is strong enough for nutritional genomics to be used for individuals yet?
Mariette: This is a great question and of course a hotly debated one. At present there is agreement that the evidence is emerging. Personally I think that we do have evidence in some cases, where we could start to incorporate nutritional recommendations into practice, as this can take around two decades to become the norm. As the science unfolds and technology improves, it is bound to change in leap and bounds. However waiting for a point where there will be enough, is in my mind always mysterious goal. We need to start somewhere, and grow with the science, and like I mentioned above, genetics is only one part of the equation. With more advanced technologies such as artificial intelligence and machine learning being used more, we can start building profiles or groups of profiles to understand how and why individuals respond in a particular way.
Maeve: So what are the main benefits of this approach?
Mariette: Research has shown that individuals who received personalised nutrition advice are more motivated, demonstrate better adherence and find it more interesting. So I think knowing that behaviour change is so difficult to achieve, this approach may be applicable to some but certainly not for all.
“Individuals who received personalised nutrition advice are more motivated [and] demonstrate better adherence”
Maeve: That sounds promising alright. Do you think that there any downsides to nutritional genomics?
Mariette: Of course, I do find at present that consumer expectations are very high. This is where I think Registered Dietitian and Nutritionists play a crucial role. If people want a test, it should be made very clear what the state of the science is. There is a lot of public education that needs to happen as this area is currently unregulated.
Secondly I also think that it needs to be considered in the context of the person. So we are only starting to learn about the impact of living in a polluted area, how stress can be devastating and so forth. So your health does not ride on just knowing your genotype, essentially your body is a system and food is information.
Lastly, this area needs regulating as it is easy to set up a genetic testing company and many in the public do not know how to identify reputable and responsible companies.
“There is a lot of public education that needs to happen as this area is currently unregulated”
Maeve: It sounds like Dietitians and Registered Nutritionists have a really important role to play with this technology?
Mariette: Absolutely, from education to translation and product development. Because of our background in biomedical science, food and nutrition, this new science is a natural fit and progression. We have a lot of value to add to companies in this personalised nutrition space. As a business consultant and Dietitian, I feel I really add value by providing technical expertise, consumer insight as well as product development ideas. We are experts in influencing behaviour and education, so opportunity is huge not only from a nutrigenetics perspective, but the personalised nutrition trend as a whole.
“[Dietitians and Registered Nutritionists] are experts in influencing behaviour and education, so opportunity is huge”
Maeve: I really hope Dietitians and Registered Nutritionists become central to communicating this exciting technology! How soon do you think it will take for this technology to be used in mainstream healthcare?
Mariette: I think to some degree it is already mainstream, simply because it is available and becoming more and more affordable. For integration into practice there is a lot of education needed, it needs to be incorporated into clinical workflows and thinking as well as of course more research into what we should actually recommend.
So in my opinion, I think within 5 -10 years most people would have been genotyped, their healthcare providers will have a record, and we will see more people (individuals and healthcare professionals) act on the information.
“I think within 5 -10 years most people would have been genotyped”
Maeve: Wow that would be brilliant! I have heard that certain DNA sequencing companies are not very reliable when it comes to nutritional information, are there any that you recommend?
Mariette: I think here, it is important to do your homework. You want to know that a company has a good scientific and tech team. You also want to know how they chose the genetic variation on their panel, how they validated them and what resources they provide such as training, access to experts etc, that their lab is certified and have excellent quality standards. I think healthcare professionals need to approach companies and always ask questions, lots of questions, it’s is the only way to learn what to look out for.
Maeve: So putting in the time to research companies properly seems really important. This is clearly a vibrant up and coming area; which biotechnologies are you most excited about?
Mariette: There are so many! I am really excited about the rapid advances in using artificial intelligence, the use of machine learning to fine-tune advice, the opportunities in using virtual reality in both education and treatment, the use of metabolomics in practice to get a better picture on individuals´ responses, as well as the micro-biome and the impact on brain health. I think the key is that we are living in an era of phenomenal technological advance that our generation will be remembered for, it’s incredibly exciting and I’m thrilled to be part of it.
“We are living in an era of phenomenal technological advance that our generation will be remembered for”
Massive thanks to Mariette Abrahams for this fascinating interview. If you are interested in learning more about this topic, you can sign-up for Mariette’s free weekly newsletter.