Dissertations / Theses on the topic 'Nutrigenomics and personalised nutrition'

Increasing level of public concerns about ageing and obesity problems accompanied by the advent of more and more health conscious consumers have put a priority on the health and wellness industry development which has started transformation from a niche category towards the mainstream. As a human being is an individual with unique known characteristics (like age, gender, health state, lifestyle) and less known characteristics like a genetic predisposition, the nutrition plan should be designed around these characteristics. Being aware of genetic predisposition of an individual allows to develop the appropriate health strategy for the particular individual. A systematization of these individual programs would support the development of a new generation of health practitioners. Russia is experiencing serious demographic problems with decreasing population and low life expectancy; high mortality rate from heart diseases and quite high obesity rates. It is expected that nutrigenomics concepts can be successfully developed in Russia due to its solid scientific base, relatively high level of medicine and the ever increasing awareness of the need for a healthy quality life especially within young generation. The goal of the thesis therefore is to analyze the key trends in the global and Russian food industries and develop a business idea of commercializing the personalized nutrition concept in the Russian food service market.

Hypertension is the most common risk factor for cardiovascular morbidity and mortality affecting approximately 1 billion people worldwide. Recently evidence has called for a more rigorous approach to lower blood pressure (BP) to levels below the current threshold. Thus, there is a clear need to identify new strategies for the prevention and treatment of hypertension including targeted, non-pharmacological approaches to reduce BP. A common polymorphism (C677T) in the folate metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) has been associated with hypertension. Furthermore, in three randomised controlled trials previously conducted at this centre riboflavin (required as a cofactor for MTHFR) has been shown to effectively lower BP in cardiovascular disease (CVD) and hypertensive patients homozygous for the MTHFR C677T polymorphism (TT genotype) in premature CVD and hypertensive patients. No previous study has however considered the BP lowering effect of riboflavin at a higher dose than previously used (1.6mg/d), or indeed considered how this novel option might translate to patient care. Finally the role of this polymorphism in the development of hypertension over time has not been previously considered. The aim of this thesis therefore was to investigate the role of the MTHFR C677T polymorphism and its interaction with riboflavin, in determining BP in generally healthy adults, and to consider the implications of this gene-nutrient interaction for a personalised nutrition approach to managing hypertension. The findings from a 10-year follow up study provide evidence that adults with the TT genotype had a higher systolic BP than those with the CC/CT genotypes at any given age from 40-65 years. Furthermore, individuals with the TT genotype had a BP in the hypertensive category at a younger age, an effect that appears to be significantly influenced by riboflavin, with the highest BP in adults with the TT genotype in combination with low riboflavin status (ft =0.155, P <0.034). In a randomised controlled trial, that investigated the BP lowering of riboflavin, preliminary findings suggest that the BP response to riboflavin may be strongest in younger adults (<55 years) and in females, but this requires further investigation and no firm conclusions can be made until this trial reaches completion (mid 2016). The GPs and genetically at-risk adults investigated reported a positive attitude towards the novel role of riboflavin in the prevention and treatment of hypertension. In conclusion, the MTHFR 677TT genotype is an important determinant of BP, furthermore in these genetically at risk individuals riboflavin offers a novel preventive and a treatment option for hypertension.

Diet and lifestyle factors are well documented for their impact on health and wellbeing. Epigenetics provides the added connection between personal genetics and environmental factors, including food, interacting with health and disease. Functional foods is a growth area of food development, augmentation and supplementation. However, more scientific validation of the claims made for functional foods and functional components is required to properly inform consumers and healthcare practitioners. There is also growing consumer acceptance of personalised genetic analysis for health and wellbeing. The commerciality of providing cost-effective genetic diet and lifestyle advice is a new and developing area in the health industry. All diseases have a genetic link, and genome-wide association studies (GWAS) are discovering genetic variations linked to complex diseases. However, nutrient information is absent for the development of dietary advice and the management and prevention of disease. The development of nutrigenomics provides information on the gene/nutrient interaction essential for the design of personalised nutrition. Functional nutrition from a combination of personalised genetic analysis and nutrigenomic interventions, represent an important new nexus for improving public health and the future of disease prevention.

Yes
Purpose – Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition. Design/methodology/approach – Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N 5 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N 5 763). Findings – An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (p
EU FP7 Project “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE. 2010.2.3–02, Project No. 265494)

Yes
Purpose – Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition. Design/methodology/approach – Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N 5 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N 5 763). Findings – An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (p
EU FP7 Project “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE. 2010.2.3–02, Project No. 265494)

To help mitigate the escalating prevalence of Type 2 Diabetes (T2D) and alleviate society of its associated morbidity and economic burden on health care, it is crucial to understand its aetiology. Both genetic and the environmental risk factors are known to be involved. Healthy diets have been proven to reduce the risk of T2D in primary prevention trials, however, which components and exact mechanisms are involved is not fully understood, in particular, the role of macronutrient intake. Body weight, glycaemic markers and T2D are all to some extent genetically regulated. There may also be genetic influences on how people digest, absorb or metabolise macronutrients. This poses the possibility that the interplay between genes and our diet may help us unravel T2D’s aetiology. The aim of this PhD was to investigate gene-diet interactions on the risk of incident T2D, focusing primarily on macronutrient intake as the dietary factor. First, I systematically evaluated the current evidence before taking a step-wise approach (hypothesis driven to hypothesis-free) to interrogate gene-macronutrient interactions. This identified 13 publications, with 8 unique interactions reported between macronutrients (carbohydrate, fat, saturated fat, dietary fibre, and glycaemic load derived from self-report of dietary intake and circulating n-3 polyunsaturated fatty acids) and genetic variants in or near TCF7L2, GIPR, CAV2 and PEPD (p < 0.05) on T2D. All studies were observational with moderate to serious risk of bias and limitations that included lack of adequate adjustment for confounders, lack of reported replication and insufficient correction for multiple testing. Second, these reported interactions did not replicate in a large European multi-centre prospective T2D case-cohort study called EPIC-InterAct. We concluded that the heterogeneity between our results and those published could be explained by methodological differences in dietary measurement, population under study, study design and analysis but also by the possibility of spurious interactions. Third, given the paucity of gene-macronutrient interaction research using genetic risk scores (GRS), we examined the interaction between three GRS (for BMI (97 SNPs), insulin resistance (53 SNPs) and T2D (48 SNPs)) and macronutrient intake (quantity and quality indicators) in EPIC-InterAct. We did not identify any statistically significant interactions that passed multiple testing corrections (p≥0.20, with a p value threshold for rejecting the null hypothesis of 0.0015 (based on 0.05/33 tests)). We also examined 15 foods and beverages identified as being associated with T2D, and no significant interactions were detected. Lastly, we applied a hypothesis-free method to examine gene-macronutrient interactions and T2D risk by using a genome-environment-wide-interaction-study. Preliminary findings showed no significant interactions for total carbohydrate, protein, saturated fat, polyunsaturated fat and cereal fibre intake on T2D. In conclusion, the consistently null findings in this thesis using a range of statistical approaches to examine interactions between genetic variants and macronutrient intake on the risk of developing T2D have two key implications. One, based on the specific interactions examined, this research does not confirm evidence for gene-diet interactions in the aetiology of T2D and two, this research suggests that the association between macronutrient intake and the risk of developing T2D does not differ by genotype.

Introdução: Poucos trabalhos correlacionam o perfil metabólico com o estado nutricional em crianças e adolescentes após intervenção dietética. Objetivos: Identificar, em uma população de indivíduos de 9 a 13 anos submetidos a uma intervenção nutricional, a existência de diferentes grupos metabólicos formados com base em dados bioquímicos (níveis de glicemia, colesterol total, triglicérides, VLDL colesterol, LDL colesterol e HDL colesterol) coletados em 3 momentos do estudo; e descrever a evolução longitudinal do perfil nutricional e metabólico destes grupos. Metodologia: Estudo clínico de intervenção auto-controlado, baseado na medida do perfil bioquímico (níveis de glicemia, colesterol total, triglicérides, VLDL colesterol, LDL colesterol e HDL colesterol) e do estado nutricional (antropometria, composição corporal e dados de ingestão alimentar) em três momentos: no início do estudo (antes de ser iniciada a intervenção), após seis semanas de suplementação de vitaminas e minerais e após outras seis semanas sem essa intervenção, para avaliar como um indivíduo, de 9 a 13 anos de idade responde à suplementação de múltiplos micronutrientes. O nível de atividade física praticado por esses indivíduos foi avaliado através do aparelho Bodybugg®. Resultados: Cento e trinta e seis indivíduos foram estudados até o terceiro momento do estudo. 43,4% eram do sexo masculino e 56,6% eram do sexo feminino. A média de idade foi de 11,39 ± 1,10 anos. A maioria dos participantes pertenciam ao estadiamento puberal 2 (43,4%) e 3 (35,3%). Em relação à classificação econômica dos participantes, a maioria pertencia à categoria B2 (38,2%) e C1 (26,5%). Do total da amostra estudada, no momento 1, 4,4% dos participantes apresentaram magreza grave; 5,9% apresentaram magreza, 41,9% estavam com o peso adequado, 22,8% tinham sobrepeso e 25% tinham obesidade. No momento 2, 3,7% dos participantes apresentaram magreza grave, 7,4% apresentavam magreza, 42,6% tinham o peso adequado, 22,1% tinham sobrepeso e 24,3% tinham obesidade e no momento 3, 3,7% dos participantes apresentaram magreza grave, 6,6% apresentavam magreza, 41,2% tinham o peso adequado, 22,8% tinham sobrepeso e 25,7% tinham obesidade. Em média encontramos: 3,7% dos participantes com magreza grave, 5,9% com magreza, 41,9% com peso adequado, 24,3% com sobrepeso e 24,3% com obesidade. Os participantes foram agrupados (clusterizados) utilizando-se como critério seu perfil metabólico (níveis de glicemia, colesterol total, triglicérides, VLDL colesterol, LDL colesterol e HDL colesterol) nos três momentos do estudo, por meio da técnica estatística K-cluster. O cluster 1 (n = 111) era composto por mais indivíduos do sexo feminino que o cluster 2 (n = 25) (p = 0,006) e apresentou melhor perfil metabólico (melhores valores para o perfil lipídico e de glicemia). Os indivíduos do cluster 1 também apresentaram menor peso, índice de massa corporal (IMC), circunferência da cintura (CC) e massa gorda (% peso) quando comparado aos participantes do cluster 2. A massa corporal magra (% peso) e a água corporal total (% peso) foram estatisticamente maiores nos participantes do cluster 1. A análise da ingestão habitual (por questionário de frequência alimentar - QFA) mostrou que os participantes do cluster 1 estavam ingerindo mais vitamina B2 e vitamina B6 quando comparados aos participantes do cluster 2 (p < 0.05). Houve menores valores para proteína C-reativa (PCR) e maiores valores para ferro sérico no cluster 1. A capacidade latente de ligação de ferro (UIBC) e leucócitos foram estatisticamente maiores no cluster 2. Não houve diferença entre o nível de atividade física praticado pelos dois clusters, ambos desempenhavam atividade física leve. A análise longitudinal mostrou que houve aumento de estatura e peso nos clusters 1 e 2. A avaliação longitudinal da ingestão habitual (QFA) no cluster 1 mostra redução da ingestão de energia, carboidrato, proteína e lipídio do momento 1 (M1) para momento 2 (M2) e momento 3 (M3). A suplementação de vitaminas mostrou resultados estatísticos significativos, consistentes com suplementação e wash out para a maioria das vitaminas e minerais nos clusters 1 e 2. A análise longitudinal (corrigindo para as variáveis idade, gênero, estadiamento puberal e ingestão de energia, carboidrato e lipídio) no cluster 1 mostrou que o colesterol total e a LDL diminuíram ao longo do estudo; a glicemia diminuiu do momento 1 para o momento 2, porém PCR aumentou no momento 2; ferro sérico e hemoglobina diminuíram no momento 2 e aumentaram no momento 3. No cluster 2, o colesterol total e o LDL diminuíram ao longo do estudo; a PCR aumentou ao longo do estudo, ferro sérico diminuiu do momento 1 para o momento 2. Conclusões: Foram encontrados dois grupos metabólicos opostos. Os indivíduos podem responder de forma diferente a uma mesma intervenção e é possível que a suplementação de múltiplos micronutrientes tenha um papel na melhora do perfil glicídico e lipídico de alguns sujeitos do estudo. Estudos de genotipagem e proteômica poderão reforçar esta hipótese e ajudar a entender como o sistema biológico de crianças e adolescentes interage para culminar em uma resposta frente a uma intervenção.
Introduction: Few studies have correlated metabolic profile and nutritional status in children and adolescents after dietary intervention . Objectives: To identify the existence of different metabolic groups formed by individuals 9-13 years undergoing nutritional intervention through biochemical data (glucose levels, total cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol and HDL cholesterol) collected in three stages of the study, and to describe the longitudinal evolution of the nutritional and metabolic profile in these groups. Methodology: Clinical intervention self-controlled study, based on measuring the biochemical profile (glucose levels, total cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol and HDL cholesterol) and nutritional status (anthropometry, body composition and dietary intake data) at three times: at baseline (before the intervention started), after six weeks of supplementation of vitamins and minerals and after more six weeks without this intervention, to assess how an individual, 9-13 years old answered the multiple micronutrient supplementation. Physical activity level was also assessed through a tool called bodybugg®. Results: One hundred and thirty six subjects were studied until the third moment of the data collection. 43.4% were male and 56.6% were female. The average age was 11.39 ± 1.10 years. Most participants belonged to pubertal stage 2 (43.4%) and 3 (35.3%). Regarding the economic status of the participants, the majority belonged to the category B2 (38.2%) and C1 (26.5%). Of the total sample, at moment 1, 4.4% of participants had severe underweight, 5.9% were underweight, 41.9% were with the proper weight, 22.8% were overweight and 25% were obese. At the moment 2, 3.7% of participants had severe underweight, 7.4% were underweight, 42.6% had normal weight, 22.1% were overweight and 24.3% were obese. And at the moment 3, 3.7% of participants had severe thinness, 6.6% were underweight, 41.2% had normal weight, 22.8% were overweight and 25.7% were obese. On average we found: 3.7% of participants with severe thinness, 5.9% with malnutrition, 41.9% with adequate weight, 24.3% overweight and 24.3% obese. The clustering of the participants used as criteria the metabolic profile (glucose levels, total cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol and HDL cholesterol) of the three stages of the study through the statistical approach K - cluster. Cluster 1 (n = 111) had a higher proportion of females when compared to cluster 2 (n = 25) (p = 0.006) and better metabolic profile (lipid and glycemia). Participants who had better metabolic profile (cluster 1) showed lower weight, body mass index (BMI), waist circumference (WC) and fat mass (weight %) when compared to participants in cluster 2. Lean body mass (weight %) and total body water (% weight) were statistically higher in participants in cluster 1. The analysis of the habitual intake (food frequency questionnaire - FFQ) showed that participants in cluster 1 were had higher intake of vitamin B2 and vitamin B6 when compared to cluster 2 (p < 0,05). Cluster 1 also showed higher values C - reactive protein (CRP) and higher levels of iron. The latent capacity for iron binding (UIBC) and leukocytes were higher in cluster 2. There was no difference between the level of physical activity practiced by clusters 1 and 2, both had light physical activity. Longitudinal analysis showed that there was an increase in height and weight in clusters 1 and 2. A longitudinal assessment of usual intake (FFQ) in cluster 1 showed reduced intake of energy, carbohydrate, protein and lipid from moment 1 (M1) to moment 2 (M2) and moment 3 (M3). Supplementation with vitamins showed significant statistical results, consistent with supplementation and washout for most vitamins and minerals in clusters 1 and 2. A longitudinal analysis (correcting for age, gender, pubertal stage, and energy intake, carbohydrate and lipid) in cluster 1 showed that total cholesterol and LDL decreased throughout the study, blood glucose decreased from time 1 to time 2, but CRP increased in moment 2; hemoglobin and serum iron decreased from 1 to 2 and from 1 to 3. In cluster 2, total cholesterol and LDL decreased throughout the study, CRP increased throughout the study, serum iron decreased from time 1 to time 2. Conclusions: We found two reverse metabolic groups. Individuals may respond differently to the same intervention, and it is possible that multiple micronutrient supplementation has a role in improving glycemia and lipid profile of some subjects. Genotyping and proteomics studies may reinforce this hypothesis and help understand how the biological system of children and adolescents interact to culminate in a response against an intervention.

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas
Numa sociedade cada vez mais preocupada com a saúde, a nutrição tem desempenhado um papel muito importante, não só com a causa da doença, mas também como uma forma de prevenção da doença. Isto ocorre porque os nutrientes são capazes de interagir com os mecanismos moleculares do organismo e assim, modificar as funções fisiológicas. A nutrigenómica (o estudo dos nutrientes na expressão dos genes) pode assim ser explorada de duas formas: os alimentos podem influenciar a atividade dos genes, e os genes podem influenciar a necessidade de certos nutrientes. Isto proporciona uma compreensão genética de como os componentes da dieta comum poderão afetar o equilíbrio entre a saúde e a doença, alterando desta forma a expressão e ou estrutura da composição genética de um individuo. Apesar de os indivíduos serem diferentes uns dos outros, o genoma é 99,9% semelhante entre eles. Esta diferença de 0.1% representa variações visíveis como a cor do cabelo, pele e olhos e diferenças mais subtis, como o aumento de predisposição para desenvolver doenças crónicas e a necessidade de determinados nutrientes e compostos bioativos. As várias mudanças nos hábitos alimentares e estilo de vida que surgem no dia-a-dia das pessoas podem assim estar relacionadas com o aparecimento de doenças influenciadas pela alimentação. Assim, lições de Nutrigenómica mostram a importância de consciencializar as pessoas para a importância da nutrição no estado de saúde de cada ser humano individual. No presente trabalho, pretende-se transmitir ao leitor uma visão compreensível mas ampla e detalhada de como a nutrigenómica é importante e quais as vantagens de usar esta ferramenta de estudo. In an increasingly health-conscious society, nutrition has played a very important role not only as the cause of disease but also as a way of disease prevention. This occurs because nutrients are able to interact with the organism’s molecular mechanisms and thereby modify physiological functions Nutrigenomics (the study of the influence of nutrients in gene expression) can thus be explored in two ways: food can influence the activity of genes and; genes can influence the need for certain nutrients. This provides an understanding of how the genetic components of common diets may affect the balance between health and disease, thereby altering the expression or structure and the genetic makeup of an individual. Despite being different from each other individual, the Human Genome is 99,9 % similar between individuals. This 0.1 % difference accounts for visible variations such in hair, skin and eye color and more subtle differences such as the increased predisposition to develop chronic diseases and the need for certain nutrients and bioactive compounds. The various changes in eating habits and lifestyle that arise in the day-to-day life of people can thus be related to the onset of diet-related disorders. Thus, lessons from Nutrigenomics indicate the importance of making people aware of the relevance of nutrition in the health status of every individual human being. The present work, aims at providing the reader with a comprehensive but broad and detailed view of how nutrigenomics is important and what are the advantages of using this study tool.

The international growth rate in the obesity epidemic has doubled since 1980 and this is an indication of poor lifestyles in many countries. The increase in obesity rates is not surprising when it happens in developed countries but when this increase appears rapidly and continuously in upper-middle income countries like Thailand it raises concerns about public health. In order to eliminate the growth rate of obesity in the Thai population, it is important to understand not only the causes of increases in body weight but also to understand what significant determinants influence behaviour related to obesity. Accordingly, dieting is the most important and effective treatment to achieve weight goals. However, in some cases diets are considered a threat to dieters as dieting might have a negative impact on body weight, therefore rising obesity rates remains a severe public health concern despite the fact that the majority of people aim to lose weight. Personalised nutrition programmes may help policy makers, marketers and professionals to introduce dietary programmes to help people achieve their weight goals. This study presents an opportunity to enhance knowledge in the context of healthy dietary behaviours focusing on the aspect of economics and social psychology. In social research, the health-related behavioural study is an important approach to understanding cognitive determinants of health behaviours such as healthy eating and physical activity, while also being a way of exploring how these determinants influence and predict such behaviour. This study aims to achieve three objectives: 1) to explore how attitudes, social norms, habits, risk attitudes, time preferences, socio-demographic and economic characteristics influence willingness to pay for a personalised nutrition programme proposed to reach weight goals; 2) to evaluate whether stated behaviour and WTP for the proposed PN programme is stable over time; 3) to assess how personality traits, time preferences, commitment, self-control, weight change and life satisfaction influence weight goal achievement. The key findings showed that the Heckman sample selection model was an appropriate econometric model that represents all determinants from economic and psychological aspects via an expectancy value model to predict health behaviour. Thailand is a potential market for Personalised Nutrition Programmes and such programmes should be a good starting point to improve the dietary habits of the Thai people. Goal commitment and self-control around eating behaviour are important inhibition facilitators to help participants stay focused when trying to achieve their weight goals.

Una dieta scorretta incrementa il rischio di malattie come l’insulino resistenza e l’obesità. Questa tesi ha l’obiettivo di valutare l’effetto di diete sbilanciate sulla fisiologia ed espressione genica in topi e suini allo svezzamento. Topi C57BL/6 sono stati sacrificati dopo 2 settimane, dopo essere stati alimentati con dieta iper-lipidica e dieta controllo. L’espressione genica è stata stimata usando la tecnologia microarray. Quattro dei sette geni identificati differenzialmente espressi tra il controllo e l’iper-lipidico sono coinvolti nella regolazione della via metabolica del sistema circadiano, che recentemente è stato mostrato avere effetti sul metabolismo lipidico e processo infiammatorio. Il secondo studio ha avuto lo scopo di capire gli effetti dello svezzamento con o senza l’aggiunta di acidificante nella dieta. I suinetti allo svezzamento (T0) sono stati comparati con i suinetti dopo una settimana (T1). Il gruppo post-svezzamento è stato alimentato con una dieta convenzionale, e metà di questi hanno ricevuto un supplemento di acido sorbico. L’aggiunta di acido sorbico nella dieta non ha causato nessuna differenza a livello fisiologico e di espressione genica. 205 geni sono stati identificati come differenzialmente espressi in T1 comparato con T0, evidenziando una forte risposta all’adattamento metabolico e agli stress subiti durante lo svezzamento.
An incorrect diet increases the risk of diseases as insulin resistance and obesity. This thesis aims at assessing the effects of unbalanced diets on gut physiology and gene expression in pig and mouse during weaning. The first research explored the impact of a high fat diet in C57BL/6 mice. High-fat-fed mice and control-fed mice were sacrificed after two weeks of treatment. Gene expression level was assessed by 90K Combimatrix microarray technology. Four of seven genes found differentially expressed between control and high fat diet mice are involved in the regulatory pathway of the circadian clock system, which was recently shown to affect lipid metabolism and inflammatory processes. Those genes were successfully validated by real time PCR. The second study aimed at understanding the weaning effect with or without acidifier addition in the diet. Piglets at weaning (T0) were compared to piglets after one week (T1). The post-weaning group was fed a conventional diet, half of which received in addition sorbic acid. The sorbic acid supplementation evidenced no effects in terms of physiology and gene expression. 205 genes were significantly differentially expressed in T1 when compared with T0, evidencing a response to the metabolic adaptation and the stress suffered during weaning.

The scope of the present work was to investigate whether the protective role of the traditional Mediterranean diet (TMD), and virgin olive oil (VOO) rich in phenolic compounds (PC), towards cardiovascular disease can be mediated through gene expression changes. Two trials were performed to assess the in vivo nutrigenomic effects of TMD and VOO in healthy volunteers. The results point out: a) significant gene expression changes of those genes related with cardiovascular-risk processes after VOO ingestion; b) a down-regulation in the expression of atherosclerosis-related genes after a 3-month intervention with a TMD; and c) an olive oil PC health-protective nutrigenomic effect within the frame of the TMD. Changes in gene expression were concomitant with decreases in oxidative damage and systemic inflammation markers. Data from our studies provide further evidence to recommend both the TMD and the VOO as a useful tool for the prevention of atherosclerosis.
El objetivo de este estudio es investigar si el papel protector de la dieta Mediterránea tradicional (TMD) y del aceite de oliva virgen (VOO), rico en compuestos fenólicos (PC), puede ser mediado a través de cambios en la expresión génica. Se realizaron dos ensayos clínicos para evaluar los efectos nutrigenómicos de la TMD y del VOO, in vivo, en voluntarios sanos. Los resultados mostraron a) cambios en la expresión génica de genes relacionados con el riesgo cardiovascular tras la ingestión del aceite virgen de oliva, b) una infra-expresión en la expresión de genes relacionados con el proceso aterosclerótico tras una intervención con TMD de 3 meses y c) que los compuestos fenólicos del aceite de oliva ejercen un efecto nutrigenómico protector en el marco de la TMD. Los cambios en la expresión génica fueron coherentes.

Alterações epigenéticas, como metilação do DNA e modificações pós traducionais em histonas, tem importante papel na carcinogênese mamária. A modulação de eventos epigenéticos constitui relevante alvo terapêutico, devido ao seu caráter reversível. Experimentalmente, o ácido docosahexaenoico (DHA), um membro da família dos ácidos graxos ômega-3, é capaz de diminuir proliferação, induzir morte celular e diminuir o potencial invasivo de células tumorais de mama. No entanto, os mecanismos antitumorais do DHA e sua capacidade de modular eventos epigenéticos ainda não estão totalmente elucidados. Nosso objetivo foi verificar, in vitro, a ação do DHA em eventos epigenéticos em diferentes linhagens de carcinoma mamário humano. Três linhagens celulares de câncer de mama (MDA-MB-231, SKBR-3 e MCF-7) foram tratadas durante 72 horas com 100 ?M de DHA ou etanol (controle). As modificações pós traducionais em histonas, acetilação no resíduo de lisina 9 da histona 3 (H3K9ac) e no resíduo 16 da histona 4 (H4K16ac), bem como trimetilação no resíduo de lisina 9 da histona 3 (H3K9me3) e no resíduo de lisina 27 da histona 3 (H3K27me3) foram avaliadas pela técnica de western blot. A análise da expressão do genes RASSF1A, DNMT1, DNMT3A e DNMT3B foi feita pela técnica da reação em cadeia da polimerase quantitativa via transcriptase reversa (RT-qPCR). A avaliação do padrão de metilação de região promotora do gene RASSF1A foi realizada pela técnica de reação em cadeia da polimerase metilação específica (MS-PCR). Foram também analisadas as fases do ciclo celular por citometria de fluxo. Comparado ao controle, o DHA induziu a acetilação no resíduo 16 da histona 4 (H4K16ac) nas linhagens MCF7 (p = 0,04) e MDA-MB-231 (p = 0,03). Observamos que a H3K9me3 foi parcialmente inibida nas linhagens MDA-MB-231 e SKBR-3, após o tratamento com DHA, mas sem alcançar valor estatisticamente significante. Encontramos também diminuição dos níveis de H3K27me3 após o tratamento com DHA nas três linhagens estudadas, porém não foi estatisticamente significativo. O DHA aumentou a expressão do gene RASSF1A na linhagem MCF-7 (1,98 vezes, p = 0,03), mas não nas linhagens MDA-MB-231 e SKBR-3. Não houve mudanças estatisticamente significativas na expressão dos genes DNMT1, DNMT3A e DNMT3B. As análises qualitativas da metilação demonstraram que a região promotora analisada do gene RASSF1A apresentou-se hipermetilada nas três linhagens celulares. Após o tratamento com DHA, houve tendência de desmetilação na região promotora do RASSF1A na linhagem MCF-7 e SKBR3, mas não na linhagem MDA-MB-231. Não houve diferença significativa na porcentagem de morte e distribuição das células MDA-MB-231, SKBR-3 e MCF-7 nas diferentes fases do ciclo celular após tratamento com DHA. Em conclusão, o DHA pode atuar em mecanismos epigenéticos e, ainda, reativar o gene supressor de tumor, como RASSF1A, anteriormente silenciado por hipermetilação, em células MCF-7. Espera-se que esses resultados contribuam para melhor compreensão do potencial papel anticâncer do DHA no câncer de mama
Epigenetic changes, such as DNA methylation and post-translational histone modifications, play an important role in mammary tumorigenesis. Epigenetic events are important as therapeutic targets, because of its reversible nature. Experimentally, docosahexaenoic acid (DHA), a member of the omega-3 fatty acids family, can reduce proliferation, induce apoptosis and decrease the invasive potential of breast tumor cells. However, the antitumor mechanism of DHA and its ability to modulate epigenetic events are not completely understood. Our objective was to verify, in vitro, the action of DHA in epigenetic events related to transcriptional reactivation of tumor suppressor gene, such as RASSF1A, in different human breast cancer cell lines. Three breast cancer cell lines (MCF-7, MDA-MB-231, SKBR-3) were treated with DHA (100 ?M) or vehicle (ethanol) for 72 hours. Western blot was used to analyze histone modification, as histone H3 lysine 9 (H3K9ac) and histone H4 lysine 16 (H4K16ac) acetylation, H3K9 trimethylation (H3K9me3) and H3K27 trimethylation (H3K27me3). Real time quantitative PCR (RT-qPCR) was performed for gene expression quantification of RASSF1A, DNMT1, DNMT3A and DNMT3B. DNA methylation of the promoter region of RASSF1A was evaluated by methylation specific PCR (MS-PCR). Moreover, we evaluated the phases of the cell cycle by flow cytometry. Compared to control cells, DHA induced H4K16ac in MCF-7 (p=0.04) and MDA-MB-231 (p=0.03). We observed that H3K9me3 was partially inhibited in MDA-MB-231 and SKBR-3 cells, after treatment with DHA, but did not reach a statistically significant value. We also found decreased levels of H3K27me3 after treatment with DHA in the three cell lines studied, but not statistically significant. DHA increased RASSF1A expression on MCF-7 (1.98 fold; p=0.03), but not in MDA-MB-231 and in SKBR-3 cells. There were no statistically significant changes in expression of genes DNMT1, DNMT3A and DNMT3B. These three breast cancer cells lines show methylation in specific region of RASSF1A promoter. DHA treatment increased RASSF1A promoter region hypomethylation in MCF-7 and SKBR-3. No significant difference was observed in the percentage of cell death nor cell distribution of MDA-MB-231, SKBR-3 and MCF-7 at different stages of the cell cycle after treatment with DHA. In conclusion, we suggest that DHA may act beneficially in epigenetic mechanisms and reactivation of tumor suppressor gene, RASSF1A as previously silenced by hypermethylation. It is hoped that these results can contribute to better understanding of the anticancer role of DHA in breast cancer

yes
Purpose - This research explores the perceptions and experiences of early adopters of the technology. Design/Method/Approach - Registered Dietitians (RD´s) (N=14) were recruited from the UK, Canada, South-Africa, Australia, Mexico and Israel. Six qualitative interviews and two focus groups were conducted online using a conference calling platform. Data were recorded, transcribed and thematically analysed. Findings - Early adopters of Nutrigenomics (NGx) were experienced, self-efficacious RD’s who actively sought knowledge of NGx through communication with one another and the broader scientific community. They considered NGx an extension of current practice and believed RD’s had the skills to deliver it. Perceived barriers to widening the application of NGx were linked to skepticism among the wider dietetics community. Proliferation of unregulated websites offering tests and diets was considered ‘pseudoscience’ and detrimental to dietetics fully embracing NGx. The lack of a sustainable public health model for the delivery of NGx was also perceived to hinder progress. Results are discussed with reference to ‘diffusion of innovation theory’. Originality/Value - The views of RD’s who practice NGx have not been previously studied. These data highlight requirements for future dietetic training provision and more inclusive service delivery models. Regulation of NGx services and formal recognition by professional bodies is needed to address the research/practice translation gap.

yes
Objective: This study explored associations between food choice motives, attitudes towards, 5 and intention to adopt personalised nutrition in order to inform communication strategies 6 based on consumer priorities and concerns. Design and Setting: A survey was administered 7 online which included the food choice questionnaire (FCQ), and items assessing attitudes 8 towards and intention to adopt personalised nutrition. Participants: Nationally representative 9 samples were recruited in 9 EU countries (N=9381). Results: Structural equation modelling 10 indicated that the food choice motives, weight control, mood, health and ethical concern had 11 a positive association and price had a negative association with attitude towards, and 12 intention to adopt, personalised nutrition. Health was positively associated and familiarity 13 negatively associated with attitude toward personalised nutrition. The effects of weight 14 control, ethical concern, mood and price on intention to adopt personalised nutrition were 15 partially mediated by the attitude. The effects of health and familiarity were fully mediated 16 by attitude. Sensory appeal was negatively and directly associated with intention to adopt 17 personalised nutrition. Conclusion: Personalised nutrition providers may benefit from taking 18 into consideration the importance of underlying determinants of food choice, particularly 19 weight control, mood and price, in potential users when promoting services and in tailoring 20 communications that are motivationally relevant.
Post peer-review accepted manuscript; changes are in red.

Yes
Personalised diets based on people’s existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N = 9381). Perceived barriers to the uptake of personalised nutrition comprised three factors (data protection; the eating context; and, societal acceptance). Trust in sources of information comprised four factors (commerce and media; practitioners; government; family and, friends). Benefits comprised a single factor. Analysis of Variance (ANOVA) was employed to compare differences in responses between the United Kingdom; Ireland; Portugal; Poland; Norway; the Netherlands; Germany; and, Spain. The results indicated that respondents in Greece, Poland, Ireland, Portugal and Spain, rated the benefits of personalised nutrition highest, suggesting a particular readiness in these countries to adopt personalised nutrition interventions. Greek participants were more likely to perceive the social context of eating as a barrier to adoption of personalised nutrition, implying a need for support in negotiating social situations while on a prescribed diet. Those in Spain, Germany, Portugal and Poland scored highest on perceived barriers related to data protection. Government was more trusted than commerce to deliver and provide information on personalised nutrition overall. This was particularly the case in Ireland, Portugal and Greece, indicating an imperative to build trust, particularly in the ability of commercial service providers to deliver personalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizens, imply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumers.
Food4me is the acronym of the EU FP7 Project ‘‘Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE.2010.2.3-02, ProjectNo.265494), http:// www.food4me.org/.

Yes
The present study explored associations between food choice motives, attitudes towards and intention to adopt personalised nutrition, to inform communication strategies based on consumer priorities and concerns. Design/Setting: A survey was administered online which included the Food Choice Questionnaire (FCQ) and items assessing attitudes towards and intention to adopt personalised nutrition. Subjects: Nationally representative samples were recruited in nine EU countries (n 9381). Results: Structural equation modelling indicated that the food choice motives ‘weight control’, ‘mood’, ‘health’ and ‘ethical concern’ had a positive association and ‘price’ had a negative association with attitude towards, and intention to adopt, personalised nutrition. ‘Health’ was positively associated and ‘familiarity’ negatively associated with attitude towards personalised nutrition. The effects of ‘weight control’, ‘ethical concern’, ‘mood’ and ‘price’ on intention to adopt personalised nutrition were partially mediated by attitude. The effects of ‘health’ and ‘familiarity’ were fully mediated by attitude. ‘Sensory appeal’ was negatively and directly associated with intention to adopt personalised nutrition. Conclusions: Personalised nutrition providers may benefit from taking into consideration the importance of underlying determinants of food choice in potential users, particularly weight control, mood and price, when promoting services and in tailoring communications that are motivationally relevant.

Yes
The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that tailored interventions such as those that could be delivered online can be effective in bringing about healthy dietary behaviour change. The present paper brings together evidence from qualitative and quantitative studies that have considered the public perspective of genomics, nutrigenomics and personalised nutrition, including those conducted as part of the EU-funded Food4Me project. Such studies have consistently indicated that although the public hold positive views about nutrigenomics and personalised nutrition, they have reservations about the service providers’ ability to ensure the secure handling of health data. Technological innovation has driven the concept of personalised nutrition forward and now a further technological leap is required to ensure the privacy of online service delivery systems and to protect data gathered in the process of designing personalised nutrition therapies.

Yes
Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the ‘framework approach’ described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Negative consumer opinion poses a potential barrier to the application of nutrigenomic intervention. The present study has aimed to determine attitudes toward genetic testing and personalised nutrition among the European public. An omnibus opinion survey of a representative sample aged 14-55+ years (n 5967) took place in France, Italy, Great Britain, Portugal, Poland and Germany during June 2005 as part of the Lipgene project. A majority of respondents (66 %) reported that they would be willing to undergo genetic testing and 27 % to follow a personalised diet. Individuals who indicated a willingness to have a genetic test for the personalising of their diets were more likely to report a history of high blood cholesterol levels, central obesity and/or high levels of stress than those who would have a test only for general interest. Those who indicated that they would not have a genetic test were more likely to be male and less likely to report having central obesity. Individuals with a history of high blood cholesterol were less likely than those who did not to worry if intervention foods contained GM ingredients. Individuals who were aware that they had health problems associated with the metabolic syndrome appeared particularly favourable toward nutrigenomic intervention. These findings are encouraging for the future application of personalised nutrition provided that policies are put in place to address public concern about how genetic information is used and held.

The aim of this research was to explore consumer perceptions of personalised nutrition and to compare these across three different levels of "medicalization": lifestyle assessment (no blood sampling); phenotypic assessment (blood sampling); genomic assessment (blood and buccal sampling). The protocol was developed from two pilot focus groups conducted in the UK. Two focus groups (one comprising only "older" individuals between 30 and 60 years old, the other of adults 18-65 yrs of age) were run in the UK, Spain, the Netherlands, Poland, Portugal, Ireland, Greece and Germany (N=16). The analysis (guided using grounded theory) suggested that personalised nutrition was perceived in terms of benefit to health and fitness and that convenience was an important driver of uptake. Negative attitudes were associated with internet delivery but not with personalised nutrition per se. Barriers to uptake were linked to broader technological issues associated with data protection, trust in regulator and service providers. Services that required a fee were expected to be of better quality and more secure. An efficacious, transparent and trustworthy regulatory framework for personalised nutrition is required to alleviate consumer concern. In addition, developing trust in service providers is important if such services to be successful.

Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de Farmácia
Nos últimos anos, o grande desenvolvimento nas áreas da biologia molecular, genética e nutrição, juntamente com a sequenciação completa do genoma humano, permitiram que a nutrição entrasse numa nova era, onde os nutrientes são reconhecidos como sendo capazes de interagir e alterar os mecanismos moleculares envolvidos nos processos fisiológicos do corpo humano, e, onde o perfil genético de cada indivíduo consegue determinar a resposta do nosso organismo a certos nutrientes. Surgem assim a nutrigenética, que estuda a influência que as variações genéticas têm na resposta do corpo à nossa alimentação, e a nutrigenómica, que estuda a influência dos nutrientes na expressão do nosso genoma. Estas duas ciências apresentam-se como o futuro promissor da nutrição, tendo o potencial para que, no futuro, consigam explicar a interação complexa entre os nutrientes e o genoma humano, permitindo aplicar estes conhecimentos na prevenção e controlo de doenças genéticas e crónicas. No entanto, a nutrigenética e a nutrigenómica ainda são áreas embrionárias, sendo necessário ainda muitos estudos para se conseguir perceber totalmente esta relação complexa, e de que forma podemos aplicar isso na prática clínica. O presente trabalho, pretende demonstrar que papel a nutrigenética e a nutrigenómica poderão ter no futuro desenvolvimento da nutrição, onde será apresentado de que forma a nutrigenética e a nutrigenómica, tentam perceber o papel da interação nutriente-genoma no aparecimento das várias doenças dentro da população, e de que forma a nutrição personalizada permite auxiliar na prevenção e controlo dessas doenças, melhorando assim a saúde da população. Além disto, serão abordados alguns riscos e obstáculos inerentes ao desenvolvimento destas ciências, e também qual o papel que o farmacêutico poderá desempenhar nestas áreas.
In the last few years, the great development in the fields of molecular biology, genetics and nutrition, alongside with the whole human genome sequencing, allowed nutrition to enter a new era, where the nutrients are capable of interacting and modulating the molecular mechanisms underlying the physiological processes of the human body, and where the genetic profile of each individual, can determine the organism’s response to the diet. Thus, this led to the arise of nutrigenetics, that studies the influence of genetic variations on the body’s response to the diet, and nutrigenomics, that studies the impact of the nutrients on genome expression. These two sciences are presented as the promising future of the nutritional science, having the potential in the future, to explain the complex interaction between nutrients and the human genome, allowing the application of this acknowledgments in the prevention and management of genetic and chronic diseases. However, nutrigenetics and nutrigenomics still are embryonic sciences, and numerous studies will be necessary for the understanding of this complex interaction, and how we can apply this to the clinical practice. This present work aims to demonstrate what role, nutrigenetic and nutrigenomics will have on the future development of nutrition, where it will be presented how nutrigenetics and nutrigenomics try to understand the nutrient-genome interaction’s role in the occurrence of the various diseases in the human population, and, how personalized nutrition can assist in the prevention and management of these diseases, improving the population’s overall health. Furthermore, it will be discussed the inherent risks and barriers in the development of these sciences, as well as the pharmacist’s role in these areas.

no
Personalised Nutrition allows individual variation in dietary, lifestyle, anthropometric, phenotypic and/or genomic information to be considered when giving dietary advice. Compared to ‘generic’ dietary health messages, personalised dietary advice has been shown more likely to result in healthy dietary change. Personalised regimes can help clients in this endeavour by putting them in control and taking into consideration individual propensity for behaviour change, motives for food choice as well as social and lifestyle factors impacting upon the eating context. Provision of personalised nutrition services across Europe should consider inter-country differences in perceived barriers to uptake of personalised nutrition including those associated with the process from the collecting of information and taking of biological samples through to how the results are interpreted and delivered. Irrespective of European country, potential consumers appear to trust health professionals such as dietitians over commercial agents to provide personalised nutrition. Dieticians, therefore, are likely to play a key role in making personalised nutrition happen in the future. Organisations representing nutrition and dietetics professionals will need to be consulted for guidance on how to address the ethical and legal issues around personalised nutrition and regulate practice. A future is envisaged where commercial personalised nutrition will work with existing health providers in bringing the benefits of personalised nutrition to the wider public.
The full text is unavailable in the repository due to copyright restrictions.

yes
Personalised nutrition (PN) may promote public health. PN involves dietary advice based on individual characteristics of end users and can for example be based on lifestyle, blood and/or DNA profiling. Currently, PN is not refunded by most health insurance or health care plans. Improved public health is contingent on individual consumers being willing to pay for the service. Methods: A survey with a representative sample from the general population was conducted in eight European countries (N = 8233). Participants reported their will- 25 ingness to pay (WTP) for PN based on lifestyle information, lifestyle and blood information, and lifestyle and DNA information. WTP was elicited by contingent valuation with the price of a standard, non-PN advice used as reference. Results: About 30% of participants reported being willing to pay more for PN than for non-PN advice. They were on average prepared to pay about 150% of the reference price of a standard, non-personalised advice, with some differences related to socio-demographic factors. Conclusion: There is a potential market for PN 30 compared to non-PN advice, particularly among men on higher incomes. These findings raise questions to what extent personalized nutrition can be left to the market or should be incorporated into public health programs
EC (FW7) funded Food4me project
The full text will be available 12 months after publication

Pregnancy complications associated with placental development affect approximately one third of all human pregnancies. Genome health is essential for placental and fetal development, as DNA damage can lead to pregnancy loss and developmental defects. During this developmental phase rapid DNA replication provides an increased opportunity for genome and epigenome damage to occur[1]. Maternal nutrition is one of the principal environmental factors supporting the high rate of cell proliferation and differentiation. Folate functions in one-carbon metabolism and regulates DNA synthesis, DNA repair and gene expression[1]. Deficiencies or defects in gene-nutrient interactions associated with one-carbon metabolism can lead to inhibition of cell division, cell cycle delay and an excessive apoptotic or necrotic cell death rate [2], which may affect placentation. This study is the first to investigate the association between genomic damage biomarkers in late pregnancy complications associated with uteroplacental insufficiency (UPI) including preeclampsia and intrauterine growth restriction (IUGR). The results indicate that genome damage in the form of micronucleated cells in peripheral blood lymphocytes at 20 weeks gestation is significantly increased in women at risk of developing an adverse pregnancy outcome. The observed OR for the high micronuclei frequency may be the highest observed for any biomarker selected in relation to risk of pregnancy complications to date (15.6 – 33.0). In addition, reduced apoptosis was observed in association with increased micronuclei, suggesting that the cells may have escaped specific cell-cycle checkpoints allowing a cell with DNA damage to proceed through mitosis. This study demonstrated that an increase in plasma homocysteine concentration at 20 weeks gestation is associated prospectively with the subsequent development of UPI, indicating a causal relationship. The MTR 2756 GG genotype was significantly associated with increased plasma homocysteine concentration and UPI. Furthermore, the MTHFD1 1958 single nucleotide polymorphism was associated with increased risk for IUGR.
http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1309296
Thesis (Ph.D.) -- School of Paediatrics and Reproductive Health, 2007

Yes
Objective: To develop a model of the psychological factors which predict people’s intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. Methods: A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N = 9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Results: Structural equation modelling indicated that the greater participants’ perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. Conclusion: The results suggest that transparent provision of information about potential benefits, and protection of consumers’ personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition.
This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement n u 265494 (http://cordis.europa.eu/fp7/home_en.html). Food4Me is the acronym of the project ‘‘Personalised nutrition: an integrated analysis of opportunities and challenges’’ (http://www.food4me.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Yes
Social Cognitive Theory has been used to explain findings derived from focus group discussions (N = 4) held in the United Kingdom with the aim of informing best practice in personalised nutrition. Positive expectancies included weight loss and negative expectancies surrounded on-line security. Monitoring and feedback were crucial to goal setting and progress. Coaching by the service provider, family and friends was deemed important for self-efficacy. Paying for personalised nutrition symbolised commitment to behaviour change. The social context of eating, however, was perceived a problem and should be considered when designing personalised diets. Social Cognitive Theory could provide an effective framework through which to deliver personalised nutrition.
This work was supported by the European Commission under the Food, Agriculture, Fisheries and Biotechnology Theme of the 7th Framework Programme for Research and Technological Development (265494).

Yes
Background: Commercial technology-enabled personalised nutrition is undergoing 19 rapid growth, yet uptake in dietetics practice remains low. This survey sought the opinions 20 of dietetics practitioners on personalised nutrition and related technologies to understand 21 facilitators and barriers to its application in practice. 22 Method: A cross-section of Registered Dietitians were recruited in the US, UK, 23 Australia, Canada, Israel, Mexico, Portugal, Spain and South Africa. The questionnaire 24 sought views on risk of genetic technology, ethics of genetic testing, usefulness of new 25 personalised nutrition technologies, entrepreneurism and the perceived importance of 26 new technologies to dietetics. Validated scales were included to assess personality (Big 27 5) and self-efficacy (NGSEI). The survey was available in English, Spanish and 28 Portuguese. Regression analyses were performed to identify factors associated with 29 integration of nutrigenetic testing into practice, and to identify factors associated with the 30 perceived importance of bio, information and mobile technologies to dietetic practice. 31 Results: A total of 323 responses (response rate 19.7%) were analysed. Dietetic 32 practitioners who had integrated personalised nutrition technology into practice perceived 33 technologies to be less risky (P=0.02), biotechnology to be more important (P<0.01), and 34 professional skills to be less important (P=0.04) than those who had not. They were also 35 more likely to see themselves as entrepreneurs (P<0.01) and to perceive lower risks to be 36 associated with technology (P<0.01). Practitioners of nutrigenetics were lower on 37 neuroticism (P<0.01) and higher on self-efficacy (P<0.01), extraversion (P<0.01) and 38 agreeableness (P<0.01). Higher perceived importance of biotechnology to dietetic 39 practice was associated with higher perceived usefulness of omics tests (P<0.01). 40 Perceived importance of information technology was associated with perceived 41 importance of biotechnology (P<0.01). Mobile technologies were perceived as important 42 by dietitians with the highest level of education (P=0.02). 43 Conclusions: For dietitians to practice technology-enabled personalised nutrition, 44 training will be required to enhance self-efficacy, address risk perceived to be associated 45 with new technologies and to instil an entrepreneurial mindset.

Yes
Personalized nutrition has the potential to improve health, prevent disease and reduce healthcare expenditure. Whilst research hints at positive consumer attitudes towards personalized nutrition that draws upon lifestyle, phenotypic and genotypic data, little is known about the degree to which registered dietitians (RD) are engaged in the delivery of such services. This review sought to determine possible factors associated with the integration of the emerging science of Nutritional Genomics (NGx) into the clinical practice setting by practicing registered dietitians. Scope Search of online databases (Pubmed; National Library of Medicine; Cochrane Library; Ovid Medline) was conducted on material published from January 2000 to December 2014. Studies that sampled practicing dietitians and investigated integration or application of NGx and genetics knowledge into practice were eligible. Articles were assessed according to the American Dietetic Association Quality Criteria Checklist. Key findings Application of nutritional genomics in practice has been limited. Reluctance to integrate NGx into practice is associated with low awareness of NGx, a lack of confidence in the science surrounding NGx and skepticism toward Direct to consumer (DTC) products. Successful application to practice was associated with knowledge about NGx, having confidence in the science, a positive attitude toward NGx, access to DTC products, a supportive working environment, working in the clinical setting rather than the public health domain and being in private rather than public practice. Conclusions There is a need to provide RGs with a supportive working environment that provides ongoing training in NGx and which is integrated with clinical practice.

yes
Background/Aims: Personalised nutrition has potential to revolutionise dietary health promotion if accepted by the general public. We studied trust and preferences regarding personalised nutrition services, how they influence intention to adopt these services, and cultural and social differences therein. Methods: A total of 9381 participants were quota sampled to be representative for each of nine EU countries (Germany, Greece, Ireland, Poland, Portugal, Spain, Netherlands, UK, Norway) and surveyed by questionnaire assessing their intention to adopt personalised nutrition, trust in service regulators and information sources, and preferences for service providers and information channels. Results: Trust and preferences significantly predicted intention to adopt personalised nutrition. Higher trust in the local department of healthcare was associated with lower intention to adopt personalised nutrition. General practitioners were the most trusted of service regulators, except for in Portugal, where consumer organisations and universities were most trusted. In all countries, family doctors were the most trusted information providers. Trust in the National Health Service as service regulator and information source showed high variability across countries. Despite its highest variability across countries, personal meeting was the preferred communication channel except in Spain (where an automated internet service was preferred). General practitioners were the preferred service providers, except in Poland, where dietitians and nutritionists were preferred. The preference for dietitians and nutritionists as service providers highly varied across countries. Conclusion: These results may assist in informing local initiatives to encourage acceptance and adoption of country specific tailored personalised nutrition services therefore benefiting individual and public health.

Yes
In order to determine the efficacy of behavior change techniques (BCT) applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques which have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development and most are not adapted for online delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized online techniques employed in a large-scale internet-based intervention to change dietary behaviour and physical activity.

Yes
Background: National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. Methods: Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n=2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n=1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. Results: A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β=-0.181, p<0.001) and waist circumference (Β=-0.155, p<0.001), and positively associated with total carotenoids (β=0.198, p<0.001), omega-3 fatty acid index (β=0.155, p<0.001), Healthy Eating Index (HEI) (β=0.299, p<0.001) and Mediterranean Diet Score (MDS) (β=0. 279, p<0.001). Findings from the longitudinal intervention study showed a greater reduction in BMI and improved dietary indices among participants with lower NPSQ9 scores. Conclusions: Healthy eating perceptions and dietary habits captured by the NPSQ9 score, based on 9 questionnaire items, were associated with reduced body weight and improved diet quality. Likewise, participants with a lower score achieved greater health improvements than those with higher scores, in response to personalised advice, suggesting that NPSQ9 may be used for early evaluation of nutritional status and to tailor nutritional advice.
European Union’s Seventh Framework Programme for 23 research, technological development and demonstration (grant agreement no. 265494). "la Caixa" Banking Foundation through a grant.

Η παρούσα εργασία αποτελεί μια πρώτη προσπάθεια αξιολόγησης της απήχησης των υπηρεσιών Διατροφογονιδιωματικής στην Ελλάδα, που ακόμα είναι ελάχιστα αναπτυγμένες στην χώρα μας. Στόχος της είναι η κατανόηση των στάσεων και απόψεων του ελληνικού κοινού αναφορικά με τη σχέση γενετικής και διατροφής. Με τη μελέτη αυτή επιδιώκουμε επίσης να εκτιμήσουμε το επίπεδο γνώσεων και το ενδιαφέρον του ευρέος κοινού στους τομείς αυτούς και να σκιαγραφήσουμε τη διάθεσή τους να υποβληθούν σε γενετικές εξετάσεις με στόχο την συσχέτιση του γενετικού τους προφίλ με τη διατροφή τους και την ακόλουθη λήψη διαιτητικών συστάσεων. Για τους σκοπούς της έρευνας συντάχθηκε ένα Ερωτηματολόγιο με 16 ερωτήσεις κλειστού τύπου. Το δείγμα μας αποτέλεσαν 300 τυχαία επιλεγμένα άτομα στην πόλη της Πάτρας, που δέχτηκαν να απαντήσουν στο Ερωτηματολόγιο. Οι απαντήσεις μελετήθηκαν σε σχέση με το Φύλο, την Ηλικιακή Ομάδα και τον Δείκτη Σωματικού Βάρους των ερωτηθέντων, για να ελεγχθεί πιθανή επίδραση των παραγόντων αυτών στις απαντήσεις τους. Τα αποτελέσματά μας καταγράφουν ότι το ευρύ κοινό στην Ελλάδα εμφανίζεται να γνωρίζει τι είναι DNA και γενετικό υλικό καθώς και το ρόλο των γονιδίων στον καθορισμό της υγείας. Επίσης, φαίνεται να υπάρχει μια καλή θεώρηση της σχέσης μεταξύ διατροφής και υγείας. Υψηλό ποσοστό του κοινού εμφανίζονται ενήμεροι σχετικά με τα πιθανά οφέλη των γενετικών αναλύσεων, αν και το ποσοστό αυτό μειώνεται με την ηλικία. Τα δεδομένα μας έδειξαν ότι μόνο στο 9.7% από τους ερωτηθέντες έχει προταθεί να υποβληθούν σε μια γενετική εξέταση για τη σχέση γονιδίων και διατροφής, παρόλο που το 84% των συμμετεχόντων απάντησαν ότι θα ήταν διατεθειμένοι να το κάνουν. Ενδιαφέρον επίσης παρουσιάζει το γεγονός ότι η μεγάλη πλειοψηφία του κοινού προτιμά την παραπομπή ενός γιατρού για μια τέτοια εξέταση και πολύ λιγότερο τη συμβουλή ενός διατροφολόγου/διαιτολόγου. Συμπερασματικά, η μελέτη αυτή αποτελεί την πρώτη κριτική αξιολόγηση των απόψεων του ευρέος κοινού στην Ελλάδα όσον αφορά στις υπηρεσίες γενετικών εξετάσεων με στόχο συμβουλευτική διατροφής. Εφόσον δεν έχει διεξαχθεί άλλη τέτοια έρευνα, θεωρούμε ότι θα μπορούσε να χρησιμεύσει σαν πρότυπο για να μελετηθούν και άλλοι πληθυσμοί, και να στοχευθούν καλύτερα εκείνοι που: α) έχουν πραγματική ανάγκη τέτοιων αναλύσεων (πχ οικογενειακό ιστορικό παχυσαρκίας η καρδιαγγειακών νοσημάτων) και β) είναι επιστημονικά στοιχειωδώς ενήμεροι και φαίνονται διατεθειμένοι να υποβληθούν στις ανάλογες αναλύσεις (άρα έχουν εμπιστοσύνη στην αποτελεσματικότητά τους).
This research constitutes a first attempt to understand the general public’s knowledge concerning basic notions and services in genetics-based nutrition, as well as reveal their attitudes and perceptions on Nutrigenomics. With this research we also aspire to assess the level of knowledge an interest of the general public in this field and evaluate their willingness to undergo such genetic analyses, in order to correlate their genetic profile with their nutrition and receive dietary recommendations. For the purposes of this study, we designed a questionnaire of 16 questions and conducted a general public survey. Our sample consists of 300 participants, randomly chosen from the public, in the city of Patras in Greece. The answers were analyzed by grouping them according to Gender, Age group and the BMI of the participants, in order to check for potential influence of these factors on the answers. Our analysis indicated that the public in Patras appears quite knowledgeable concerning DNA and the role of the genome in determining overall health. Participants also have a good grasp of the relation of nutrition to health conditions. A large proportion of the general public is aware of the existence of gene-based disorders and the potential benefits of genetic testing, although this proportion declines steadily with age. Our data revealed that only 9.7% of respondents from the general public had been advised to take a genetic test in order to explore the relationship between their genes and their nutritional status. However, 84% of them would be willing to undergo nutrigenomic analysis to correlate their genetic profile with their diet. Interestingly, to do so, the vast majority of the general public would prefer referral from a physician than from a dietitian/nutritionist. Our study has provided the first critical evaluation of the views of the general public with regard to genetics and genetic testing services in Greece and, since no other such study has been conducted so far, it should serve as a model for replication in other populations, so that we could target the groups that a) are in need of such analyses due to family history of obesity or cardiovascular disease, and b) are fundamentally scientifically aware and seem willing to undergo such tests.

Nutrigenomics studies the genome-wide influence of nutrients to understand the association between nutrition and human health. Studies in animal models and humans have demonstrated that dietary n-3 polyunsaturated fatty acids (PUFA) from fish oil may be beneficial in inflammatory bowel diseases (IBD). This thesis aimed to test the hypothesis that dietary n-3 PUFA eicosapentaenoic acid (EPA) reduced and n-6 PUFA arachidonic acid (AA) increased colitis in the interleukin- 10 gene-deficient (Il10–/–) mouse model of IBD, and that these PUFA altered the intestinal bacteria community during colitis development using genome-wide expression and bacterial profiling. Using a combined transcriptomic and proteomic approach, the time-course study defined the onset and progression of colitis in Il10–/– mice. Histopathology, transcript and protein changes before and after colitis onset involved in innate and adaptive immune responses suggested delayed remodelling processes in colitic Il10–/– mice and 11 weeks of age as suitable time point to study the effects of dietary PUFA on colitis development. Comparing the transcriptome and proteome profiles associated with colon inflammation of mice fed with the AIN-76A or oleic acid (OA) diet showed that OA was an appropriate control for unsaturated fatty acids in multi-omic studies. The PUFA intervention study indicated that dietary EPA-induced lipid oxidation might have a potential anti-inflammatory effect on inflamed colon tissue partially mediated through activation of peroxisome proliferator-activated receptor alpha (PPARα). Unexpectedly, dietary AA decreased the expression of inflammatory and stress colonic genes in Il10–/– mice. Altered intestinal bacteria community observed in Il10–/– mice before and after colitis onset was associated with the lack of IL10 protein led to changes in intestinal metabolic and signalling processes. Interestingly, dietary EPA and AA seemed to change intestinal bacteria profiles during colitis development. The role of PPARα in the colon was further examined in a concluding study which identified vanin1 as a likely new PPARα-target gene which may also be involved in lipid metabolism. These findings using a state-of-the-art approach combining transcriptomics, proteomics and physiology provide a basis for future research on molecular mechanisms underlying the effects of dietary PUFA, and might contribute to the development of fortified foods that improve intestinal health and wellness.

alpha-tocopherol is the most abundant form of vitamin E in human plasma and tissues. Inter-individual differences in plasma alpha-tocopherol concentration or its response to dietary alpha-tocopherol may be due, in part, to polymorphisms in vitamin E metabolism genes (alpha-tocopherol transfer protein (alpha-TTP), tocopherol associated protein (TAP) and CYP4F2). The thesis objectives were to determine whether common polymorphisms in the alpha-TTP (rs6994076 A>T), TAP (rs2072157 C>T and Arg11Lys) and CYP4F2 (Val433Met) genes influence plasma alpha-tocopherol concentration or modify the association between dietary and plasma alpha-tocopherol. Subjects (n=1248), 20 to 29 years from the Toronto Nutrigenomics and Health study completed a food frequency questionnaire. Fasting blood samples were used for genotyping and to measure plasma alpha-tocopherol concentration. The alpha-TTP and TAP Arg11Lys polymorphisms significantly altered plasma alpha-tocopherol. The alpha-TTP polymorphism only influenced plasma alpha-tocopherol in individuals not using supplements. None of the polymorphisms examined modified the plasma alpha-tocopherol response to dietary alpha-tocopherol.