Personalized Nutrition through Genetics

How Nutrigenomics can Optimize Diet for Bone HealthIn the July issue of Jama (Journal of the American Medical Association) there was an article outlining the results of a huge meta-analysis of genes related to calcium absorption, use and excretion.

The study looked at hundreds of thousands of patients and compared their genetic data to their blood calcium levels. They found that there were several genes that influenced calcium levels, and 6 genes that had a significant impact on the circulating calcium levels. 

In this week's article we look at why this is important in the treatment of osteoporosis and more importantly in protecting patients against cardiovascular disease. 

Read the Abstract in Jama

Calcium is a double edged swordStudies are mixed on calcium supplementation. Although it has been recommended for osteoporosis prevention for decades, many studies have found that supplementing calcium increases the risk of cardiovascular disease. (Study, study). Calcium supplementation in women with existing cardiovascular disease has also been associated with an increased risk of dementia (study). In this current study those participants who had the genetic variants associated with higher blood calcium levels also had increased risk of heart attacks and strokes as well. Not all studies have been consistent on this topic. Many studies failed to find any significant connection between calcium supplementation and cardiovascular disease. These genetic variants influencing calcium absorption, utilization and excretion may provide the missing piece of the puzzle that explains these discrepancies.

It bears stating that this doesn't change the basic tenet of nutrition, namely, that nutrients exist and operate within the fabric of a complex diet consisting of various nutrients. You can't provide a single concentrated nutrient as a supplement and expect it to behave as it does in a healthy diet. Calcium is no different than any other nutrient in this regard, and depends on other nutrients for proper use. The best approach is, as always, a complex, nutrient dense diet rich in whole, unprocessed foods.
Vitamins D and K influence the function and absorption of CalciumIn those with sufficient vitamin D, calcium is less likely to end up plastered to the blood vessel walls. Sufficient vitamin D stores also seem to help regulate absorption. In order to provide adequate Vitamin D through sun exposure, a minimum of about 10 minutes in full sun, exposing arms and legs is needed 2-3 times per week. (study) Vitamin K2 also helps to protect blood vessel walls from calcification by supporting the proteins that clean calcium out of the blood vessels. (article)

So what about your Genes?Genetic consultations at The Parani Clinic consist of 3 one hour sessions where we dive deep into your genes. We evaluate genes like the ones appearing in this study as well as hundreds of others. Our goal through these sessions is to give you a detailed template for the best practices for your health; from the best diet for you to the most effective exercise approaches, and specific lifestyle strategies. We can often identify environmental toxins that your system is especially sensitive to and help you to form strategies to avoid exposure to them. As in the case of calcium for the participants in this study, there are nutrients you will need in smaller amounts and some you will need in larger amounts based on your genes. The capacity for personalized genetic medicine to optimize your health through uncovering all the specific fine adjustments about how your body functions is exciting and promising. It allows us to identify and treat disease long before it appears. 

In the context of osteoporosis, if a person has multiple genes that increase circulating calcium levels, then attempting to address osteoporosis by adding a calcium supplement is not only ill advised, it should be avoided as it will likely increase their risk of heart attack or stroke without offering much benefit in terms of bone strength. 

For those with genetic variants increasing calcium levels, here are a few simple interventions that are likely to be helpful:

• Make sure to consume vitamin K2 regularly (it activates a protein that removes calcium from the blood vessel walls and helps it to get back into the bones). 
• Avoid calcium supplements
• Test your vitamin D levels yearly and take supplemental vitamin D if needed to keep your 25 hydroxy vitamin D above 40
• In patients requiring blood thinner treatment, Vitamin K antagonists (such as warfarin, and Coumadin) may not be the best option. Because patients taking these medication need to limit their vitamin K intake, they open themselves up for additional cardiovascular damage. Consider consulting with your doctor to find a suitable replacement. 

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