AN INDIVIDUALIZED DIET: A WAY FORWARD!

Did you know that foods can have beneficial or adverse (side) effects, depending on the patient’s genotype?

We know today that there is genetic and biochemical individuality, which are the ways in which each organism responds to external factors (such as food) differently. Therefore, there is no single type of food that makes all people lose weight.

Well, knowing that, I want to highlight a review study, published last year: A Personalized Dietary Approach-A Way Forward to Manage Nutrient Deficiency, Effects of the Western Diet, and Food Intolerances in Inflammatory Bowel Disease, which brought the personalized dietary approach to inflammatory bowel disease (IBD) and also made an addition to food intolerances and how certain genotypes can affect them. I decided to share with you, with the intention of stressing the importance of a personalized approach, with prior knowledge of some genetic and biochemical aspects, which explain this variability in responses to food.

The sensitivity of dairy products, for example, in people with IBD is about 10% to 20%. This sensitivity to dairy products is often associated with a reduction in the enzyme lactase (necessary for the digestion of lactose) in adulthood. It is known that in most mammals, the activity of the enzyme lactase decreases soon after weaning. However, in humans this enzyme activity can persist into adulthood. Thus, this persistence is a genetically determined characteristic. In Europe, a single allele – T-13910 of the lactase-chlorophyll hydrolase (LCT) gene – is the main one. However, in Africa and the Middle East, many other mutations are associated with the persistence of lactase.

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Celiac disease also has genetic links. Gluten intolerance is associated with genetic variants of the main gene of the histocompatibility complex, class II, DQ alpha 1 (HLA-DQA1) and the main histocompatibility complex, class II gene, DQ beta 1 (HLA-DQB1). Remembering that there is an antibody test to detect the disease. However, there is still no definitive test for sensitivity to non-celiac gluten, and the recommended one in this case is to avoid consuming foods containing gluten.

And lastly, I will talk about Foodmaps, which are fermentable oligo, di- and monosaccharides and polyols that, if reduced in the diet, have been shown to be effective in reducing abdominal symptoms associated with Irritable Bowel Syndrome. Recent research indicates that following a strict diet in Foodmaps can also affect the genome of the microbiome and encourage the intestinal microbiota to decrease Bifidobacterium. IBD patients have their intestinal microbiota altered and, during treatment, it may be necessary to supplement with important bacteria for a good prognosis of the patient.

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