NUTRIGENOMICS | Dr. Sara Gottfried | TEDxMarin

NUTRIGENOMICS | Dr. Sara Gottfried | TEDxMarin

November 19, 2019 7 By Ewald Bahringer


Translator: Talita Mahfuz Adamo
Reviewer: Tanya Cushman Imagine a world where you’re not
obsessively counting calories. Imagine a world where you’re not caught
between bingeing on the couch and spending hours at the gym. Imagine a world where you’re not jumping from shame to punishment with food. I can show you how. That’s the promise of nutrigenomics, which is basically the way that your innermost self,
your DNA, talks to your food. [Love] [Hate] It’s also a way to move beyond
a love-hate relationship with food. Twenty years ago, I had
a love-hate relationship with food. So I lived a little south of here. I was at the University
of California, San Francisco. I was an intern, 27 years young. After a 36-hour shift, I’d come home, open the freezer and get a pint of ice cream
out of the freezer. Can anyone relate to this? (Laughter) So that pint of ice cream, sometimes it would be
Häagen-Dazs coffee flavored, other times it would be
Ben & Jerry’s Super Fudge Chunk. And I would sit
in front of the television, pint in one hand, spoon in the other. I’d taste a few bites, and then I’d space out watching TV and find myself
scraping the bottom of the pint. That was a lot of calories. Let’s just say that
wasn’t the best nutrigenomics. So our food is meant
to have a positive effect on the activity of our DNA. It’s meant to create a shield for health. But that’s not what I was doing. Because I often had food
that was more like a bad boyfriend. (Laughter) And even though I felt lousy about it, I kept going back to those foods
that were not good for me. Now, if you don’t know
what to eat, I get it. It can be super confusing. One day eggs are good;
the next day they’re the worst thing. Same thing with coffee.
Now we’re putting butter in coffee. (Laughter) You know, when I was growing up,
calories were the most important thing. Now, it’s what those calories
do to your hormones, especially insulin. So if you’re confused
about nutrition, I totally get it. I mean, not only does the media sort of change the messaging
with nutrition, we also have bad science, Big Food, and even our own government’s bad advice about food. So what I want to do
is take three powerful ways that Big Food has taught us
about our relationship with food and share those with you tonight. So we’re going to talk about the genome. We’re going to talk about
how food talks to the genome. And I want to start with this idea that one person’s superfood
is another person’s poison. Coffee. It’s delicious. It’s also used by millions of people
as a morning ritual. And it’s highly addictive. Here’s the deal with coffee: There’s one gene in particular
that determines whether you’re a fast metabolizer
or a slow metabolizer of caffeine. So if you look to the person next to you, chances are one of you
is a fast metabolizer and the other is a slow metabolizer. So let me explain. Fast metabolizers are the ones
who drink a cup of coffee and they feel like a rockstar. They have more mental acuity. They’re on task. They have a lower risk of heart disease. They even have a lower risk
of Alzheimer’s disease. They get all of the benefits
and none of the risks. So if you follow the literature on coffee, you may have noticed that about
half of the studies say it’s good for you and half say it’s not good for you. And that’s because
they haven’t separated those studies into those who have the fast gene
versus the slow gene. So those are the fast metabolizers. Then there’s the rest of us,
the other half of the population: slow metabolizers of caffeine. That’s the category I’m in. So I drink a cup of coffee,
and I’m a nightmare. (Laughter) I just heard my husband laugh. (Laughter) So it takes my cortisol
from a pretty normal level to sky high. I’m the type of person who has
a much higher rate of sudden cardiac death when I drink a cup of coffee. So my liver metabolizes caffeine
three times slower than a fast metabolizer. So we get all of the risks
and none of the benefits. How do you know? Well, you could do trial and error, right?
That’s what a lot of people do. But what I’ve found is that if you do trial and error
instead of testing yourself, you have a lot of sleepless nights
until you get to the truth. What I prefer is to test. [genotype phenotype] So there are two things to test. There’s your genotype. For instance, do you have the fast or the slow gene
when it comes to caffeine? And then there’s the phenotype. Phenotype is your set of characteristics. It’s what makes me Sara, and it’s my genotype
interacting with my environment, like coffee. So the second way
that food interacts with DNA, and Big Data informs this, this concept that genes load the gun,
but food pulls the trigger. Now, I realize that a gun
is not the best metaphor nowadays. But this is a really telling analogy that was first coined by Francis Collins. He was the director
of the Human Genome Project, which completed the first mapping
of the human genome in 2003. He’s also now the head
of the Institutes of Health in Bethesda. So the idea here is that
if you know your genomics, you also really need
to consider your environment. Let me give you an example: I have a patient
in my practice named Julie. She’s 46. Her mother developed
Alzheimer’s disease, early onset. And so she was concerned
that she might have the Alzheimer’s gene. So she came to me to test for the gene. There was a good news-bad news
situation here. So the good news was
that she did not have the gene. She was negative for ApoE4, one of the key genes that predicts
your risk of Alzheimer’s disease. But what we found was that she had
an elevated fasting blood sugar. One of the ways of looking
at blood sugar over time is to look at your hemoglobin A1c, and this is something
that’s performed pretty routinely. And we found that she had prediabetes. So even though she didn’t have
the gene for Alzheimer’s, she was increasing her risk
of dementia and Alzheimer’s because of the way she was eating
and how that was raising blood sugar. So, she happened to have
a fondness for donuts. (Laughing) So we had to change
the way that she was eating. We had to find the foods
that stabilized her blood sugar. What are those foods? Well, it’s basically the way
our DNA evolved millions of years ago, so that we’re eating the foods
that grow in the ground and also that roam the planet. So things like plants, nuts, seeds,
vegetables, fruits as well as anti-inflammatory
wild meat and seafood. So that’s what she started eating. She corrected her blood sugar problem. And when you fix your blood sugar, that actually reduces
60% of your risk of cognitive decline over your lifetime. That’s pretty dramatic. The third concept is that it’s not just your genes
and the environment that matters. It’s the context in which you eat. So our brains evolved over time
to scan the environment, looking for situations
that could be potentially dangerous, where you have a greater risk
of physical injury. And there are three situations
that make your brain set off an alarm. Those three situations are social conflict, social rejection
and social isolation. Now, as I started to look at this area,
which is called “social genomics,” I got really interested
because one of the problems is that when you have your brain perceive
one of these dangerous situations where physical injury is likely to occur, it actually triggers inflammation. Inflammation is like
a bad frat party in your body. It’s a good thing for a couple of days, like three days, but after that, if it doesn’t turn off,
if it’s like a fire that keeps burning, it can cause all kinds of problems. It can lead to chronic disease, things like breast cancer,
Alzheimer’s disease, diabetes. So what we want to do
is we want to avoid these situations that trigger the immune system
to make you inflamed. Now, one of the worst situations
is eating in the car. (Laughing) I’m shocked to learn that eighty percent
of Americans eat in the car. Twenty percent regularly eat meals
at high speed on the freeway. Twenty percent! This is not good! (Laughter) You have social isolation –
you’re alone in a car – you have distracted driving, your chance of physical injury
is actually quite high, and it’s basically telling
your immune system, “Attack! Attack! Attack!” It’s not good. We need a much more calm environment. So what I want is for you to leave here with a prescription
for how to eat your next meal. So let’s do that together;
let’s wrap up these three big ideas. The first is you want
to consider your genotype. And that’s something
you can test pretty easily. I use 23andMe, I use Pathway – there’s lots of different labs out there
that are affordable. You also want to look at the environment
and how that’s interacting with your DNA. You can do it with biomarker testing. We talked about checking
your fasting blood sugar, for instance. Also hemoglobin A1c. And then, finally,
you want to consider the context. You want to make sure that your immune system
is not getting triggered by your brain to cause inflammation in your body. So that’s how you craft your next meal. Thank you for your attention
and bon appétit. (Applause) (Cheers)