Christophe Matthys van de Universiteit Gent gaat na wat al bewezen werd op het vlak van gepersonaliseerde voeding.

1. Personalised nutrition – is er al
iets wetenschappelijk bewezen?
Prof. dr. ir. Christophe Matthys
Klinische en Experimentele Endocrinologie, KU Leuven

3. Genen effect op voeding
• Phenylketonurie (PKU)
– Mensen met deze genetische aandoening produceren het enzym niet dat nodig is voor de afbraak
van phenylalanine ‐ een essentieel aminozuur aanwezig in zuivelproducten, vlees, vis, noten en
peulvruchten.
– Phenylalanine wordt gewoonlijk omgezet in een ander aminozuur, genaamd tyrosine. Bij personen
waarbij het enzym ontbreekt, wordt het in plaats ervan omgezet in phenylpyruvic zuur.
– Als er zich te veel van dit zuur ophoopt in het lichaam, kan dit leiden tot een verstoorde ontwikkeling
van de hersenen en in ernstige gevallen, geestelijke achterstand en epilepsie.
– Dit betekent dat mensen met PKU zich moeten houden aan een dieet dat phenylalaninerijke
voedingsmiddelen vermijdt.

4. Voeding op gen‐expressie
IRE: Iron Response Elements
IRP: Iron Regulatory Proteins

5. Nutrigenomics & Nutrigenetics: Two
Sides of a Coin
Castle, D., Cline, C., Daar, A.S., Tsamis, C., Singer, P.A. (2007). Science, society and the supermarket. The opportunities and challenges
of nutrigenomics. New Jersey: Wiley.

6. Steps in personalised nutrition
• Personalisation based on personal food
preferences
• Personalisation based on phenotype
• Personalisation based on genotype
• Personalisation based on microbiota

7. PHENOTYPE INTERVENTIONS

8. Celis‐Morales, International Journal of Epidemiology, 2016,

11. Verschil op gewicht
DIETFITS, JAMA, 2018

12. Verschil op risicofactoren
Mansoor et al, B J Nutr, 2015
Cholesterol (LDL) Bloeddruk (SBP) Diabetes (glucose)
Laag KH beter Laag vet beter
Laag KH beter Laag vet beter
Laag KH beter Laag vet beter

13. GENOTYPE INTERVENTIONS

14. Effect of the MTHFR 677CT
Polymorphism on Blood Pressure
• MTHFR genotype and hypertension
• Novel modulating role of vitamin B2
• Wider Impact
• Thanks to Mary Ward & Helene McNulty,
University of Ulster, Ireland

15. Is MTHFR 677CT Polymorphism
a risk factor for CVD?
• The most important genetic determinant of homocysteine
concentrations
• Homozygosity (TT genotype) results in lower MTHFR enzyme
activity and increased homocysteine concentrations in vivo
• Meta‐analyses1‐4 estimate excess risk of CVD (by 14‐21%) risk in
individuals with the TT genotype, but large geographical variation
between countries
1Wald DS et al. BMJ 2002; 325: 1202–1206.
2Klerk et al. JAMA 2002; 288: 2023–2031.
3Lewis et al. BMJ 2005; 331: 1053–1056.
4Holmes et al. Lancet 2011; 378: 584‐594.

16. MTHFR 677C→T and BP
CC CC
CT
CT
TT
TT
DBP(mmHg)
SBP(mmHg)
1996: A graded relationship between BP and the number of T
alleles first reported
*
Nishio et al. 1996 Jpn J Hum Genet 41(2), 247-251.

17. One Carbon Metabolism

18. Responses of EGRac and systolic BP to
intervention with riboflavin (1.6 mg/d ,16 weeks) or placebo in patients with
the MTHFR 677TT genotype
Wilson et al. 2013 Hypertension; 61:1302‐1308

19. Lewington et al. 2002 Lancet; 360:1903‐1913.
2 mmHg
decrease in SBP
10% reduction
in risk of stroke
mortality
• Meta‐analysis of 61 prospective, observational studies
including over 1 million adults1
Impact of BP reduction
• Potential public health significance of this gene‐
nutrient interaction on BP

20. Lifestyle factors targeted to reduce BP
Modified from Chobanian et al. 2003 JNC 7 report
Lifestyle factor SBP decrease (mmHg)
Weight loss (per 10 kg) 5 - 20
Riboflavin (genotype‐specific) 6 ‐13
Physical activity 4 - 9
Sodium reduction 2 - 8
Limit alcohol 2 - 4

21. MICROBIOTA INTERVENTIONS

22. Figure 1 The ‘diet hypothesis’
Jain, N. & Walker, W. A. (2014) Diet and host–microbial crosstalk in postnatal intestinal immune homeostasis
Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2014.153
Effect of microbiota?

23. Sonnenburg et al. Nature, 535, 56–64

25. Effect of microbiota?
Zeevi et al., 2015, Cell 163, 1079–1094

27. TUSSENOPLOSSING

28. + +

29. Results
Hurkmans et al. HTA 2017

31. HOE REALISTISCH?

32. 32

33. Proceedings of the Nutrition Society (2016), 75, 106–114

34. Link between diet and health
outcomes

35. 35
AUTHORS' CONCLUSIONS:
Mindful of the weak evidence based on a
small number of studies of limited quality,
the results of this review suggest that
communicating DNA‐based disease risk
estimates has little or no effect on smoking
and physical activity. It may have a small
effect on self‐reported diet and on
intentions to change behaviour. Claims that
receiving DNA‐based test results motivates
people to change their behaviour are not
supported by evidence. Larger and better‐
quality RCTs are needed.

36. Figure 1
The Lancet Diabetes & Endocrinology DOI: (10.1016/S2213-8587(18)30037-8)