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Patient or Client Name

30-Jul-19

Nutrition and Fitness Genetic Profile Report

Nutrition and Fitness Genetic Profile Report |


30-Jul-19Welcome and Introduction

On the following pages you will find personalized nutrition and fitness recommendations based on your genetic test results. This report is based on the analysis of your DNA sample and personal information you provided such as your height, weight, and gender. This approach to weight management is based on the most advanced science available. The goal is to help you develop an approach to nutrition and fitness based on your own unique genetic blueprint. Some of the topics covered in your report include:

What your DNA can tell you about the right balance of macronutrients for you

What your test results suggest about your exercise and movement needs

What your results suggest about your health related behavioral tendencies

Now that you know more about what your DNA reveals about your nutritional and fitness needs, we can provide you with the support you need to make the most of this information. You have embarked on a journey to a healthier life and we are honored to be your partner on this journey. Thank you for choosing us as your weight management partner.

Best Regards,

The Genetic Weight Management Team

Important: Please consult your physician before beginning any nutrition or fitness program. The information contained in this report is for weight management purposes only. It is not intended to prevent, diagnose or treat any medical condition and should not replace the advice of your physician. If you experience pain or physical difficulties while eating a reduced calorie diet or during exercise, please stop and contact your physician immediately.

If you are currently being treated for any illness or medical condition, taking prescription medication, or following a doctor recommended diet, it is essential for you to consult with your physician before starting this program and to follow up with your physician on a regular basis after you start losing weight. Changes to your nutritional program may create physical changes that should be monitored by a physician. If you are on prescription medication, losing weight may require a change in your treatment program or medication dosage. After review by your physician, any changes made by your physician to this program should be followed.



30-Jul-19Welcome and Introduction

Patient or Client NameWelcome

Here’s what’s included in your report:

Section One - Overview of Your Genetic Test Results

Section One gives you an overview of your genetic results. It also gives you a quick snapshot of what these results can tell you about your nutrition and fitness needs.

Section Two - A Nutrition Plan Based on Your Genetics

Section Two explain in greater detail what your genetic results reveal about your nutritional needs. This section also gives some practical ways to optimize your nutritional plan.

Section Three - A Fitness Program Based on Your Genetics

The ideal approach to fitness varies from one individual to the next. Section Three explains what your DNA can tell you about the best activities for you, and how much activity you need for optimal health.

Section Four - Genetics and Healthy Behavior

Your genes help determine how easy or difficult you may find following a program of healthy eating and daily activity. This section tells you what your DNA says about your behavioral tendencies related to health.



30-Jul-19Your Results

The two charts on the following page show a summary of an ideal nutrition and fitness program as revealed by your DNA. In the sections of this report that follow, you will find a more detailed explanation of what we recommend based on the analysis we performed on the DNA sample you provided.

Test Results at a Glance

Your Results

Understanding Your Genotype

Your Recommended Nutrition and Fitness Programs

Here are your individual results for the variations of the genes we tested. In following sections of this report you will find out more about what each of these variations means individually, as well as how they may interact to provide you with practical guidelines for optimal nutrition and fitness.

Name: Patient or Client Name

Gender: Female

DOB: 28-Aug-97 Height: 172.7 cm (68 inches)

Weight: 108 kg (238 lbs)

Nutrition and Fitness Genetic ProfileReport:

ID : 4314141

Sample: 4314141 Source: Buccal Swab

Gene Variant Result

ACE D>I (G>A) AG

ACTN3 C>T TC

ADRB2 Gln27Glu (C>G) CG

ADRB2 Arg16Gly (A>G) GG

ADRB3 Trp64Arg (T>C) TT

APOA2 -265T>C TT

CLOCK G>A AG

COMT G>A AG

DRD2 C>T TC

eNOS T>C TT

FABP2 Ala54Thr (G>A) GG

FTO T>A TT

GIPR C>T CC

GLUT2 -265T>C GG

IL6 -174G>C CC

IRS1 C>T CC

LEPR C>T TT

LIPC -514C>T CC

LIPC -250G>A GG

MTHFR C>T TT

PPARG2 Pro12Ala (C>G) CC

TAS2R38 T>C TC

TCF7L2 A>G AG

TNF -308G>A GG




Your Results: Your Fitness Program Recommendations

Your Results: Your Recommended Macronutrient Ratios

Optimal Blend Program

3 to 4 hours/week of moderate intensity exercise

This chart shows an appropriate proportion of fats, carbohydrates and proteins based on your genetic test results. Section 2 gives additional details on your nutrition related genetic markers, recommended caloric intake, and recommended daily servings based on your genetic profile.

This is your recommended physical activity level based on your genotype. Please see Section Three for more information on designing a genetically appropriate exercise program.

Your Current Weight Management Status

Your Recommended Nutrition and Fitness ProgramsThe following nutrition and fitness suggestions are likely to help you optimize your health based on analysis of your DNA. A more detailed explanation of each is found in Section 2 and Section 3 of this report.

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015.

55% of total calories25% of total calories

20% of total calories

Fats

Proteins

CarbohydratesUSDA

Recommended Macronutrient Proportions for Typical American Diets*

Carbohydrates

45-65%

Proteins

10 - 35%

Fat

20 - 35%

Low Intensity Activities ------------------ Moderate Intensity ------------------ Maximum Intensity Activities

3 to 4 hours/week of moderate intensity exercise

1 MET<--------------------------------------- Exercise Intensity --------------------------------> 12 METs




Your Current BMI is: 36.18

BMI is not a direct measure of body fat, and should be interpreted within the context of gender, age, and level of muscularity. For example, given the same BMI, women will tend to have more body fat than men. Similarly, for a given BMI older people will tend to have more body fat than younger people. Individuals who are very muscular such as trained athletes, will tend to have less body fat for a given BMI. The World Health Organization recommends that adults maintain a BMI between 18.5 and 25.0.

There are certain indicators, such as body mass index (BMI), which may be helpful in assessing your overall fitness level. These numbers need to be interpreted carefully because they are affected by many variables, such as bone structure and muscle mass. Nutritional and fitness indicators should be discussed with your personal health care provider before using them as the basis for any nutritional or fitness program.

Your Current Weight Management Status

* BMI guidelines are based on the recommendations of the World Health Organization (Global Database on Body Mass Index. WHO. 2006. http://www.who.int/bmi/index. Retrieved July 27, 2012.)

Below Recommended Range

Within Recommended Range

Above Recommended Range

below 18.5

18.5 - 25

above 25

Recommendation BMI




DNA carries the instructions for the structure and function of every cell in the body. DNA plays a central role in all life processes. It is responsible for a great deal of what makes us who we are, including how we respond to different foods and physical activities. There is a large assortment of interesting information about DNA and genetics available at libraries, book stores, and on the internet. This section gives a very basic overview of some basic terms used frequently throughout this report. For those interested in knowing more about genetics, a search of available resources will quickly turn up a great deal of additional information tailored for different educational backgrounds. The end of this report also contains an extensive list of references specific to the genes discussed in this report.

DNA stands for deoxyribonucleic acid. It is a very long molecule which is usually found in the form of a double-stranded helix. The DNA double helix has become a familiar icon in the modern world and appears in many stylized forms in business, academics and popular culture. DNA performs its biological functions mainly by coding for the structure of proteins. Proteins are responsible for the structure and functioning of all living things. Changes in a protein's structure can have a dramatic effect on the way the protein functions in the body. This is how differences in DNA translate into differences in individuals.

DNA

The long DNA molecule is made up of many smaller molecules called nucleotides. A typical DNA molecule has approximately 3 billion of these nucleotide building blocks arranged end-to-end, like beads on a string. Nucleotides are sometimes represented as beads in simplified or artistic renderings of DNA, but in fact they are complex molecules, as shown in the accompanying diagram.

There are four different types of nucleotides found in DNA. They are often represented by the letters A (for adenine), C (for cytosine), G (for guanine) and T (for thymine). You will see these four letters throughout your report. They are the letters of the genetic code. It is the arrangement of these bases within the DNA molecule which determines the meaning of the genetic instructions, similar to the way that the arrangement of letters in a book determine its information content.

Nucleotides

Genetics and Weight Management




Genes

A section of DNA which codes for a particular protein is called a gene. Genes are also the molecular basis of heredity because they are passed from parents to offspring. Generally, humans have two copies of each gene, one inherited from each parent. The study of genes and heredity is the science of genetics.

Within each cell, genes are organized into packages called chromosomes. For the purpose of understanding your results, it isn't important exactly which chromosome a gene is on, however the term chromosome comes up very often in genetics. Normally, humans have 23 pairs of chromosomes. One member of each pair is inherited from the mother and one is inherited from the father.

SNPs

Different forms of the same gene are referred to as variants or alleles of that gene. In many cases, the change of a single nucleotide can alter the functioning of a gene and have significant consequences. A change involving one nucleotide is called a single nucleotide polymorphism, or SNP. A simple analogy might be changing the "b" in "bat" to a "c" and thereby changing the meaning of the word.

Scientists have identified certain SNPs which have a significant impact on weight management. These important SNPs are the foundation of this report. Because you have two copies of each gene tested, your result for each SNP consists of two letters (standing for their respective nucleotide). These two letters represent your genotype for that SNP.

Some SNPs have an effect on the way your body processes macronutrients such as fats and carbohydrates. Others affect how your body responds to exercise. Some SNPs affect your response to both diet and exercise.



30-Jul-19Nutrition and You

Based on your test results, this section suggests appropriate caloric contributions from carbohydrates, fats and proteins to power your metabolism.

Individuals express great genetic variability in the way they process fats, carbohydrates and proteins. The proportion of these macronutrients in your daily food intake plays a key role in maintaining healthy weight and optimal energy levels. Knowing your own genetic predispositions can help you choose the best balance of macronutrients to support your nutritional and fitness goals.

Proper dietary levels of fats, carbohydrates and proteins are all necessary for good health, so fad diets which severely restrict one or more of these macronutrient groups have many disadvantages. A better approach is to adopt the best diet for you based on your unique needs.

Nutrition and You

Carbohydrates

According to Your Genotype

Dietary carbohydrates are best known as a source of energy, however carbohydrates and their derivatives also play key roles in the immune system, blood clotting, development, and other vital functions. Your test results suggest that carbohydrates should make up about 55% of the calories in your diet.

Proteins are large biological molecules which perform a vast array of structural and metabolic roles within living organisms. Dietary proteins provide an energy source and amino acids for building new proteins. Your test results suggest that proteins should make up about 20% of the calories in your diet.

Dietary fats play many vital roles including: maintaining healthy skin and hair, insulating body organs against shock, maintaining body temperature, promoting healthy cell function, and serving as energy stores for the body. Your test results suggest that fats should make up about 25% of the calories in your diet.

55% Carbohydrates

20% Proteins

25% Fats

Your genetic test indicates that a Balanced balance of nutrients will provide the optimal health and weight management benefits.

55 % of daily caloric intake

A Balanced Nutritional Program is Most Suitable to Your Genetic Profile

Proteins20 % of daily caloric intake

Fats25 % of daily caloric intake


Patient or Client NameNutrition and You30-Jul-19

FTO

APOA2TCF7L2

IRS1

GIPRLIPC

TNF

Your Genetic Results Related to NutritionIn this section you will find your results for the individual genetic markers which, together, help determine how you tend to process macronutrients (carbohydrates, fats, and proteins). You will see your result for each marker, along with a brief description of some of the effects associated with your particular genotype. If you want more information on one or more of these SNPs, you can refer to the references at the end of this report, as well as information available online or at your library.

Gene

Brief Description of Effects

SNP Your

Genotype

Please keep in mind that the combination of all of these gene variations is used to make your nutrional recommendations found in this report. The effect of any one gene must be understood within the context of many complex interactions.

ADRB2 CGrs1042714 This gene is important in mobilizing stored body fat. Clinical study data have demonstrated that individuals who have this genotype (CG) may, depending on other genetic factors and gender, have an increased risk of gaining excessive weight with a high carbohydrate diet.

APOA2 TTrs5082 The APOA2 gene encodes the lipoprotein apoA-II, the second most abundant protein in HDL. HDL, also known as "good" cholesterol, plays an important role in the composition of fat molecules found in the blood and tissues of the body. When expression of this gene is lowered, the result is increased triglyceride production and storage as body fat. Individuals with this genotype (TT) have normal expression of this gene. Depending on other genetic factors, they tend to have normal HDL levels and respond well to both physical activity and caloric reduction programs for weight loss.

FABP2 GGrs1799883 The FABP2 gene is involved in absorbing dietary fats from the digestive tract. Clinical studies have demonstrated that individuals with this genotype (GG) tend to have normal absorption of dietary fat.

FTO TTrs9939609 Some variants of the FTO gene are recognized as being strongly associated with a risk for being overweight. This gene affects the hypothalamus region of the brain, which regulates appetite, energy intake, and satiety. It also affects the rate at which fat cells accumulate. Depending on other genetic and environmental factors, individuals with the TT genotype tend to display a normal risk for weight gain. They tend to respond well to both diet and exercise.


Patient or Client NameNutrition and You30-Jul-19

GIPR CCrs2287019 GIPR is the acronym for the glucose-dependent insulinotropic polypeptide receptorgene. GIPR encodes a protein which plays an important role in the release of insulin after ingestion of glucose and fat. Clinical studies have demonstrated that individuals with the CC genotype have normal GIPR activity with no negative impact on weight management.

IL6 CCrs1800795 This gene plays a role in glucose and lipid metabolism. Individuals with this genotype (CC) tend to have normal plasma levels of IL6 and tend to oxidize fat effectively following a meal.

IRS1 CCrs2943641 The IRS1 gene codes for an important mediator protein in the insulin signaling pathway and is important in generating energy from dietary carbohydrates. Other variants of the IRS1 gene may contribute to blood glucose remaining in circulation longer and ending up stored as fat. Clinical studies have demonstrated, however, that this genotype (CC) improves the processing of dietary carbohydrates and may, depending upon other genetic factors, allow for relatively higher levels of carbohydrate intake without negative effects.

LIPC GGrs2070895 LIPC, the hepatic lipase gene, is involved in the hydrolysis of triglycerides and phospholipids in LDL and HDL particles. Individuals with this genotype (GG) tend to have normal blood fat levels.

LIPC CCrs1800588 The hepatic lipase gene (LIPC) catalyzes the hydrolysis of triglycerides and phospholipids in LDL and HDL particles. Individuals with this genotype (CC) tend to have normal blood fat levels.

PPARG2 CCrs1801282 This gene is involved in fat and carbohydrate metabolism, as well as in fat cell formation. Individuals with this genotype tend to have an increased risk of being overweight. Individuals with this genotype (CC) may also have a higher sensitivity to the amount and quality of dietary fat in their diet.

TCF7L2 AGrs4132670 The TCF7L2 gene is a key regulator of glucose metabolism in the liver and also affects the metabolism of dietary fat. Increased expression of this gene tends to decrease production of insulin. Individuals with the AG genotype have an elevated expression of this gene. Depending on other genetic and environmental factors, clinical studies have demonstrated that these individuals may experience improved glycemic control with a diet which includes lower levels of fat.

TNF GGrs1800629 This gene is important in regulating the body's inflammatory response. An elevated level of TNF alpha is associated with in an increase in the systemic inflammatory response, which has been demonstrated in studies to contribute to excess weight gain. Individuals with this genotype (GG) have the normal level of expression of this gene.




Your Ideal WeightThe ideal weight for an individual is subject to many variables. This section of your report suggests a range of ideal weights based on your gender, height and frame size. Please keep in mind that there are other variables not accounted for in these estimates.

Another way to estimate your ideal weight is from your own experience. You probably have a good idea of what your own ideal weight is. Keep in mind that your ideal weight will change if there are changes to your muscle mass. Your muscle mass will tend to decline with age unless you engage in a program of activity designed to prevent this, so your ideal weight may decline as well. On the other hand, if you increase your muscle mass, your ideal body weight will also increase.

The range of ideal weight estimates offered below is based on the height and gender information in your profile. The formulas used for these calculations are very similar to those published by physicians for calculating medication dosages. They have since been widely adopted for other purposes which call for estimating ideal body weight. Frame size is mainly determined by the size of the skeleton and musculature, and is a somewhat subjective term. Because of this and many other variables, the ideal weights given here are estimates only. There are a number of online calculators and other resources for helping you estimate both your frame size and your ideal weight range.

Small Frame: 124 lbs (56 kgs)

Medium Frame: 138 lbs (63 kgs)

Large Frame: 152 lbs (69 kgs)

Your physician or other qualified health professional is the best source of recommendations on your ideal weight. They will have the expertise to take into account all of the important variables and integrate them into a precise target range for your ideal weight.

Your physician may be the best source of advice on what your individual weight management goals should be. Your doctor has both the expertise and the access to details about you as an individual that allow for more exact estimates of what the best weight goals are for you personally.

According to Your Profile




Some Recommended Foods and Serving Unit SizesThis section lists specific foods and how large a serving unit is. Notice that serving units don't always correspond to a typical "serving size" or "portion size" found in other systems. This is to give more precise control over nutrient dense foods such as meats. You can substitute foods with similar nutritional profiles.

Different foods contain different levels of carbohydrates, fats and proteins. The chart below, developed by our food science team, gives you an estimate of how much of each macronutrient is typically provided by a serving of food from each of the six groupings. These are practical estimates, and macronutrient content varies somewhat among the foods assigned to each group.

Starches, Grains, Legumes

Vegetables

Fruit

Meat and Meat Substitutes

Dairy

Oils and High Fat Foods

Food Category

15 grams

5 grams

15 grams

12 grams

3 grams

2 grams

7 grams

8 grams 5 grams

3 grams

5 grams

Protein FatCarbohydrate

Vegetables

Description Serving Unit

Tomato or vegetable juice 1/2 cup

Raw vegetables 1 cup

Cooked vegetables 1/2 cup


Fruit

Melon (cubes) 1 cup

Fresh fruit 1 small

Dried fruit 1/4 cup





Meats and Meat Substitutes

Tofu 4 oz (1/2 cup)

Peanut butter 1.5 Tbsp

Meat, poultry, fish 1 oz

Egg 1 each

Cottage cheese 1/4 cup

Beans, lentils (add one starch) 1/2 cup

Cheese 1 oz



Tortilla (whole wheat) 1 six inch

Sweet potato 1/3 cup

Squash, winter 1 cup

Rice, brown varieties 1/2 cup (cooked)

Popcorn, plain 3 cups

Whole Wheat Pasta 1/2 cup (cooked)

Dry flour or grains 3 Tbsp (uncooked)

Dry cereals, unsweetened 1/2 cup

Cooked cereals 1/2 cup (cooked)

Bread, whole wheat slice (1 oz)

Beans, peas, lentils 1/2 cup (cooked)


Dairy

Yogurt, plain 1 cup

Yogurt, Greek 2/3 cup

Milk, Reduced Fat 1 cup



Oil-based salad dressing 1 Tbsp

Oil (grape seed, olive) 1 tsp

Nuts 10 each

Mayonnaise 1 tsp

Cream cheese 1 Tbsp

Butter or margarine 1 tsp




If You Wish to Lose Weight: Getting Started

Your activity level has a significant effect on the number of calories you should consume as part of a healthy weight reduction program. Engaging in at least a moderate level of activity is important to healthy weight loss. Please use the calorie and gram recommendations which correspond most closely to your level of activity. Always consult your healthcare professional before any changes to your diet or exercise routines.

Serving units for common foods are defined on pages 15 and 16 of this report. Please keep in mind that the serving units used in this system are not necessarily equivalent to the serving or portion sizes you may already be familiar with. For example, as serving unit of meat, poultry, fish, or cheese is one ounce. This system allows for more exact recommendations for foods that have a high density of macronutrients such as fat and protein.

This section is your personalized guide to begin losing excess fat at a rate of about 1.5 to 2 pounds per week using the combination of carbohydrates, fats, and proteins appropriate for your genotype. If you are already at a healthy weight, skip to "Maintaining a Healthy Weight." The recommendations in this section are appropriate only if you need to lose weight. They should be continued only until you achieve a healthy weight, then go to "Maintaining a Healthy Weight."

Your genetically appropriate macronutrient proportions are expressed in calories. To make these proportions useful in everyday life, they need to be expressed in easily measured units such as grams.

Keep in mind that carbohydrates, fats and proteins have a different caloric content per gram, so their ratios will appear different when expressed as grams than they do when expressed as calories. Carbs and proteins both have approximately 4 calories per gram, while fats yield about 9 calories per gram.

Proteins FatsCarbohydrates

1076 Calories 391 Calories 489 Calories

269 grams 98 grams 54 grams

12 35 5 72

Weekly Activity Level: Moderately Active

Extremely Active

Very Active

Moderately Active

These guidelines apply if you exercise 3 - 5 times per week at a moderate to vigorous intensity.

2711

2334

Daily Calorie Intake

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Daily Macronutrient Target in Calories and GramsExercise Level

Grains , Starches and Legumes Vegetables Fruit

Meats and Meat Substitutes Dairy


Serving Units Per Day by Food Group



30-Jul-19Diet and Nutrition





15 35 6 82



Weekly Activity Level: Very Active

Extremely Active

Very Active

Moderately Active

Moderate to vigorous exercise 6-7 days per week.

2711

1956

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19 35 8 92



Weekly Activity Level: Extra Active

Extremely Active

Very Active

Moderately Active

Very heavy daily exercise, such as vigorous exercise twice per day or a job demanding a lot of physical activity.

2334

1956

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2334

2711

Daily Macronutrient Target in Calories and Grams


Exercise Level Daily Calorie Intake

Daily Macronutrient Target in Calories and Grams


Exercise Level Daily Calorie Intake




Staying on CourseWith a small to moderate amount of weight to lose, individuals can use the calorie and serving suggestions in the previous section until they achieve their goals. If they need to lose a lot of weight, they may need to further reduce their calorie intake and serving quantity as they approach their target weight. This is because they will tend to burn fewer calories as their body mass decreases. This reduction in average daily calorie expenditure can be partially or fully offset with increased activity.

Basal metabolic rate is the amount of energy a person needs to to maintain basic body functions such as breathing, circulation, body temperature and cell maintenance. The main factors used to estimate BMR are gender, height, weight, and age. There are other factors which affect basal metabolic rate which are more difficult to account for precisely including individual biochemical differences and overall health.

A good general strategy is to lose about a pound each week by maintaining an average calorie intake around 500 calories less than the calories expended each day. Total daily calorie expenditure will be approximately equal to basal metabolic rate (BMR) plus the energy burned due to physical activity.

Light exercise (1 - 3 days per week)

Moderate exercise (3 - 5 days per week)

Heavy exercise (6 - 7 days per week)

Very heavy exercise (twice per day, heavy workouts)

BMR x 1.375

BMR x 1.5

BMR x 1.725

BMR x 1.9

Activity Level Average Daily Energy Expenditure

Little or no exercise BMR x 1.2

There are many tools available online for estimating basal metabolic rate, total daily energy expenditure, and the number of calories burned during specific exercises. To lose weight at a healthy rate of about one pound per week, the goal is to consume about 500 calories less each each day than the total daily energy expenditure.

Total daily energy expenditure (TDEE) can be estimated by adding the calories burned due to physical activity to the basal metabolic rate. A rough approximation of how total daily energy expenditure increases with activity can be made with the following formulas.

Basal Metabolic Rate (BMR)

Total Daily Energy Expenditure (TDEE)

Total Daily Energy Expenditure - 500 calories = Target Calories for Healthy Weight Loss

Adjusting Calorie Intake to Continue Losing Weight

In general, for each ten pounds lost, average energy expenditure will decrease about sixty to seventy calories per day if other factors, such as activity level, remain the same. Individuals with a lot of weight to lose should consult their healthcare professional throughout the process and can also use online tools to estimate changes in their daily calorie needs.




Maintaining a Healthy Weight

Small

Medium

Large

1372

1436

calories

calories

1499 calories

Approximate MacronutrientTarget in Calories (Cal) and Grams (gr)

Maintenance Calories

755 Cal 274 Cal 343 Cal189 gr 69 gr 38 gr





Vegetables

Fruit

Medium Frame Large FrameSmall Frame

6 7

3 3 3

5 5 5

7

3 4 4

4 5 5

2 2 2


Dairy


When calculating your daily calorie needs, frame size and activity level are both important. Individuals of the same height and gender may differ substantially in the mass of their bones and muscles. If you're not sure what your frame size is, your health care provider is the best source of guidance. Also, please be sure to use the guidelines which most closely match your current level of activity. If your activity level changes over time, then your calorie and serving levels should be adjusted appropriately.

Food Category

Your Frame Size

Sedentary

Lightly Active

Daily CalorieIntake

Daily Calorie Expenditure

Your genetically appropriate macronutrient levels are initially calculated in calories. To be useful in selecting the right foods and serving sizes, the calories need to be expressed as grams. To convert your calorie allowance to actual grams for each macronutrient, simply divide the number of calories by the calories/gram of that macronutrient. Carbohydrates and proteins have approximately 4 calories per gram, whereas fats yield about 9 calories per gram. This means that your macronutrient proportions will appear different when expressed in grams rather than calories.

Consuming the right quantity and proportion of carbohydrates, fats and proteins each day contributes to maintaining optimal weight, good overall health and high energy levels. The recommendations in this section are based on your genetic results along with your other personal information such as height, weight, gender, and age. If you want to feel your best and maintain a current weight you are satisfied with, this section is for you!

(little or no exercise)

Activity Level 1




Small

Medium

Large

1647

1723

calories

calories

1799 calories







Your Frame Size

Lightly Active

Small

Medium

Large

1784

1867

calories

calories

1949 calories







Your Frame Size

Moderately Active


Vegetables

Fruit


9 10

3 3 3

5 5 5

10

4 5 5

5 6 6

2 2 2


Dairy


Food Category


Vegetables

Fruit


10 11

3 3 3

5 5 5

12

5 5 5

6 6 6

2 2 2


Dairy


Food Category

(1 - 3 days per week)


Activity Level 2

Activity Level 3




Small

Medium

Large

2333

2441

calories

calories

2549 calories







Your Frame Size

Extra Active


Vegetables

Fruit


15 16

3 3 3

5 5 5

17

6 7 7

8 8 9

2 2 2


Dairy


Food Category

Small

Medium

Large

2059

2154

calories

calories

2249 calories







Your Frame Size

Very Active


Vegetables

Fruit


13 13

3 3 3

5 5 5

14

6 6 6

7 7 8

2 2 2


Dairy


Food Category


(twice per day, heavy workouts)

Activity Level 4

Activity Level 5


Patient or Client NameNutrition and You

Your Essential NutrientsNutrients are the components in foods that are vital to survival and growth. Macronutrients provide most of the energy and raw materials for an organism to function. Macronutrients include carbohydrates, fats, proteins, and macrominerals such as calcium which are required in relatively large quantities.

Micronutrients are nutrients required in smaller quantities to support a wide range of physiological functions. Micronutrients include vitamins, which are organic compounds required in tiny amounts by an organism. Micronutrients also include microminerals such as zinc, which are required in quantities less than 100 milligrams per day.

Nutrient Main FunctionYour Recommended

Daily IntakeBest Sources

Vitamin A

Required for normal vision, gene expression, and immune function.

5,000 IU

Sweet potato, carrots, spinach, dairy products, liver and fish oil

Vitamin B3

Assist in digestion and conversion of food into energy, aids production of cholesterol.

20 mg

Meat, fish, poultry, and whole grain breads

Vitamin B6

Assists in metabolizing proteins and sugar, coenzyme in amino acid metabolism.

2 mg

Poultry, pork, liver, eggs, beans, and sunflower seeds

Vitamin B12

Important in production of red blood cells, coenzyme in nucleic acid metabolism.

6 μg

Liver, red meat, poultry, fish, and eggs


Patient or Client NameNutrition and You

Vitamin C

Antioxidant that protects cells against damage, boosts the immune system, forms collagen.

60 mg

Red or green peppers, citrus fruits, tomatoes, Brussels sprouts, strawberries, potatoes

Vitamin D

Crucial in metabolizing calcium for healthy bones.

400 IU

Milk, fish oils, and fatty fish such a tuna and salmon

Vitamin EAntioxidant that protects cells against damage.

30 IU

Corn, olives, asparagus, vegetable oils, green leafy vegetables

Vitamin KImportant in blood clotting and bone health.

80 μg

Green vegetables, cabbage, plant oils and Brussels sprouts

Calcium

Essential for bone growth, blood clotting, muscle contraction, and nerve transmission.

1000 mg

Milk, yogurt, hard cheeses, spinach, fortified cereals

FolateCoenzyme in the metabolism of nucleic and amino acids.

400 μgDark leafy vegetables, citrus fruit, avocados, whole grains, liver

Zinc

Supports immunity, nerve function, and the regulation of gene expression.

15 mg

Red meats, some seafood

Cholesterol

Necessary nerve function, sex hormone production, and the production of vitamin D.

300 mg

Eggs, beef, chicken, and shellfish.

Omega-3Lowers inflammation, controls clotting, and builds cell membranes.

~500 mgAnchovies, salmon, trout, tuna, oysters, walnuts, flaxseed oil




12 cups per day

Your daily water intake is based on your current weight. Your recommended intake can be calculated as half your weight in pounds converted to ounces, up to 100 ounces of water per day.

Your Recommended Daily Water Intake

3 liters per day

or

Sufficient water intake can have significant benefits for weight management and general health. Adequate hydration contributes to a more efficient metabolism and removal of cellular waste products. Many people notice a marked improvement in their energy level when they increase their fluid intake to optimal levels. Adequate water intake can also assist in complying with a diet program by reducing feelings of hunger. Some people find that drinking recommended amounts of water makes complying with the rest of their dietary plan much easier and more comfortable. A well accepted minimum guideline is to drink in ounces an amount equal to approximately half your weight in pounds, up to 100 ounces of water, every day. For example, a 180 pound person would drink 90 ounces of water, or approximately twelve eight ounce glasses. This may seem like a lot of water, but studies indicate this is the optimal quantity. The following chart indicates your recommended daily water intake based on the weight you reported at the time you submitted your profile information.

According to Your Profile




Alcohol and YouSome studies suggest that daily consumption of moderate levels of alcohol may have positive health effects for many people. The positive effects of alcohol may include increased levels of good cholesterol (HDL) and reduced risk of heart disease, dementia, and gallstones. The USDA defines moderate consumption as no more than two drinks per day for men and no more than one drink per day for women. Experts agree any benefits of alcohol consumption come from consistent and moderate consumption; occasional heavy drinking is not beneficial.

From a weight management perspective, alcohol has the potential to add calories and negatively effect your ability to burn fat. Here are a few examples of what you may expect from some common drinks.

Light Beer

Regular Beer

Martini

Margarita

Daiquiri

Many studies indicate alcohol has negative health effects which may offset the positive effects mentioned above. For example, alcohol interferes with the absorption of folate and can increase the risk of certain types of cancer.

12 oz.

12 oz.

3 oz.

8 oz.

20 oz.

105

140

205

200

1120

6.0 grams

13.2 grams

0.3 grams

16.8 grams

42.0 grams

Type of Drink Serving Size Calories Carbohydrates

Your genetic test results are consistent with normal metabolism of dietary fats and carbohydrates. However, consuming alcohol can still have negative effects on your ability to metabolize fat and still adds calories to your diet. If your BMI is greater than 30, studies have shown that the effects of alcohol on weight management may be even greater.

While there is some research which suggests that moderate consumption of alcohol may have some health benefits, the meaning of these results is still unclear. If you do consume alcohol it is always good to discuss this with your personal healthcare providers and to keep in mind that moderation is essential.

Wine (red/white) 5 oz. 100 0.4 - 0 .8 grams




30-Jul-19Your Ideal Fitness Program

Your Ideal Fitness Program

Recommended for You: Activities with a Moderate Level of Intensity

Your genetic test results indicate that your body should respond well to moderate intensity activities with a MET value between 3 and 6 METs. Your ulimate goal should be to accumulate 15 - 20 MET-hours of these 3-6 MET activities each week. The following sections will explain that you calculate MET-hours by simply multiplying the MET value of your activity by the duration in hours.

MET value x duration (in hours) = MET-hours

If you're just starting out, begin your fitness program with lower intensity activities for shorter durations.

DNA plays a large role in determining the optimal intensity and duration of activity needed to maintain a healthy weight and good overall fitness. Some people require a vigorous workout regimen in order to achieve these goals. Others may get better results from moderate levels of activity. The best program for the individual is based on genetics, diet and prior levels of activity and training.

In consultation with a qualified health professional, the recommendations described in this report are aimed at maintaining a healthy weight and overall conditioning. Generally, more intensive training is required to achieve skill and conditioning for those wishing to perform at the competition level.


This section of your report focuses on answering two questions. The first is what types of activity are likely to give you the best results. The second is how much time you will need to invest weekly to stay fit and healthy.

Always consult your physician or qualified health professional before beginning a new fitness routine. If you experience any pain or difficulties during any new activity, stop immediately and contact your qualified healthcare provider. It is always better to begin a new fitness program gradually and add exercise intensity and duration gradually.




ADRB3

eNOS ACTN3

ADRB2

FTO

ACE

ADRB2

In this section you will find your individual results for each of the activity and fitness related SNPs tested in your DNA sample. You will also find a brief description of some of the effects known to be associated with your genotype for each SNP. If you want a more in depth explanation of any of these markers you can refer to the list of resources found in the final section of the report.

Your Genetic Results Related to Exercise

Gene Brief Description of EffectsSNP Your

Genotype

Please keep in mind that single genes do not provide enough information to determine the best program for you. Your entire panel of test results is used to generate the physical fitness recommendations you will find in the next section of the report. An algorithm is used to integrate the effects of each individual marker and provide you with specific recommendations for your fitness program. The next sections of your report put this information to use in optimizing your activities and fitness program based on your genetic profile.

FTO Certain variants of the FTO gene are widely recognized as being strongly associated with a risk for being overweight. However, depending on other genetic and environmental factors, individuals with this genotype (TT) tend to have a normal risk for weight gain and respond well to diet and exercise.

TTrs9939609

ADRB3 ADRB3 is important in energy metabolism and in reducing abdominal and subcutaneous body fat. Depending on other factors, this genotype (TT) may tend to lower the intensity of exercise required to achieve and maintain a healthy weight.

TTrs4994

ACE ACE is one of the most studied and thoroughly documented SNPs related to fitness and weight maintenance. This genotype (AG) is associated with increased expression of the ACE gene. Depending on other genetic and environmental factors, this genotype tends to increase the intensity of exercise required to effectively manage weight.

AGrs4343

eNOS eNOS, the endothelial nitric oxide synthase gene, is the key promoter for the production of nitric oxide (NO). Nitric oxide plays a role in regulating vascular tone and facilitates vasodilation. Depending on other genetic and environmental factors, individuals with this genotype (TT) may have an increased oxygen supply to muscles in response to exercise.

TTrs2070744




ACTN3 ACTN3 is involved in the formation of the major component of the z line where actin filaments are cross-linked in fast-twitch muscle fibers. These muscle fibers are responsible for generating explosive, powerful contractions needed for activities such as sprinting and weightlifting. Depending upon other factors, individuals with this genotype (TC) are equally suited for strength-oriented and endurance-oriented activities. Depending on other genetic and environmental factors, these individuals may be more likely to perform well in sports requiring all-around performance where both strength and endurance play a role. These sports include football, handball, tennis and basketball.

TCrs1815739

ADRB2 This gene is important in mobilizing stored body fat. Individuals with this genotype (CG) may have difficulty losing weight with diet alone and may (depending on other genetic and environmental factors) benefit from engaging in vigorous exercise to support their weight loss efforts.

CGrs1042714

ADRB2 Depending on other genetic and environmental factors, individuals with this genotype (GG) may not readily mobilize body fat in response to exercise. Human intervention studies have demonstrated that individuals with this genotype may (depending on other genetic and environmental factors) tend to be more successful in losing body fat when they exercise at a moderate rather than an intense level.

GGrs1042713




The previous section listed some of the specific effects of your genotype for the exercise-related SNPs in your genetic test. Looking at these effects individually for each SNP may not give you much insight into how you should be exercising. To determine the net effect of all of these markers, we apply an algorithm that factors in the individual effects and their interactions. This algorithm indicates that you may expect to achieve good weight control and overall health results with a fitness program of moderate intensity (as opposed to requiring a high intensity program). This does not mean that a more intense fitness regimen will be harmful, only that you may be able to maintain a healthy weight on a program of moderate intensity.

Some individuals may prefer to design a program based on activities they already enjoy such as biking, running, or swimming. You may already have a fitness program you would like to adjust based on this additional knowledge about your genetics and your metabolism. Or you may wish to design a program from scratch. Either way, this section of your report shows you how to apply the results of your genetic test to building or refining your own fitness program. If you have a fitness trainer or coach, you may wish to share the information in this part of your report with them so that they can incorporate it into your program.

The MET SystemThe MET system allows you to easily design a custom fitness program based on your own unique metabolism. MET stands for “metabolic equivalent.” Many people are familiar with METs because they often appear on the display monitors of gym equipment as an indicator of exercise intensity. Many fitness experts recommend the MET system as a way to set goals and track progress.

Activity Intensity and METsMETs are a measure of the rate at which the body expends energy. One MET is the rate at which your body expends energy while sitting at rest. MET values are usually expressed as a multiple of 1 MET, so a value of 4.5 METs would indicate that an activity uses 4.5 times as many calories as resting. One advantage of the MET system is that it is designed to be independent of the proportions of the individual.

Build Your Fitness Program Based On Your Metabolism




Accurate MET values are available for a wide variety of physical activities, so they are an excellent way to build a fitness program and track your progress. The Compendium of Physical Activities is a comprehensive catalog of MET intensities first published in 1993 and updated in 2000 and 2011. The Compendium is still an ongoing project and the very latest information on MET values can be found at the website: https://sites.google.com/site/compendiumofphysicalactivities/.

Activity Duration and MET Hours

A good way to set activity goals is to track MET-hours per week. To calculate MET hours, you multiply the MET value of the activity by the number of hours it is performed. MET-hours for various activities can be added up through the week and compared to a goal that is based on your current level of fitness and your genotype.

MET value x Duration (in hours) = MET-hours

For example: 5.0 METs x 3.0 Hours = 15.0 MET-hours




Analysis of your genetic markers indicates that you will respond best to activities with a moderate level of intensity. These activities will have a MET value between 3 and 6. Some common forms of exercise appropriate for your genotype are found in the following table. If an activity you are interested in does not appear in your table of recommended activities in this report, you can usually locate its MET value online. There are many good resources available. Simply search on terms such as "MET value" and "exercise."

The Best Activities for Your GenotypeThis section suggests some exercises which your genetic data indicates may be appropriate as part of your general fitness program. The chart gives the MET (metabolic equivalent) value of each activity. You can use MET values as a simple way to compare the relative intensity of different exercises. An activity with a MET value of 6 is about twice as strenuous as an activity with a MET value of 3. Exercise sessions should last at least 20 minutes to count toward your total.

Target Heart RateMET value Activity

Conditioning

bicycling, stationary, 30-50 watts, very light to light effort3.5 129 to 139 beats per minute

calisthenics (e.g., pushups, sit-ups), moderate effort3.8 129 to 139 beats per minute

circuit training, moderate effort4.3 129 to 139 beats per minute

bicycling, stationary, 51-89 watts, light-to-moderate effort4.8 129 to 139 beats per minute

resistance (weight) training5.0 129 to 139 beats per minute

Elliptical trainer, moderate effort5.0 129 to 139 beats per minute

rowing, stationary ergometer, general, vigorous effort6.0 129 to 139 beats per minute


Running

jogging, on a mini-tramp4.5 129 to 139 beats per minute

running, 4 mph (15 min/mile)6.0 129 to 139 beats per minute


Sports

volleyball, general4.0 129 to 139 beats per minute

tennis, doubles4.5 129 to 139 beats per minute

basketball, shooting baskets4.5 129 to 139 beats per minute

boxing, punching bag5.5 129 to 139 beats per minute

volleyball, competitive, in gymnasium6.0 129 to 139 beats per minute

skateboarding, competitive, vigorous effort6.0 129 to 139 beats per minute





Walking

stair climbing, slow pace4.0 129 to 139 beats per minute

walking, 3.5 mph, level, brisk, firm surface4.3 129 to 139 beats per minute

hiking, cross country6.0 129 to 139 beats per minute


Water Activities

water walking, moderate effort, moderate pace4.5 129 to 139 beats per minute

swimming, backstroke, recreational4.8 129 to 139 beats per minute

swimming, breaststroke, recreational5.3 129 to 139 beats per minute

canoeing, rowing, 4.0-5.9 mph, moderate effort5.8 129 to 139 beats per minute


Winter Activities

skiing, downhill, alpine or snowboarding, moderate effort5.3 129 to 139 beats per minute

skating, ice, 9 mph or less5.5 129 to 139 beats per minute




You should respond well to a moderate intensity fitness program consisting of activities with a MET value between 3.0 and 6.0. You should begin your program gradually, with an ultimate goal to achieve a minimum of 15-20 MET-hours of these activities each week. To calculate MET-hours, multiply the MET value of the activity by the duration (in hours).

Starting Goals: 5-10 MET-hours/weekExamples:

5 MET-hours can be achieved by 15 minutes of brisk walking (3.5 METs) 6 days per week

10 MET-hours can be achieved by 30 minutes of brisk walking 6 times per week

Intermediate Goals: 10-15 MET-hours/weekExample:

15 MET-hours can be achieved by walking briskly for 45 minutes 6 days per week

Ultimate Goals: 15-20 MET-hours/weekExample:

Bicycling 10 mph (5.8 METs) for 45 minutes, 6 days per week

A Program of Moderate Intensity ActivitiesBased on Your Genotype Your Goal Should Be...

The previous section focused on specific exercises and activities which may be most effective for you based on your genetic profile. The amount of time you spend on your fitness activities is just as important as choosing the correct activity.

The MET system offers an easy way for you to measure the fitness value of your workouts using units referred to as MET-hours. All you need to know is the MET value of your activity and the duration of your workout.

The calendar week is a natural framework for establishing goals, organizing your fitness program, and tracking your progress. Your ultimate program should consist of exercise sessions that are at least 20 minutes in duration for maximum benefit.

MET Value x Duration (in hours) = MET-hours





Your Competitive Edge

Earlier in this section we discussed fitness activities and schedules which might be expected to give you the greatest weight management benefits for your genotype. Aside from weight management, your genetic makeup also predisposes you to perform better at certain types of sports and activities than at others. For example, you may be a better sprinter than distance runner based upon your proportion of fast to slow twitch muscle fibers. Your genetic profile can give you insight into your competitive strengths and weaknesses from the perspective of performance.

Keep in mind that that genetic predispositions are substantially modified by training and practice. If there is a sport or activity you particularly enjoy, you will probably be more motivated to put the effort into the preparation needed to achieve high levels of performance. However, genetics can tell you which sports may come more naturally to you. It is also true that genetics plays a large role in determining which athletes will attain elite status in various sports.


Your Natural Athletic Strengths

Your genetic profile is consistent with a balanced proportion of fast and slow twitch muscle fibers. Slow twitch muscle fibers play an important role in endurance activities. They contain a large number of mitochondria, which are the chemical powerhouses of cells. Mitochondria require oxygen to supply energy to the cell, so they perform best under aerobic conditions where oxygen supply can keep up with energy demands. Fast twitch muscle fibers get a large proportion of their energy from processes that do not require oxygen (anaerobic metabolism). They can exert great force, but fatigue quickly and must be rested.

Individuals with a higher proportion of slow twitch muscle fibers will perform best at activities which require long periods of sustained, aerobic activity. Such activities include jogging, distance running, cycling, step aerobics, elliptical training, and rowing. Individuals with a higher proportion of fast twitch muscle fibers will tend to perform best at activities which emphasize shorter, more intense bursts of effort such as sprinting, or power lifting. With a good balance of both fiber types, you may find that you have competitive edge in situations which call for a good balance of both endurance and bursts of high intensity. For example, you might find that you can be very competitive in a long tennis match which requires both stamina and explosive bursts of energy.




Resistance Training and YouMany studies have proven that significant health and fitness benefits are achieved by including resistance training as part of any physical activity program. Your genetic profile can help you design the best program for you. Benefits will include an increase in lean muscle mass, enhanced muscle tone, and an increase in resting metabolic rate. When properly planned and executed, resistance training contributes to a fit appearance and makes other physical activities easier. It also offsets the muscle loss which usually accompanies the aging process.

The ideal approach to resistance training varies with the ratio of fast to slow twitch muscle fibers. Individuals with predominantly fast twitch fibers can expect better results from using heavier loads for shorter periods of time. Fast twitch fibers generate more force, but also fatigue more quickly. Individuals with more slow twitch fibers will generally achieve better results by using lighter loads for longer periods. A balanced proportion of fiber types calls for a middle of the road approach with moderate loads and intervals.


Your genetic profile indicates that, because you may have a balanced ratio of slow and fast twitch muscle fibers, you may benefit most from an intermediate approach which equally challenges both types of muscle fibers. You may get the best results using moderate resistance loads, moderate exertion times, a moderate number of repetitions, and moderate resting time between sets. You may wish to use the following as a general guideline for your resistance training:

2 - 6 sets

8 - 15 repetitions per set

rest periods of approximately 60 seconds between sets

It is very important to begin any new resistance program with lighter loads and increase them gradually. The result will be a more successful program with a lower risk of injury.



30-Jul-19Genetics and Healthy Behavior

Hunger and Satiety

The tendency to develop and maintain healthy eating habits varies greatly from person to person. Genetics plays an important role in these differences. The good news is that you can always take steps to maintain healthy eating behaviors, no matter what your genetic predispositions are. Knowing your genetic tendencies can help you choose the best strategies for you.

Eating for Pleasure

FTO and Ghrelin

Genetics and Healthy Behavior

Some individuals experience much greater difficulty choosing healthy foods, while others have more trouble controlling the quantity they consume. Some people have challenges with both quality and quantity. Individual differences in eating behavior result from a complex interaction of factors including genetics, past experience, and the present environment. One example is the FTO gene, which influences the activity of an important hunger signaling hormone known as ghrelin.


Your variant of the FTO gene (TT) is consistent with normal levels of the hunger-stimulating hormone known as ghrelin. This result indicates that you may expect a normal level of difficulty with appetite control and food selection. However, there are many factors which influence individual eating habits. Even though you may not be genetically predisposed to excess difficulty with appetite control and food choices, you may still experience challenges controlling food quantity and quality. Modern society makes it very easy to consume more energy than we need for our daily activities, and excess energy intake is stored in fat cells.

There are some simple strategies you can use to make it even easier to stay in control of your caloric intake. Increasing protein and fiber intake can increase feelings of fullness while taking longer to digest than foods high in fat and processed carbohydrates. Some foods, such as soups, non-starchy vegetables, and salads take more energy and time to process and make it easier to control caloric intake. Drinking water between meals can help reduce the desire to consume excess calories in the form of snacks, while increased water intake during meals can help increase a sense of fullness. It takes time after consuming a meal for the brain to get the message that you are full, so consider taking the time to eat slowly, chew thoroughly and occasionally put the fork down. Pre-planned meal programs with careful attention to portion control may be helpful.




Eating for Pleasure

Eating for pleasure, in the absence of hunger, can be a real problem for many of us. The brain has "reward centers" whose purpose is to encourage us to engage in behaviors with survival benefits. Sometimes, especially in our modern world, this same circuitry can have the opposite effect, causing us to behave in ways which are harmful to our health and wellbeing.

Scientists have long known that dopamine levels are often involved in behaviors which are pleasurable, but which can also have negative consequences. Such activities include alcohol consumption, drug abuse, and binge eating. Recent research has focused on genetic differences among individuals which affect the functioning of dopamine in the brain.

DRD2 and Dopamine

Neurotransmitters are chemicals which carry messages from one nerve cell to another. They also regulate the overall responsiveness of various brain systems to stimulation. The neurotransmitter dopamine plays a key role in determining which activities we find rewarding.


According to Your GenotypeThe DRD2 polymorphism of the D2 dopamine receptor has been correlated with reduced dopamine receptor density in the brain. Dopamine receptors play a key role in the experience of pleasure, and individuals with fewer of these receptors may be more susceptible to the overconsumption of food to experience this pleasure.

Your version of this DRD2 polymorphism (TC) indicates that you may have more difficulty managing your weight because of a reduced sensation of satisfaction. This can lead to problems like binge eating. This genotype may also lead to an increased preference for higher calorie foods and an increased tendency toward impulsivity.




Appetite and Energy Output Levels

Researchers have discovered that we have internal, biochemical regulatory systems which play a role in determining and stabilizing the amount of fat tissue we tend to accumulate. Consider that consuming a mere 100 calories a day more than you burn would result in gaining 10 pounds every year. That's about the number of calories in a slice of bread. Generally, individuals don't experience such dramatic variances in their weight, even with no conscious effort to regulate calorie intake and output.

LEPR and Leptin

Some people seem to be able to eat all they want and not gain a single pound, while others count every calorie and still struggle to maintain a healthy weight. Physical activity levels explain part of this individual variance, but it's clear that there must be other factors in this equation.


Scientists have discovered that the hormone leptin plays a key role in regulating the amount of fat that an individual carries. Leptin accomplishes this by affecting functioning of a small but important region of the brain called the hypothalamus. The hypothalamus plays a large role in regulating both hunger and energy expenditure. The receptor for leptin, a protein named LEP-R, is coded by the LEPR gene. Variations in the LEPR gene have been associated with a variety of weight related issues.

Your genotype (TT) is consistant with average levels of difficulty maintaining a healthy weight. Keep in mind that this is one of many environmental and genetic factors which affect your weight management efforts. You may still expect to benefit from developing skills to utilize in challenging situations, maintaining proper hydration, fine-tuning macronutrient levels, and establishing a regular physical fitness program. Working with a physician or dietitian to fine tune your program may be helpful.

Because you have the favorable version of the LEPR gene, you may not have to work quite as hard to keep your weight at desirable levels. Once you have established the right physical fitness regimen and your diet contains the right proportion of carbs, fats, and proteins, you will be on your way to a lifetime of healthy weight management.




Taste and Food Preference

As researchers learn more about the physiological basis of decision making, they are discovering that genetics plays an important role. Research shows that genetic differences actually cause foods to taste different to different people.

Researchers are not sure about the cause, but it seems to be related to the ability to taste the chemicals PROP and PTC and perceive them as unpleasant. Certain variants of the TAS2R38 also increase the number of taste buds responsible for detecting bitter compounds. Individuals with this added sensitivity to bitter compounds are often referred to as "supertasters."

Sugar Cravings

TAS2R38 and food preferences

The TAS2R38 gene has been shown to affect an individual's perception that certain compounds in food have a bitter taste. As a result, it affects their ability to enjoy some healthy foods, such as cruciferous vegetables, while finding sweets particularly satisfying.


Your genotype for the TAS2R38 gene (TC) is associated with an intermediate sensitivity to certain bitter compounds in some foods. Sensitivity to bitter compounds can lead to avoidance of cruciferous vegetables such as broccoli, cabbage and cauliflower. Your version of the TAS2R38 gene is also associated with a somewhat increased preference for sweet foods. Both of these tendencies might contribute to making less healthy food choices.

Search for fruit and vegetable choices that are both healthy and pleasing to your palate. There is a wide variety of low calorie, nutrient dense food in this category and, with so many to choose from, you should be able to put together a diet strategy which is both healthful and sustainable in the long term. You may find that it is helpful to keep a log of fruits and vegetables that you enjoy.

If you find you have tendency to overindulge in sweets, you may want to make them less readily available. You may find it helpful to engage in activities which result in the natural release of endorphins such as light exercise and spending time with family and friends.




Sugar Cravings

The tendency to crave sugar is associated with difficulty controlling weight and maintaining overall good health. Sugar, especially refined sugar, comes with many negative effects on weight management and overall health. Everyone does not experience the same tendency to crave sugar and sweet foods. Brain chemistry and blood sugar levels both play a major role in the desire to consume sugar in one's diet. Once again, genetics plays a big part. Certain proteins found in cell membranes are key to the movement of glucose from our blood into our cells. Because of genetic variations, some individuals have glucose transporter proteins which move glucose more efficiently. These genetic variations play a role in how likely a person is to experience sugar cravings.

Increased sugar consumption leads to the dual problems of increased calorie intake combined with the unhealthy effect sugar consumption has on insulin levels and function. To make matters worse, foods high in sugar are often low in other important nutrients and high in unhealthy saturated fats. Controlling sugar intake, especially processed sugar that is quickly absorbed, is fundamental to long term health.

GLUT2


A polymorphism of the gene that codes for GLUT2 transporter is associated with significantly increased cravings for sugars. Your genotype (GG) indicates that you have the form of this gene which is associated with a normal tendency to crave sugars in your diet.

Even with the more favorable form of this gene, you may still experience a challenge with craving sugars and sweet foods. Keep in mind that sugar cravings tend to increase when they are indulged. As you decrease the amount of sugar in your diet, you will probably find that the craving for sugar will soon decrease as well. Some researchers point out that dietary sugar has a powerful stimulating effect on the same brain functions involved in drug addictions and other impulsive behaviors based on acquired habits.

Another helpful strategy is to limit the availability of high sugar foods in your immediate environment. Generally, it is easier to avoid buying a box of cookies at the store than to resist them once you have them in your house. It is helpful to observe which situations trigger a craving for sugar and avoid them when possible.




Mood and Food Selection

Mood can play a significant role in your ability to make good food choices. Studies have demonstrated that individuals will tend to make healthier food choices when they are in a positive mood. We are more likely to choose indulgent foods when we are in a negative mood. There are a variety of theories as to why this is the case, and there may be more than one cause at work.

Another factor may be that mood affects our ability to think abstractly, as well as our ability to consider long term consequences. Making wise food choices often requires abstract thinking about health consequences, as well as the ability to make decisions on effects that are not as immediate as the enjoyment of the moment.

MTHFR

One mechanism may be the interaction of food and the pleasure centers in the brain. Foods high in sugar and fat may provide a temporary relief from a negative frame of mind.


Methylenetetrahydrofolate Reductase (MTHFR) is an enzyme which plays an important role in the way folate is processed. Variations in the MTHFR gene have been studied in relation to a number of important health issues, including some related to weight management.

Your genotype (TT) corresponds to a version of the MTHFR gene which is associated with reduced MTHFR activity. This can result in decreased folate activity, as well as lower levels of serotonin and dopamine, both of which play a central role in the regulation of mood. You may benefit from a diet which supports higher levels of folate, as well as activities which naturally boost levels of serotonin and dopamine. Foods which supply folate include dark green leafy vegetables, fruits, fruit juices, nuts, beans, peas, dairy products, meat, grains and eggs. A regular exercise program can be an excellent way to promote positive moods and support healthy levels of mood enhancing brain chemicals.

Practicing mindfulness in your eating habits should increase your tendency to think abstractly about the health implications of different foods. The ability to link your food choices with their health impact increases with practice, and can replace the tendency to indulge in foods high in sugars and fats because they may be a source of brief enjoyment.




Circadian Rhythm and Maintaining a Healthy Weight

Recently, several studies have suggested that the disruption of the circadian system may contribute to difficulty maintaining a healthy weight. Shift work, sleep deprivation and exposure to bright light at night show a correlation with carrying extra body fat.

Individual variations in the CLOCK gene may also have an effect on the ability to lose weight in response to calorie restriction. Carriers of the G allele (GG and GA) tend to have a higher BMI and may experience greater difficulty in losing weight in response to reduced caloric intake.

Neurotransmitter Balance

The CLOCK gene

Genetics also plays a role in a healthy circadian rhythm. Although the biological mechanisms are not fully understood, individuals with a specific variation of the CLOCK gene may experience a disruption in the chronobiology system. Like other factors which affect circadian rhythm, variations in this gene can affect the ability to maintain a healthy weight.


Your genotype (AG) is correlated with some added challenges losing weight in response to a low calorie diet. The following are some strategies to achieve and maintain your healthy weight goals. Keep in mind that your genotype for this marker is only one of many factors which interact to affect your circadian rhythm and dietary responses.

Your genotype is correlated with a shorter sleep duration. Work toward creating an ideal sleep environment. Normal sleep duration is correlated with a lower BMI and greater ease losing weight in response to a reduced calorie diet.

You may have higher blood plasma levels of the hunger stimulating hormone ghrelin, which helps to increase feelings of hunger and makes it more likely that excess calories will be consumed. You may wish to emphasize proteins and fiber in your diet to help offset this effect.

You may tend to have a preference to consume more of your calories later in the day. It is more difficult to burn calories consumed in the evening or at night. Try to offset this effect by working to adopt the habit of eating your evening meal as early as possible. Work hard to adopt habits which discourage late night snacking.




Neurotransmitter Balance

Studies indicate that the proper balance and processing of neurotransmitters plays an important role in maintaining healthy habits. Catechol-O-methyltransferase is an enzyme involved in the breakdown and inactivation of certain neurotransmitters including dopamine, epinephrine and norepinephrine.

COMT

The COMT gene is responsible for the production of this important enzyme, and research has shown that variations in this gene can have important consequences for maintaining a healthy weight and lifestyle. For those with the less favorable version of this gene, there are strategies which may help offset its negative effects.


Your test result (AG) indicates that you have a moderately favorable form of the COMT gene. There are many strategies you can employ to boost your levels of helpful neurotransmitters such as dopamine which contribute to maintaining a healthy weight.

Emphasize high-quality proteins in your diet. Protein provides amino acids that are needed to make neurotransmitters and stabilize blood sugar.

Emphasize high fiber vegetables in your diet. Vegetable fiber helps stabilize blood sugar levels, which reduces risk of mood swings.

Avoid drinks sweetened with sugar. Sugars change our blood sugar levels and increase mental fuzziness and tiredness. This can resemble symptoms of depression.

Avoid alcohol. Alcohol is a depressant which decreases the levels of "feel good" neurotronsmitters naturally present in the brain.

Engage in physical activity – this produces stimulating neurotransmitters which play a role in fostering upbeat moods, increased energy, focus and sleep.


References

Fatty Acid Binding Protein (FABP2)

Baier, L.J. et al. An amino acid substitution in the human intestinal fatty acid binding protein is associated with increased fatty acid binding, increased fat oxidation, and insulin resistance. J Clin Invest 95, 1281-7 (1995).

Levy, E. et al. The polymorphism at codon 54 of the FABP2 gene increases fat absorption in human intestinal explants. J Biol Chem 276, 39679-84 (2001).

Hegele, R.A. et al. Genetic variation of intestinal fatty acid-binding protein associated with variation in body mass in aboriginal Canadians. J Clin Endocrinol Metab 81, 4334-4337 (1996).

Yamada, K. et al. Association between Ala54Thr substitution of the fatty acid-binding protein 2 gene with insulin resistance and intra-abdominal fat thickness in Japanese men. Diabetologia 40, 706-10 (1997).

Albala, C. et al. Intestinal FABP2 A54T polymorphism: association with insulin resistance and obesity in women. Obes Res 12, 340-5 (2004).

Agren, J.J., Valve, R., Vidgren, H., Laakso, M. & Uusitupa, M. Postprandial lipemic response is modified by the polymorphism at codon 54 of the fatty acid-binding protein 2 gene. Arterioscler Thromb Vasc Biol 18, 1606-10 (1998).

Thumser, Alfred E.; Moore, Jennifer Bernadette; Plant, Nick J. Current Opinion in Clinical Nutrition & Metabolic Care: March 2014 - Volume 17 - Issue 2 - p 124–129.

Syed Tasleem Raza, Jalees Fatima, Faisal Ahmed, Shania Abbas, Zeashan Haider Zaidi, Seema Singh, Farzana Mahdi. Association of angiotensin-converting enzyme (ACE) and fatty acid binding protein 2 (FABP2) genes polymorphism with type 2 diabetes mellitus in Northern India. Journal of the Renin-Angiotensin Aldosterone System 2014, Vol. 15(4) 572–579.

Zhu Li, Chang-Lin Ni, Wen-yan Niu, Bao-cheng Chang and Li-Ming Chen. The intestinal fatty acid binding protein-2 Ala54Thr polymorphism is associated with diabetic retinopathy in Chinese population. Diabetology & Metabolic Syndrome (2015) 7:23.

Peroxisome Proliferator-Activated Receptor Gamma (PPARG)

Luan, J. et al. Evidence for gene-nutrient interaction at the PPARgamma locus. Diabetes 50, 686-9 (2001).

Rankinen, T. et al. The Human Obesity Gene Map: The 2005 Update. Obesity 14, 529-644 (2006).

Lindi, V.I. et al. Association of the Pro12Ala polymorphism in the PPAR-gamma2 gene with 3-year incidence of type 2 diabetes and body weight change in the Finnish Diabetes Prevention Study. Diabetes 51, 2581-6 (2002).

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Cuthbert C.E., Ramdath D.D., Foster J.E. Frequency of Fat Mass and Obesity-Associated Gene rs9939609 and Peroxisome Proliferator-Activated Receptor Gamma 2 Gene rs1801282 Polymorphisms among Trinidadian Neonates of Different Ethnicities and Their Relationship to Anthropometry at Birth. J Nutrigenet Nutrigenomics

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Beta-2-Adrenergic Receptor (ADBR2)

Ellsworth, D.L. et al. Influence of the beta2-adrenergic receptor Arg16Gly polymorphism on longitudinal changes in obesity from childhood through young adulthood in a biracial cohort: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 26, 928-37 (2002).

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Gonzalez Sanchez, J.L. et al. The glutamine 27 glutamic acid polymorphism of the beta2-adrenoceptor gene is associated with abdominal obesity and greater risk of impaired glucose tolerance in men but not in women: a population-based study in Spain. Clin Endocrinol (Oxf) 59, 476-81 (2003).

Martinez, J.A. et al. Obesity risk is associated with carbohydrate intake in women carrying the Gln27Glu beta2-adrenoceptor polymorphism. J Nutr 133, 2549-54 (2003).

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Louise F. Saliba; Rodrigo S. Reis; Ross C. Brownson, et al. Obesity-related gene ADRB2, ADRB3 and GHRL polymorphisms and the response to a weight loss diet intervention in adult women. Genet. Mol. Biol. vol.37 no.1 Ribeirão Preto 2014.

Eisenach, J. H., Schroeder, D. R., Pavey, E. S., Penheiter, A. R., Knutson, J. N., Turner, S. T. and Joyner, M. J. (2014), Interactions between beta-2 adrenoceptor gene variation, cardiovascular control and dietary sodium in healthy young adults. J Physiol, 592: 5221–5233. doi:10.1113/jphysiol.2014.276469.

Beta-3-Adrenergic Receptor (ADBR3)


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Fat Mass-Obesity Associated Gene (FTO)

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Boissel, S. et al. Loss-of-function mutation in the dioxygenase-encoding FTO gene causes severe growth retardation and multiple malformations. Am J Hum Genet 85, 106-11 (2009).


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Gisele K. Rodrigues, M.Sc., Cristina M.M. Resende, Ph.D., Danielle F. Durso, Ph.D., et al. A single FTO gene variant rs9939609 is associated with body weight evolution in a multiethnic extremely obese population that underwent bariatric surgery. Nutrition, Volume 31, Issues 11–12, November–December 2015, Pages 1344–1350.

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Interleukin-6 (IL6)

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Razquin, C. et al. A Mediterranean diet rich in virgin olive oil may reverse the effects of the -174G/C IL6 gene variant on 3-year body weight change. Mol Nutr Food Res 54 Suppl 1, S75-82.

Pâmela F. Todendi, Elisa I. Klinger, Michele B. Ferreira. Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents. Anais da Academia Brasileira de Ciências (2015) 87 (2).

Raquel de Oliveira, Tamiris Invencioni Moraes, Alvaro Cerda, Mario Hiroyuki Hirata, et al. ADIPOQ and IL6 variants are associated with a pro-inflammatory status in obeses with cardiometabolic dysfunction. Diabetology & Metabolic Syndrome (2015) 7:34.

Haiming Cao. Adipocytokines in obesity and metabolic disease. J Endocrinol February 1, 2014 220 T47-T59.

Ljiljana Lukic, Nebojsa M. Lalic, Natasa Rajkovic, Aleksandra Jotic, et al. Hypertension in Obese Type 2 Diabetes Patients is Associated with Increases in Insulin Resistance and IL-6 Cytokine Levels: Potential Targets for an Efficient Preventive Intervention. Int. J. Environ. Res. Public Health 2014, 11(4), 3586-3598.


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Angiotensin 1-Converting Enzyme (ACE)

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Human Heptic Lipase Gene (LIPC)

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Apolipoprotein A-II (APOA2)

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Insulin Receptor Substrate 1 (IRS1)

Sesti, G. et al. Defects of the insulin receptor substrate (IRS) system in human metabolic disorders. The FASEB Journal, Vol. 15(12) 2099-2111 (2001).

Rung, J. et al. Genetic variant near IRS1 is associated with type 2 diabetes, insulin resistance and hyperinsulinemia. Nat Genet 41, 1110-1115 (2009).

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Transcription Factor 7-like 2 (TCF7L2)

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Jin, T. & Liu, L. The Wnt signaling pathway effector TCF7L2 and type 2 diabetes mellitus. Mol Endocrinol 22, 2383-92 (2008).

Savic, D. et al. Modulation of TCF7l2 expression alters behavior in mice. PLoS One 6, e26897 2009.

Savic, D. et al. Alterations in TCF7L2 expression define its role as a key regulator of glucose metabolism. Genome Res 21, 1417-25, 2008.

Hindy, G. et al. Role of TCF7L2 risk variant and dietary fibre intake on incident type 2 diabetes. Diabetologia 55, 2646-54, 2008.

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Franklin, C.S. et al. The TCF7L2 diabetes risk variant is associated with HbA(1)(C) levels: a genome-wide association meta-analysis. Ann Hum Genet 74, 471-8, 2008.

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Glucose-Dependent Insulinotropic Polypeptide Receptor (GIPR)

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Saxena, R. et al. Genetic variation in GIPR influences the glucose and insulin responses to an oral glucose challenge. Nat Genet 42, 142-8.

Burgdorf, K.S. et al. Association studies of novel obesity-related gene variants with quantitative metabolic phenotypes in a population-based sample of 6,039 Danish individuals. Diabetologia 55, 105-13.

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Alpha-actinin-3 (ACTN3)

Eynon, N. et al. The ACTN3 R577X polymorphism across three groups of elite male European athletes. PLoS One 7, e43132.

MacArthur, D.G. & North, K.N. ACTN3: A genetic influence on muscle function and athletic performance. Exerc Sport Sci Rev 35, 30-4 (2007).

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Endothelial Nitric Oxide Synthase Gene (eNOS)

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Hela Ben Nasr, Saloua Dimassi, Refka M’hadhbi, Haithem Debbabi, et al. Functional G894T (rs1799983) polymorphism and intron-4 VNTR variant of nitric oxide synthase (NOS3) gene are susceptibility biomarkers of obesity among Tunisians. Obesity Research & Clinical Practiceonline 5 May 2015.

Bruno M. Silvaa, Thales C. Barbosaa, Fabricia J. Nevesa, et al. eNOS gene haplotype is indirectly associated with the recovery of cardiovascular autonomic modulation from exercise. Autonomic Neuroscience, Volume 186, December 2014, Pages 77–84.

Carlos H. Sponton, Rodrigo Esposti, Cynara M. Rodovalho, Maycon J. Ferreira, Aline P. Jarrete, Chadi P. Anaruma, Mauricio Bacci Jr., Angelina Zanesco. The presence of the NOS3 gene polymorphism for intron 4 mitigates the beneficial effects of exercise training on ambulatory blood pressure monitoring in adults. American Journal of Physiology - Heart and Circulatory Physiology, 15 June 2014 Vol. 306 no. 12, H1679-H1691.

Fat Mass-Obesity Associated Gene (FTO)

Frayling, T.M. et al. A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 316, 889 - 894 (2007).

Rong, R. et al. Association analysis of variation in/near FTO, CDKAL1, SLC30A8, HHEX, EXT2, IGF2BP2, LOC387761, and CDKN2B with type 2 diabetes and related quantitative traits in Pima Indians. Diabetes 58, 478-88 (2009).

Wardle, J. et al. Obesity Associated Genetic Variation in FTO Is Associated with Diminished Satiety. J Clin Endocrinol Metab. 2008 Sep;93(9):3640-3.

Karra, E. et al. A link between FTO, ghrelin, and impaired brain food-cue responsivity. The Journal of Clinical Investigation 123(3), 3539-3551 (2013).

Nadia Micali, Alison E. Field, Janet L. Treasure and David M. Evans. Are obesity risk genes associated with binge eating in adolescence? Obesity, Volume 23, Issue 8, pages 1729–1736, August 2015.

Clare H. Llewellyn, PhD; Maciej Trzaskowski, PhD, MSc; Cornelia H. M. van Jaarsveld, PhD; Robert Plomin, PhD; Jane Wardle, PhD. Satiety Mechanisms in Genetic Risk of Obesity. JAMA Pediatr. 2014;168(4): 338-344.

Dopamine Receptor D2 (DRD2)

Comings, D.E., Gade, R., MacMurray, J.P., Muhleman, D. & Peters, W.R. Genetic variants of the human obesity (OB) gene: association with body mass index in young women, psychiatric symptoms, and interaction with the dopamine D2 receptor (DRD2) gene. Mol Psychiatry 1, 325-35 (1996).

Wang, G.J., Volkow, N.D., Thanos, P.K. & Fowler, J.S. Similarity between obesity and drug addiction as assessed by neurofunctional imaging: a concept review. J Addict Dis 23, 39-53 (2004).

Heber, D. & Carpenter, C.L. Addictive genes and the relationship to obesity and inflammation. Mol Neurobiol 44, 160-5.

Fetissov, S.O. & Meguid, M.M. On dopamine, D2 receptor, and Taq1A polymorphism in obesity and anorexia. Nutrition 25, 132-3 (2009).

Noble, E.P. The DRD2 gene in psychiatric and neurological disorders and its phenotypes. Pharmacogenomics 1, 309-33 (2000).

Leptin Receptor (LEPR)

Répásy J., Bokor S., Erhardt É., Molnár D. Association of Gln223 Arg polymorphism of the leptin receptor gene


References

with indicators of energy expenditure in obese children. Nutrition 30(7-8):837-40 (2014).

Traurig, M.T., Perez, J.M., Ma, L., et al. Variants in the LEPR gene are norminally associated with higher BMI and lower 24-h energy expenditure in Pima Indians. Obesity 20, 2426-2430 (2012).

Farooqi, I.S., O'Railly, S. Mutations in ligands and receptors of the leptin-melanocortin pathway that lead to obesity. Nature Online 4 (2008).

Mette Hollensted, Tarunveer S Ahluwalia, Christian Theil Have, Niels Grarup, et al. Common variants in LEPR, IL6, AMD1, and NAMPT do not associate with risk of juvenile and childhood obesity in Danes: a case–control study. BMC Medical Genetics 2015, 16:105.

Taste receptor 2 member 38 (TAS2R38)

Tepper, B.J. 6-n-Propylthiouracil: a genetic marker for taste, with implications for food preference and dietary habits. Am J Hum Genet 63, 1271-6 (1998).

Tepper, B.J. & Nurse, R.J. PROP taster status is related to fat perception and preference. Ann N Y Acad Sci 855, 802-4 (1998).

Duffy, V.B. & Bartoshuk, L.M. Food acceptance and genetic variation in taste. J Am Diet Assoc 100, 647-55 (2000).

Drewnowski, A., Henderson, S.A., Shore, A.B. & Barratt-Fornell, A. Nontasters, tasters, and supertasters of 6-n-propylthiouracil (PROP) and hedonic response to sweet. Physiol Behav 62, 649-55 (1997).

Glucose Transport Protein (GLUT2)

Barroso, I., Lan, J., Middelberg, R. et al. Candidate Gene Association Study in Type 2 Diabetes Indicates a Role for Genes Involved in b-Cell Function as well as Insulin Action. PloS Biology Vol 1(1), 041- 055 (2003).

Eny, K., Wolever, MS, et al. Genetic variation in Glucose Transporter type 2 is associated with intake of sugars in 2 distinct populations. Physiol Genomics (2008) 33:355 – 360.

Florez, JC, Jablonski, KA, McAteer, JB. et al. Effects of Genetic Variants Previously Associated with Fasting Glucose and Insulin in the Diaetes Prevention Program. PloS One Vol 7(9), e44424 (2012).

Stolarczyk, E., Guissard, C., Michau, A., et al. Detection of extracellular glucose by GLUT2 contributes to hypothalamic control of food intake. Am J. Physiol Endocrinol Metab 298: e1078 – e1087 (2010).

Eny, K., Wolever, MS, et al. Genetic variation in TAS1R2 (Ile191Val) is associated with consumption of sugars in overweight and obese individuals in 2 distinct populations. Am J Clin Nutr (2010) 92:1501-1501.

Methyltetrahydrafolate Reductase Gene (MTHFR)

Di Renzo, L., Marsella, L.T., Sarlo, F., Soldati, L., et al. C677T Gene Polymorphism of MTHFR and Metabolic Syndrome: Response to Dietary Intervention. Journal of Translational Medicine 12:329 (2014).

Stahl, Steven. L-Methlyfolate: A Vitamin for Your Monoamines. Journal of Clinical Psychiatry 69:9 (2008).

Yang, J., Liu, J., Liu, J, Li, W, et al. Genetic Association Study with Metabolic Syndrom and Metabolic-Related Traints in a Cross-Sectional Sample and a 10-Year Longitudinal Sample of Chinese Elderly Population. Public Library of Science One 9 (6), e100548 (2014).

Marini, N.J., Gin, J, et al. The Prevalence of Folate-Remedial MTHFR Enzyme Variant in Humans. PNAS 105 (2008).


References

Yang, B., Fan, S., Zhi, X, et al. Association of MTHFR C677T and MTRR A66G Gene Polymorphisms with Metabolic Syndrome: A Case-Control Study in Northern China. International Journal of Molecular Science 15(12): 21687 (2014).

Yang, B., Fan, S., Zhi, X., et al. Associations of MTHFR C677T and MTRR A66G Gene Polymorphisms with Metabolic Syndrome: A Case-Control Study in Northern China. Int. J. Mol. Sci. 15(12):21687-702 (2014).


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