7. Arkadianos Final Clinical Experience Upon Mycellf Test_kg

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Clinical Experience with the MyCellf test Ioannis Arkadianos M.D. Scientific and Medical Consultant of Sciona in Eurogene Member of International Society of Nutrigenetics/Nutrigenomics Historical Back up  Clinical experience from 2003 until 2008 (250+ tests) 2003 Body Benefits Nutrition Test 7 Genes - 9 SNPs 2004 Cellf Test 19 Genes - 24 SNPs 2008 MyCellf Test 27 Genes - 38 SNPs    Patient approach 1st Appointment  Medical History  Blood tests (programming)  MyCellf questionnaire  BMI estimation, Fat measurement, Blood pressure measurement  Sample collection Patient approach 2nd Appointment Explanation of the MyCellf test Review of blood tests Supplements if needed Instructions Programming for follow up      Difficulties in Patient approach    New terms for them (Nutrigenetics/Nutrigenomics) Misunderstanding with Food Intolerance It’s not exact a test for losing weight (maybe it helps, but there is the need for more clinical data) Scientific Presentations  Publication in - 10/2007   Posters in : 3 European Congresses on Obesity 14th , 15th, 16th (2005, 2007, 2008) 6th International Conference on Nutrition and Fitness (2004) “Nutrition Journal” Publication Rosalynn D Gill, Keith A Grimaldi Improved weight management using genetic information to personalize a calorie controlled diet " Ioannis Arkadianos, Ana M Valdes, Efstathios Marinos, Anna Florou, Nutrition Journal 2007, 6:29 (18 October 2007)  Total accesses to this article: 5530 (21/11/2008) “Nutrigenetic" diets may aid weight loss: study Wed Nov 7, 2007 4:38pm EST “Nutrition Journal” Publication 14.0% 12.0% 10.0% p<0.004 8.0% NoTest ScionaTest % BMI Loss 6.0% 4.0% 2.0% 0.0% 30-45 -2.0% -4.0% -6.0% 90-100 100-300 300+ Follow-up (days) “Nutrition Journal” Publication Improved glucose in Nutrigenetics group JAMA’s review  Our publication in NJ was reviewed and included in JAMA’s review article REVIEW CLINICIAN’S CORNER Delivery of Genomic Medicine for Common Chronic Adult Diseases A Systematic Review Arkadianos et al, 2007 Nonrandomized comparison (Greece) 1320 JAMA, March 19, 2008—Vol 299, No. 11 JAMA’s Review Study Selection Original research articles and systematic reviews dealing with common chronic adult-onset conditions were reviewed. A total of 3371 citations were reviewed, 170 articles retrieved, and 68 articles included in the analysis.     JAMA’s Review Arkadianos et al, 2007 “A nonrandomized comparison of Greek patients who had at least 2 unsuccessful attempts at weight loss compared conventional diet and nutrition counselling with nutrition counselling informed by a nutrigenomics test result. For the first 300 days, weight loss between groups was not statistically different, but among the 50% of patients with more than 300 days of follow-up, there was a statistically significant difference of about 5 kg, with the test group weighing less on average.” OMICS A journal of Intergrative Biology Review Dissecting the Nutrigenomics, Diabetes, and Gastrointestinal Disease Interface: From Risk Assessment to Health Intervention Lunnette R. Ferguson The University of Auckland Auckland, New Zealand OMICS A Journal of Integrative Biology Volume 12, Number 4, 2008 OMICS A journal of Intergrative Biology Review     Arkadianos et al. (2007) investigated whether genetic information could be used to tailor a diet and exercise program that would help individuals toward a sustainable weight loss. They identified a group of 50 subjects who had a history of failure at weight loss. They offered these individuals a genetic test that screened 24 variants in 19 genes involved in metabolism. They also selected 43 patients attending the same clinic, and matched for age, sex, frequency of clinical visits, and BMI at initial clinic visit, who were not offered the screening test, but otherwise treated according to standard clinic protocol. They considered reduction in BMI and fasting blood glucose after 100 days and again after 300 days. They showed statistically significant differences between the groups. At the 300-day time point, 73% individuals in the nutrigenetics group compared with 32% in the control group were likely to have maintained some weight loss. For those subjects who showed characteristics of IGT at the start of the trial, 57% of the nutrigenetics group but only 25% of the control group showed a reduction in blood glucose levels. It is essential that these exciting preliminary results are rigorously followed up in subsequent workntained some weight loss Review Why study gene–environment interactions? Jose M. Ordovasa and E Shyong Taib Current Opinion in Lipidology 2008, 19:158–167 a Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA and b Department of Endocrinology, Singapore General Hospital, Department of Medicine and Center for Molecular Epidemiology, National University of Singapore, Singapore Review  Two recent reports * provided some support to the beneficial influence on some parameters of health of such ‘genetic advice’; however, the studies are rather limited in size, and the products offered must be further validated and considerably improved if they are to have a significant impact on the health of the population. * Arkadianos I. et al, Nutrition Journal 2007 Kornman K, et al , Nutrition 2007 Case report 1 Man 40 years old – in 3 months           BMI HCY Insulin B12 Folic acid Chol HDL LDL Tg CRP 34,8 31,8 56 11 23,5 11 287 355 2,2 9,3 212 170 54 42 132 104 134 122 1,37 (0.5) 0,15 Case report 1      continue Genes influence: HCY, B6, B12, Folic acid MTHFR MTHFR MTRR MTR CBS C677T A1298C A66G A2756G C699T TT Homozygous AA A/G AA C/T Gene influence Insulin sensitivity  PPAR–γ2 Pro12Ala CC Genes influence Chol metabolism   CEPT G279A LPL C1595G G/A C/G Case report 1   continue He doesn’t eat fish at all (and continues not to eat) He eats a lot of meat all his life (rich in B12) Instructions for Nutrition according to his genetic profile     Supplements B50 complex Folic acid 800µg n-3 700mg Case report 2  Man 46 years old – in 4 months ΒΜΙ U.A. CHOL HDL LDL TC/HDL TG SGOT SGPT HCY : Folic : B12 : 29,7 8,6 270 43 210 6,2 126 37 82 15 9,9 603 - 28,6 - 6,5 - 232 - 49 - 161 - 4,7 - 110 - 25 - 55 - 10,36 - 10,15 - 1105             Case report 2   continue Note the improvements in his blood profile with very little BMI reduction Genes influence B12, B6 ,Folic acid, HCY MTHFR MS –MTRR MTR CBS C677T C/T A66G A/G A1256G AA C699T C/T      Nutrition instructions according to his gene profile B12 : 50μg Folic Acid : 450μg + from foods Β6 : 50 mg Simple Multiantioxidant formula     Homocysteine Reduction from Poster : 14th European Congress on Obesity 2005          8 Patients 6 men – 2 women All with SNPs in genes associated with Folic and HCY cycle Average follow up 4,5 months Supplements given 400μg Folic Acid + from food 50mg B6 50μg B12 Nutrition according to their gene profile HCY Reduction Case         continues HCY 18,13 - 12,2 11,9 - 7,5 11,9 - 7,7 12 - 8,7 12,1 - 10,1 15 - 10,36 14,37 - 9 11,2 - 9,5 from Poster : 14th European Congress on Obesity 2005 ΒΜΙ 1 2 3 4 5 6 7 8 36,5 - 34,8 25,2 - 23 37,7 - 36,9 30,5 - 28,5 43 - 39 29,7 - 28,6 39,5 - 33 27 - 27   In all cases we had reduction in HCY levels Note that in a lot of cases we have significant reduction in HCY levels even with little BMI reduction Clinical remarks    Significant improvement of the “chronic fatigue syndrome” (95-100%) especially in patients with SNPs in genes associated with B12, Folic acid and B6 vitamins (MTHFR, MTRR, MTR, CBS) Difficulties in losing weight in patients with SNPs in genes GSTM1 (deletion), GSTT1 (deletion), GSTP1 Significant reduction in Total Chol and LDL levels – in a lot of patients even with little BMI reduction without medicines (see also the 2 cases report above). It looks like the supplements of B complex vitamins and folic acid help (needs more data). Nutrigenomics/Nutrigenetics applications Weight Management Obesity Bone Health Heart Health Aging Related Conditions Glucose/ Protein Metabolism Insulin Sensitivity B vitamin metabolism Inflammation Cholesterol Lipid Metabolism Joint Health Eye Health Oxidative Stress Triglyceride Clearance Blood Flow Blood Pressure Alzheimer’ s Disease Skin Care Detox Physical Activity Thank you Winter Summer