In this interview Dr. Valentini Konstantinidou, an expert in nutritional genomics talk to us very honestly about what nutrigenetics can and cannot do nowadays. Valentini, from Greece, after a long career investigating the interactions between genes and nutrients, is currently working on her business project – DNAnutricoach – with which she aims to bring the benefits of nutrigenetics closer to society

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Photos by Miquel Ràmia

Hi Valentini, I know that you have a long research career in nutrigenetics and nutrigenomics. How did you approach these topics?
I began to study nutrition as a biomedical tool to prevent diseases, focussing on the benefits of extra virgin olive oil and the Mediterranean diet in 2001 when I first visited Barcelona. That moment coincided with the first decoding of the human genome (Human Genome Project) – too early to incorporate genetic data into our studies. Only later, during my doctoral thesis, I began to study the changes in the expression of our genes after consuming the Mediterranean diet and extra virgin oil for a long period, and it was a surprise to discover how much nutrition influences our genes (nutrigenomics). During my last postdoctoral studies, in the group of Professor José María Ordovás (IMDEA, Madrid), I explored more in deep the concept of nutrigenetics – the study of variations in the genome that can explain the different response of each person to food.
And how did you end up creating your own company, DNAnutricoach?
I always had a concern about the impact of scientific results on society. In my opinion, the results in nutrigenetics and nutrigenomics should influence people and help them in making decisions. I also had the urgency to tell the truth about nutritional genomics to avoid the false expectations of the public. DNAnutricoach is born like this and now it is a Spanish trademark: our team works hard to allow each person to have a realistic nutrigenomic knowledge. Scientific advances, especially in biomedicine, come often with exaggerated promises – for example, that they will heal everything or that a person can lose weight out of the blue – and maybe they are creating a myth that could be even more harmful. Nutrigenetics and nutrigenomics have great potential: we should carefully apply what we know so far, making it clear that we can not give precise information in 100% of cases.
What kind of false expectations does the public have? What cannot nutrigenetics do today?
The public usually expects quick, easy, and miraculous solutions. For example, in the case of obesity, the public often blames the genes and hopes that a nutrigenetic analysis will allow a fast loss of all the excess weight. This is not possible for many reasons. In addition, we are not yet able to customize nutritional recommendations too precisely, for example specifying the quantity in grams or exact nutrients. The studies in nutrigenetics are very expensive, not only because they need high budgets but because they require a lot of time: they need to follow a large number of individuals for a long period in order to reach statistical significance. Also, verification and replication of results are required. In addition, there are many environmental factors that are difficult to control – even so there are some promising results valid for smaller groups, for example as in the case of the Spanish study PREDIMED with around 7000 people involved.
So what can nutrigenetics help us with? Can you explain us some real cases?
Many cases are people who do not want to lose weight and are often healthy; they simply care about their health and well-being. For example, a nutrigenetic analysis can help people who train for marathons and who are used to permanent pain and fairly high levels of inflammation. To solve such pain and inflammation in the tendons and / or soft tissues, an absolute rest is generally recommended, which is not always followed. In some cases, and that depends on some variations in specific genes (SNPs), a diet can help the recovery, for example eating more cruciferous vegetables or more omega-3 (caution that these are examples). In some cases, we succeeded removing the pain and the inflammation within a couple of months without the person even stopping the training. This was already done through empirical knowledge: a precise personal history helps a nutritionist to suggest changes in the diet, then he/she need to observe how the body reacts to these changes to ensure and / or modify the recommendations. Nutrigenetics is a tool that adds more information – for example predispositions – and allows to give a complete picture avoiding the “test” phase.
This is why at DNAnutricoach we do not offer only a nutrigenetic analysis because an analysis alone doesn’t provide much help. Only coaching allows to take into account all the variables of a person and find the appropriate habit for his/her well-being. In addition, a person needs some help to correctly apply the recommended changes, which sometimes are very demanding, and to correctly interpret the results. For example, there are people who are convinced that they are obese because they have a genetic predisposition, and that takes away their motivation to lose weight. A nutrigenetic analysis that discards this predisposition becomes a strong incentive that allows real changes in their lifestyle. With coaching, we help and follow the person to transform a simple knowledge into an habit.
And what do you think there will be in the future of nutrigenetics?
I do not believe that we will reach the point to ensure 100% accurate and safe personalization advice with nutrigenetics only, because there are many variables in play. Our health is a complex puzzle of many factors – among them nutrition and genetics. But there are also the neurological and psychological mechanisms, environmental variables, the personal microbiome and many other factors that we are still discovering. Only the synergy between nutrigenetics and other information will help us to understand this puzzle and to be more precise in the prevention of diseases.
What would you like to know by sequencing and interpreting your DNA?
Well, I already have a real example – because thanks to my work I have been able to do my own sequencing. This had a strong impact on my life: it helped me quit smoking. I always said that I would do it sometime in the future, but the information hidden in my genes made me change my perspective and take action immediately. It is not easy to leave these habits, much less if they are habits of many years, but the motivation was so strong that didn’t want to become a smoker again. I highly recommend this type of analysis because our DNA carries a wealth of knowledge about us that is priceless. Although we still can not completely decipher all that information, our DNA is not going to change and in the future we can add more and more interpretations of  the genetic data.