Navigating Food Choices with Genes with Amanda Archibald

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Navigating Food Choices with Genes with Amanda Archibald

What can genes tell us about our personal or cultural food choices?

Ahead of her visit to Australia in May 2019 for the 7th BioCeuticals Research Symposium, Andrew talks to nutritionist and nutrigenomics expert, Amanda Archibald. Amanda is the mastermind behind The Genomic Kitchen and a founding pioneer in the field of culinary genomics.

Today Amanda shares with us an insight into her career journey and how she has become a leader in actionable education delivering nutrigenomics to everyday consumers. Amanda is passionate about using genetic information as the road map to success in medicine when it comes to applying food or supplements therapeutically.

Covered in this episode

[00:58] Introducing Amanda Archibald
[01:50] Amanda's career as an analyst
[05:06] Stepping into the world of nutrigenomics
[12:46] The Genomic Kitchen: letting food do its best job
[19:49] The cultural nuances of taste and palates
[22:50] Taking the guess-work out of dietary intervention
[29:18] Taking the guess-work out of supplementation
[32:58] Is testing essential?
[38:42] What will Amanda be sharing at the 7th BioCeuticals' Research Symposium?
[42:12] Where to find out more about The Genomic Kitchen?

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Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining us on the line today is Amanda Archibald. She's the founder of The Genomic Kitchen, a system of choosing, preparing and understanding food-based culinary genomics. A term she coined to express this revolutionary merging of genomic science, nutrigenomics, and the culinary arts. 

Widely recognised for her trail-blazing work as a culinary nutritionist and dietician, Amanda has a long-standing commitment to redefining the food, nutrition, and cooking education footprint in ways that make them understandable, meaningful, and fundamentally achievable for all. Welcome to FX Medicine, Amanda. How are you?

Amanda: I'm great. Thank you so much for having me, Andrew. It's good to be back with you.

Andrew: And I can't wait to meet you and to hear what you've got to teach us at the 2019 BioCeuticals Symposium. But I guess first can you take us a little bit through your history because you trained as an analyst, right? What's your journey to become a nutritionist from there?

Amanda: Well, you know, the journey is sort of intertwined because I was a nutritionist or a dietician before I was an analyst.

Andrew: Ahh, got you. Got you.

Amanda: Yeah. So it's a little bit of a convoluted journey but I was working in Europe. And so I was working for the United States government. And I don't want to say I tired of that. I didn't at all. But I had another opportunity to work with a U.S. company while I was living in Europe and that work basically put me in touch with... It's a British company, it's based out of London, The Intel Group, this also has a significant presence here in the United States. And that is a company that produces these essentially market intelligence reports for a wide variety of industries but, of course, my work was focused on the food industry and their clients that would be, you know, food processors, ingredient suppliers, trade groups, etc., etc. 

So working with them, you know, I became a senior research analyst and was part of the team that would together these market intelligence reports. You know, asking questions like, "Why do Americans eat what they do?" I was focused on the U.S., by the way.

Andrew: Yep. 

Amanda: But a variety of really interesting reports. Another one like meal occasions, which means breakfast, lunch, and dinner. 

Andrew: Yeah. 

Amanda: But it was, you know, highly demanding working and as they would say, you know, "There's only a specific mind that can be an analyst because we have to search through a huge amount of data to get to what's important for, you know, the marketing groups or the research groups of these companies to know, right now, what's actionable, what do they need to know, so what's relevant, and what's correct.

Andrew: This was a British-based company, I know that you were focusing on U.S. behaviours, but did they have data from the U.K.? And was it vastly different at that stage from the U.S. or was it pretty much the same?

Amanda: So it was interesting. I just worked in the U.S. market. It's an interesting question because I would always ask them, "Well, why don't we bring in perspectives from around the world." 

Andrew: Yeah. 

Amanda: Because, you know, I grew up in Europe and when you're looking at product development, I mean, there's phenomenal trends in product development that come from around the world and also in behaviours. Look at consumer electronics. It has nothing to do with food but I knew when I was working in Europe that we were doing things in consumer electronics or even in banking that we hadn't even touched on in the United States, you know. 

Andrew: Right. 

Amanda: So we were very focused...my work really was focused on the U.S. market but I was aware of trending in the U.K. in fact, fascinated by it, but it didn't come into the reports I was writing for the U.S. market. 

Andrew: Got you. 

Amanda: They're very segmented, yeah. 

Andrew: Yeah, and then, of course, genomics came along.

Amanda: Oh, it did.

Andrew: So I've got to ask you about this because you were at the sort of cutting edge of this when it first happened. And there was a lot of scepticism in the beginning. What made you realise, "Ooh, this could be interesting?"

Amanda: So I'll take it back...because your listeners may wonder, "Well, how did you get from being in nutrition into being an analyst? How did you get out of that and get into this?" 

Andrew: Yeah. 

Amanda: So, you know, I mean, I was trained in nutrition science. I was trained as a dietician. And after many years of being in the analyst world and working overseas, I said, "Wait, you know, I'm trained as a dietician. How do I hone my talents that I have there and kind of get back into the field, if you will?" And the space for me has always...because growing up in Europe I was lucky, my dad gardened, that was his hobby, his passion. And then when my parents divorced, my stepfather was in the wine business in France. 

Andrew: Right. 

Amanda: Hey, you know, gardening and wine. So I grew up with a huge...I know it doesn't get any better. I grew up with a great appreciation for food. You know, food was a very important part of my life and my parents made sure we understood that. I grew up in an era when our parents cooked. Imagine that, you know? And so food throughout my journey has been very, very important.

So I stepped back from analysis back into the nutrition field and I founded a company called Field to Plate. And my focus then was really to develop tools and educational platforms for, you know, doctors and principally dieticians that could really help them connect nutrition science to the plate. Because most people get locked into no man's land. And as I say, I was trained to be an expert in the interpretation of clinical nutrition science but what was lost was the food part. Which was so much a part of, literally, my DNA, you know? Not just as a...you know, a pun, but it was so important to me. I couldn't understand through my education here in the U.S. why we weren't jumping up and down and excited about food. And, you know, that never quite resonated at university but it never was lost on me with my European background.

Andrew: Yeah. 

Amanda: So when I stepped back into nutrition science and nutrition education, my work was always culinary. And I created these very interesting educational platforms, which actually took me... they were culinary food-tasting based, and they took me to South Africa. 

And in South Africa, I met a leading researcher in nutrigenomics and she saw my work. And I just did mapping work. So my mapping work to explain these difficult scientific processes so they'd become visual instead of, like, lists, you know, that, right? You know, we do a lot of lists in medicine. 

Andrew: Yep. 

Amanda: And it's hard for the consumer. It really is. And anyway, with her expertise in nutrigenomics she said, "Oh, my gosh, you know, we're in this cutting edge field. And how you think and what you're doing is critical to how we translate nutrigenomics." So I sort of said, "Hey, let me understand what's going on in nutrigenomics." And I was always a biochemistry geek so this was fantastic. 

Andrew: Right. 

Amanda: I could finally apply what I actually learned in biochemistry because it always made sense to me. 

And so this was what? 4 years ago, really, 4 years ago when this started to blossom, maybe longer than 4 years. And, you know, that immediately catapulted me back deeply into science right at the edge of genomics. And, you know, I said, "Oh, well I'm back in the field of biochemistry. I understand how that works with our genes. How are we going to do the culinary part?” 

Because a genomic report, genomic information is no good if you can't translate it to the plate, you know, we're in that same space of leaving people in the no man's land, except genomics is far more complex, but far more rewarding. So you know, that was really my journey. You know, I was at the right place, right time, wanted to do the translation piece. And so that's where culinary genomics came from. Culinary translation of genomic or nutrigenomic information.

Andrew: I like the way that, you know, you twigged to that because, like, biochemistry's been one of my geeky things ever since I saw the Boehringer Biochemical Pathways Wall Charts.

Amanda: Yep. 

Andrew: And, you know, which I still have. And now, it's LaRoche. You can see them online. And for our FX Medicine listeners, we'll put those up on the FX Medicine website for you to access

But I used to see these pathways. And you just see it as a given. That line goes to that, via that enzyme. That works always. That's what it is, black and white. But it's not so. And the genomic aspects and how foods interact with it explains why sometimes it doesn't work and some people get more benefit from our food and things like that. 

Amanda: Exactly. 

Andrew: So what was it that sort of made the jump between the black and white book, you know, Lehninger, or whatever it was, in biochemistry to, "I can do work here. I can use this to help my patients?"

Amanda: So, you know, genomics, I mean, that's a long journey, right? Biochemistry isn't easy. And for some people, they get it and other people never will, right? 

So, yeah, you have to, as I explain to clinicians, you have to really want to, first of all, want to learn this. Secondly, give yourself a break because it isn't easy. But I think what genomics does in biochemistry, it allows us all to learn it in action. So I don't know about when you were in school but biochemistry was, like, the one course everyone ran from as fast as they could. I think it's because you were learning these cycles, that they were, like, two-dimensional, right? It's, like, this leads to this and this leads to this and, you know, molecularly, this is how this molecule changes, you know. This is what a methyl group looks like. But you never were able to apply it because we didn't have genomics. 

Well, genomics makes biochemistry come alive because you see how SNPs impact the way a cycle operates and you see what the outcome is when a certain cycle doesn't work. 

Andrew: Yep. 

Amanda: But that to me was absolutely fascinating. And then when you add the food piece, which is how the body works, it's, like, the light bulbs come on. But, you know, when I'm teaching biochemistry and I'm not an advanced biochemist by any means. You know, biochemistry is not my major. But as a nutrition major, you know, many, many years ago, you know, nutrition is biochemistry.

Andrew: Yes, yeah. 

Amanda: So it's very interesting to pick up biochemistry and teach it to fellow clinicians and see the light bulbs go on. Because they're now learning it three-dimensionally. 

Andrew: Yeah. 

Amanda: It's not just molecules like organic chemistry and, "This is how this cycle," as I say it, "how this cycle turns, and this is how they all interact. And this is the role of food to drive those cycles." So it's… genomics just allows things, I believe, to become three-dimensional, if that makes any sense.

Andrew: Yeah. Yeah, I like that. The thing that turned it on for me was having patients and that I could attribute an aberrant biochemistry or something going wrong and I could attribute that to that face, that person, and help that person. That was the thing to me. 

Amanda: Exactly.

Andrew: Let's delve further though into The Genomic Kitchen. Because this is where you take food groups and then you apply it to a person, not a population. Correct?

Amanda: I can do both. 

Andrew: Right. 

Amanda: That's the beauty of it. We can do both. I can speak out of both sides of my mouth, if you will. 

So the reason I created The Genomic Kitchen, there were two reasons. Well, there's probably more than two. So we have two different populations. Obviously, you know, I'm working still at a professional level teaching clinicians about the fundamentals of nutrigenomics. I'm not offering an advanced certification course, you know, BioCeuticals does that, right

So what I do for so, so many clinicians, people who are sort of looking and saying, "I should know something about nutrigenomics, right? It's the future of medicine but I don't know where to start." I offer them the gateway to understanding the very basics of nutrigenomics and how you can apply it if you don't have genomic information, which I think's really important.

So, you know, I took my biochemistry and this field of nutrigenomics and said, "What is it that we can apply, if you will, at a public health level?" Which I think's important because we have to address the public health level because most people right now are not going to access a genomic test. They're just not. You know, especially with insurance here in the United States, we're a ways away from that. 

Andrew: Yep. 

Amanda: But what I felt was important was that, you know, we basically all have the same genes. It's the SNPs that differentiate us. 

Andrew: Yep, yep. 

Amanda: But food works the same way for all of us. It's how much of the food and whether you need supplementation is what the difference is. 

So why not, when I'm working with clinicians and the public too, show them there's a way they can take advantage of food? We just reorganised the toolbox a little bit differently. Which is what I did, I created a culinary toolbox or an ingredient toolbox where the ingredients are specifically chosen for how they work with our biochemistry.

So I teach that to clinicians. So it's entry-level for clinicians, doctors, chefs, okay, and chefs as well. They learn a little bit differently, and I think that you and I talked about at that one point in time. 

But I also, for the public, you know, I created a long course then but we just shortened it so they too can say, "You know, how can I take advantage of this for the personalised medicine era? I'm not quite ready to do a genomic test yet, or maybe the one I've got isn't broad enough, but can I start to create a grocery list and can I start to cook with foods that talks to my genes?" 

Andrew: Yeah. 

Amanda: And that's what I did with The Genomic Kitchen. So a long-winded answer but at the individualised level, certainly I'm trained to interpret genomic tests and SNPs. And we're going to be bringing that in as a company probably a little late this year, hopefully.

Andrew: How exciting.

Amanda: Yes, very exciting but you can only do one thing at once. So you attack the public health from the entry-level education stuff. 

Andrew: Yeah. 

Amanda: And then once you've got all of that automated and sorted out, you can then focus on how can I service the individual patient and how am I going to do that and with what themes. That's where we're at.

Andrew: So when you're talking about different food groups and the preparation that is more specific for that person, what about the dose? You know, I mean, the portion size is one of the biggest issues in our convenient society, how much we eat. I guess you've also got the poor foods. So I guess that's where the choice of foods would be really important but what about the dose? Does choosing the foods help you also to modulate how much we eat or is that a separate thing that you need to attack?

Amanda: Well, it's both ends and it's a great point. And, you know, of course, I'm working here from the United States. And what I've maintained for so, so many years and it's probably the same in Australia, is a lot of what we have to do in nutrition and health education is help people understand their innate palate. We really have to bring them back to understanding what great food tastes like. Because once you understand great food, we can look at it hormonally or genomically or genetically, right? But once you've reset the palate, people I've found will gravitate to choosing great food. And then you can get away from the excesses of eating the wrong food. 

Andrew: Right. 

Amanda: So we know, and, you know, you know through your training, oh my gosh, we could spend hours talking about this, that so many people through the wrong food choices have set off, like, hormonal fireworks almost, where they can't control their appetite.

Andrew: Right. 

Amanda: Or they're overeating from emotion and stress. So we can use genomics to kind of reset that, but we could also use food, introduce them to great-tasting food, to also reset their palate. So we're working physiologically but also kind of emotionally as well.

Andrew: Is that a long-term thing though? Like, do you find that it takes quite a few months to reset the palate or can you do it quite quickly?

Amanda: No, resetting, I think it takes a long time. And, you know, one of the things that I've really appreciated so much in this work and, again, I can only speak from the U.S. perspective. Is we have a population in distress. 

Andrew: Oh yeah. 

Amanda: And I don't know what the percentages are but probably in your practice, you're seeing a lot of people they may manifest with diabetes, heart disease, you know, weight issues, but the underlying issues are emotional, right?

Andrew: Yep. 

Amanda: And they're stress-driven. And our intake forms point that out. So yes, that probably speaks to genetic markers there.

But until we undo and sort out the emotional issues, food is a part of that but the mental health issues, emotional issues, are underlying so much stress that we're seeing, which is undermining our genes and our responses, hormonal responses, underlying the gut, right? So that once we're working with dysbiosis that fires off, you know, from the gut completely different signals that impact that leptin-ghrelin axis. 

So it's almost like we have to look at where do we start? What do we have to undo first so that we can let food do its best job? 

Andrew: Yep. 

Amanda: You probably agree with this from your clinical medicine training. So food is extremely important. It's the principal information source but we cannot, cannot, avoid the isolation, depression, stress, emotional issues that, at least here in the United States, are pervasive and invasive.

Andrew: And I guess that ties right back to genomics. You know, when you think about, you know, the poster child of genomics, which would be your methylation cycle. And there you've got the anxieties, stress, depression, all of these other mood-altering or mood alternations and then you can address it with foods. 

One of my questions is you've got quite a different palate in the U.S. compared to an Australian type palate. 

Amanda: Yes, yes. 

Andrew: And we are a lot more salty. Now, that's a vast generalisation. But, you know, here's the very simplistic one of that. Peanut butter and jelly versus Vegemite, right? An American can't stand Vegemite.

Amanda: No and I can't stand peanut butter. It's just like the most revolting thing that I can think of. 

Andrew: Right. 

Amanda: And, again, it's cultural, right? 

Andrew: Yeah. 

Amanda: But I think when I first started hiking here, you take peanut butter or banana and peanut sandwiches, I'm like, no we don't. We do not take that. Where's the Marmite or where's the Vegemite? Because, yeah, growing up in the U.K. even though we're… 

Andrew: You had Marmite.

Amanda: We had Marmite, yeah. So I grew up with a savory palate too.

Andrew: Right, right. 

Amanda: And to this day you will not convince me to eat most of the sweet... I won't eat candy in the U.S. You know, growing up in Europe, we had great, great chocolate, you know? Especially growing up in the U.K., those companies are all gone now but, you know, outside of the U.K. and Central Europe, you know, if you're going to eat sweet food it's tiny bites and it tends towards more tart, you know. 

Andrew: Right. 

Amanda: So I don't have an issue with sweet in the United States but the American palate is sweeter, like you said. And I think it's going to change. But it is sweeter.

Andrew: Ah, you said it's going to change?

Amanda: Yep. Yes, well, that's a huge statement from Amanda Archibald. But I really think... You know, that's extremely political and that, you know, with our subsidised crops, you know, we have grains and sugar in so many products. But I think the consumer here is getting smarter.

Andrew: Okay. 

Amanda: They're starting to see, connect the dots. We have a long, long, long way to go. But I think genomics is super cool in that, you know, you can look at SNPs, you can look at the taste SNPs, you know, the TAS2R family, to see why people may be predisposed to eating sweeter foods. 

Once they see that and once they can see that, you know, some of the SNPs can predispose them to, you know, storing more fat more readily, if you will. Or harvesting calories more readily. That is, like, staring... You can't deny your genes. And so genomics is so powerful in helping people understand where their health is, why they may be prone to putting on weight or whatever. Why their kids like sweet food over savory, and what we can do about it, which is where the kitchen comes in. That's why it's so powerful.

Andrew: You mentioned before about you can work on a personal level or a population level. We've got the Mediterranean Diet, you've got the DASH Two. So Mediterranean is a cultural diet. DASH Two is, you know, a vegetarian-based therapeutic diet for conditions. And then you've got the new kids on the block, the Keto diet, the Paleo diet. Are we talking... Like, their population-type things I guess. Keto's more personalised but where does your sort of Genomic Kitchen come in? How does it differ and how does it compare?

Amanda: Well, I think the comparison I'd say with Keto and Paleo is that both of those approaches really focus on whole food. I mean, how those foods are arranged is different, right?

Andrew: Right, right. 

Amanda: But where genomics is so powerful, so we'll look at individualised genomics, and I think I just blogged on this; Why the Keto diet isn't for everyone, is for some of us, that approach is a disaster for our genes. And I think there's a lot of people out there that are just guessing, right? 

Andrew: Yeah. 

Amanda: They're doing great. You can do two people who have no idea what their biomarkers are who both can drop weight like a rock because they're eating whole foods again. If we organise the calories and we distribute it into the fat and protein, okay, fine. But, you know, we know, and I would be one of them if I were to do that, yip, my lipid panel would be pretty sad. 

So that's what I think. You know, a lot of these "approaches" are done blindly. And genomics helps remove the blinders to say, "You know what? There are other ways that we can optimise how food works in your body and Keto or some modifications, it would be great." But yes, 70% and 60% fat, not for you, or we need to manipulate the fats and even that. So there's a lot of blind trust I think.

Andrew: Yeah. I've got to wonder how many people out there say they're going to attempt Keto and then all they do is have bad fats. So it's, like, "Ahh."

Amanda: Yeah, we don't know. Or is it just, you know, I mean, again, I think it may be a process along a continuum for some people that if they move from processed foods or as Michael Pollan says, "food-like substances…" 

Andrew: Yeah. 

Amanda: You know, that are bought but just not recognised, into food that our body may recognise like a plant or something that had a face, I think that's Michael Pollan as well. 

Andrew: Yeah. 

Amanda: You know, it's made a step. The next step would be, you know, the biohackers and health optimisers is like, look, up until this point, you've lost weight, you feel better, you're at the gym, you know, you're lifting your weights and doing your Tough Mudder's or whatever, you know, these crazy races. But let's take a look inside because you're getting away with it. You look great and you feel great but your inner biochemistry is what we're most interested in.

Andrew: And can you find then that somebody who might look great, feel great, you tweak their biochemistry using nutrigenomics and then they raise to another level? Is that what you find?

Amanda: Yeah, exactly. Or, you know, like I said, this is you. These are your genes. And while you look great, how long is that going to last?

Andrew: Right. 

Amanda: You know, when your triglycerides go through the roof or what have you? So I think we're only just learning. We're in the early stages of learning that. S, you know, each person is an individual but, you know, a lot of what I'm doing... But that's at an individual level but at a population-based level, instead of telling people, "Just eat your fruits and veggies and, you know, choose the low glycemic ones." Now we can take people and say, "When you're in the produce department, we want you to gear towards these specific vegetables because they contain bioactives that work with key genes. And here's how those genes work. And here's how this food works. And here's what you do in the kitchen." That is extremely powerful for everyone.

Andrew: Yeah. 

Amanda: Whether you know your genomic information or not. Because food, it all works the same way. For some people, we need to tweak because we know. So oftentimes, we supplement.

Andrew: To me, it's sort of heading back to where we need to. So often there was a look at, you know, we've said it before, the biochemistry if you like, or even when you're talking about a, not a food group but a food biomarker. Allicin from garlic, for instance, indoles from Brassica vegetables, that sort of thing. Even flavones or various flavonoids or flavols, you know, the rutin and the quercitin, and all of these things. And then we'd say, "Oh, yes, but that's a supplement." What you're doing is you're saying, "Yes, yes, yes. Hang on. These are the foods that contain these."

Amanda: Yes. I mean, there are foundational foods... This is where the Mediterranean is so interesting. There are foundational foods that we know contain a bioactive that basically activates transcription factors that initiate gene transcription.

Andrew: Yep. 

Amanda: Right? If we look at the fundamentals of functional medicine, they are, you know, mitigate oxidative stress, inflammation, support biotransformation, support the gut, right? There are other pillars. So, this applies to everyone, whether they're sitting in front of us or not. And these are terms we've not talked to the public about. At least, those of us who are trained clinically, we still do talk to people. Half the clinical population is in denial, that detoxification is actually a process, I think sometimes. So, you know, we're too busy, you know, managing a ‘system’ or we're managing a part of the body as I’d say. So… instead of managing the body as a system. 

Andrew: Yeah. 

Amanda: So if we go back to the tenants of functional medicine, explain to the public, "Look. It's not about your heart. We don't eat foods that are just just for your heart, because it works everywhere in the body." We have to change the food conversation so the public understands how food functions in the body, which food we're talking about, how it impacts the body, and then importantly, how to prepare it so you get the best impact from that food each time you eat it. That's what I'm working on.

Andrew: So obviously whole foods should always be the basis of any nutritional prescription, dare I say that word. But then you get practitioners that will very often use functional foods, certainly for sick people who might have digestion issues, might have chronic fatigue, whatever. And then there's supplements, these isolated chemicals.

Amanda: Right. 

Andrew: Which, you know, we might want to use to bolster up one area.

Amanda: Sure. 

Andrew: The classic example here is added folic acid during fertility management and pregnancy and iodine for anybody who is pregnant. What are the benefits, what are the differences, and, indeed, what about any pitfalls with any of these like functional foods and supplements?

Amanda: Yeah. So I can really speak more clearly to supplements, that would be where my knowledge base would be more to whole foods and supplements. 

So, you know, I'm an absolute avid believer, as I think any of us who work in clinical nutrition or medicine is, that we need to measure it before we intervene, right? 

Andrew: Yep, yep. 

Amanda: I don't know about Australia but in the United States, you know, the supplement industry is doing real well and we have a lot of people who think they need to supplement with Vitamin D or whatever the supplement of the day is. You know, it's the same when we're looking at Keto. Is Keto right for me? Well, you may feel good and look good but the reality is that biomarkers or lab data will tell you where you are on the continuum. 

And so for me, supplementation really should be taken in conjunction with a baseline lab to indicate whether you do need to supplement and whether you respond to the recommended dose or whether you need more. And I think Vitamin D is a perfect example of that.

Andrew: Great idea.

Amanda: Same with so many supplements, right? We, people can blindly take them because they've read about it. I mean I’m sitting on watching all kinds of people say in a Health Coach Network, "Hey, I have a patient with this. What do you recommend?" I always want to go in and say, "Well, get a measurement before you recommend anything. You don't know what you're doing. You're working blind." 

Andrew: Yeah, yeah. 

Amanda: And it's a waste of money for the consumer to pick supplements without knowing what their baselines are or what the impact of that supplement is. So, you know, I think we're almost choosing supplements pharmacologically and not knowing we are without working with an expert who can evaluate and intervene and support. So I'm all about the supplements.

Andrew: A wise professor here once said, "If I can't change it, I won't treat it." And it sounded a little bit off-ish, a little bit arrogant, if you like, at the time. But I think I get what he meant. And that is, "If I can't make sure that I'm benefitting that patient, why am I putting a treatment into place?" And I wholeheartedly get that that's what you're saying, you know, about if you can't give a valid reason why you're doing something, why are you doing it?

Amanda: Yeah and a valid reason will come from, you know, the assessment, validation, you know, baseline biomarkers, baseline, you know, lab information, intervene, re-evaluate. I mean, that's how we're taught. 

So I think there's a lot of recommendations and I don't completely disagree with, you know, take a multi-vitamin supplement as "an insurance policy" but in some ways for some people when economics are at play, even that's too much, right? You know, that's a lot of money for a really good supplement flying blind...

Andrew: When you could add it to your, let's say your organic budget. You know, you could divert that money to your organic food and get a much better bang for buck, particularly if you combined it with a genomic test. I guess this is where my next question's going to head. And that is, do you first always do a genomic test to apply these principles? Do you combine them with labs? And, indeed, now that you've got experience with this, do you go, "Oh, I know this lab's going to change in you because you've got this sort of SNP?"

Amanda: No, we can't always guess that, you know, because the body is so dynamic, right? I mean, I can use my own example of how you can't guess. You know, my genomics, you know, you've got to walk the walk to talk the talk. My genomics, you know, SNPs throughout my Vitamin D, you know, pathway including the receptor... I forgot to go into Vitamin A, but let's not mess up the biochemistry here, but, you know, we'll keep it safe. 

You know, everything from my oestrogen metabolism, to my Vitamin D pathway, to collagen SNP... I can't remember what the SNP was, suggest that, “Ooh, you have a problem not only building bone matrix but you probably have high turnover,” so but that doesn't look too great, right? 

Andrew: Right. 

Amanda: So I run and I get my DEXA, my bone mineral density scan, and it came back awful. I mean, I'm like, "Oh, my gosh." 

Andrew: Right. 

Amanda: My OB-GYN said, "Oh, Amanda." I said, "You're not supposed to tell me it's bad." I'm like, "Oh, yeah. That's horrible."

Amanda: So fortunately at this time, I lived in Denver. And I went to see an excellent physician who worked in bone metabolism. He was, you know, a lead researcher. And he said, "I'm going to wring your bones inside and out." So he ordered labs I'd never even heard of, you know? Some of these biomarkers… but they came back optimal. 

Andrew: Right. 

Amanda: So I have no high bone turnover at all, but if I didn't have genomics and I had that DEXA scan, guess what? I would be on Fosamax or something. 

Andrew: Got you. 

Amanda: You know, I would be a lead candidate. And then we also, because he measured my 1,25-hyroxy and it came back optimal. So even though I have these SNPs, if I didn't do the extra steps, so that the genomics provided the signpost to get the lab, you know, to get the evaluation, to get the lab, to put it all together to say, "You're fine," you know. So I could have been taking high doses of Vitamin D. My mother did that all her life with osteoporosis. It didn't make any difference.

And so… but other areas that, you know, in my case, my report suggested, hey, you do need to take DIM, you need ubiquinol. 

Andrew: Yep. 

Amanda: You know, you do not convert to the active form of CoQ10. So, you know, I think what genomics does is it's a signpost to evaluate and it tells us how to intervene. And I think in terms of saving money on the right supplements, it tells you exactly where to go. 

Andrew: Yeah. 

Amanda: And I love that.

Andrew: That's a very smart thing. I can see that as almost like a lab. You know, like, what we'd normally consider to be a laboratory assessment, you're using these, the genomic SNPs, to say, "Well, you've got a deficiency in converting that to this. So this is where your, yeah, shortfall is." I love it.

Amanda: Yeah. And, you know, you intervene with...you try to intervene with food first, obviously.

Andrew: Yeah, always.

Amanda: So really we need to say, "Biomarker, food-focused," unless it's extenuating circumstances where... like with the ubiquinol, for example, we know you're not going to convert ubiquinone to ubiquinol. So then we supplement, given your risk, in this case, we look at oestrogen metabolism. So, yes, food first, re-evaluate, if not responding, supplement, re-evaluate. And that way, I think we help the consumer spend their money wisely on food and on the appropriate high-quality supplements at the dose that works for them instead of guessing. And there's so much guesswork going on. 

Andrew: Yes, yes. 

Amanda: There's so much. I can't imagine how you could recommend supplements to someone without evaluating pre and post.

Andrew: Yeah but I also like what this is saying. This is saying, "It's more than just a supplement." It's saying, "Even down to which form," why you might have, as you said, a seeming deficiency on one hand but your actual tissues were optimal when you looked further. 

Amanda: Yep. 

Andrew: Conversely, you know, blindly giving one form of a supplement, CoQ10 let's say, when you really require the activated form. 

Amanda: Exactly. 

Andrew: That sort of, you know, knife edge thing. It's really good.

Amanda: Well, I mean, it's critical because if you think about that, you're leaving somebody kind of out in the wild. 

Andrew: Yeah. 

Amanda: You know, you are not supporting their biochemistry and their SNPs will tell you that. And so as I've been trained, you know, the genomic information is one tool, an important one in the clinical toolbox, but it doesn't... I think it sits right there with the intake, you know, that helps you really evaluate... What's the risk if somebody has a number of SNPs in their detoxification pathway, you know, if they've worked all their life in a coal mine?

Andrew: Yeah, no good.

Amanda: We need to intervene fast, not so great, you know, or they've been exposed to whatever. Worked in a nail salon for goodness sakes, versus somebody who may have SNPs but, you know, they've worked out in a beautiful environment not exposed to any pesticides or what have you. 

So the intake form I think is just critical to guiding the prioritisation as well, because it costs time and money. Food can't fix it all.

Andrew: So you teach, you know, as you said, practitioners right down to chefs how to modulate food to give the best benefit and how to work it in. What will you be taking practitioners through at the 2019 BioCeuticals Symposium? What will you be giving them, what tools will you be giving them so that they can go, "Ah. This is change. This is how I, you know, can use this," I guess without giving too much away? You need to attend the symposium.

Amanda: Yeah, yeah, yeah. Let me find it. What am I teaching? Let me go find it. You work as hard. We're teaching a lot. So I think we're teaching a couple plenary sessions. The first one has actually got nothing to do with my area, which is culinary genomics. And it's looking at... And it's called "Navigating the Blue Zones in the Age of Genomics." 

Andrew: Yeah. 

Amanda: And that was sort of looking at longevity and genome-wide area studies and what do we know about... If we could roll it all up, what are the principal SNPs? And how do we cross-map genomics to the observations from the blue zones? And so, you know, parts of blue zones, of course, is one of the...I don't want to say it’s hallmarks of longevity research, but he garnered a lot of attention...

Andrew: I love it.

Amanda: ...and got us all fascinated, right? 

Andrew: Yeah. 

Amanda: So I went in and looked at genome-wide area studies. And then I started to say, "Okay. Let's dig a little deeper here. Let's look at what the folks in Sardinia and Icaria are eating.”

Andrew: Right. 

Amanda: You know, based on what [inaudible] that they're eating, based on, you know, what is reported from science. And when you put that together, and this is fascinating, I wish I had a half a day to talk about it, not 75 minutes. 

When you put it together, you start to realise that the fundamentals of what they're eating, the components and the ingredients that they're eating, are speaking to their genes. 

Andrew: Yeah. 

Amanda: So to me it's like, "Ah-ha.” You know, chrysin, so, honey is used across the Mediterranean as a sweetener. It contains chrysin and chrysin can activate the Nrf2 or the NRF2 pathway. Hello? We just turned on, you know, the most potent source of antioxidants we could. So we're teaching that.

And then I'll be teaching about culinary genomics. What is it? Where did it come from? Where does culinary genomics look like in the kitchen? You know, what are the definitions? What does the toolbox look like? Why was the tool box put together? And how do these ingredients work?

Andrew: And then you'll be doing some workshops.

Amanda: Yes. I am doing a case study. So I'll actually...you know, presenting a soup-to-nuts case study. So more because of my work and I'm going to spend just as much on the clinical side it's okay. We're all smart here at this conference. We sort of get the clinical side. What are you going to do with the clinical information in the kitchen? How do you walk that into the kitchen? So here's the ingredients. Here's the nutrient focus. Here's the ingredients that are going to deliver that nutrient focus. How can you ensure those nutrients will be delivered to the gut? What's the culinary considerations? And what's going to be sort of culinary techniques we can look at for receipe organisation that you can grab at and get your individuals’ working with right away? 

So I’ll be teaching about some of the concepts of how we can do that. Or how, if we're busy as doctors, etc., how we can have our support staff, so our health coaches or what have you, help do the coaching, you know, what that looks like.

Andrew: And The Genomic Kitchen, I've got to raise this for those listeners that might not be in Australia, might not be able to attend the BioCeutical Symposium and, of course, our international listeners. The Genomic Kitchen, how can they get further information about it and do they enroll? Is it a course that they have to be there, or can they do it online?

Amanda: Yeah. I work mainly online. There are more workshops in the U.S. right now where you can experience The Genomic Kitchen either as an individual or as a, you know, a professional. 

So if you go to the genomickitchen.com and look under courses, you'll see it divided into health professionals and individuals. And you can see what we're doing there.

But, again, for clinicians I think this is a point to emphasise is, you know, I'm not a certification advanced biochemistry company. My focus is really to help clinicians who are interested in this area, or have some knowledge, kind of step into the kitchen. You know, we go from the biochemistry into what are the foods that deliver that biochemistry, or support that biochemistry and what do you do with them in the kitchen? 

So it's a good, you know, baseline course… Or even for people who have had advanced training, we still need to know what do you do with this in the kitchen? What's a toolbox I can talk to my patients about?

Andrew: Yeah, absolutely. I mean, it's crucial.

Amanda: So that's what's we're doing.

Andrew: As you say, it's crucial from an economic point of view. Because you really have to, you know, be wise to look after the, you know, the dollar, the budget, of the patient without getting too personal into their monetary situation. But you really have to be responsible about, you know, what bang for buck you're giving. And I think what you're doing is you're really targeting it in, I mean, right down to the genes. So it's awesome stuff. It's brilliant.

Amanda: Yep, it's exciting. I can't imagine doing it any other way anymore. We have that information. So whether you have a genomic test or whether you want to know how genes work, we can kind of plug both ends of the market, if you will. 

Andrew: Yep. 

Amanda: And hopefully, in the end, genomic testing will be part of being a human. It will be a right, you know.

Andrew: Yeah, that's right.

Amanda: Because it sure would save a lot of dollars, right?

Andrew: Well, that's exactly right.

Amanda: A lot of dollars.

Andrew: Amanda, I for one, I just can't wait to meet you and to hear what you're going to impart to all of us at the Symposium because what you're doing, like, this is cutting edge. It's brilliant.

Amanda: Thank you. It's exciting.

Andrew: Yeah, very exciting.

Amanda: It's exciting out there.

Andrew: Thank you so much for taking us through that today. One last quick question. So do you always do a genomic test before you apply the principals of nutrigenomics?

Amanda: So much of my work, Andrew, is really focused on the public health arena. It's focused on broad-based education. 

Andrew: Yep. 

Amanda: However, when I'm working with individuals, I can't see any point in seeing an individual without genomic information, I mean that's what we do. 

Andrew: Yeah. 

Amanda: So, you know, there are so many other clinicians out there who are practising without genomic information. So, you know, the public has a lot of opportunity. So for us and many of the practitioners now, that's part of the entry to working with us. Because otherwise, you know, I think we're seeing blind.

Andrew: Yeah, that's right.

Amanda: So I would not see an individual one-on-one without some form of a genomic test. So which one we choose, of course, depends on whether they have an active diagnosis or whether they're really just saying, "Hey, I'm just interested," and then we can choose a different path.

Andrew: Yeah. Amanda, seriously, thank you so much for taking us through this. Like, there's a lot more to learn. I get it. So, you know, if you can attend the Symposium, please do, but certainly, look up The Genomic Kitchen and get wise about this because this is where we're sort of heading with personalised medicine. And it's really going to be the lynchpin I think with patients' treatment plans, to make sure they get the most out of, you know, the food that they eat. 

Amanda: Exactly. 

Andrew: So, brilliant stuff. Thank you so much for joining us on FX Medicine.

Amanda: Thank you. Thanks, Andrew.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.



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FX Medicine Podcast
FX Medicine is at the forefront of ensuring functional and integrative medicine gains the recognition it deserves and ultimately establishes itself as an integral part of standard medical practice. Hosted by Andrew Whitfield-Cook, our podcasts are designed to promote research and evidence-based therapeutic practises, acting as a progressive force for change and improvement in patient health and wellbeing.