Translator: Talita Mahfuz Adamo Reviewer: Tanya Cushman
Imagine a world where you're not obsessively counting calories.
Imagine a world where you're not caught between bingeing on the couch
and spending hours at the gym.
Imagine a world where you're not jumping
from shame to punishment with food.
I can show you how.
That's the promise of nutrigenomics,
which is basically
the way that your innermost self, your DNA, talks to your food.
[Love] [Hate]
It's also a way to move beyond a love-hate relationship with food.
Twenty years ago, I had a love-hate relationship with food.
So I lived a little south of here.
I was at the University of California, San Francisco.
I was an intern, 27 years young.
After a 36-hour shift, I'd come home,
open the freezer
and get a pint of ice cream out of the freezer.
Can anyone relate to this?
(Laughter)
So that pint of ice cream,
sometimes it would be Häagen-Dazs coffee flavored,
other times it would be Ben & Jerry's Super Fudge Chunk.
And I would sit in front of the television,
pint in one hand, spoon in the other.
I'd taste a few bites,
and then I'd space out watching TV
and find myself scraping the bottom of the pint.
That was a lot of calories.
Let's just say that wasn't the best nutrigenomics.
So our food is meant to have a positive effect
on the activity of our DNA.
It's meant to create a shield for health.
But that's not what I was doing.
Because I often had food that was more like a bad boyfriend.
(Laughter)
And even though I felt lousy about it,
I kept going back to those foods that were not good for me.
Now, if you don't know what to eat, I get it.
It can be super confusing.
One day eggs are good; the next day they're the worst thing.
Same thing with coffee. Now we're putting butter in coffee.
(Laughter)
You know, when I was growing up, calories were the most important thing.
Now, it's what those calories do to your hormones,
especially insulin.
So if you're confused about nutrition, I totally get it.
I mean, not only does the media
sort of change the messaging with nutrition,
we also have bad science, Big Food,
and even our own government's bad advice
about food.
So what I want to do is take three powerful ways
that Big Food has taught us about our relationship with food
and share those with you tonight.
So we're going to talk about the genome.
We're going to talk about how food talks to the genome.
And I want to start with this idea
that one person's superfood is another person's poison.
Coffee.
It's delicious.
It's also used by millions of people as a morning ritual.
And it's highly addictive.
Here's the deal with coffee:
There's one gene in particular that determines
whether you're a fast metabolizer or a slow metabolizer of caffeine.
So if you look to the person next to you,
chances are one of you is a fast metabolizer
and the other is a slow metabolizer.
So let me explain.
Fast metabolizers are the ones who drink a cup of coffee
and they feel like a rockstar.
They have more mental acuity.
They're on task.
They have a lower risk of heart disease.
They even have a lower risk of Alzheimer's disease.
They get all of the benefits and none of the risks.
So if you follow the literature on coffee,
you may have noticed that about half of the studies say it's good for you
and half say it's not good for you.
And that's because they haven't separated those studies
into those who have the fast gene versus the slow gene.
So those are the fast metabolizers.
Then there's the rest of us, the other half of the population:
slow metabolizers of caffeine.
That's the category I'm in.
So I drink a cup of coffee, and I'm a nightmare.
(Laughter)
I just heard my husband laugh.
(Laughter)
So it takes my cortisol from a pretty normal level to sky high.
I'm the type of person who has a much higher rate of sudden cardiac death
when I drink a cup of coffee.
So my liver metabolizes caffeine three times slower
than a fast metabolizer.
So we get all of the risks and none of the benefits.
How do you know?
Well, you could do trial and error, right? That's what a lot of people do.
But what I've found
is that if you do trial and error instead of testing yourself,
you have a lot of sleepless nights until you get to the truth.
What I prefer is to test.
[genotype phenotype]
So there are two things to test.
There's your genotype.
For instance,
do you have the fast or the slow gene when it comes to caffeine?
And then there's the phenotype.
Phenotype is your set of characteristics.
It's what makes me Sara,
and it's my genotype interacting with my environment,
like coffee.
So the second way that food interacts with DNA,
and Big Data informs this,
this concept that genes load the gun, but food pulls the trigger.
Now, I realize that a gun is not the best metaphor nowadays.
But this is a really telling analogy
that was first coined by Francis Collins.
He was the director of the Human Genome Project,
which completed the first mapping of the human genome in 2003.
He's also now the head of the Institutes of Health in Bethesda.
So the idea here is that if you know your genomics,
you also really need to consider your environment.
Let me give you an example:
I have a patient in my practice named Julie.
She's 46.
Her mother developed Alzheimer's disease, early onset.
And so she was concerned that she might have the Alzheimer's gene.
So she came to me to test for the gene.
There was a good news-bad news situation here.
So the good news was that she did not have the gene.
She was negative for ApoE4,
one of the key genes that predicts your risk of Alzheimer's disease.
But what we found was that she had an elevated fasting blood sugar.
One of the ways of looking at blood sugar over time
is to look at your hemoglobin A1c,
and this is something that's performed pretty routinely.
And we found that she had prediabetes.
So even though she didn't have the gene for Alzheimer's,
she was increasing her risk of dementia and Alzheimer's
because of the way she was eating and how that was raising blood sugar.
So, she happened to have a fondness for donuts.
(Laughing)
So we had to change the way that she was eating.
We had to find the foods that stabilized her blood sugar.
What are those foods?
Well, it's basically the way our DNA evolved millions of years ago,
so that we're eating the foods that grow in the ground
and also that roam the planet.
So things like plants, nuts, seeds, vegetables, fruits
as well as anti-inflammatory wild meat and seafood.
So that's what she started eating.
She corrected her blood sugar problem.
And when you fix your blood sugar,
that actually reduces 60% of your risk of cognitive decline
over your lifetime.
That's pretty dramatic.
The third concept
is that it's not just your genes and the environment that matters.
It's the context in which you eat.
So our brains evolved over time to scan the environment,
looking for situations that could be potentially dangerous,
where you have a greater risk of physical injury.
And there are three situations that make your brain set off an alarm.
Those three situations
are social conflict, social rejection and social isolation.
Now, as I started to look at this area, which is called "social genomics,"
I got really interested because one of the problems
is that when you have your brain perceive one of these dangerous situations
where physical injury is likely to occur,
it actually triggers inflammation.
Inflammation is like a bad frat party in your body.
It's a good thing for a couple of days,
like three days,
but after that, if it doesn't turn off, if it's like a fire that keeps burning,
it can cause all kinds of problems.
It can lead to chronic disease,
things like breast cancer, Alzheimer's disease, diabetes.
So what we want to do is we want to avoid these situations
that trigger the immune system to make you inflamed.
Now, one of the worst situations is eating in the car.
(Laughing)
I'm shocked to learn that eighty percent of Americans eat in the car.
Twenty percent regularly eat meals at high speed on the freeway.
Twenty percent!
This is not good!
(Laughter)
You have social isolation - you're alone in a car -
you have distracted driving,
your chance of physical injury is actually quite high,
and it's basically telling your immune system,
"Attack! Attack! Attack!"
It's not good.
We need a much more calm environment.
So what I want is for you to leave here
with a prescription for how to eat your next meal.
So let's do that together; let's wrap up these three big ideas.
The first is you want to consider your genotype.
And that's something you can test pretty easily.
I use 23andMe, I use Pathway -
there's lots of different labs out there that are affordable.
You also want to look at the environment and how that's interacting with your DNA.
You can do it with biomarker testing.
We talked about checking your fasting blood sugar, for instance.
Also hemoglobin A1c.
And then, finally, you want to consider the context.
You want to make sure
that your immune system is not getting triggered by your brain
to cause inflammation in your body.
So that's how you craft your next meal.
Thank you for your attention and bon appétit.
(Applause) (Cheers)