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3 Type of Training Cardio respiratory training Strength & Resistance Training Flexibility YOUR DIET PLAN - BALANCED YOUR EXERCISE PLAN AVERAGE VO2 MAX, ENDURANCE and SPRINTING, LOW INFLAMMATION, LESS FLEXIBILITY Frequency 3-4 days/week 3-4 days/week 3-7 days/week Carbohydrates - 55% Proteins - 25% Fats - 20% Duration mins 45 mins- 1 hour 2 days in a week mins or 5-10 mins every day Intensity 5 on the BORG S Scale 70% of HR MAX. Talk test can talk heavy breathing, but not out of breath to stop exercise % of 1rm and 8-20 reps for 2-3 seconds Stretch in the full range of motion to the point of mild tightness. Dynamic stretches, static stretches hold for 15secs Exercices Medium Intensity Cardio Training Method. eg., Walking brisk, jogging, cycling, aerobics, etc High intensity internal training or circuit training. Pick an exclusive strength exercise. Do 8-10 reps x 1sec and likewise do 8-12 exercise back to back and repeat it twice or thrice. eg., 8x1 Burpees & x1 Lunges Yoga Taichi etc or with assistance try, PN7 stretches, passive stretches or supplies active static stretches contracting on other major muscles Pg i

4 FOOD Regulation of Energy Intake Bitter Taste Perception Sweet Taste Perception Carbohydrate Response Protein Response Fiber Response Saturated Fat Response Poly Unsaturated Fat Response Mono Unsaturated Fat Response Propensity for Weight Regain NUTRIENTS Vitamin A Requirement Vitamin D Requirement Vitamin E Requirement Vitamin B6 Requirement Vitamin B9 Requirement Vitamin B12 Requirement Vitamin C Requirement Iron Requirement Calcium Requirement Phosphate Requirement Unfavourable May dislike More likely Beneficial Unfavourable Favourable Unfavourable Unfavourable Decreased Salt Sensitivity SENSITIVITIES Caffeine Sensitivity INTOLERANCES Gluten Intolerance Risk Lactose Intolerance Risk EXERCISE Aerobic Capacity Anaerobic Capacity Endurance Power Flexibility Muscle Fatigue and Lactate Threshold Muscle Injury Slow metabolizer Risk Average Average Average Excellent Excellent Excellent Average Injury Repair Exercise and Fat Loss Excellent Excellent Magnesium Requirement Antioxidant Needs Pg 1

5 We believe that our choice of food, quantity and frequency of intake is voluntary. However, hormones play a significant role in influencing these choices. The hormones secreted are in-turn regulated by genes. Individuals with certain genotypes have been observed to experience difficulty in feeling full and hence tend to eat more without feeling satisfied. They snack frequently and tend to crave energy dense foods high in sugars and fats. About 70% of overweight people have low satiety and people with low satiety eat 10% more calories per meal than people with normal satiety. Unfavourable Allele Association MC4R eating DRD2 No Binge eating disorder & emotional eating FTO Low satiety, increased eating Key Recommendations Favourable Likelihood of excess calorie consumption and obesity Likelihood excess calorie consumption and obesity Likelihood of excess calorie consumption and obesity Portion control is the key to regulate satiety. For instance, 10 cashews and half a plate of cherry tomatoes (450g) provide the same 80 calories Practice mindful eating strategies. To start with, eat one meal a day or week in a slower, more attentive manner. For instance, start noticing the color, flavor, and texture of your food while eating. (Refer Table 1. Seven simple ways of mindful eating) Include healthy snacks, timed appropriately between the meals to help maintain satiety and control food cravings. (Refer Table 2. Seven tips for smarter snacking) Include protein & fiber (eggs, millets, pulses & legumes) rich foods in your diet. (Refer Table 3. List of foods rich in protein) Pg 2

6 Carbohydrates provide the main source of energy for the body. However, excess consumption, particularly in Individuals with certain genotypes can lead to excess weight gain, diabetes and other conditions. The Center for Disease Control and Prevention estimates that 75 million Americans now suffer from metabolic syndrome due to increased consumption of refined carbohydrates. By modifying your carbohydrate consumption according to your genotype you can maintain a healthy and balanced lifestyle and reduce the likelihood of developing the aforementioned conditions. PPARG MMAB SREBP1C FTO No No Unfavourable Allele Association risk of obesity with higher CHO intake (>246 g/day) Decreased HDL-C in response to high carb intake Elevated HDL-C & reduced APO lipoproteins B(males) and decreased serum triacylglycerol, insulin, HOMA-IR with high CHO and low fat diet risk of BMI and obesity in response to high carbohydrate intake and low physical activity May be prone to excess consumption of calorie dense foods, metabolic complications May be prone to changes in HDL-C based on carb intake May be prone to gender specific changes in serum lipids and glucose metabolism May be prone to excess calorie consumption & obesity PPARGC1A weight gain May be prone to obesity and related risks 3 Key Recommendations Consume a maximum of 60 % of daily calories through carbohydrates. (Refer Table 4. Macronutrient Composition of Common American cereals) Consume moderate to low glycemic foods to help maintain blood sugar levels. (Refer Table 5. glycemic index of foods) Try to add a protein source in every meal. (Refer Table 3. List of foods rich in protein) Monounsaturated fats helps in improving insulin sensitivity, therefore consider including olive oil, almond, avocados and fatty fishes (sardine) instead of other fatty foods Pg 4

7 Dietary proteins provide amino acids for the synthesis of body proteins, active enzymes and other biologically important nitrogenous compounds in the body. High protein diets, particularly in individuals with certain genotypes can have beneficial effect on weight maintenance. By modulating your protein intake according to your genotype can help address the above mentioned conditions and help maintain optimal body weight. TFAP2B No Key Recommendations Allele Association Better weight maintenance with high protein diets Beneficial May find it relatively easy to maintain body weight with associated health benefits The Dietary Guidelines recommends 56g for men and 46g for women Vegetable proteins are of poorer quality due to their low digestibility and lack in providing all the essential amino acids. Daily inclusion of foods such as chia seed, hemp seed, rice- bean combination, soy proteins can help get the essential amino acids from your diet. (Refer table 3. List of protein rich foods for vegetarians) To know more about your requirements for different amino acids. (Refer to table 6. Amino acid requirements for American adults) 3 Pg 5

8 Saturated fats are solid at room temperature. They are predominantly derived from animal and dairy products and also from some vegetable oils. Individuals with certain genotypes may have higher levels of LDL cholesterol and more prone to weight gain in response to high levels of saturated fat in their diet. Such individuals may benefit from limiting saturated fat intake. Replacing both saturated and trans fats with unsaturated (poly and mono unsaturated) fats helps to improve cholesterol levels, insulin sensitivity and BMI. APOA2 Key Recommendations Unfavourable Allele Association BMI, obesity and insulin resistance in response to high saturated fat intake (> 22g/ day) Favourable May be prone to obesity and metabolic complications The recommended daily dietary fat intake is: saturated less than 10% and trans fats to less than 1% of your daily energy intake (USDA,2015) The preferred substitution for saturated fats (mayonnaise, butter,meat fats,coconut and palm kernel oils) (Refer Table 8. Foods rich in saturated fats) is monounsaturated fats (abundant in olive oil and canola oil) and polyunsaturated fats (abundant in soya bean and sunflower oil) 4 Pg 7

9 s influences an individuals tendency to gain weight back after losing weight and there are some genes that have protective effect from weight regain. Adiponectin is a hormone that is produced by the fat cells and is involved in the utilization of fat to obtain energy. Higher adiponectin levels are considered beneficial for weight loss and health. tic variations influence the adiponectin levels in our body. Individuals with certain genotypes are more likely to gain weight back, while others are more likely to maintain the weight loss. It is therefore best after losing weight to maintain a healthy diet, exercise and nutrition plan to maintain the weight loss and support long term health. MBOAT4 ADIPOQ PPARG NEGR1 Unfavourable Allele Association chance of fear of weight gain and anorexia nervosa weight regain under energy restricted diet Risk allele is associated with weight regain upon lifestyle intervention weight regain in multiple populations Favourable Higher likelihood of weight regain 3 Higher likelihood of weight regain 2 Higher likelihood of weight regain 4 Higher likelihood of weight regain 5 BDNF weight regain May be prone to metabolic complications 5 FTO weight regain after bariatric surgery Higher likelihood of weight regain 2 Pg 10

10 Vitamin D, the 'Sunshine Vitamin', is essential for absorption of calcium from the intestine. It is also important for immunity as it improves our body's defense against harmful microorganisms. Our body can synthesize sufficient Vitamin D from cholesterol when the skin is exposed to adequate amounts of sunlight. A particular genotype is responsible for lower levels of Vitamin D in some individuals. Low Vitamin D levels pose the risk of rickets and osteoporosis-related fractures. An increase in Vitamin D intake is recommended improve calcium absorption and overall health. Allele Association GC No Decreased levels of vitamin D VDR Decreased levels of vitamin D Key Recommendations May benefit from increased vitamin D intake May benefit from increased vitamin D intake The Dietary Guidelines recommends daily dietary intake of 600 units of vitamin D Aim for at least 15 minutes exposure to sunlight preferably between 10 am to 3 pm to improve vitamin D synthesis Soybean, soymilk, cheese, egg, salmon, tilapia and mushrooms are major dietary sources of vitamin D, (Refer Table 14. Foods rich in Vitamin D) in addition include calcium rich foods such as low fat milk & milk products, broccoli, kale, collards, ragi, soybean, fishes like sardine and salmon to facilitate calcium absorption Include body weight exercises along with other physical activity to improve synthesis of vitamin D and reduce calcium loss from bone 3 3 Pg 12

11 Vitamin B9 or Folate is an essential B vitamin, which plays a major role in DNA synthesis and repair. Vitamin B9 has a vital role in several cellular functions. Vitamin B9 is essential for the conversion of homocysteine to methionine in the cell. An excess accumulation of homocysteine can induce inflammation, damage blood vessels, increase blood pressure and cause a disturbance in heart health. A particular genotype causes increased Vitamin B9 requirement due to a reduced enzymatic conversion efficiency of Homocysteine to Methionine. Allele Association MTHFR No Decreased folate levels Key Recommendations May benefit from increased vitamin B9 intake The Dietary Guidelines recommends daily intake of 400 mcg of Vitamin B9 B vitamins especially folate aid in maintenance of bone density, therefore include folate food sources in your daily diet Food sources of Vitamin B9 include green and leafy vegetables (like spinach, broccoli, brussels sprouts and lettuce) dark coloured fruits (such as oranges), beans, peas, lentils, fortified grains, nuts and peaches. (Refer Table 17. Foods rich in Vitamin B9) Inclusion of other B vitamins such as riboflavin and cobalamin along with folate improves the efficiency of homocysteine elimination. Food sources of Riboflavin include milk & milk products, whole grains & millets, kidney beans and lean meat and cobalamin is found in mushroom, tofu, milk & milk products, egg and lean meat 4 Pg 15

12 Iron is a mineral essential for oxygen transport through the blood (bound to proteins like hemoglobin in RBC & myoglobin in muscle). Hepcidin regulates the entry of iron into the circulation. Iron deficiency leads to anemia. According to the Center for Disease Control (CDC) 9.5% of women between the age group of years have low body iron stores in America. This translates into higher rates of incidence of infections and illness in the country. Individuals with certain genotypes have reduced ability to absorb iron from the diet. Regulating hepcidin levels and increasing dietary sources of iron can be beneficial. Allele Association HFE(M2) Iron deficiency in woman May benefit from increased iron intake 3 HFE(M1) Decreased serum iron levels. May benefit from increased iron intake 3 TMPRSS6(M2) No Decreased Hb and ferritin levels May benefit from increased iron intake 4 TMPRSS6(M1) No Key Recommendations Decreased serum iron levels in male and decreased Hb and ferritin levels May benefit from increased iron intake 4 The Dietary Guidelines recommends daily intake of iron to be 8 mg for men and 18 mg for women Include iron rich foods in your diet. (Refer to Table 18. list of foods rich in Iron) Include vitamin C rich foods, which aids in the absorption of iron (Refer to Table 19. to List of vitamin C rich foods) Pg 18

13 Antioxidants are found in vegetables, fruits, whole cereals, nuts, oil seeds and green tea. They play a key role in reducing the ill effects of 'free radicals' and thereby prevent premature aging, tissue damage and the onset of chronic diseases. Individuals with certain genotypes have lower efficiency to defend themselves against free radical damage. They would benefit from an increased intake of antioxidant rich foods. CAT Allele Association Decreased catalase activity, antioxidant status and increased risk for many diseases SOD2 Accelerated aging Key Recommendations May be prone to increased risk for many chronic conditions May be prone to various chronic metabolic complications The Dietary Guidelines recommends daily consumption of fruits and vegetables (400g) to meet the daily antioxidant requirement. Due to your genetic profile, you may benefit from an increased intake antioxidant rich foods Three servings (each serve 100g) of vegetables and 1 serving (100g) of fruit every day is ideal to meet your antioxidant requirement Inclusion of foods rich in selenium, glutathione, and manganese in your daily diet improves the efficiency of antioxidant enzymes Daily inclusion of foods rich in antioxidant nutrients vitamins A, C, E and Co-enzyme Q10 reduces the damage caused by free radicals during tissue metabolism. (Refer to Table 24. Foods rich in Antioxidants) 4 3 Pg 22

14 Caffeine is a stimulant found in coffee, tea, chocolate, many soft drinks and energy drinks. Caffeine is a potent vasoconstrictor and makes one feel more alert by increasing blood pressure. However, this stimulant effect can also cause jitters, anxiety, and difficulty in sleeping. How quickly an individual metabolizes caffeine has been shown to be influenced by their genotype. Certain genetic variations slow down caffeine metabolism; as a result of which caffeine is retained in the blood for an extended time. This increases the risk of caffeine-associated health disturbances like reduction in bone mineral density, increased blood pressure and heart ailments. CYP1A2 Key Recommendations Slow metabolizer Allele Association Reduced caffeine metabolism in heavy coffee drinkers Likely to be slow metaboliser 3 The American Heart Association recommends a limit of 100 milligrams of caffeine in a day which equates to limiting your coffee/tea intake to not more than one cup in a day for caffeine sensitive individuals Prefer decaffeinated beverages over the regular caffeine- containing beverages; or go for antioxidant-rich beverages like green tea & herbal teas which have low caffeine content Avoid beverages like filter coffee ( mg per small cup) and energy drinks (40-200mg in 240ml), as they contribute high doses of caffeine. (Refer Table 25. Caffeine content of different beverages) Consume adequate amount of water to prevent dehydration induced by excessive caffeine ingestion Pg 24

15 Lactose intolerance is a common food intolerance that affects as much as 75% of the American population. Its symptoms include abdominal bloating and pain, diarrhea, flatulence and nausea. Lactose intolerance occurs when the small intestine does not produce enough lactase (the enzyme that breaks down the milk sugar lactose into the simpler molecules, galactose and glucose). An individual's ability to metabolize lactose is influenced by their genetic makeup. A genetic variation can influence lactase activity in adults and thereby regulate lactose metabolism. MCM6 Key Recommendations Risk Allele Association Lactose intolerance is high among carriers of this variant May be intolerant to milk and milk products According to National Institute of Health (2010), a daily tolerable level of lactose is 12 g, which equates to 1 cup (237 ml). Therefore limit your consumption to 1 cup /day and try to distribute the intake throughout the day Consume milk along with meals or with other foods- example: milk with corn flakes, muesli or with rice, milk with fruits that may lessen the symptoms of lactose intolerance. (Refer to Table 27 for lactose free milk substitutes) Inclusion of fermented milk products like curd/dahi, yoghurt, buttermilk that contains lactic acid (easily absorbable form of lactose) improves lactose intolerance Milk is also an excellent source of bioavailable calcium. So it becomes essential to include nondairy calcium rich foods in your diet such as ragi, broccoli, oranges, pinto beans, spinach, soy milk and rice milk to fulfill your calcium needs, if you are lactose intolerant 4 Pg 26

16 Anaerobic capacity is the total amount of energy obtainable from the anaerobic energy systems. The better able your anaerobic energy systems are at utilising energy and recovering, the higher the intensity you are able to maintain. By increasing anaerobic capacity you will be able to buffer more lactate at a faster rate, produce and use more anaerobic enzymes and continue turning body fuels into useable energy for immediate access. We have analysed genes that have shown to be associated with anaerobic threshold. Allele Association PPARD Decreased anaerobic threshold PPARGC1A Decreased anaerobic capacity NUTRIENTS TO BOOST YOUR PERFORMANCE Hydroxy methyl butyrate, Manganese and Ascorbic acid ACTIVITIES Average Anaerobic threshold could be improved by training your body to remove lactate better and to juice up the aerobic mitochondrial enzymes Anaerobic capacity could be improved by endurance training even if the baseline capacity is low Short sprints, High intensity interval training (HIIT) with moderate intervals & recovery periods 2 2 Pg 28

17 Power measures the rapid burst of energy observed during the high intensity activities of shorter duration. Type II or fast twitch muscle fibers allow us to perform rapid, high intensity exercises. The ability of blood vessels to constrict and make oxygen utilization more efficient is also important for power. We have analysed genes that determine the percentage distribution of muscle fibers (slow twitch and fast twitch) and their ability to exert maximal power over a short period of time. Allele Association MTC1 Decreased power performance NOS3 No Decreased power based performance ACTN3 Decreased power based performance & decreased muscle power ACE No power performance NUTRIENTS TO BOOST YOUR PERFORMANCE Less likely to benefit from power based activities Less likely to benefit from power based activities Less likely to benefit from power based activities More likely to benefit from power based activities Caffeine (maximum 400mg/day). Slow metabolisers of Caffeine should not consume above 100mg/day ACTIVITIES Excellent High intensity exercises including running, cycling, high intensity interval training, cross fit training/aerobic exercises, strength training with high weights and less reps Pg 30

18 Sportsmen and runners who place stress on the Achilles tendon have the greatest likelihood of muscle injury and tendinopathy. The Achilles tendon connects your calf muscles to your heel bone. Tendinopathy describes either the inflammation or tiny tears to the tendon. Individuals with certain genotypes have certain are more prone to injury than others and such individuals are at increased risk of tendinopathy and other muscle injury. Allele Association MCT1 muscle injury COL5A1 No Bilateral quadriceps tendon rupture MMP3 risk of Achilles tendinopathy MMP3 risk of Achilles tendinopathy NUTRIENTS TO BOOST YOUR PERFORMANCE Alpha linolenic acid, Eicosapentaenoic acid, Docosahexaenoic acid ACTIVITIES Average Higher likelihood of tendinopathy and injury Possible higher incidence of tendinopathies involving Achilles tendon injury. Individuals may require adequate surgical treatment to avoid permanent loss of knee function Higher likelihood of tendinopathy and injury Higher likelihood of tendinopathy and injury All forms of physical activity with moderate rest periods Pg 33

19 Exercise can positively regulate bodily functions and decrease fat levels. Regular exercise renders weight control through improved metabolism and oxidation of fatty acids. Oxidized fatty acids in addition to glucose can be used as a fuel source for the body during exercise. Regular exercise is a healthy way for fat loss and weight control. How efficiently people respond to exercise in terms of fat oxidation is dependent on their genes. The influence of the carbohydrate & fat metabolism impacts weight response to exercise. LIPC INSIG2 No Allele Association HDL-C in physically active women Higher levels of subcutaneous fat in women and men gained subcutaneous fat with resistance training. NUTRIENTS TO BOOST YOUR PERFORMANCE Protein, Capsaicin, Bromelain and Quercetin ACTIVITIES Excellent Exercise induced decrease in TG, VLDL & LDL and increase in HDL Resistance training may trigger adiposity 3 Your genetic results indicate that fat loss in response to exercise is very efficient in you. You have lesser chances for weight regain due to responsiveness for weight maintenance through exercise 4 Pg 35

20 Strength of association () is the strength of scientific evidence for association between the SNP and a trait 5 (Strong association) indicates that a marker has been validated in >2,000 people and the association has been replicated in atleast two studies and one multi ethinic population. 4 (Strong association) means that a marker has been validated in >2,000 people and the association has been replicated in atleast one study in other populations. 3 (Medium association) indicates a study of >400 people. 2 (Prelimnary association) denotes the study with <400 people with positive association. Pg 36

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