Interpreting this Report

Transcription

1 Personalized Repor for Tes 1. Paien Inerpreing his Repor Geneic variaions conribue o iner-individual differences in nuriional needs and responses o dieary facors. Knowing a paien s geneic makeup can improve he efficacy of nuriional recommendaions and relaed decisions on a personalized basis. PureGenomics enables healhcare praciioners o idenify geneic variaions ha are informaive in opimizing nuriional suppor. The geneic markers in his repor are known as single nucleoide polymorphism (SNPs), which are geneic variaions involving he replacemen of a single DNA building block, called a nucleoide, wih anoher. Millions of SNPs occur hroughou a person s genome. However, only a small number are informaive in clinical pracice. This repor only includes SNPs ha are well-researched, clinically relevan, and nuriionally responsive. Genoype noaion and erminology Genoype refers o how many copies, if any, conain he variaion. Every person has wo copies of each gene. If only one copy is affeced, he genoype is heerozygous, (+/-, yellow). If boh copies are affeced, he genoype is homozygous (+/+, red). If neiher copy has he variaion, he genoype is called wild-ype (-/-, green). Usually, a wild-ype resul is considered ypical and does no have clinical or nuriional implicaions.

2 The erm allele refers o he possible versions of he gene, which differ by a leer (nucleoide). For example, if your MTHFR C677T resul is C/C, you have wo C alleles. If your resul is C/T, you have one C allele and one T allele. If your resul is T/T, hen you have wo T alleles. A grey resul indicaes ha genoype could no be deermined due o absence of raw daa for his SNP. This is may be due o a laboraory error. Clinical Prioriy Clinical prioriy helps praciioners deermine which SNPs should be preferenially considered over ohers. Clinical prioriy is subjecively assigned he likelihood ha a paien will respond o he recommendaions indicaed. This is he foundaional naure of he nurien in quesion, he relaive srengh of evidence supporing he efficacy of he nuriional recommendaion, and he scienific raing (see below). means ha he clinical prioriy will vary subsanially from one paien o he nex oher facors. Addiional (see Recommended Assessmen Mehods) is needed deermine wheher he nuriional recommendaions are necessary. Scienific Raing Published sudies of varying size and qualiy have associaed he markers in his repor wih nurien saus and/or clinical parameers, which are described under Wha he SNP means. Much of he evidence supporing hese associaions comes from observaional sudies ha deeced an increased or decreased incidence of he nuriional or clinical rai wih a given genoype. A scienific raing is assigned for each SNP on he basis of he size of he sudies and wheher he findings were replicaed in separae invesigaions. This raing sysem does no currenly accoun for he relaively rare inervenional sudies, which are needed o assess he efficacy of dieary, lifesyle or supplemen inervenions. As new research is published, his raing sysem and he individual raings for each SNP may be updaed. Based on a sudy of 5000 or more subjecs; findings have been replicaed in a leas 1 addiional sudy

3 Based on a sudy of subjecs; findings have been replicaed in a leas 1 addiional sudy Based on a sudy of subjecs; findings have been replicaed in a leas 1 addiional sudy (no change) Based on a sudy of subjecs wihou replicaion, or 1 smaller human sudy (< 200 subjecs) wih findings ha have been replicaed in a leas 1 addiional small sudy Based on 1 smaller sudy wihou replicaion Published sudies of varying size and qualiy have associaed he markers in his repor wih nurien saus and/or clinical parameers, which are described under Wha he SNP means. A scienific raing is assigned for each SNP on he basis of he size of he sudies and wheher he findings were replicaed in separae invesigaions. Much of he evidence supporing he relaionships beween SNPs and nuriional or clinical rais comes from observaional sudies ha deeced an increased or decreased incidence of he rai in subjecs wih a given genoype. I is imporan o recognize ha hese sudies have limiaions, and ha he raings do no accoun for differences in he soundness of design of supporing sudies. These raings do no accoun for he relaively rare inervenional sudies ha are needed o assess he efficacy of dieary, lifesyle or supplemen inervenions. As new research is published, his raing sysem and he individual raings may be updaed. Assessmen SNPs are simply markers of geneic predisposiion. Dieary, environmenal, geneic, and epigeneic facors ofen modify he influence of a SNP on a person s physiology. Therefore a posiive resul does no necessarily mean ha an acion needs o be aken. Use addiional esing and oher findings from he clinical evaluaion o deermine wheher any or all of he dieary modificaions and/or supplemen recommendaions are appropriae for he individual and his/her specific healh objecives. Examples of appropriae ess and reference ranges are shown

4 under Assessmen. 1 Supplemen Dosage and Duraion of Use Geneic daa alone canno deermine nurien dosage requiremens or ideal duraion of use. Refer o he dosing insrucions prined on produc labels and in produc lieraure, which is easily accessible when using he E-scrip ool. These dosing insrucions are appropriae for mos aduls published sudies in mixed-genoype populaions. Specific nurien esing may be useful for furher dosage adjusmens and for monioring progress.

5 Gene SNP Wha i means Clinical Prioriy Mehylaion SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen Plasma B6 Aduls: ng/ml CBS rs (C699T) This SNP may affec homocyseine levels. Low 2 Serum homocyseinecbs aciviy is inversely No curren recommendaions PureGenomics &reg associaed wih homocyseine levels. Men: Women: Urinary esrogen COMT rs4680 (V158M) You may have difficuly meabolizing esrogens and cerain neuroransmiers. 3 meabolie raio (2- OH(E1+E2) / 16a- OHE1) Indicaes how effecively a paien mehylaes esrogens (2-hydroxyesrone o 2-mehoxyesrone) Premenopausal, lueal phase women: Posmenopausal women: Manage sress wih mediaion, yoga or breahing exercises. Include vegeables such as broccoli, cauliflower, Brussels Sprous in your die o suppor esrogen meabolism. Talk o your healh care provider abou supplemen opions for hormonal balance and if applicable, for sleep and relaxaion suppor. Lihium (oroae), Magnesium (glycinae), Adenosyl/Hydroxy B 12,DIM Deox, SAMe and PureGenomics &reg Men: "

6 FUT2 rs (G772A) This SNP may reduce risk of B12 deficiency, bu i may also reduce he numbers of friendly baceria in your digesive rac. 4 Serum B12 (for -/- only) Aduls: ng/l You may need a viamin B12 supplemen. Your healh care provider will deermine he dose ha is righ for you. Adenosyl/Hydroxy B 12 and PureGenomics &reg Serum homocyseine MTHFR rs (A1298C) This SNP reduces he body s abiliy o uilize folic acid. 1 A useful indicaor of overall mehylaion compeence Men: Women: RBC Folae Aduls: >280 ng/ml Ea pleny of green, leafy vegeables, which provide folae in a form he body can use. Discuss supplemen opions wih your healh care provider. Folae 1000 and PureGenomics &reg RBC From 23andMe: MTHFR rs (C677T) Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he High 5 Serum homocyseine A useful indicaor of overall mehylaion compeence Men: Women: RBC Folae Aduls: >280 ng/ml RBC From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. General Foundaional Suppor daa does no appear.

7 MTR rs (A2756G) This SNP may increase viamin B12 requiremens. 2 Mehylmalonae A marker of inracellular levels of B12 Aduls: No recommendaions. PureGenomics &reg MTRR rs (A66G) This SNP may increase viamin B12 requiremens. 2 Mehylmalonae A marker of inracellular levels of B12 Aduls: You may need a viamin B12 supplemen. Your healh care provider will deermine which produc and wha dose is righ for you. Adenosyl/Hydroxy B 12 and PureGenomics &reg From 23andMe: TCN2 rs (C766G) Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he 4 Mehylmalonae A marker of inracellular levels of B12 Aduls: From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. General Foundaional Suppor daa does no appear. *Consul your healh care provider for specific nuriional supplemen recommendaions.

8 Gene SNP Wha i means Clinical Prioriy Viamin & Mineral SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen Serum reinol BCMO1 rs (A379V) This SNP reduces he body s abiliy o make viamin A from dieary bea caroene. Viamin A is essenial for immune defenses, healhy skin nigh vision, and macular healh. 1 Aduls: mcg/dl Serum bea-caroene Men: 4-51 mcg/dl Women: 6-77 mcg/dl Boh assays are useful as viamin A saus may be low and serum bea-caroene levels may be No curren recommendaions PureGenomics &reg elevaed due o poor conversion o reinol. Serum reinol BCMO1 rs (R267S) This SNP reduces he body s abiliy o make viamin A from dieary bea caroene. Viamin A is essenial for immune defenses, healhy skin nigh vision, and macular healh. 1 Aduls: mcg/dl Serum bea-caroene Men: 4-51 mcg/dl Women: 6-77 mcg/dl Boh assays are useful as viamin A saus may be low and serum bea-caroene levels may be No curren recommendaions PureGenomics &reg elevaed due o poor conversion o reinol.

9 Sudies have linked GC rs his SNP wih lower viamin D levels, even wih adequae dieary inake and/or sunligh exposure hydroxy viamin D3 An indicaor of overall viamin D saus Aduls: ng/ml You may need exra viamin D. Your healh care provider may recommend a supplemen. Viamin D liquid *Consul your healh care provider for specific nuriional supplemen recommendaions.

10 Gene SNP Wha i means Clinical Prioriy Deoxificaion SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen The A allele is CYP1A2 rs (CYP1A2*1F) associaed wih increased TNFexpression. Some sudies show higher circulaing levels in A High 2 Self-repored, daily caffeine inake, sress levels and sleep habis No recommendaions No recommendaions allele carriers.

11 NurEval FMV (Genova Diagnosics ) GPx1P1 rs (Pro198Leu) From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. Low 3 includes an analysis of anioxidan saus as par of he comprehensive evaluaion. The Oxidaive Sress Analysis 2.0 (Genova Diagnosics ) provides a more indeph of anioxidan defenses. Urinary F2- isoprosanes are also From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. No recommendaions useful in assessing and monioring sysemic anioxidan saus. GSTP1 rs1695 (I105V) This SNP may reduce he body s abiliy o eliminae cerain oxins. Low 2 No mehods are currenly available for his SNP. Consume a die rich in fruis and vegeables. Include cruciferous vegeables such as broccoli, Brussels sprous, arugula, kale and cauliflower. Your healh care provider may recommend supplemens o suppor deoxificaion. Liposomal Gluahione, Alpha Lipoic Acid 400 mg, N-aceyl-l-cyseine (NAC), DIM Deox, Nrf2 Deox

12 NQO1 rs (C609T; Pro187Ser) The T allele is associaed wih reduced enzyme aciviy. Low 4 No mehods are currenly available for his SNP No recommendaions No recommendaions NurEval FMV (Genova Diagnosics ) includes an analysis of anioxidan saus as par of he comprehensive SOD2 rs4880 (VAL16ALA) Individuals wih his SNP may have increased anioxidan requiremens. High 5 evaluaion. The Oxidaive Sress Analysis 2.0 (Genova Diagnosics ) provides a more indeph of No recommendaions. Asaxanhin, DIM Deox, Ascorbic Acid or Buffered Ascorbic Acid (powder or capsules) anioxidan defenses. Urinary F2- isoprosanes are also useful in assessing and monioring sysemic anioxidan saus. *Consul your healh care provider for specific nuriional supplemen recommendaions.

13 Gene SNP Wha i means Clinical Prioriy Weigh Managemen SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen This SNP is associaed wih low blood levels of ADIPOQ rs adiponecin, a hormone ha mainains healhy glucose and lipid meabolism. This relaionship has been demonsraed in Caucasians of European descen. Is relevance o oher ehnic groups Low 3 Serum adiponecin If BMI is Men: 4-26 µg/ml Women: 5-37 µg/m LIf BMI is kg/m² Men: 4-20 µg/ml Women: 5-28 µg/ml If BMI is >30 kg/m² Men: 2-20 µg/ml Women: 4-22 µg/ml No recommendaions No recommendaions populaions has no been esablished.

14 APOA2 rs5082 This SNP is associaed wih increased food inake and weigh gain. Homozygous carriers are prone o weigh gain when sauraed fa inake is high. 4 Body Mass Index (BMI) Aduls: Body Composiion Fa Mass Index as measured by dual energy x-ray absorpiomery Men: 3-6 kg/m² No recommendaions No recommendaions Women: 5-9 kg/m² FADS rs Reduced abiliy o conver omega-3 fay acid precursors (linolenic acid from flaxseed oil and oher plan sources) o acive omega-3 fay acids (EPA and DHA). High prioriy if vegan or avoiding fish 4 Omega-3 index Aduls: % Ensure adequae inake of omega-3 fay acids from cold-waer fish or fish oil. Plan sources of omega-3 precursors, such as nus, seeds and seed oils, may no provide opimal suppor. EPA/DHA Essenials

15 Geneic predisposiion FTO rs o a higher body weigh and body fa percenage. This is due, in par, o increased appeie and diminished saiey afer meals. Carriers may be more likely o lose weigh hrough die and lifesyle modificaions han 5 Body Mass Index (BMI) Aduls: Body Composiion Fa Mass Index as measured by dual energy x-ray absorpiomery Men: 3-6 kg/m² Women: 5-9 kg/m² No recommendaions No recommendaions non-carriers. MC4R rs The C allele increases he producion of he melanocorin 4 recepor. Carriers of he C allele are likely o have increased appeie and higher daily caloric inake, which may make weigh managemen difficul. 4 Body Mass Index (BMI) Aduls: Body Composiion Fa Mass Index as measured by dual energy x-ray absorpiomery Men: 3-6 kg/m² Women: 5-9 kg/m² No recommendaions No recommendaions

16 Body Mass Index (BMI) Aduls: Body Composiion PPARG rs (Pro12Ala) The G allele is associaed wih reduced PPARgamma funcion. This may influence he body s uilizaion of lipids. Low 4 Fa Mass Index as measured by dual energy x-ray absorpiomery Men: 3-6 kg/m² Women: 5-9 kg/m² Fasing glucose Aduls: No recommendaions No recommendaions mmol/l HbA1c Aduls: % Or oher relaed meabolic esing *Consul your healh care provider for specific nuriional supplemen recommendaions.

17 Gene SNP Wha i means Clinical Prioriy Cogniive Healh & Memory SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen BDNF rs6265 (V66M) The T allele is associaed wih alered dopamine signaling. This may affec shor-erm memory performance. Low 1 No mehods are currenly available for his SNP Regular exercise is one of he bes ways o suppor your body s abiliy o make BDNF. Your die should include fruis, vegeables and ea, which are rich in polyphenols, and fermened foods such as kefir or yogur, which provide beneficial baceria ha suppor naural BDNF producion. Include zinc-rich foods such as spinach, nus, seeds and lean meas and omega-3 fay acids from fish such as wild salmon, sardines and herring. Magnesium (glycinae), Lihium (oroae) or lihium liquid, Trace Minerals, CurcumaSorb Mind

18 Urinary esrogen COMT rs4680 (V158M) You may have difficuly meabolizing esrogens and cerain neuroransmiers. 3 meabolie raio (2- OH(E1+E2) / 16a- OHE1) Indicaes how effecively a paien mehylaes esrogens (2-hydroxyesrone o 2-mehoxyesrone) Premenopausal, lueal phase women: Posmenopausal women: Manage sress wih mediaion, yoga or breahing exercises. Include vegeables such as broccoli, cauliflower, Brussels Sprous in your die o suppor esrogen meabolism. Talk o your healh care provider abou supplemen opions for hormonal balance and if applicable, for sleep and relaxaion suppor. Lihium (oroae), Magnesium (glycinae), Adenosyl/Hydroxy B 12,DIM Deox, SAMe and PureGenomics &reg Men: " Serum homocyseine MTHFR rs (A1298C) This SNP reduces he body s abiliy o uilize folic acid. 1 A useful indicaor of overall mehylaion compeence Men: Women: RBC Folae Aduls: >280 ng/ml Ea pleny of green, leafy vegeables, which provide folae in a form he body can use. Discuss supplemen opions wih your healh care provider. Folae 1000 and PureGenomics &reg RBC

19 From 23andMe: MTHFR rs (C677T) Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he High 5 Serum homocyseine A useful indicaor of overall mehylaion compeence Men: Women: RBC Folae Aduls: >280 ng/ml RBC From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. General Foundaional Suppor daa does no appear. TPH2 rs (G703T) This enzyme convers rypophan o 5-HTP, he precursor of seroonin, which mainains emoional well-being. Low 2 No mehods are currenly available for his SNP Your die should emphasize fruis, vegeables, fiber, and adequae proein, all of which provide essenial nuriens and phyochemicals ha suppor emoional wellness. Emphasize lean meas and poulry as proein sources, which are rich sources of rypophan, a precursor of seroonin. Your healh care provider may recommend a supplemen if oher facors indicae he need for mood suppor. 5-HTP, SeroPlus

20 *Consul your healh care provider for specific nuriional supplemen recommendaions.

21 Gene SNP Wha i means Clinical Prioriy Glucose Homeosasis SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen ADRA2A rs The A allele is associaed wih increased alphaadrenergic recepor expression, which may affec insulin release by he pancreas. 4 Fasing glucose Aduls: 70 and 100 mg/dl HbA1c Aduls: % Serum corisol AM: 7-25 mcg/dl PM: 2-14 mcg/dl No recommendaions No recommendaions Alkaline phosphaase A marker of zinc SLC30A8 rs The A allele may influence glucose homeosasis. Zinc has been shonwn o modify his effec. Low 4 saus Men: U/L Women: U/L Fasing glucose Aduls: mg/dl HbA1c Ensure adequae zinc inake. Zinc 15 Aduls: % Or oher relaed meabolic esing

22 Fasing glucose TCF7L2 rs The T allele may influence glucose homeosasis. 4 Aduls: 70 and 100 mg/dl HbA1c Aduls: % Or oher relaed No recommendaions No recommendaions meabolic esing *Consul your healh care provider for specific nuriional supplemen recommendaions.

23 Immune SNPs Gene SNP Wha i means Clinical Prioriy Scienific raing Assessmen Die & Lifesyle * Supplemen IL-6 rs (C-237G; C- 174G) The G allele is associaed wih increased cellular producion of IL-6 2 HsCRP Aduls: Manage sress, ge adequae sleep and exercise regularly EPA/DHA Essenials, Resverarol SLC23A1 rs The A allele is associaed wih lower circulaing viamin C levels 4 Self-repored dieary viamin C inake No recommendaions No recommendaions The A allele is TNF-alpha rs (A-308G) associaed wih increased TNFexpression. Some sudies show higher circulaing levels in A 2 HsCRP Aduls: No recommendaions No recommendaions allele carriers. *Consul your healh care provider for specific nuriional supplemen recommendaions.

24 Gene SNP Wha i means Clinical Prioriy Energy & Finess SNPs Exercise Type Scienific raing Assessmen Die & Lifesyle * Supplemen The G allele provides ACE rs4343 a modes geneic advanage in spors requiring fas-wich fibers, such as sprining and weigh lifing. Individuals wih he A allele are more likely o excel in endurance-oriened Low 5 No You are likely o perform bes in endurance-oriened spors. If you choose o engage in srengh/power spors, you may need o rain more consisenly o achieve a high level of performance. No spors.

25 Individuals wih he C allele have a geneic advanage in srengh and power-oriened spors ha require sprining or shor, ACTN3 rs inense burss of aciviy. The Low 5 No No recommendaions. No endurance-oriened TT genoype is linked o greaer muscle soreness following hese ypes of aciviies. *Consul your healh care provider for specific nuriional supplemen recommendaions. Addiional recommendaions preferred exercise ype For srengh/power ahlees: Whey Basics Creaine powder BCAA capsules Elecrolye Energy Formula Niric Oxide Ulra (capsules or sick pack) For endurance ahlees: Whey Basics Niric Oxide Ulra (capsules or sick pack) L-Gluamine Elecrolye/Energy Formula

26 Gene SNP Wha i means Clinical Prioriy Energy & Finess SNPs Injury Risk Scienific raing Assessmen Die & Lifesyle * Supplemen COL1A1 rs The TT genoype reduces risk of spors relaed endon and ligamen injuries, according o a meaanalysis of 6 case conrol sudies involving 2314 Caucasian subjecs. 2 Hisory of endon/ligamen injury; paricipaion in high-volume or highinensiy raining Warm up properly prior o exercise, paricularly before plyomerics and uphill running. Include flexibiliy and mobiliy exercises for he calves and knees as par of your rouine. Use proper echnique o minimize unnecessary srain on your endons and ligamens. Ligamen Resore Occasionally, a user's COL5A1 rs12722 daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he 2 Hisory of endon/ligamen injury; paricipaion in high-volume or highinensiy raining Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. No recommendaions daa does no appear.

27 MMP3 rs The G allele has been shown o influence he resilience of he Achilles endon. 2 Hisory of endon/ligamen injury; paricipaion in high-volume or highinensiy raining No No *Consul your healh care provider for specific nuriional supplemen recommendaions.

28 Gene SNP Wha i means Clinical Prioriy Energy & Finess SNPs Exercise Response Scienific raing Assessmen Die & Lifesyle * Supplemen Individuals wih he A allele (paricularly he AA genoype) end o experience greaer ADRB2 rs increases in VO2 max wih endurance raining compared o hose wih he GG varian. In a sudy of 316 marahon Low 2 No You are likely o respond well o endurance raining, achieving aboveaverage VO2max improvemens. No runners, he A allele was associaed wih he fases finishing imes. The TT genoype is associaed wih suppressed VO2max improvemens AMPD1 rs following 20 weeks of aerobic raining (3 x Low 2 No No recommendaions. No 50 min/week a 55 75% maximal hear rae)

29 Exercise ypically improves insulin sensiiviy, bu LIPC rs individual resuls vary. CC and CT genoypes are likely o experience greaer improvemens in insulin sensiiviy 2 Fasing glucose, HbA1c If mainaining healhy glucose homeosasis is a clinical goal, regular exercise is likely o resul in significan improvemens. No compared o TT carriers. Individuals wih he LPL rs328 GG or GC varian are likely o experience greaer fa loss wih endurance raining compared o hose 1 Body composiion You are likely o achieve ypical fa loss wih endurance raining. No wih he CC varian.

30 PPARGC1A rs The G allele is associaed wih higher VO2max, a deerminan of endurance capaciy. Low 2 No You are likely o achieve ypical or modes improvemens in VO2 max hrough regular aerobic raining. Alhough you lack he geneic advanage associaed wih he GG genoype, i is unlikely o negaively affec your finess gains unless you compee a a high level. No *Consul your healh care provider for specific nuriional supplemen recommendaions.

31 Gene SNP Wha i means Clinical Prioriy Cardiovascular Healh SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen Individuals wih GG ACE rs4343 genoypes are more suscepible o he vascular effecs of high sauraed fa inake (45% of oal 2 Blood pressure: < 110/70 No No calories). This polymorphism AGT rs699 alers plasma AGT levels, wih a 10 30% increase among C allele carriers. These individuals may be more sensiive o he effecs of dieary sodium on vascular 2 Blood pressure: < 110/70 Limi sodium inake o 2,300 mg per day and mainain adequae inake of poassiumrich foods, such as fruis and vegeables. Aim for a daily poassium inake of 4,700 mg per day. Magnesium glycinae, Niric Oxide Ulra, Poassium Cirae funcion.

32 Individuals wih he C allele (paricularly CC CRP rs1205 genoypes) are predisposed o higher levels of C-reacive proein (CRP) han hose wih he TT 5 hscrp: Aduls: Manage sress, mainain a healhy weigh, ge adequae sleep and exercise regularly. Resverarol, CurcumaSorb, EPA/DHA Essenials. varian. C allele carriers meabolize caffeine more slowly and are a greaer risk for CYP1A2 rs (CYP1A2*1F) adverse cardiovascular healh effecs of moderae o High 5 Blood pressure: < 110/70 No No heavy caffeinaed coffee consumpion (a leas 2-3 cups of coffee per day).

33 Occasionally, a user's EDN1 rs5370 daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he 2 Blood pressure: < 110/70 Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. No recommendaions daa does no appear. From 23andMe: MTHFR rs (C677T) Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he High 5 Serum homocyseine A useful indicaor of overall mehylaion compeence Men: Women: RBC Folae Aduls: >280 ng/ml RBC From 23andMe: Occasionally, a user's daa may no allow us o deermine his or her genoype confidenly a a paricular SNP. I is possible ha fuure review will allow us o call he genoype, bu unil ha ime, he daa does no appear. General Foundaional Suppor daa does no appear.

34 PON1 rs662 Paraoxonase-1 (PON1) is an anioxidan enzyme ha helps o mainains lipoproein redox saus and cardiovascular healh. This polymorphism, known as Q192R, alers is anioxidan aciviy. 3 Oxidized LDL (serum): Consume a polyphenol-rich die. Major sources of polyphenols ha suppor PON1 include berries, pomegranae juice, ea, red wine. Medierranean die consiuens, such as nus, fruis and vegeables, have been effecive in supporing his enzyme. Mainain adequae inake of anioxidans (viamins C, E, bea caroene), selenium and essenial fay acids. EndoLOX, EPA/DHA Essenials. In he HERITAGE mulicener clinical sudy, greaer PPARD rs increases in HDL were achieved among AG and GG genoypes following an exercise program. 2 HDL-C: Men: 40 mg/dl or below; Women: 50 mg/dl or below You are likely o achieve ypical improvemens in HDL choleserol wih regular exercise. No Carriers of he AA varian had a ypical response.

35 SLCO1B1 rs The C allele may increase he risk of coenzyme Q10 depleion in individuals receiving sains. Only relevan o sainreaed paiens 5 For paiens receiving sains: Serum coenzyme Q10: µg/ml No. No. *Consul your healh care provider for specific nuriional supplemen recommendaions.

36 Gene SNP Wha i means Clinical Prioriy Foundaion SNPs Scienific raing Assessmen Die & Lifesyle * Supplemen CYP2R1 rs The G allele is associaed wih lower circulaing viamin D levels hydroxy viamin D3:Aduls: ng/ml You may need exra viamin D. Your healh care praciioner may recommend a supplemen. Viamin D3 capsules or liquid FADS1 rs (rs174537) Reduced abiliy o conver omega-3 fay acid precursors (linolenic acid from flaxseed oil and oher plan sources) o acive omega-3 fay acids (EPA and DHA). High prioriy if vegan or avoiding fish 2 Omega-3 index: Aduls: % Ensure adequae inake of omega-3 fay acids from cold-waer fish or fish oil. Plan sources of omega-3 precursors, such as nus, seeds and seed oils, may no provide opimal suppor. EPA/DHA essenials FADS1 rs (rs174546) Reduced abiliy o conver omega-3 fay acid precursors (linolenic acid from flaxseed oil and oher plan sources) o acive omega-3 fay acids (EPA and DHA). High prioriy if vegan or avoiding fish 2 Omega-3 index: Aduls: % Ensure adequae inake of omega-3 fay acids from cold-waer fish or fish oil. Plan sources of omega-3 precursors, such as nus, seeds and seed oils, may no provide opimal suppor. EPA/DHA essenials *Consul your healh care provider for specific nuriional supplemen recommendaions.

37 Mehylaion Pahway Viamin D Viamin A

38 Deox & Anioxidan Weigh Managemen and Meabolic Healh Essenial Fay Acids

39 Cogniive Healh & Memory

40 Limiaions of his Repor This informaion is inended for use by healhcare praciioners, is for informaional purposes only, and does no esablish a docor-paien relaionship. The geneic daa in his repor is inended o complemen oher esing and healh informaion and is no inended o subsiue for a medical evaluaion. Paiens should no ake any supplemen wihou he guidance of a healh professional. If you are a paien, consul your physician, nuriionally oriened healh care praciioner, and/or pharmacis for any healh problem and before using any supplemens or before making any changes in prescribed medicaions. This repor provides informaion abou how an individual s geneics may influence heir nurien requiremens and/or response o nuriional supplemens. The seleced geneic markers are no predicive of disease, and he recommendaions are no inended o diagnose, rea, cure or preven any disease. Since nuriional genomics is a rapidly evolving field, he informaion provided in PureGenomics repors may be updaed periodically as new research is published. Foonoes 1 Reference ranges were obained from Ques Diagnosics and he Mayo Clinic. These ranges apply o aduls only