Dietitian Connection Live Chat – Supported by Bond University Master of Nutrition and Dietetics Practice

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Live Blog Nutrigenomics with Melissa Adamski
 


  Nutrigenomics with Melissa Adamski (08/28/2014) 
7:26
Welcome to tonight’s live chat! Our topic is Nutrigenomics
And welcome to our guest moderator – Melissa Adamski

Thank you to Bond University Master of Nutrition and Dietetics Practice for sponsoring the live chat.

Thursday August 28, 2014 7:26 
7:26
We will start in five minutes – just wanted to get the site up and ready as everyone is logging in
Thursday August 28, 2014 7:26 
7:29
My name is Maree Ferguson and I am the Director of Dietitian Connection
Thursday August 28, 2014 7:29 
7:30
A big welcome to tonight’s live chat – we have a great topic tonight to discuss!
Thursday August 28, 2014 7:30 
7:30
If you could please introduce yourself and where you work and/or what city you are based in that would be terrific
Thursday August 28, 2014 7:30 
7:31
[Comment From GuestGuest: ] 

Hi I am Melissa and I am a lecturer at a number of universities and consultant in the area of nutritional genomics in Melbourne.

Thursday August 28, 2014 7:31 Guest
7:31
Welcome and thanks for joining us Melissa!
Thursday August 28, 2014 7:31 
7:31
[Comment From LizLiz: ] 

Hi, I’m Liz Isenring from Bond Uni, Gold Coast

Thursday August 28, 2014 7:31 Liz
7:31
Hi Liz, thanks for joining in
Thursday August 28, 2014 7:31 
7:32
Welcome to Melissa our guest moderator
Thursday August 28, 2014 7:32 
7:32
[Comment From MarietteMariette: ] 

Hi There I´m Mariette Abrahams Dietitian based in Portugal

Thursday August 28, 2014 7:32 Mariette
7:32
[Comment From MeganMegan: ] 

Hi I’m Megan, PhD Student, Brisbane

Thursday August 28, 2014 7:32 Megan
7:33
[Comment From GuestGuest: ] 

Hi, my name is Emily and I work in lecturing and research at Curtin Uni in Perth

Thursday August 28, 2014 7:33 Guest
7:33
[Comment From Melissa AdamskiMelissa Adamski: ] 

No worries- looking forward to it

Thursday August 28, 2014 7:33 Melissa Adamski
7:33
Melissa Adamski BSc MND APD AN, is an Accredited Practising Dietitian and Accredited Nutritionist who has extensive experience working in the field of nutritional genomics. She currently lectures and consults to universities on the practical aspects of this emerging field and enjoys educating and inspiring the public and healthcare professionals on this exciting new area of science. Melissa is also a corporate dietitian, with a large health based company and runs her own successful private practice, Nutted Out Nutrition, in Melbourne, Australia
Thursday August 28, 2014 7:33 
7:33
Welcome to our guest moderator – Melissa Adamski!
Thursday August 28, 2014 7:33 
7:33
Thanks to everyone joining in tonight
Thursday August 28, 2014 7:33 
7:33
[Comment From Melissa AdamskiMelissa Adamski: ] 

Mariette hi! Nice to see you joining us- it’s been a while since we have spoken

Thursday August 28, 2014 7:33 Melissa Adamski
7:34
We have four questions this evening for Melissa and you will have time to ask questions as well
Thursday August 28, 2014 7:34 
7:34
first question Melissa
Thursday August 28, 2014 7:34 
7:34
Question 1 – Do you think nutritional genomics is relevant to dietetic practice?
Thursday August 28, 2014 7:34 
7:34
[Comment From Melissa AdamskiMelissa Adamski: ] 

Absolutely- for the future and now.

Thursday August 28, 2014 7:34 Melissa Adamski
7:35
How so?
Thursday August 28, 2014 7:35 
7:35
[Comment From Melissa AdamskiMelissa Adamski: ] 

Not matter what area of dietetics and nutrition practice you work in, nutritional genomics will touch on your area- either it is now or closely in the future. E.g. public health dietitians, research dietitians, private practice dietitian, corporate dietitians, clinical dietitians etc.

Thursday August 28, 2014 7:35 Melissa Adamski
7:35
[Comment From GuestGuest: ] 

Hi, I am Amy, an APD currently living in Sweden

Thursday August 28, 2014 7:35 Guest
7:35
[Comment From Melissa AdamskiMelissa Adamski: ] 

I see it touching our work

Thursday August 28, 2014 7:35 Melissa Adamski
7:35
Wow thanks for joining us Amy, what time is it there?
Thursday August 28, 2014 7:35 
7:35
[Comment From GuestGuest: ] 

Hello, Im Katherine – a private practice dietitian

Thursday August 28, 2014 7:35 Guest
7:35
Welcome Katherine, thanks for joining
Thursday August 28, 2014 7:35 
7:35
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Gives us a greater understanding of the role of genetics in health and disease, particularly chronic disease  Can help develop more effective therapeutic interventions for managing existing disease.  Early identification of disease susceptibility to help prevent or reduce risk  Help develop more targeted prevention strategies

Thursday August 28, 2014 7:35 Melissa Adamski
7:36
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Take personalized nutrition/ individualised dietary recommendations to the next level (based on a person’s genotype).  Provide food based recommendations to change gene expression.  Development of functional foods  Development of public health messages conveying the role of genes and environment and how nutrition recommendations can be tailored to an individual’s genetic variations.

Thursday August 28, 2014 7:36 Melissa Adamski
7:36
Wow a global crowd this evening, thanks for joining Mariette
Thursday August 28, 2014 7:36 
7:36
[Comment From GuestGuest: ] 

11.30am here in Sweden. I usually miss these things as they are am Aus, so this is great!

Thursday August 28, 2014 7:36 Guest
7:36
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Public are already accessing tests- either direct to consumer or through healthcare professionals- and we need to provide evidenced based advice if they ask us

Thursday August 28, 2014 7:36 Melissa Adamski
7:36
[Comment From CourtneyCourtney: ] 

Hi I’m Courtney, private practice dietitian, based in Sydney.

Thursday August 28, 2014 7:36 Courtney
7:36
Hi Courtney, thanks for joining
Thursday August 28, 2014 7:36 
7:37
[Comment From GuestGuest: ] 

Is there meant to be sound?

Thursday August 28, 2014 7:37 Guest
7:37
No it’s just a text chat
Thursday August 28, 2014 7:37 
7:37
[Comment From reneerenee: ] 

Hey. Renee from Melbourne here 🙂 trying to do this via my phone due to a faulty laptop!

Thursday August 28, 2014 7:37 renee
7:37
welcome Renee
Thursday August 28, 2014 7:37 
7:37
Any other comments on question one from anyone else?
Thursday August 28, 2014 7:37 
7:38
[Comment From Melissa AdamskiMelissa Adamski: ] 

One from me

Thursday August 28, 2014 7:38 Melissa Adamski
7:38
[Comment From LizLiz: ] 

Where to start. We have people accessing tests all over the place. How do we access accurate and useful info

Thursday August 28, 2014 7:38 Liz
7:38
[Comment From Melissa AdamskiMelissa Adamski: ] 

Anyone have an example of how it has touched their nutrition work

Thursday August 28, 2014 7:38 Melissa Adamski
7:38
[Comment From VivianVivian: ] 

Hi I’m Vivian, dietitian based in Sydney – very interested in nutritional genomics!

Thursday August 28, 2014 7:38 Vivian
7:39
Welcome Vivian
Thursday August 28, 2014 7:39 
7:39
[Comment From Melissa AdamskiMelissa Adamski: ] 

Absolutely Liz, and this is a tough one

Thursday August 28, 2014 7:39 Melissa Adamski
7:39
[Comment From WolfWolf: ] 

Hello all, Wolf Marx reporting in

Thursday August 28, 2014 7:39 Wolf
7:39
Welcome Wolf, we have a global audience this evening or morning!
Thursday August 28, 2014 7:39 
7:39
[Comment From Melissa AdamskiMelissa Adamski: ] 

Start with the evidence (journals etc) but go to the international bodies and associations

Thursday August 28, 2014 7:39 Melissa Adamski
7:40
Question 2 for Melissa
Thursday August 28, 2014 7:40 
7:40
Question 2 – If a patient presents to you with results from a nutrigenetic test and asks you to advise them, what would be 3 factors to consider?
Thursday August 28, 2014 7:40 
7:40
[Comment From Melissa AdamskiMelissa Adamski: ] 

International society of nutrigenetics and nutrigenomics

Thursday August 28, 2014 7:40 Melissa Adamski
7:41
[Comment From Melissa AdamskiMelissa Adamski: ] 

Q2 1st factor Why did the patient have the test? What did they want to know? • Helps to direct you in your line of counselling • Helps you to understand whether the test results/ part of the test results could be useful in your response/recommendations to patient • Remember there are two main ways a nutrigenetic test can be used

Thursday August 28, 2014 7:41 Melissa Adamski
7:41
[Comment From Megan RossiMegan Rossi: ] 

I am all for this emerging area, but do we have enough/ any evidence to make recommendations yet?

Thursday August 28, 2014 7:41 Megan Rossi
7:41
[Comment From Melissa AdamskiMelissa Adamski: ] 

Factor 2 Which company performed the test? • What are their expertise? Staff? Training? • What marketing claims do they make? • Do they perform test themselves or outsource it?

Thursday August 28, 2014 7:41 Melissa Adamski
7:42
[Comment From Fiona SutherlandFiona Sutherland: ] 

Hi Fiona Sutherland APD here from Melbourne, know very little about this topic but looking forward to learning more. Thanks Maree & Melissa!

Thursday August 28, 2014 7:42 Fiona Sutherland
7:42
[Comment From WolfWolf: ] 

Megan, I was also wondering this!

Thursday August 28, 2014 7:42 Wolf
7:42
[Comment From Melissa AdamskiMelissa Adamski: ] 

there is tonnes of evidence- to make recommendations- but I guess the main question is WHAT RECOMMENDATION?

Thursday August 28, 2014 7:42 Melissa Adamski
7:42
Welcome Fiona
Thursday August 28, 2014 7:42 
7:43
[Comment From Melissa AdamskiMelissa Adamski: ] 

There is a lot of evidence, we just need to know how to critique it to provide the right advice

Thursday August 28, 2014 7:43 Melissa Adamski
7:43
[Comment From OliviaOlivia: ] 

Hi Everyone – Olivia here from UQ

Thursday August 28, 2014 7:43 Olivia
7:43
[Comment From CourtneyCourtney: ] 

Melissa, I was wondering if you know which companies offer credible testing?

Thursday August 28, 2014 7:43 Courtney
7:43
Thanks for joining Olivia!
Thursday August 28, 2014 7:43 
7:43
[Comment From MarietteMariette: ] 

Also a comment,your own knowledge and limitation. There is so much to learn and putting results into perspective that we need to be sure that SNP tested were done on the relevant population ie women only, Asians etc

Thursday August 28, 2014 7:43 Mariette
7:44
[Comment From Melissa AdamskiMelissa Adamski: ] 

Great comment Mariette- relevance of tests to diff population groups and sub populations is crucial

Thursday August 28, 2014 7:44 Melissa Adamski
7:44
[Comment From Fiona SutherlandFiona Sutherland: ] 

Are there companies that are known to perform reputable tests?

Thursday August 28, 2014 7:44 Fiona Sutherland
7:44
[Comment From Melissa AdamskiMelissa Adamski: ] 

Courtney- it is hard to establish what is credible…

Thursday August 28, 2014 7:44 Melissa Adamski
7:45
[Comment From Melissa AdamskiMelissa Adamski: ] 

You have to think not only accuracy of testing on DNA sample BUT also interpretation and reporting

Thursday August 28, 2014 7:45 Melissa Adamski
7:45
[Comment From Melissa AdamskiMelissa Adamski: ] 

Factor 3 to consider (from Q2) Which HCP performed the test and why? Or did they order it off the internet? • What were their qualifications in recommending a test? • What is their knowledge of genetics and nutritional genomics? • Why did they recommend the test?

Thursday August 28, 2014 7:45 Melissa Adamski
7:46
[Comment From LizLiz: ] 

what areas do you feel we have good evidence currently. Eg I had a chat with a Prof from USA who felt this area in tailoring nutrition in older adults would probably only impact about 10%. Your thoughts?

Thursday August 28, 2014 7:46 Liz
7:46
[Comment From Melissa AdamskiMelissa Adamski: ] 

IN regards to companies- look at their staff, expertise and also their claims

Thursday August 28, 2014 7:46 Melissa Adamski
7:46
[Comment From Melissa AdamskiMelissa Adamski: ] 

that will help with you decision on if reputable

Thursday August 28, 2014 7:46 Melissa Adamski
7:47
Any other questions /comments on question 2 – If a patient presents to you with results from a nutrigenetic test and asks you to advise them, what would be 3 factors to consider?
Thursday August 28, 2014 7:47 
7:48
[Comment From Megan RossiMegan Rossi: ] 

Can you please give us one example of how you have used it in practice i.e.. Can we test for a specific gene which will identify patients who are more likely to malabsorb specific nutrients and therefore need more through the diet? Sorry for my ignorance in this area.

Thursday August 28, 2014 7:48 Megan Rossi
7:48
[Comment From Melissa AdamskiMelissa Adamski: ] 

There are many SNPs that hold good evidence behind them Liz, starting with most well known MTHFR C677T, however it is the translation into how you advise on it which is where evidence starts to reduce

Thursday August 28, 2014 7:48 Melissa Adamski
7:48
[Comment From AmyAmy: ] 

Good question Liz. In addition, is there any tests that seem to be ‘popular’ at the moment?

Thursday August 28, 2014 7:48 Amy
7:49
[Comment From LizLiz: ] 

yes I agree, so how can we progress this and ensure dietitians are well trained and at the forefront of this advice?

Thursday August 28, 2014 7:49 Liz
7:49
[Comment From Melissa AdamskiMelissa Adamski: ] 

The alternate practitioners LOVE any test to do with methylation pathways, inflammation, detox and autism

Thursday August 28, 2014 7:49 Melissa Adamski
7:49
[Comment From OliviaOlivia: ] 

What about epigenetic testing – is that happening anywhere?

Thursday August 28, 2014 7:49 Olivia
7:49
[Comment From OliviaOlivia: ] 

What about epigenetic testing – is that happening anywhere?

Thursday August 28, 2014 7:49 Olivia
7:50
[Comment From Melissa AdamskiMelissa Adamski: ] 

Olivia, I believe credible epigenetic testing only in research due to complexity

Thursday August 28, 2014 7:50 Melissa Adamski
7:50
[Comment From OliviaOlivia: ] 

I think being aware of some of the basics is a start

Thursday August 28, 2014 7:50 Olivia
7:50
[Comment From Melissa AdamskiMelissa Adamski: ] 

but methylation tests are around

Thursday August 28, 2014 7:50 Melissa Adamski
7:50
Moving on to question 3
Thursday August 28, 2014 7:50 
7:50
[Comment From Melissa AdamskiMelissa Adamski: ] 

and telomere tests

Thursday August 28, 2014 7:50 Melissa Adamski
7:50
[Comment From OliviaOlivia: ] 

Yes, that’s what I would have thought. I have heard of some companies/groups “offering” it.

Thursday August 28, 2014 7:50 Olivia
7:50
Question 3 – Is there a difference between nutritional genomics, nutrigenetics and nutrigenomics?
Thursday August 28, 2014 7:50 
7:51
[Comment From Melissa AdamskiMelissa Adamski: ] 

Defintely!

Thursday August 28, 2014 7:51 Melissa Adamski
7:51
Tell us more
Thursday August 28, 2014 7:51 
7:51
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Nutritional Genomics: Study of human genome, nutrition and health. It is the overarching term with a number of areas of science including nutrigenetics and nutrigenomics

Thursday August 28, 2014 7:51 Melissa Adamski
7:51
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Nutrigenetics: describes “how human genetic variation results in distinct nutritional requirements

Thursday August 28, 2014 7:51 Melissa Adamski
7:52
[Comment From Melissa AdamskiMelissa Adamski: ] 

 Nutrigenomics: studies the effect of nutrients on the genome at the molecular, cellular and systemic levels, as well as the effect of nutrients on gene expression

Thursday August 28, 2014 7:52 Melissa Adamski
7:52
[Comment From Melissa AdamskiMelissa Adamski: ] 

Essentially nutrigenetics and nutrigenomics are the opposite of each other- nutrigenetics looks at how the genes we were born with affect our nutrition requirements, while nutrigenomics looks at the effect of food and nutrients we take in and how they affect gene expression

Thursday August 28, 2014 7:52 Melissa Adamski
7:53
[Comment From Melissa AdamskiMelissa Adamski: ] 

Nutrigenetics = simpler and more evidence to start implementing in practice as only need a DNA sample

Thursday August 28, 2014 7:53 Melissa Adamski
7:53
[Comment From OliviaOlivia: ] 

Yes it’s the nutrigenomics that is the complete minefield!! 🙂

Thursday August 28, 2014 7:53 Olivia
7:53
[Comment From Melissa AdamskiMelissa Adamski: ] 

Nutrigenomics = more complex and difficult as usually need a sample of target tissue

Thursday August 28, 2014 7:53 Melissa Adamski
7:54
[Comment From Melissa AdamskiMelissa Adamski: ] 

Definitely olivia

Thursday August 28, 2014 7:54 Melissa Adamski
7:54
Thanks for that explanation – I think I have been using terms interchangeably
Thursday August 28, 2014 7:54 
7:54
Any other questions/comments on terminology?
Thursday August 28, 2014 7:54 
7:54
[Comment From OliviaOlivia: ] 

…until we find appropriate markers in blood or somewhere else that are representative of what is going on in the target tissue…if ever

Thursday August 28, 2014 7:54 Olivia
7:54
[Comment From MarietteMariette: ] 

Epigenetics also falls under Nutritional genomics and is rapidly evolving

Thursday August 28, 2014 7:54 Mariette
7:55
Have faith Olivia, it will happen one day – and I bet you will be one of the researchers…
Thursday August 28, 2014 7:55 
7:55
[Comment From Melissa AdamskiMelissa Adamski: ] 

definetly Mariette and I have heard the newer nterm nutritional epigenetics

Thursday August 28, 2014 7:55 Melissa Adamski
7:55
[Comment From Megan RossiMegan Rossi: ] 

Can we have an example of nutrigenetics in practice?

Thursday August 28, 2014 7:55 Megan Rossi
7:55
[Comment From OliviaOlivia: ] 

Would it be fair to say the epigenetics modulates the nutritional genomics?

Thursday August 28, 2014 7:55 Olivia
7:56
[Comment From Melissa AdamskiMelissa Adamski: ] 

Yes Olivia- and the complexity continues 🙂

Thursday August 28, 2014 7:56 Melissa Adamski
7:56
[Comment From OliviaOlivia: ] 

Thanks 🙂

Thursday August 28, 2014 7:56 Olivia
7:56
[Comment From Melissa AdamskiMelissa Adamski: ] 

SImple MTHFR C677T genetic test

Thursday August 28, 2014 7:56 Melissa Adamski
7:56
[Comment From Melissa AdamskiMelissa Adamski: ] 

a SNP in MTHFR gene

Thursday August 28, 2014 7:56 Melissa Adamski
7:57
[Comment From OliviaOlivia: ] 

and how do we best manage this one?

Thursday August 28, 2014 7:57 Olivia
7:57
[Comment From Melissa AdamskiMelissa Adamski: ] 

causes some people to metabolise folate up to 70% less

Thursday August 28, 2014 7:57 Melissa Adamski
7:57
[Comment From reneerenee: ] 

I’m with Megan. As a newbie to this area I would love am example

Thursday August 28, 2014 7:57 renee
7:57
[Comment From Melissa AdamskiMelissa Adamski: ] 

we know this with good evidence and it is in our NRVs from 2006

Thursday August 28, 2014 7:57 Melissa Adamski
7:57
[Comment From Melissa AdamskiMelissa Adamski: ] 

that some people need higher folate levels

Thursday August 28, 2014 7:57 Melissa Adamski
7:57
[Comment From Melissa AdamskiMelissa Adamski: ] 

BUT THE BIG QUESTION IS HOW MUCH??

Thursday August 28, 2014 7:57 Melissa Adamski
7:58
[Comment From Melissa AdamskiMelissa Adamski: ] 

ANd this is where translation gets difficult

Thursday August 28, 2014 7:58 Melissa Adamski
7:58
[Comment From MarietteMariette: ] 

Do you assess their folic acid intake and supplement if appropriate with bioavailable folate?

Thursday August 28, 2014 7:58 Mariette
7:59
[Comment From Melissa AdamskiMelissa Adamski: ] 

because the evidence looks at just simple nutrient requirements all the way up to relating the SNP to disease states

Thursday August 28, 2014 7:59 Melissa Adamski
7:59
Moving on to question 4
Thursday August 28, 2014 7:59 
7:59
Question 4 – Who do you think should provide advice on nutritional genomics to the public?
Thursday August 28, 2014 7:59 
8:00
[Comment From Melissa AdamskiMelissa Adamski: ] 

Yes Mariette that is absolutely the start- look at it in terms of all other information you gather about the patient

Thursday August 28, 2014 8:00 Melissa Adamski
8:00
[Comment From Melissa AdamskiMelissa Adamski: ] 

so you know the context you are interpreting it in

Thursday August 28, 2014 8:00 Melissa Adamski
8:00
[Comment From Melissa AdamskiMelissa Adamski: ] 

scary thing is many gps and alternate prac are doing the test and then

Thursday August 28, 2014 8:00 Melissa Adamski
8:01
[Comment From Melissa AdamskiMelissa Adamski: ] 

giving out one size fits all advice

Thursday August 28, 2014 8:01 Melissa Adamski
8:01
[Comment From OliviaOlivia: ] 

Dietitians in the know?

Thursday August 28, 2014 8:01 Olivia
8:01
[Comment From Melissa AdamskiMelissa Adamski: ] 

Q4 Nutritional genomics is an interesting mix of knowledge and skill- genetics, nutrition and genetic counselling

Thursday August 28, 2014 8:01 Melissa Adamski
8:02
[Comment From Melissa AdamskiMelissa Adamski: ] 

Perfect practitioner = geneticist+ dietitian+genetic counsellor all rolled into one.

Thursday August 28, 2014 8:02 Melissa Adamski
8:02
[Comment From Melissa AdamskiMelissa Adamski: ] 

However, when discussing nutritional genomics with the public it is more of a counselling role- so I think a dietitian upskilled in genetics, with training on how to discuss genetics with patients/the public is the way to go.

Thursday August 28, 2014 8:02 Melissa Adamski
8:02
[Comment From OliviaOlivia: ] 

So we have to go back to the books 🙂 ?

Thursday August 28, 2014 8:02 Olivia
8:02
[Comment From Melissa AdamskiMelissa Adamski: ] 

lol yes olivia I think so

Thursday August 28, 2014 8:02 Melissa Adamski
8:02
[Comment From MarietteMariette: ] 

Dietitians should be the ones but are we vocal enough?

Thursday August 28, 2014 8:02 Mariette
8:03
Wow that’s a lot of studying I imagine! What kind of training does a geneticist and genetics counsellor do?
Thursday August 28, 2014 8:03 
8:03
[Comment From OliviaOlivia: ] 

Lots…..

Thursday August 28, 2014 8:03 Olivia
8:03
[Comment From Melissa AdamskiMelissa Adamski: ] 

many dietitians have old school genetics training e.g. classic genetics

Thursday August 28, 2014 8:03 Melissa Adamski
8:03
[Comment From Melissa AdamskiMelissa Adamski: ] 

mutation= disease state

Thursday August 28, 2014 8:03 Melissa Adamski
8:03
[Comment From AmyAmy: ] 

This sounds like something that will need to be added to the curriculum in the future!

Thursday August 28, 2014 8:03 Amy
8:04
[Comment From Melissa AdamskiMelissa Adamski: ] 

but now we know so much more from human genome project

Thursday August 28, 2014 8:04 Melissa Adamski
8:04
[Comment From Melissa AdamskiMelissa Adamski: ] 

and our knowledge has grown

Thursday August 28, 2014 8:04 Melissa Adamski
8:04
[Comment From Melissa AdamskiMelissa Adamski: ] 

so yes we need to retrain I think

Thursday August 28, 2014 8:04 Melissa Adamski
8:04
[Comment From Melissa AdamskiMelissa Adamski: ] 

it is Amy

Thursday August 28, 2014 8:04 Melissa Adamski
8:05
[Comment From OliviaOlivia: ] 

Be need to be more vocal and explain the science properly in an easy to understand way

Thursday August 28, 2014 8:05 Olivia
8:05
[Comment From Melissa AdamskiMelissa Adamski: ] 

Remember- geneticists don’t have a working knowledge of nutrition/how to provide nutrition recommendations/individuliased nutrition therapy. Genetic counsellors are taught how to discuss genetics with clients, but can have any type of healthcare professional background (most work in clinical genetics).

Thursday August 28, 2014 8:05 Melissa Adamski
8:05
[Comment From Melissa AdamskiMelissa Adamski: ] 

thats the key olivia

Thursday August 28, 2014 8:05 Melissa Adamski
8:05
[Comment From Melissa AdamskiMelissa Adamski: ] 

translation! And that is where dietitians come in

Thursday August 28, 2014 8:05 Melissa Adamski
8:05
[Comment From Fiona SutherlandFiona Sutherland: ] 

Sounds like some workshops could be well received Melissa?? Sign me up!

Thursday August 28, 2014 8:05 Fiona Sutherland
8:05
[Comment From OliviaOlivia: ] 

We definitely need to embed it in the curriculum.

Thursday August 28, 2014 8:05 Olivia
8:05
[Comment From Megan RossiMegan Rossi: ] 

I think it is fantastic that you are taking it on board so early, as often dietitians miss the window of opportunity and other less skilled groups become the “specialist” in the area. I take my hat off to you.

Thursday August 28, 2014 8:05 Megan Rossi
8:06
[Comment From Melissa AdamskiMelissa Adamski: ] 

So once again, I come to dietitians being very well placed to advise on nutritional genomics to the pblic- but with extra learning and training. This highlights importance of building networks with geneticist and genetic counsellors. Build a strong network to work together to provide the best advice to customers.

Thursday August 28, 2014 8:06 Melissa Adamski
8:06
[Comment From Melissa AdamskiMelissa Adamski: ] 

Thanks megan- it was a hard slog for many years

Thursday August 28, 2014 8:06 Melissa Adamski
8:06
[Comment From LizLiz: ] 

How much in dietetics training and how much as intensives for APDs and ongoing PD

Thursday August 28, 2014 8:06 Liz
8:06
[Comment From Melissa AdamskiMelissa Adamski: ] 

and many critisisms

Thursday August 28, 2014 8:06 Melissa Adamski
8:07
[Comment From Melissa AdamskiMelissa Adamski: ] 

it is in DAA curriculm but more as optional I believe

Thursday August 28, 2014 8:07 Melissa Adamski
8:07
[Comment From MarietteMariette: ] 

It is incorporated in the curriculum in the UK but my experience has been that new grads are so excited about the area but have no one to turn to and experienced ones are not confident to incorporate it into practice. How can this gap be bridged?

Thursday August 28, 2014 8:07 Mariette
8:07
[Comment From Melissa AdamskiMelissa Adamski: ] 

most unis now putting it in but as an FYI

Thursday August 28, 2014 8:07 Melissa Adamski
8:07
[Comment From Melissa AdamskiMelissa Adamski: ] 

not a HOW to do in practice

Thursday August 28, 2014 8:07 Melissa Adamski
8:07
[Comment From GuestGuest: ] 

So what shall we be telling our student nutritionists and dietitians? Introducing them to the terminology and how to be critical? Is this enough?

Thursday August 28, 2014 8:07 Guest
8:08
[Comment From Melissa AdamskiMelissa Adamski: ] 

Agree Mariette- and british dietetic assoc has done great work

Thursday August 28, 2014 8:08 Melissa Adamski
8:08
[Comment From OliviaOlivia: ] 

yes they are

Thursday August 28, 2014 8:08 Olivia
8:08
[Comment From Melissa AdamskiMelissa Adamski: ] 

I think so- not just terminology but more about the practical issues etc they will come up against

Thursday August 28, 2014 8:08 Melissa Adamski
8:09
[Comment From Melissa AdamskiMelissa Adamski: ] 

and how to critique genetic research is essential

Thursday August 28, 2014 8:09 Melissa Adamski
8:09
Is anyone conducting genetic testing in their practice?
Thursday August 28, 2014 8:09 
8:09
[Comment From OliviaOlivia: ] 

maybe you need to make a movie Melissa and we can show it in class 🙂

Thursday August 28, 2014 8:09 Olivia
8:09
with popcorn?
Thursday August 28, 2014 8:09 
8:09
[Comment From Melissa AdamskiMelissa Adamski: ] 

I like to think of it as you need to look for 3 pieces of evidence

Thursday August 28, 2014 8:09 Melissa Adamski
8:10
[Comment From OliviaOlivia: ] 

absolutely

Thursday August 28, 2014 8:10 Olivia
8:10
[Comment From Melissa AdamskiMelissa Adamski: ] 

1. what is the evidence on the variation itself

Thursday August 28, 2014 8:10 Melissa Adamski
8:10
[Comment From Melissa AdamskiMelissa Adamski: ] 

2. what is the evidence of the effect on health

Thursday August 28, 2014 8:10 Melissa Adamski
8:10
[Comment From Melissa AdamskiMelissa Adamski: ] 

the first 2 usually have good evidence

Thursday August 28, 2014 8:10 Melissa Adamski
8:11
[Comment From Melissa AdamskiMelissa Adamski: ] 

3rd one is where geneticists kinda stop

Thursday August 28, 2014 8:11 Melissa Adamski
8:11
[Comment From Melissa AdamskiMelissa Adamski: ] 

so the evidence is piling up for nutritional genomics and variations

Thursday August 28, 2014 8:11 Melissa Adamski
8:11
[Comment From Melissa AdamskiMelissa Adamski: ] 

but not what to do about it!!!!!

Thursday August 28, 2014 8:11 Melissa Adamski
8:11
[Comment From AmyAmy: ] 

Is the testing itself expensive?

Thursday August 28, 2014 8:11 Amy
8:12
[Comment From Melissa AdamskiMelissa Adamski: ] 

love the movie idea

Thursday August 28, 2014 8:12 Melissa Adamski
8:12
[Comment From Melissa AdamskiMelissa Adamski: ] 

but with icecrea

Thursday August 28, 2014 8:12 Melissa Adamski
8:12
[Comment From Melissa AdamskiMelissa Adamski: ] 

no amy not at all

Thursday August 28, 2014 8:12 Melissa Adamski
8:12
[Comment From Melissa AdamskiMelissa Adamski: ] 

oop no $$ are coming down

Thursday August 28, 2014 8:12 Melissa Adamski
8:12
[Comment From OliviaOlivia: ] 

yes, it is rather mind boggling. and the working out what to about it costs big bucks!!

Thursday August 28, 2014 8:12 Olivia
8:12
[Comment From OliviaOlivia: ] 

soooo much cheaper now

Thursday August 28, 2014 8:12 Olivia
8:12
[Comment From Melissa AdamskiMelissa Adamski: ] 

private industry is driving this space

Thursday August 28, 2014 8:12 Melissa Adamski
8:13
[Comment From OliviaOlivia: ] 

ice cream is fine with me

Thursday August 28, 2014 8:13 Olivia
8:13
[Comment From AmyAmy: ] 

Are there any popular tests doing the rounds that have little evidence? That we should be aware of?

Thursday August 28, 2014 8:13 Amy
8:13
[Comment From Melissa AdamskiMelissa Adamski: ] 

last yr american company offering whole genome

Thursday August 28, 2014 8:13 Melissa Adamski
8:13
[Comment From Melissa AdamskiMelissa Adamski: ] 

FOR $99

Thursday August 28, 2014 8:13 Melissa Adamski
8:13
[Comment From Melissa AdamskiMelissa Adamski: ] 

over the internet!!!

Thursday August 28, 2014 8:13 Melissa Adamski
8:14
[Comment From OliviaOlivia: ] 

now THAT is ridiculous

Thursday August 28, 2014 8:14 Olivia
8:14
[Comment From Melissa AdamskiMelissa Adamski: ] 

but in Aus some healthcare professionals are charging big $$ some very cheap

Thursday August 28, 2014 8:14 Melissa Adamski
8:14
[Comment From Megan RossiMegan Rossi: ] 

Are any dietitian’s doing research in this area? Melissa maybe you could get some! (free labour work horses we are 😉 )

Thursday August 28, 2014 8:14 Megan Rossi
8:14
[Comment From Melissa AdamskiMelissa Adamski: ] 

Lots amy unfortunatley

Thursday August 28, 2014 8:14 Melissa Adamski
8:14
[Comment From Melissa AdamskiMelissa Adamski: ] 

a good rule of thumb is if nutrigenetic test is saying it predicts disease

Thursday August 28, 2014 8:14 Melissa Adamski
8:15
[Comment From Melissa AdamskiMelissa Adamski: ] 

usually means didgy test

Thursday August 28, 2014 8:15 Melissa Adamski
8:15
[Comment From Melissa AdamskiMelissa Adamski: ] 

oops dodgy

Thursday August 28, 2014 8:15 Melissa Adamski
8:15
[Comment From MarietteMariette: ] 

And I know some US dietitians recommending the $99 one and then picking out the nutriion related ones

Thursday August 28, 2014 8:15 Mariette
8:15
[Comment From AmyAmy: ] 

An example?

Thursday August 28, 2014 8:15 Amy
8:15
[Comment From Melissa AdamskiMelissa Adamski: ] 

most nutrigenetic variations that we can use now are not gene-disease

Thursday August 28, 2014 8:15 Melissa Adamski
8:16
[Comment From Melissa AdamskiMelissa Adamski: ] 

Thats scary mariette- what if they find out info the patient doesnt want to know

Thursday August 28, 2014 8:16 Melissa Adamski
8:16
[Comment From Melissa AdamskiMelissa Adamski: ] 

ethics!!!!! Do they tell them???

Thursday August 28, 2014 8:16 Melissa Adamski
8:16
[Comment From OliviaOlivia: ] 

yes that is terrible

Thursday August 28, 2014 8:16 Olivia
8:17
[Comment From OliviaOlivia: ] 

I think targeted testing is better than the whole genome – too many risks at this stage

Thursday August 28, 2014 8:17 Olivia
8:17
[Comment From Melissa AdamskiMelissa Adamski: ] 

Amy an eg is a NG test that tells a patient they WILL get type 2 diabetes

Thursday August 28, 2014 8:17 Melissa Adamski
8:17
[Comment From MarietteMariette: ] 

I guess they take clinical responsibility for that, I am not sure

Thursday August 28, 2014 8:17 Mariette
8:17
[Comment From Melissa AdamskiMelissa Adamski: ] 

Big difference

Thursday August 28, 2014 8:17 Melissa Adamski
8:17
[Comment From Melissa AdamskiMelissa Adamski: ] 

when it was prob looking at genes involved in carb metabolism

Thursday August 28, 2014 8:17 Melissa Adamski
8:17
[Comment From OliviaOlivia: ] 

and what does it really mean anyway

Thursday August 28, 2014 8:17 Olivia
8:17
[Comment From EmilyEmily: ] 

What are the dangers to watch out for if more and more people are having their whole genome tested? Can just anyone offer telling the general public what the results mean?

Thursday August 28, 2014 8:17 Emily
8:18
[Comment From Melissa AdamskiMelissa Adamski: ] 

Of course Emily- this are is not strongly regualted in aus

Thursday August 28, 2014 8:18 Melissa Adamski
8:18
[Comment From Melissa AdamskiMelissa Adamski: ] 

its just like anyone can offer nutrition advice

Thursday August 28, 2014 8:18 Melissa Adamski
8:19
[Comment From Melissa AdamskiMelissa Adamski: ] 

And any healthcare prof can conduct a genetic test (currently)

Thursday August 28, 2014 8:19 Melissa Adamski
8:19
[Comment From OliviaOlivia: ] 

are their impacts on insurance policies in the US?

Thursday August 28, 2014 8:19 Olivia
8:19
[Comment From EmilyEmily: ] 

another space for misinformation to raise its ugly head

Thursday August 28, 2014 8:19 Emily
8:19
[Comment From Melissa AdamskiMelissa Adamski: ] 

Mariette do you know?

Thursday August 28, 2014 8:19 Melissa Adamski
8:19
[Comment From MarietteMariette: ] 

I heard recently tat all genetic testing needs to be declared in Canada.

Thursday August 28, 2014 8:19 Mariette
8:20
[Comment From Melissa AdamskiMelissa Adamski: ] 

In Aus- any genetic test has potential to affect life insurance

Thursday August 28, 2014 8:20 Melissa Adamski
8:20
Any other questions for Melissa?
Thursday August 28, 2014 8:20 
8:20
[Comment From MarietteMariette: ] 

n the US although it is a fear in the US. The FDA has just last week changed its regulation on genetic testing so things will change albeit slowly for the nutrigenetic trsting market

Thursday August 28, 2014 8:20 Mariette
8:21
[Comment From OliviaOlivia: ] 

let’s collaborate on a textbook for dietitians, or a handbook; although you’re probably already doing that!!!

Thursday August 28, 2014 8:21 Olivia
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

My advice to dietitians…

Thursday August 28, 2014 8:21 Melissa Adamski
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

dont get put off on this area!

Thursday August 28, 2014 8:21 Melissa Adamski
8:21
[Comment From MarietteMariette: ] 

Count me in for a textbook!

Thursday August 28, 2014 8:21 Mariette
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

be excited

Thursday August 28, 2014 8:21 Melissa Adamski
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

be open minded

Thursday August 28, 2014 8:21 Melissa Adamski
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

be leaders

Thursday August 28, 2014 8:21 Melissa Adamski
8:21
[Comment From Melissa AdamskiMelissa Adamski: ] 

yet be critical

Thursday August 28, 2014 8:21 Melissa Adamski
8:22
[Comment From AmyAmy: ] 

That is what I was thinking Olivia! Do you have anything happening in terms of info for dietitians Melissa?

Thursday August 28, 2014 8:22 Amy
8:22
[Comment From OliviaOlivia: ] 

Be ingeneious haha

Thursday August 28, 2014 8:22 Olivia
8:22
[Comment From Melissa AdamskiMelissa Adamski: ] 

lol we actually Olivia not a text book but

Thursday August 28, 2014 8:22 Melissa Adamski
8:22
[Comment From Melissa AdamskiMelissa Adamski: ] 

I am dveloping a Monash University Nutritional Genomics short course 5-6 week online short course + 1 day practical seminar for dietitians

Thursday August 28, 2014 8:22 Melissa Adamski
8:22
[Comment From EmilyEmily: ] 

great advice, valid for all nutrition areas too

Thursday August 28, 2014 8:22 Emily
8:22
[Comment From Melissa AdamskiMelissa Adamski: ] 

Will be in Feb 2015

Thursday August 28, 2014 8:22 Melissa Adamski
8:22
That’s awesome Melissa!
Thursday August 28, 2014 8:22 
8:23
[Comment From Melissa AdamskiMelissa Adamski: ] 

Mariette- maybe we should 🙂

Thursday August 28, 2014 8:23 Melissa Adamski
8:23
[Comment From OliviaOlivia: ] 

well done 🙂

Thursday August 28, 2014 8:23 Olivia
8:23
[Comment From Melissa AdamskiMelissa Adamski: ] 

Thank you

Thursday August 28, 2014 8:23 Melissa Adamski
8:23
[Comment From OliviaOlivia: ] 

A book wouldn’t go astray either 🙂

Thursday August 28, 2014 8:23 Olivia
8:23
To go with the course…
Thursday August 28, 2014 8:23 
8:23
[Comment From OliviaOlivia: ] 

indeed!!!

Thursday August 28, 2014 8:23 Olivia
8:23
[Comment From Melissa AdamskiMelissa Adamski: ] 

Also a good read is Lynette Ferguson: Nutrigenomics and Nutrigenetics in Functional Foods and Personalized Nutrition

Thursday August 28, 2014 8:23 Melissa Adamski
8:23
[Comment From Melissa AdamskiMelissa Adamski: ] 

Maybe Olivia we should talk too 😉

Thursday August 28, 2014 8:23 Melissa Adamski
8:24
[Comment From MarietteMariette: ] 

I will be in touch!

Thursday August 28, 2014 8:24 Mariette
8:24
[Comment From Melissa AdamskiMelissa Adamski: ] 

Lynette is Head of dietetics at Auckland

Thursday August 28, 2014 8:24 Melissa Adamski
8:24
[Comment From Melissa AdamskiMelissa Adamski: ] 

and is head of nutrigenomics NZ

Thursday August 28, 2014 8:24 Melissa Adamski
8:24
[Comment From OliviaOlivia: ] 

Would love to chat. Might need to visit Auckland too 🙂

Thursday August 28, 2014 8:24 Olivia
8:25
Wow what a great chat tonight!
Thursday August 28, 2014 8:25 
8:25
[Comment From Melissa AdamskiMelissa Adamski: ] 

And work with clients

Thursday August 28, 2014 8:25 Melissa Adamski
8:25
Thank you so much to our guest moderator, Melissa Adamski for explaining all things nutrigenomics this evening
Thursday August 28, 2014 8:25 
8:25
[Comment From OliviaOlivia: ] 

yes thank you Melissa!!!!! well done 😀

Thursday August 28, 2014 8:25 Olivia
8:25
[Comment From Melissa AdamskiMelissa Adamski: ] 

You’re welcome

Thursday August 28, 2014 8:25 Melissa Adamski
8:26
[Comment From Melissa AdamskiMelissa Adamski: ] 

I had a great time

Thursday August 28, 2014 8:26 Melissa Adamski
8:26
[Comment From Melissa AdamskiMelissa Adamski: ] 

And great to see so much interest

Thursday August 28, 2014 8:26 Melissa Adamski
8:26
[Comment From Melissa AdamskiMelissa Adamski: ] 

🙂

Thursday August 28, 2014 8:26 Melissa Adamski
8:26
And thank you to everyone around Australia and the world (Sweden, Portugal, and elsewhere) for participating
Thursday August 28, 2014 8:26 
8:26
[Comment From OliviaOlivia: ] 

we’ll stay in touch re this area – we need strength in numbers

Thursday August 28, 2014 8:26 Olivia
8:26
[Comment From EmilyEmily: ] 

Thank you very much for sharing your knowledge, Melissa

Thursday August 28, 2014 8:26 Emily
8:27
[Comment From MarietteMariette: ] 

Good Night/Day All

Thursday August 28, 2014 8:27 Mariette
8:27
[Comment From AmyAmy: ] 

Thanks for having it at an appropriate time for us up this end of the world!

Thursday August 28, 2014 8:27 Amy
8:27
Glad we could accommodate Amy
Thursday August 28, 2014 8:27 
8:27
[Comment From Melissa AdamskiMelissa Adamski: ] 

Absolutely Olivia! That teleconference 🙂

Thursday August 28, 2014 8:27 Melissa Adamski
8:27
And lastly thanks to our supporter, Bond University Master of Nutrition and Dietetics Practice
Thursday August 28, 2014 8:27 
8:27
[Comment From OliviaOlivia: ] 

Sure thing Melissa 🙂

Thursday August 28, 2014 8:27 Olivia
8:28
[Comment From WolfWolf: ] 

Thank you melissa (and everyone!). A very interesting discussion!

Thursday August 28, 2014 8:28 Wolf
8:28
[Comment From Melissa AdamskiMelissa Adamski: ] 

Thanks Wolf and everyone else for listening (I can ramble 🙂 )

Thursday August 28, 2014 8:28 Melissa Adamski
8:28
We love your rambling!
Thursday August 28, 2014 8:28 
8:29
[Comment From OliviaOlivia: ] 

we sure do!

Thursday August 28, 2014 8:29 Olivia
8:29
[Comment From OliviaOlivia: ] 

g’nite – time for pizza. My genes like it.

Thursday August 28, 2014 8:29 Olivia
8:30
[Comment From OliviaOlivia: ] 

Thanks to DC for organising!

Thursday August 28, 2014 8:30 Olivia
8:30
[Comment From Melissa AdamskiMelissa Adamski: ] 

Yes thank you Maree and Bond

Thursday August 28, 2014 8:30 Melissa Adamski
8:31
Good night/morning, depending where you are
Thursday August 28, 2014 8:31