John, based on a review of your genetic data, your diet type is Mediterranean.

The latest in nutrition science has taught us that people respond very differently to dietary fat based, in part, on genetics. The source, type and amount of fat we consume has been the focus of western dietary advice for decades, and hundreds of genes have been investigated to better identify people who stand to benefit from lower fat diets. We've refined the best studied heart health genes down to what we consider to be the key players, and offer the insights below as a strategy for keeping major risk factors associated with cardiovascular disease, such as LDL-C and LDL-P, in a healthy range.

The Mediterranean diet lowers overall fat intake and instead emphasizes greater consumption of fiber rich carbohydrates. Why? Based on our scoring system, we believe your genotype is more likely to make significant amounts of “extra” cholesterol when eating a diet rich in saturated fat. While we need cholesterol to be healthy, and 80% of cholesterol in the body is made by the body, too much cholesterol circulating in lipoproteins, called LDL, is bad for heart health. Put another way, eating a diet higher in saturated fat will likely cause significant increases in your LDL-C numbers. Consider this study which evaluated healthy individuals on a high fat diet for changes in cholesterol. Some saw LDL-C go up by 107% on the high fat diet, while others saw an increase of only 5%. The average increase in LDL-C was 44%.

We estimate you will be closer to the average LDL-C increase of 44% than the 5% group when eating too much saturated fat. While it’s possible you could see a substantial uptick in LDL-C when eating a high saturated fat diet, your triglycerides are more likely to be in a normal range which is a sign of the ability to use “carb fuel” more efficiently.

Saturated fats have gotten a bad rap for a long time, but no two people respond in exactly the same way to dietary fat. While saturated fat will increase LDL-C in all people to some degree, those with a genetic predisposition see the largest increases. When cholesterol numbers go up to dangerous levels while eating saturated fat rich foods, it’s a sign that fat in the diet should be curtailed. In these people, foods like butter, cream, cheese, meats, and eggs, should be limited or excluded altogether.

Highest Saturated Fat Foods

Biggest sources of saturated fat in the American diet:

Pizza, cheese and dairy products

Meat and processed meats

Grain-based desserts

Butter

Coconut products such as MCT oil

However, fat is not the whole story when it comes to heart health. Several well-designed studies have shown that sugars, which are commonly used to replace saturated fats in prepared foods, may actually be more harmful to health for some people, and that in some instances, a high unsaturated fat intake (especially omega 6 polyunsaturated fats found in vegetable oils and processed foods) can also be harmful to health.

Excuse us for a vast oversimplification, but when fat and cholesterol is the predominant problem, people tend to see increases in their LDL-C and cholesterol numbers. Conversely, when the body can’t handle a diet high in simple carbohydrates and sugar, triglycerides and insulin levels rise to unhealthy levels. In some, both fat and sugar is an issue simultaneously, and there is never a time when dessert and sweet foods are a healthy choice. You can think of LDL as “fat taxis” that shuttle cholesterol, triglyceride and plant fats around the body. While you don’t necessarily want LDL at zero, lower is better for heart health. Why? The fewer taxis on the road, the less likely one takes a “wrong turn” and delivers a piece of fat into your artery wall, which is the triggering event for heart disease.

Based on an analysis of your fat metabolism genes, we believe it’s more likely you will see “cholesterol rich” LDL, rather than “triglyceride rich” LDL when eating a diet that is too high in saturated fat. This does not mean sugar is a healthy food for you, if you eat sweets and refined carbohydrates to excess, triglycerides will go high as well. However, Mediterranean genotypes are likely to use “carb fuel” more efficiently than “fat fuel.” A diet that limits saturated fats, and emphasizes fiber rich complex carbohydrates and omega-3 rich foods, like wild fish, is more likely to be the best option for your heart health.

Carbohydrates are types of “macromolecules” built from individual sugar molecules. They can exist as simple sugar molecules (monosaccharides), or more complex chains of two or more sugar molecules (disaccharides and polysaccharides). The simple sugars are turned into glucose and rapidly absorbed into the bloodstream through the small intestine. By contrast complex carbohydrates are slower to digest and take more time to be converted into glucose. Complex carbohydrates are beneficial because they ferment in the colon where they feed the “good guy” microbes in the gut, which in turn produce short chain fatty acids, which are protective against conditions like leaky gut.

It is this process of breaking down and absorbing carbohydrates that causes our blood sugar levels to rise. The simple “fast carbs,” like bagels, cause an immediate spike, whereas the complex “slow carbs,” like rolled oats, don’t spike blood sugar as rapidly. When blood sugar rises, the pancreas makes insulin, which is the hormone responsible for helping the body absorb glucose. Our cells love glucose because they can use it to make energy. Historically, pure glucose was in short supply and our neolithic ancestors would have gorged on it whenever possible. However, these days, with the prevalence of processed foods, simple sugars are too readily available. This has caused changes in the average person’s blood sugar levels. Elevated blood sugar levels, in turn, are associated with diseases like type 2 diabetes, heart disease, obesity, and even cancer.

Highest Glycemic Foods

These foods quickly convert into sugar in the body:

White and whole wheat bread

Corn tortillas

Processed cereals

White potatoes

Instant oats

White rice

Some of us are at greater risk for chronically elevated blood sugar levels than others who use “carb fuel” more readily. For these people, insulin can’t get rid of all the sugar in the blood and the storage options for glucose become full. This leaves blood sugar chronically elevated, which causes inflammation. It also causes the body to convert the unused sugar and carbohydrate into triglyceride fats, which can be bad for heart health. The glycemic index (GI) metric has been developed to help us identify how rapidly our body will convert carbohydrate sources into glucose. A GI value of 55 is often identified as the cutoff between low and high-GI foods. Regardless of genetics, as a general rule, it is always best to lean towards lower GI slow carb sources.Our panel of SNPs is specifically targeted at predicting how you will respond to various carbohydrate sources.

After analyzing your carbohydrate genes, the good news is that you are more likely to perform well on a mixed carbohydrate diet. You should feel free to include some high-GI fast carb foods, but should always attempt to maintain a majority low-GI slow carb intake. While you have a genetic profile that can more efficiently clear the spikes in blood sugar they cause, refined grains, such as corn tortillas, bread products and pasta are not healthy options as a staple, regardless of genetics. They can be enjoyed as a treat, but should be limited to a few portions per week as refined carbohydrates and sugar can negatively impact the health of the microbiome.

To play along at home, work with your doctor to measure heart health markers like triglycerides, fasting glucose, fasting insulin, HbA1c, and if you have access to a more advanced lab, VLDL. We would predict that, unless you are eating a large amount of sugar and fast carbs, these markers are more likely to be in a healthy range and that LDL-C could trend high when an excess of saturated fat is consumed.

Good

Based on a review of your wheat genes, you are more likely to be able to incorporate wheat into a healthy diet. However, scoring well on wheat tolerance from a genetic standpoint does not always mean you will thrive eating a diet high in processed wheat products. Unfortunately, many of the processed wheat products in America, such as pretzels and crackers, contain pesticides, such as glyphosate, that many are sensitive to. Eating small batch bread products and sourdough from specialty bakeries, as well as wheat products from bakeries in Europe, should not be a problem for you subject to blood sugar and carbohydrate recommendations outlined in your diet plan.

We get to protein last, but not because protein isn’t important. Eating enough protein is vital to ensure the body has sufficient building materials to make its own proteins, and proteins can even act as an alternative energy source when fat and carbohydrate stores are low. However, digesting these complex molecules can be a difficult process and there are several ways in which nutritional wellbeing can be affected.

As a Mediterrranean genotype, you should have little issue digesting protein from a wide variety of sources. You do not carry markers for lactose or histamine intolerance. Given the slight reduction in saturated fat intake associated with the Mediterranean diet, omega 3 rich fish like wild salmon, lean animal protein, and whole food sources of plant proteins are the best bet for staple foods.

Your LDL Genes

We have identified that you may have issues maintaining a good HDL:LDL ratio and would therefore recommend observing your circulating LDL:HDL ratio, which can be determined with a simple non-invasive lab test. However, by maintaining a diet low in saturated fats you should naturally be addressing this issue. Food choice doesn’t have as big of an impact on HDL as it does LDL, so if you find your numbers are out of range, try incorporating more plant based foods that have been shown to help decrease LDL, such as olive oil, beans, certain whole grains like oats, flax, nuts, chia seeds, and even avocados. When LDL markers are out of range, it can be a good idea to cut down even further on the amount of saturated fat consumed in the diet.

Your Methylation status: High Risk

Based on a review of all your SNPs in the methylation cycle we have determined that you are at a high risk of having issues with this pathway. We would therefore recommend that you consider supplementing your diet with a moderate to high dose B multivitamin that includes the methylated version of these vitamins. You may also wish to investigate each SNP at an individual level and tailor your vitamin B intake accordingly, but we would always recommend starting at a very low dose, and working upwards, while ensuring you have a ready supply of other B vitamins in your diet. Do not take any new supplement without first discussing with your doctor. For information on choosing a B vitamin and selecting dose, see this blog post.

Low Absorber

You are unlikely to absorb sterol in foods like avocado, nuts and seeds, and high quality oils, such as avocado and olive oil. These foods can be eaten as part of a healthy, balanced diet.

Consider Reduction

Analysis of your sodium SNPs suggests that you may wish to consider reducing your sodium intake. Salted, cured and other processed foods are high sources of sodium and intake should therefore be minimised.

High Risk

You are less likely to produce adequate levels of superoxide dismutase and glutathione, two antioxidants the body uses to excrete and neutralize toxins. This does not necessarily mean levels of these antioxidants will be low, however, you may benefit from limiting exposure to air pollution and other environmental toxins, even including mercury dental amalgams, chlorine in tap and shower water, and heavy metals found in large species of fish, such as tuna and swordfish. For a list of products we have identified as being green and free from toxic elements, check out our ecoHome directory.

Good

Sleep is a complex topic which makes giving a single sleep “score” difficult. For that reason, we have broken aspects of your sleep score down into the chronotype and caffeine sub-sections below. As a general rule, your overall sleep score suggests that you should have no issues sleeping soundly as long as you maintain a healthy diet, minimize stress and maintain good sleep hygiene. Poor sleep hygiene, like eating large meals before bed, lots of screen time, having more than one alcoholic drink, or overdoing it with caffeine, will impact sleep regardless of genetic predisposition.

Fast metabolizer

Congratulations, you are likely a fast metabolizer of caffeine. This means your body does a good job of breaking down caffeine once it enters your system and the caffeine you do drink has a shorter half life. Nevertheless, we still recommend avoiding all caffeine within 6 hours of your usual bedtime. For more on the genetics of caffeine metabolism, see this blog post.

Maximum daily dose: 200-400 mg per day

Lark

Your genetics suggest that you are likely to be a morning-lark and should therefore focus on completing activities that require a lot of concentration in the morning, saving more mundane or physical work till the afternoon. In the same vein, while you may be able to leap out of bed in the morning, this is predicated on the right bedtime and a good night’s sleep. As a general rule, you will do best with a bedtime before 10 pm.

Optimal bedtime: between 9 - 10pm

Optimal work hours: between 6am - 11am

Healthy response

You do not carry genetic markers linked to reductions in mental health when consuming THC in cannabis products. However, despite a very low risk for any psychological or metabolic issues, we recommend avoiding synthetic THC altogether.

• Cannabis dose: Below 70 mg of THC per day of use
• Ideal THC content: Max of 50% THC content. Look for products with higher CBD ratios.

In moderation

Good news, you are likely to efficiently and effectively metabolize the byproducts of alcohol. This gives you a little more wiggle room with an evening glass of wine, however, we still recommend sticking well within dietary guidelines.

Alcoholic beverages per week:

• 7 units per week for men (never more than 2 drinks at one sitting)
• 4 units per week for women (never more than two drinks at one sitting)

Normal

The CBS genes make an enzyme called cystathionine beta synthase (CBS). CBS helps convert homocysteine to cystathionine as the first step in the transsulfuration pathway. You can think of the transsulfuration pathway as the complicated chain of biochemical reactions the body uses to metabolize sulfur. Perhaps the transsulfuration pathway’s most important job is to help produce glutathione, a powerful antioxidant we need to stay in good health.

When the CBS gene is highly active, the body cycles through homocysteine at a very rapid pace. Since the body makes ammonia as a byproduct of metabolizing sulfur, some have theorized that increased CBS activity results in higher levels of ammonia in the blood, which can lead to sulfur sensitivity in some individuals.

Based on an analysis of CBS and your other sulfur metabolism genes, it is unlikely that you will have issues metabolizing sulfur. Your sulfur metabolism should be normal. This means you are less likely to have sensitivity to sulfur containing supplements like glutathione, NAC, alpha lipoic acid, epsom salt, garlic, taurine, and others. Sulfur rich cruciferous vegetables should be included in your diet many times per week.

Limited Use

NSAIDs (non-steroidal anti inflammatory drugs) such as aspirin, ibuprofen (Advil or Motrin) and naproxen (Aleve or Naprosyn) can be metabolized differently depending on our genetics. These drugs are one of the more common causes of allergic reactions, especially at higher doses. During an allergic reaction your immune cells release histamine which is an attempt to protect the delicate tissues of the body from further harm, but despite your body’s best intentions, histamine actually induces a lot of the symptoms associated with allergies.

Histamine is normally broken down by an enzyme called diamine oxidase (DAO) which is encoded for by the AOC1 gene. There are several important SNPs in this gene, but for NSAID purposes, we are looking at rs10156191. This gene is associated with lower DAO levels. Since NSAID drugs further lower DAO, those with variants in rs10156191 tend to have sensitivity to drugs like aspirin and ibuprofen. There are also two SNPs in CYP genes, rs1799853 and rs10509681 which regulate your response to NSAIDs, with those carrying risk alleles being at heightened risk of intestinal bleeding.

Analysis of your SNPs suggests that you are unlikely to have an allergic reaction to NSAID drugs. However, this doesn’t mean these drugs are a good choice for pain management as they tend to damage the lining of the stomach and cause internal bleeding.