1. NEUTRIGENOMICS
A PERIO-NUTRITION INTERRELATIONSHIP
PRESENTED BY:
ANUSHRI GUPTA
1ST YEAR PG
DEPT. OF PERIODONTICS

2. INTRODUCTION
• Gingivitis and periodontitis are prevalent forms of periodontal disease in humans and are the result of
inflammatory and immune responses to bacterial infections of the gingival tissues.
• Periodontitis is "an inflammatory disease of the supporting tissues of the teeth caused by specific
microorganisms or groups of specific microorganisms, initiating progressive destruction of the
periodontal ligament and alveolar bone with pocket development, recession, or both."
-Newman & Carranza, 10th edition
• Improved understanding of the mechanism behind periodontal tissue destruction, the potential
protective role of nutrients and the advent of modern genomic measurement tools have led to an
increased interest in the association between nutrition and periodontal disease.

3. • Host based risk factors such as genetic background of an individual, socio-economic status, smoking and
dietary habits have all been suggested to alter the innate susceptibility of the host to periodontal
disease.
• Investigating the relation amongst nutrients and periodontal disease has been important to understand
the potential role of dietary modification in the prevention and treatment of periodontal disease and
the ultimate prevention of tooth loss through periodontal disease.
-Dang & Walker et. al. Periodontol 2000 (2014)

4. Evolution of Nutrigenomics
• On 25th April 1953, Watson and Crick published “the molecular structure of DNA”
• In 1997, the first nutrigenomics company was launched.
• If the genomic era was said to have a precise birth date, it was on April 14, 2003. That was when Human
Genome Project was launched with the participation of former U.S President Bill Clinton and former British PM
Tony Blair which contained the complete sequencing of the human genome.
• It was then realized that a new era in biological and medical sciences was beginning. This is often referred to as
the ‘omics’- revolution.
• In 2004, NuGo (European Nutrigenomics Organization) was born and funded until June 2010.
• In 2007, Nestle Research Center joined the industrial platform of the Kluyver Centre for Genomics of industrial
fermentation, Netherlands.
• In 2008, US Berkeley scientist predicted human genome tests within five years for $100
- Mhaske M, et. al. (2018)

5. What is Nutrigenomics?
• Specific bioactive feed components present in diet act as the key environmental factors which regulate
gene expression. (Mead, 2007)
• With these knowledge a new area of study called “NUTRIGENOMICS” has emerged. (Roche et al 2006)
• The study of how genes and gene products interact with dietary chemicals to alter phenotype and,
conversely, how genes and their products metabolize nutrients is called nutritional genomics or
“Nutrigenomics”. (Kaput et al, 2005)
• It will determine the individual nutritional requirements based on the genetic makeup of the person as
well as the association between diet and chronic diseases
• It will identify the genes involved in physiological responses to diet and the influence of environmental
factors on gene expression.

6. NUTRIGENETICS
• Nutrigenetics term was used first time by Dr R.O. Brennan in 1975 in his book Nutrigenetics
• Nutrigenetics identifies how the genetic make up of a particular individual co-ordinates his
or her response to various dietary nutrients
• Genetic polymorphisms can influence response to environmental elements, such as
enzymatic activities changes that affect circulating concentrations and ultimately the
effectiveness of chemicals and their metabolites
• It also reveals why and how people respond differently to the same nutrient.
- Farhud et. al. (2010)

7. • Nutrients and genome interact at two
levels:
1) Nutrients can induce or repress gene
expression thereby altering individual
phenotype.
2) Conversely, single nucleotide
polymorphisms (SNP) can alter the
bioactivity of important metabolic
pathways and mediators and influence
the ability of nutrients to interact with
them

8. Single nucleotide
polymorphism (SNP)
• Most of the genes have small sequence
differences –polymorphisms- that vary
among individuals
• SNP are the most common type of variation
• Specific genetic polymorphisms in human
populations change their metabolic
response to diet and influence the risk
patterns of disease
• Some SNPs change the recipe for the gene
so that either a different quantity of the
protein is produced or the structure of the
protein molecule is altered
- Farhud et. al. (2010)

9. ROLE OF NUTRITION
• Nutrient is defined as a source of nourishment, such as food, that can be metabolized by an organism to
give energy and build tissue whereas nutrition is the organic process by which an organism assimilates
food and uses it for growth and maintenance.
• Nutrients can be divided into six major classes, i.e. fats, carbohydrates, proteins, minerals, vitamins,
and water; these can be further subdivided into two broad categories, “macronutrients” (fats,
carbohydrates, and proteins) which are required in large quantities from the diet and
• “micronutrients” (minerals, vitamins, trace elements, amino acids, and polyunsaturated fatty acids
[PUFA]) which are only required in small quantities in the diet and which are essential for a range of
biological processes important in supporting optimal health.
- Tomar, et. al. (2017)

10. The four basic principles of
nutrigenomics are:
i. Improper diets are risk factors for disease.
ii. Dietary chemicals alter gene expression and /or change genome structure.
iii. The degree to which diet influences the balance between healthy and disease
states may depend on an individuals genetic makeup.
iv. Some diet-regulated genes are likely to play a role in the onset, incidence,
progression, and/or severity of chronic diseases.
- R. Yasothai, (2016)

11. How Nutrigenomics
Work? • Nutrigenomics is an emerging field of science and
technology unrevealing inter-relationships between
nutrients and human genome using modern tools such as
transcriptomics, metabolomics and proteomics.

12. Practical application of
Nutrigenomics
1. Genes and proteins expressed differentially in health and disease that are modifiable by
nutrients are identified.
2. Genes, proteins, and metabolites which are influenced by specific nutrients that are known to
be beneficial or harmful are identified.
3. To identify genes, proteins, and metabolites that are altered by dietary fats associated with
cardiovascular disease.
4. To identify genes, proteins, and metabolites that is altered by omega 3 fatty acids.
5. Genetic variations that alter the nutrient-gene interactions in applications 1 and 2 are
identified
- Mhaske M et. al. (2018)

13. Nutrition-gene interaction
1. Direct interactions: Nutrients after interacting with a receptor, behave as transcription
factors that can bind to DNA and induce gene expression
2. Epigenetic interactions: Nutrients can alter the structure of DNA so that gene expression is
altered
3. Genetic variation: Common genetic variations such as single nucleotide polymorphisms
(SNPs) can alter the expression or functionality of genes.

14. How does diet
affects our gene
expression ?
Genes express themselves through proteins.
Enzymes are special proteins designed to get things started.
Our genome instructs ribosomes to produce many enzymes that
destroy toxins.
• Some foods such as cauliflower, broccoli and brussels sprout contain chemicals
that actually tell our gene to direct biosynthesis of these enzymes
• In some individuals genes give unclear instructions for making an enzyme,
(phenylalanine hydroxylase (PAH) ) that metabolizes the amino acid,
phenylalanine. As a result this amino acid accumulate in body fluids, thereby
causing brain damage.
• A diet restricting this amino acid will stop the damage if detected in early infancy.
Eg: fish, chicken, tofu, milk, cheese, beans, seeds, nuts, and whole grains.

15. NUTRITIONAL MODULATION OF
PERIODONTAL INFLAMMATION
• Inflammation is a localized protective response elicited by injury or destruction of
tissues, which serves to destroy, dilute, or wall off both the injurious agent and the
injured tissue.
• Chronic and non resolving inflammation is destructive and is central to a number of
chronic diseases, periodontitis being one of them.
• Oxidative stress is a key driver of chronic inflammation and as a result has a central role
in the pathogenesis of a wide range of chronic inflammatory diseases.
• Periodontal attachment destruction is caused by hyper-inflammatory response which
fails to eradicate the causative pathogens and generates prolonged release of neutrophil
proteolytic enzymes, pro-inflammatory mediators, and reactive oxygen species (ROS).

16. Oxidative stress is central to
the pathogenesis of a number
of systemic diseases including
periodontitis and has been
proposed
as a potential mechanistic link
with systemic disease

17. NUTRITIONAL MODULATION OF
PERIODONTAL INFLAMMATION
Antioxidant vitamins (vitamins A, C and E)
Trace elements (selenium, copper and zinc)
Depleted during periods of inflammation
Counteract reactive oxygen species (ROS) damage to cellular
tissues
Modulate immune-cell function through regulation of redox-regulated
transcription factors
Affect production of cytokines & prostaglandins

18. • These vitamins and trace elements are also known to play a pivotal role in maintaining
epithelial tissue integrity and structure, which is also relevant to periodontal health.
- Dang & Walker et. al. Periodontol 2000 (2014)
Selenium
important redox functions
Selenium-dependent
glutathione enzymes
Reduction of damaging lipid and
phospholipid hydroperoxides
to harmless products

19. DISCUSSION
• Improved understanding of the mechanism behind periodontal tissue destruction, potential
defensive role of nutrients, and advent of modern genomic measurement tools has led to an
increased interest in the association between nutrition and periodontal diseases.
• Researchers have found irrefutable evidence that macronutrients and micronutrients
modulate proinflammatory and anti-inflammatory cascades, which influence a person’s
baseline inflammatory status.
• A lack of nutrients does not cause gingival inflammation but may be a predisposing factor by
disrupting the process of tissue repair.

20. • Nutritional interventions for varying severities of gingivitis are the same as those for
promoting overall health by encouraging adequate intake of all food groups and analyzing
fermentable carbohydrate intake to determine potentially damaging habits that intensify the
gingivitis.
• This ensures an acceptable immunological response for optimal healing and can help to
prevent or minimize infections, thereby controlling the consumption of dietary sugars and
fats, will aid in reducing the levels of oxidative stress and minimizing the inflammatory
sequelae.

21. Elevated glucose and lipid
levels
ROS at a rate that exceeds endogenous
antioxidant defenses
OXIDATIVE STRESS
Chronic Inflammatory Pathologies
Transcribe several proinflammatory
cytokines
Lipid peroxidation (chain reaction
on PUFA side chains)
Low density lipoprotein gets
oxidised
Toll like receptors- 2/4, on
inflammatory cell membranes
Activation of NF-κB
Protein kinase- C enzyme

22. • PUFAs of the omega-3 form (ω-3 PUFAs) found in fish oils, lower postprandial triglyceride levels and
findings observed by Yokoyama M et al. (2007) in their randomized control study observed that it has
anti-inflammatory and cardiovascular protective effects.
• Kesavalu et al. (2006) demonstrated that rats infected with Porphyromonas gingivalis and fed a diet rich
in ω-3 PUFAs for 22 weeks experienced less bone loss than control, rats fed a diet rich in n-6 PUFAs.
• A recent randomized, double-blinded, clinical trial by Van der Velden et al. (2011) investigated potential
clinical benefits of a powdered fruit and vegetable juice concentrate on the treatment of patients with
chronic periodontitis.
• It was concluded that supplementation with the fruit and vegetable concentrate results in increased
pocket depth reduction, following standard nonsurgical therapy when compared to a placebo control.

23. • Further, as an adjunct to scaling and root planning, selected application of beneficial bacteria would also
achieve and maintain periodontal health.
• Oral administration of probiotics may benefit oral health by preventing the growth of harmful
microbiota or by modulating mucosal immunity in the oral cavity.
• Probiotics are also known to produce AOs, which in turn prevent plaque formation by neutralizing the
free electrons which are needed for the mineralization of plaque.
• On the other hand, prebiotics are non-digestible oligosaccharides that affect the proliferation of resident
commensal bacteria, which may exert beneficial effects on the host by directly stimulating expression of
IL-10, interferon, enhancement of immunoglobulin A secretion, and modulation of inflammatory
responses in pathogens.
- Tomar, et. al. (2017)

24. • For inhibition and management of
periodontitis, daily nutrition should include
sufficient AOs (berries, kiwi fruit), Vitamin D,
and calcium.
• The recommendations of the 2011 European
workshop on periodontology suggest that the
dental team should consider, including advice
to all patients, to increase levels of fish oils,
fibers, fruits, vegetables and to reduce levels
of refined sugars as part of a periodontal
prevention/treatment regimen and a general
health benefit message. (Chapple et. al. 2012)

25. CONCLUSION
• Diet is an important environmental factor that
interacts with the genome to modulate disease
risk.
• The future of nutrigenomic research promises to
provide additional knowledge of biological
function and individual response to diet.
• Based on the pathology of periodontal disease,
the assumption is that specific nutrients which
can modulate immune and inflammatory
responses could in turn modulate periodontal
health.

26. REFERENCES
• Tomar N, Gupta C, Kaushik M, Wadhawan A. Nutrigenomics: A perio-nutrition interrelationship. J
Oral Res Rev 2017;9:32-6.
• Singh-Dang T, Walker M, Ford D, Valentine RA. Nutrigenomics: the role of nutrients in gene
expression. Periodontol 2000 2014;64:154–160.
• Mhaske M, Bhandari S, Rathod V. An unprecedented concept: Nutrigenomics in periodontics. Int
J Adv Res Dev 2018;3:504-506.
• Singh S, Kalra P. Nutrigenomics in periodontics- An overview. Int J Oral Health Den 2017; 3(2):74-
76.
• Yasothai R. Development and Principles of Nutrigenomics. Int J Sci Env Tech. 2016;5(6): 2765 –
2768.
• Farhud DD, Yeganeh MZ. Nutrigenomics and Nutrigenetics. Iran J Public Health. 2010; 39(4): 1–14.

27. THANK YOU