Nutrition Society Silver Medal Lecture Nutrigenetics and personalised nutrition: how far have we progressed and are we likely to get there?

Nutrigenetics and personalised nutrition are components of the concept that in the future genotyping will be used as a means of defining dietary recommendations to suit the individual. Over the last two decades there has been an explosion of research in this area, with often conflicting findings reported in the literature. Reviews of the literature in the area of apoE genotype and cardiovascular health, apoA5 genotype and postprandial lipaemia and perilipin and adiposity are used to demonstrate the complexities of genotype-phenotype associations and the aetiology of apparent between-study inconsistencies in the significance and size of effects. Furthermore, genetic research currently often takes a very reductionist approach, examining the interactions between individual genotypes and individual disease biomarkers and how they are modified by isolated dietary components or foods. Each individual possesses potentially hundreds of 'at-risk' gene variants and consumes a highly-complex diet. In order for nutrigenetics to become a useful public health tool, there is a great need to use mathematical and bioinformatic tools to develop strategies to examine the combined impact of multiple gene variants on a range of health outcomes and establish how these associations can be modified using combined dietary strategies.

Dietary, physiological, genetic and pathological influences on postprandial lipid metabolism

Most of diurnal time is spent in a postprandial state due to successive meal intakes during the day. As long as the meals contain enough fat, a transient increase in triacylglycerolaemia and a change in lipoprotein pattern occurs. The extent and kinetics of such postprandial changes are highly variable and are modulated by numerous factors. This review focuses on factors affecting postprandial lipoprotein metabolism and genes, their variability and their relationship with intermediate phenotypes and risk of CHD. Postprandial lipoprotein metabolism is modulated by background dietary pattern as well as meal composition (fat amount and type, carbohydrate, protein, fibre, alcohol) and several lifestyle conditions (physical activity, tobacco use), physiological factors (age, gender, menopausal status) and pathological conditions (obesity, insulin resistance, diabetes mellitus). The roles of many genes have been explored in order to establish the possible implications of their variability in lipid metabolism and CHD risk. The postprandial lipid response has been shown to be modified by polymorphisms within the genes for apo A-I, A-IV, AN, E, B, C-I and C-III, lipoprotein lipase, hepatic lipase, fatty acid binding and transport proteins, microsomal trigyceride transfer protein and scavenger receptor class B type I. Overall, the variability in postprandial response is important and complex, and the interactions between nutrients or dietary or meal compositions and gene variants need further investigation. The extent of present knowledge and needs for future studies are discussed in light of ongoing developments in nutrigenetics.

Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial

Background: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain. Objective: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome. Design: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets. Results: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10−4 mL · μU−1 · min−1 (interquartile range: 2.0, 4.2 × 10−4 mL · μU−1 · min−1), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, −4% (−12.7%, 5.3%); for the HM/HGI group, 2.1% (−5.8%, 10.7%); for the HM/LGI group, −3.5% (−10.6%, 4.3%); for the LF/HGI group, −8.6% (−15.4%, −1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations. Conclusions: This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298.

Mathematical modelling for the digital society

We argue the case for a new branch of mathematics and its applications: Mathematics for the Digital Society. There is a challenge for mathematics, a strong “pull” from new and emerging commercial and public activities; and a need to train and inspire a generation of quantitative scientists who will seek careers within the associated sectors. Although now going through an early phase of boiling up, prior to scholarly distillation, we discuss how data rich activities and applications may benefit from a wide range of continuous and discrete models, methods, analysis and inference. In ten years time such applications will be common place and associated courses may be embedded within the undergraduate curriculum.

Observed adaptation to climate change: UK evidence of transition to a well-adapting society

This paper investigates whether and to what extent a wide range of actors in the UK are adapting to climate change, and whether this is evidence of a social transition. We document evidence of over 300 examples of early adopters of adaptation practice to climate change in the UK. These examples span a range of activities from small adjustments (or coping) to building adaptive capacity, implementing actions and creating deeper systemic change in public and private organisations in a range of sectors. We find that adaptation in the UK has been dominated by government initiatives and has principally occurred in the form of research into climate change impacts. These actions within government stimulate a further set of actions at other scales in public agencies, regulatory agencies and regional government (or in the devolved administrations), though with little real evidence of climate change adaptation initiatives trickling down to local government level. The water supply and flood defence sectors, requiring significant investment in large scale infrastructure such as reservoirs and coastal defences, have invested more heavily in identifying potential impacts and adaptations. Economic sectors that are not dependent on large scale infrastructure appear to be investing far less effort and resources in preparing for climate change. We conclude that while the government-driven top-down targeted adaptation approach has generated anticipatory action at low cost, it may also have created enough niche activities to allow for diffusion of new adaptation practices in response to real or perceived climate change. These results have significant implications for how climate policy can be developed to support autonomous adaptors in the UK and other countries.

Amyloid formation: interface influence

The causes of pathological conditions such as Alzheimer’s and Parkinson’s diseases are becoming better understood. Proteins that misfold from their native structure to form aggregates of β-sheet fibrils — termed amyloid — are known1,2 to be implicated in these ‘amyloid diseases’. Understanding the early steps of fibril formation is critical, and the conditions, mechanism and kinetics of protein and peptide aggregation are being widely investigated through a variety of in vitro studies. Kinetic aspects of the dispersion of the protein or peptide in solution are thought to influence the fibrillization process by mass-transfer effects. In addition, mixing also leads to shear forces, which can influence fibril growth by perturbing the equilibrium between the isolated and aggregated proteins, causing existing fibrils to fragment and create new nuclei3. Writing in the Journal of the American Chemical Society, David Talaga and co-workers have now highlighted4 an additional factor that can influence the fibrillization of amyloid-forming proteins — the presence of hydrophobic interfaces.

The strategy makers: thoughts on war and society from Machiavelli and Clausewitz

Introductory chapter. Introduction and excerpts from works of Seigneur de Fourquevaux (1548); Francois Loque – Saillans (1589); Matthew Sutcliffe (1593); Don Bernardino de Mendoza (1595); Paul Hay du Chastelet (1668); Marquis Santa Cruz de Marcenado & Zanthier (1724-30/1775); Guibert (1772); Rühle von Lilienstern (1816/1817).