Personalization in healthcare: solution for the “holistically effective” approach

Today I came across with 2 studies published in high-impact factor journals [Cell group] giving opposite messages regarding the use of dietary supplements, due to unexpected interactions and influences on health conditions.

Impairment of an Endothelial NAD+-H2S Signaling Network Is a Reversible Cause of Vascular Aging

– A positive effect of Nicotinamide mononucleotide (NMN), a molecule used in supplements for active aging since many years, on improving blood vessels functionality of old mice (comparable to 70-year-old humans), being a decline in capillary density and blood flow a major cause of mortality and morbidity. Interestingly, the molecular mechanism behind (that increased levels of the anti-aging enzyme SIRT1) is similar to workout and dietary restriction

The Dietary Supplement Chondroitin-4-Sulfate Exhibits Oncogene-Specific Pro-tumor Effects on BRAF V600E Melanoma Cells

– A negative effect of chondroitin-4-sulfate (CHSA), a natural glycosaminoglycan approved as a dietary supplement used for osteoarthritis, that selectively promotes the tumor growth of melanoma cells containing a specific genetic characteristic (mutation V600E of the gene BRAF) which is present in around 50% of melanomas. Not only this, it seems that it confers drug resistance to a commonly used anti-melanoma therapy (BRAF inhibitors).

Of course, these are only two examples of many studies regarding the (sometimes unpredicted) interactions between the use of supplements and health/disease conditions unrelated to their first indications. Dietary supplements contain a variety of ingredients, both natural herbal/botanicals and other categories (such as vitamins, minerals, amino acids), and in any case, it is important to understand their effects and effectiveness, because “natural” does not always mean “harmless” and “safe”1. It is actually very important to understand the label instructions, follow the healthcare providers advice (and tell them about any supplement you are taking) and trust only products with clear label statements and only from trusted manufacturers.

In the pursuit of effectiveness and safety, the healthcare trend towards Personalization will be relevant also in the Supplements field where an accurate and solid scientific background is necessary and must be always kept in mind along any step of product design and buyer journey. Indeed, a more comprehensive approach that takes into account not only the properties of any ingredient but also the eventual effects in different contexts is the safest and effective solution.

For example, as in the case of CHSA dangerous effect for a specific group of cancer patients, Genotype is an important piece of information to be considered to personalize both therapeutic treatments and dietary advice. However, it is reasonable to look for genetic information only if the “Biological plausibility” could apply: “a gene–environment interaction will only be accepted if it can be reproduced in two or more studies and also seems plausible at the biological level” []

The success of any Personalization approach resides in the use of a combination of any relevant information, as personal characteristics (genetics, age, anthropometrics, health status, family history) and context information, and never prioritizes any of them in isolation. I am confident that many relevant success stories, based on Personalization in wellbeing and healthcare, are coming and each one of us will be witness or main player in one or many of them!

Note 1: Easy-to-access basic information regarding dietary supplements could be found here and here (respectively from the US and European official Authorities websites).

Elisa Guida, PhD

Brand and Account Manager