Testes de nutrigenética: aplicações na prevenção e tratamento da obesidade

Abstract

Obesity is a chronic, complex, and often polygenic disease. In this context, several treatments are listed to mitigate the growth of the disease and nutritional genomics has gained prominence with possible tools to assist in the prevention and/or treatment of obesity, with nutrigenetics (NT) testing. Therefore, this thesis is divided into two chapters, aiming to evaluate whether NT can be used to prevent and/or treat obesity. In the first chapter, a narrative review was carried out to show the current panorama of obesity and NT, covering the themes of precision nutrition, exposome, genetic tests sold directly to the consumer. The benefits and negative aspects of using NT as a tool to help prevent or treat overweight and obesity were also analyzed. Some entities, such as the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) are against the use of NT for obesity. The Academy of Nutrition and Dietetics recommends its use, however not in isolation, but within a context of well-conducted anamnesis. Therefore, NT should not be used alone in the treatment of obesity, but always associated with a clinical assessment, within individualized treatment or at a public health level. In the second chapter, a retrospective study was carried out, evaluating the relationship of 29 candidate gene polymorphisms related to obesity. Thus, 112 individuals were divided into two groups: 64 eutrophic (BMI< 25 kg/m²) and 48 overweight and obese (BMI≥ 25 Kg/m²). It was verified that the population was in Hardy–Weinberg equilibrium and a multivariate logistic analysis was performed to verify whether the polymorphisms were associated with overweight and obesity. In this analysis, it was found that of the 29 polymorphisms listed in the NT marketed in Brazil, only ADIPOQ rs17300539, PPARG rs1801282 were associated with overweight and obesity; SOD rs4880 was related to protection against overweight and obesity. Thus, it was shown that more studies are needed to validate which SNP are related to overweight and obesity in the Brazilian population. So, the thesis shows that NT can be used in clinical practice, but not in isolation. In addition to the use of NT, a good clinical anamnesis must be carried out, as lifestyle choices, even if the patient has SNPs that increase the predisposition to obesity, can epigenetically alter gene expression and impact the phenotype.