Interaction between genetic and dietary factors affecting cardiovascular risk

Abstract

Socio-economic development and progressive urbanization has been accompanied by an increase in the rates of cardiovascular disease (CVD) in developing countries. The cause of this increase is multifactorial. It is very likely that changes in lifestyle (particularly diet and physical activity) play an important role. The evidence that some ethnic groups may be at particular risk when exposed to an urban environment suggests that genetic factors may also be involved. This situation is exemplified by the experience of Chinese, Malays and Asian Indians in Singapore, where Asian Indians have three times the rates of myocardial infarction compared to Chinese despite exposure to a similar environment. However, genetic factors do not seem to explain the differences between ethnic groups either. Rather, it appears that a complex interplay of environmental and genetic factors give rise to these ethnic differences. Some genetic variants appear to identify subgroups of the population that are maladapted to an urban lifestyle. For example, a high fat diet is associated with higher serum triglyceride and lower HDL-cholesterol concentrations (a more atherogenic phenotype) in those with the TT genotype at position -514 of the LIPC locus while those with the CC or CT genotypes have lower serum triglyceride and higher HDL-cholesterol concentration (a less atherogenic phenotype) under the same dietary conditions. These types of findings may provide the basis for personalized lifestyle modification therapy that will optimize the benefits of such therapy for the individual concerned.