top of page

Ep. 215 How to Use Nutrigenomics to Optimize Health with Kristina Hess


I am delighted to have the opportunity to converse with Kristina Hess today! Kristina is a premier health coach, licensed dietician, and nutritionist with a functional and integrative approach.


Everyone should feel free to experiment with different types of nutritional dogma. However, we should always stay open-minded and lean into whatever our bodies need. I love that Kristina has married the trajectory of her life with genetics and nutrition. So I asked her to join me on the podcast to discuss nutrigenomics. 


In this episode, Kristina shares her backstory and talks about growing up and living all over the world, her history of veganism, and healing her body with a nutrient-dense, whole food, primal/paleo diet. She gives some examples of genetic tendencies and low penetrants. She and I dive into gene variants, nutritional choices that include the use of ethanol or alcohol, seed oils, lifestyle choices, and testing. Kristina also provides recommendations for working with individuals trained in the unique form of genetics and study of nutrition and gene expression, known as nutrigenomics.

I hope you will gain a lot from today’s fascinating conversation with Kristina Hess! Stay tuned for more!


IN THIS EPISODE YOU WILL LEARN:

  • Kristina talks about the Keto Symposium, the very first low-carb conference on the ketogenic lifestyle and fasting. She explains why it is so special.

  • Kristina shares her interesting backstory.

  • How Kristina finally realized that the vegan lifestyle was damaging her body.

  • Kristina explains what nutrigenomics is.

  • Some gene variants are older and have not changed or adapted to more modernized food. Kristina explains how lifestyle choices can impact those variants. 

  • What can people do to impact their gene expression?

  • It is important to take your gene data to a qualified professional for interpretation and talk to them about your lifestyle.

  • Kristina discusses some of the more common gene combinations she sees that could cause weight loss resistance.

  • Kristina talks about isolated low penetrant gene SNPs.

  • Be a detective and do some testing when in doubt.

  • Kristina talks about alcohol and how it could impact epigenetic signaling. 

  • Why should you avoid consuming seed oils?

  • Some lifestyle habits everyone should adopt.

 

“I think statistically, a lot of kids end up with disordered eating if they have a parent with that issue.” “I went fully paleo, and that changed my whole life.”

-Kristina Hess

 

Connect with Cynthia Thurlow  


Connect with Kristina Hess


Transcript:

Cynthia: Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent are to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.


Today, I had the opportunity to connect with Kristina Hess, who's a premier health coach and licensed dietitian and nutritionist with a functional and integrative approach. One of the reasons why I wanted to bring her on board was to talk about the impact of nutrigenomics, which is the byproduct of nutrition and gene expression. We dove deep into her backstory, which included things like living all over the world, and her history of veganism, and how going to a nutrient dense Whole Foods, primal/paleo diet helped heal her body, examples of genetic tendencies, and low penetrance gene variants, the role of nutritional choices, including the use of ethanol or alcohol and seed oils, the impact of lifestyle choices, as well as testing. She provided some incredible broad base recommendations, as well as ways to work with individuals that are trained in this very unique form of genetics superimposing on nutrition.


Today, I am delighted to welcome my friend, Kristina Hess. Before we dive into your backstory, we have a very special announcement to make about Keto Symposium for which I will be an honored guest to be speaking at this event along with other friends of mine like the amazing Ben Azadi. But Kristina, tell us a little bit about this event, why it's so special, and the fact it's in New York City, which I think most if not all of us would love an excuse to come visit the city because it's been a while since I was last there.


Kristina: Absolutely. The city in September is an absolutely glorious time to come to New York. It's not too hot, it's just beautiful weather, and of course, there's so much to do. And now, that things are back open in New York, Broadway, there're so many other things to do in addition to coming to the conference. Yes, the very first low carb conference on ketogenic lifestyle and fasting and yeah, lots of experts including you, so excited. I love going to conferences. I don't know, I love learning. I just consider myself a lifelong learner. It's been fun to put this together. This live in-person conference is three years in the making. This plan began in 2019. The first one was originally supposed to be in 2020 in Greenwich, Connecticut and was cancelled. So, then last year it was a virtual conference. And so, this year, finally, we are in person, yay. 


Cynthia: Well, and I think everyone including people who speak on stages like myself, like you, we're just so grateful to be able to have the opportunity to connect with people again.


Kristina: Yes.


Cynthia: If you're in the tristate area, you definitely want to check this out. What I love is that it's a one-day event. So, it makes it a little bit easier. Some people struggle to be able to-- [crosstalk]  


Kristina: It’s a one and a half day event. 


Cynthia: One and a half. Okay.


Kristina: Yeah. We actually kick off Friday evening with a couple of keynotes, and we're going to have a reception, and you can register, and get your swag, and all that fun stuff, and then it's an all-day event Saturday. Yeah, so, you can still enjoy the city and do lots of other fun things, too.


Cynthia: Absolutely. We'll make sure in the replay and in our show notes that will include the discount codes that people can use. But before I forget, you have such an interesting backstory. We were talking about it before we started recording and I always feel that our influences of our parents, and where we grow up, and our relationships with food can really be instrumental in creating an environment of whether we have a healthy relationship with food or an unhealthy relationship with food. I think let's start from the beginning. Tell us a little bit about where you grew up, and how you grew up, and the influences of your family, and how you're eating trajectory, because I'm wanting you to talk about your period of your life when you were a vegan, which I think is relevant. 


Kristina: Ah, sure.


Cynthia: And how that evolved into where you are today.


Kristina: Yeah, so, I grew up overseas. My dad worked in banking and my mom was a diplomat. We were overseas for most of my childhood and we moved back to the States when I was just shy of 13. Living abroad, really, we ate very just whatever was local, fresh, very healthy foods. We lived in South America for a period of time. In Venezuela, it was the 80s, oil, big business and then we moved to Milan, Italy. I lived on pasta, but really fresh, really fresh, fresh, fresh food and we would come back to the States in the summertime, and I would stay with my grandparents for a couple of months, and that's where I got all these processed yummy treats, the Doritos, and Entenmann's coffee cake, and Klondike bars for dessert, and I just have such fond memories. [laughs] All those Americans with the cereal, oh, my goodness. But we didn't have any of that when we were abroad, ever. So, it was when we come back to the States that we would have these indulgences.


I was interested in nutrition at a very young age, simply because my mom battled with her relationship with food and talked about it a lot. I had a different reaction. I think statistically, a lot of kids end up with also disordered eating if they have a parent with that issue. I actually went, I don't know, I had my own version of disordered eating, which was orthorexia, I think in college, but really, I was so committed to, I'm going to take care of my body because the other version which I just saw as this punishment like being on some terrible diet and suffering, and it was all about the quick fix, it seemed or I want to eat all the cookies, and then purge them, and I wasn't down for that. I read a lot of nutrition books, whatever was hot at the time. And so, I ended up going with the trends of the time. I was into the low fat, no fat period, and I just would scoop out my bagels, and eat my bananas, and wouldn't touch any fat, and really, things changed, but I did experiment with veganism, which actually evolved into raw veganism.


Cynthia: Wow.


Kristina: Yes, I went fully raw and I lasted four months and I did not have a social life. I would take sometimes 48 hours to prepare either dehydrated foods, right juice, all kinds of things, and then make these soup. Everything was very elaborate. What ended up happening was, I had some pretty severe nutritional deficiencies and I ended up fracturing bones. It really didn't click with me. I first broke my collarbone. I'm a skier. I grew up ski racing and falling, I don't know how many times, but let's say a lot and this is pre-helmet days.


Cynthia: That's real skiing, I grew up in that timeframe, too. [laughs] 


Kristina: Yes. I fell on my head a lot and I never broke any bones. But I was doing this raw vegan thing and I fell. I thought, “Well, this is coincidence.” The first bone that I broke, it was coincidence. I recovered from that, and I started training for a marathon, and I was putting in miles, and I ended up fracturing the femoral neck in my hip.


Cynthia: Acetabulum.


Kristina: Yes, and it was just fully almost cracked, almost to the end. That is when it really, really clicked that, these vegan lifestyles really damaging my bone health. Later, not to jump too far ahead, but once I learned about genetics and testing genes, I realized I don't have any of the predispositions to be a plant-based person. I was not surprised much later and I could have saved myself decades of headache had I known about this whole genetic piece to what should I eat and this would be better for me. 


I did have this vegan period and then ended up finding my way to CrossFit to recover. After all my injuries, I found my way to CrossFit, and I went fully paleo, and that changed my whole life. I really love the whole paleo approach and philosophy to just real food and hunter-gatherer. Again, that genetic piece, we're looking at what we're supposed to eat and some people have adapted to more modern food and some people haven't. My body responded amazingly well. I've always been a person that's had to really be mindful of her weight and didn't realize it, but that was the beginning of understanding that hitting my protein targets and being low carb was really good for me.


Cynthia: I always find people's journeys because at the time, it might not have made sense that you became a vegan, but now, looking back retrospectively, that allowed you to course correct and end up exactly where you were destined to be and I think it's such a beautiful story. I think for so many of us, I always say like, “I thought I ate such a healthy diet,” because I was telling my patients everything I learned in my medical training and it wasn't until I had a child with life-threatening food allergies that I started to question everything. Then that actually sent me down a rabbit hole of going gluten free, and then ultimately lower carb, and now, carb cycling and fasting. And so, it makes sense now, but I know at that time it did not. 


I think for many people if they're recovered vegan. I have a family member. It's taken her years to course correct. Going back to eating meat, but she feels so much better. I think for a lot of people, it's okay to have experimentation with different types of nutritional dogma. But I think we always have to remain open minded to really leaning into what our bodies intrinsically need. I love that you've married your trajectory of your life with genetics and nutrition. I think the easiest way to start the conversation is to actually define what nutrigenomics is, then it'll make sense to people once they hear it. I think a lot of people don't necessarily recognize what it is, but it makes sense. Once you say it, it's like, “Oh, okay, the interplay of epigenetics, and nutrition, and how that can turn genes on and off.” This is actually what brought you into this nutrigenomics and probably the need for having individuals who are savvy being able to take the research, and combine it with nutritional recommendations and bio individuality is probably being a teacher, because that's where you started your career-career was probably, a normal extension of what you were interested in.


Kristina: Absolutely. I say, I was a teacher before I became a clinical nutritionist. I do have the heart of a teacher and I love to educate the people that I work with and really spend time, so that they understand the mechanisms of how their bodies work. Nutrigenomics is this marriage between nutrition and genomics. Genetics falls into three buckets. Everyone's heard of 23andMe or ancestry.com and that is really looking at where did you come from? Are you mostly European, or Asian, or African? That's one bucket of genetics. There's this whole other bucket of genetics, which is all about diseases. That bucket tends to look at one gene. That's a real anomaly, and how to treat this gene, and there is no amount of food or anti-inflammatory protocol that's going to treat that disease really. That kind of genetics is not what we're talking about here. 


Nutrigenomics is really looking at these more, not these fixed genes, but the more malleable genes, where you have all the power in the world to influence their expression. What's really neat is that in this field, you can look at a family, a group of genes that will pertain to a particular area or system in your body say, detoxification or genes that pertain to fitness. I'm actually pretty injury prone and I didn't know that I have some variants on collagen genes that if you looked at that, there are genes that can tell you if you would do better with more endurance training or better with lifting, I didn't understand any of that until I got into this, but it makes perfect sense. If you give two people a marathon plan, let's say, and one person does great with it and the other person gets injured, that's based on your genetics. Someone like Usain Bolt, he has a very particular set of genes. That gene, your genes are just potential. They're not, oh, you're doomed to x, y, z. It's just potential. but if you don't, A, have the potential or B, use that potential, it's not going to express. 


I find it fascinating. I think it's really the future of our profession to really understand this body of science. It's still so new and I'm constantly evolving with how I learned to translate these things and interpret them because it's so important to look at the whole person just because you do have what we say, spelling changes in your genes. That's all they are. It is how we make words, and then sentences, and we make meaning out of our language. That's all we're doing with looking at. Gene translation is we're now have four letters and you might have some changes on those letters. Are you doomed? No. And they might not even be expressing at the moment based on how you're living. So, I find it all fascinating, but it is important to really look at the whole person, and what's going on, and what is their family history, and what do they like to eat, how do they manage stress, all of those pieces are so important.


Cynthia: Well, and I think it's an important distinction. As an example, when I was preparing for this, the recognition as someone that was in graduate school and undergrad during the time of the Human Genome Project, I remember my faculty members that were especially in oncology research, we're really excited about this. I'm really dating myself, but it's relevant. When we're looking at these genetics, looking at differentiating between high penetrance, so like a BRCA gene, genetics that make people more susceptible to developing certain types of cancers versus things like MTHFR, which if anyone's familiar with that, I actually have two copies. That's considered to be, correct me if I'm wrong, low penetrance because-


Kristina: Totally.


Cynthia: -it doesn't necessarily mean you're going to have all these problems. What's interesting is, even though I myself, I think I'm pretty well versed in the very basics related to this. I have many family members not surprisingly, they're all homozygous for this particular gene, the MTHFR. And probably, 10 years ago, they've started all taking methylfolate and methylated vitamins.


Kristina: Which is all you need. [laughs] 


Cynthia: What's interesting is, you could take 10 of us, and most of us were taking methylated vitamins, and then one person got sick from taking vitamins, and so-


Kristina: Really? Yeah.


Cynthia: Ended up going to the emergency room. 


Kristina: Oh.


Cynthia: It really just speaks to the fact that there's no one size fits all philosophy. 


Kristina: Sure.


Cynthia: We all have differing lifestyle choices that can influence whether or not these genes are activated or not and your work really focuses in on the low penetrance, so-


Kristina: Totally.


Cynthia: -the things, it's not correlation means causation. 


Kristina: Totally.


Cynthia: You could have a gene and if it doesn't get turned on, you may not even have any issues, but really relevant in something that we were talking about before is things like recognizable-- MTHFR is one I think a lot of people are familiarized with. I think it’s about-- [crosstalk] 


Kristina: It’s gotten too much attention, though and too much importance. A lot of these genes, this people are looking at them in isolation and freaking out. [crosstalk] 


Cynthia: Do you think it is sensationalized by the media or do you think it's people who are trying to better understand what's going on and they want to fix? Haven't we conditioned our patients that a pill is going to fix whatever ails them and people think a supplement is going to fix everything. I always remind people, if you really have to lean into the lifestyle piece, it's still, there's, no quick fix. 


Kristina: No.


Cynthia: You really do have to do the work. I love to just snap my fingers and make it easy, but the work is still the work.


Kristina: The work is still the work. I guess you really do have to look at so much more than just one. It's low hanging fruit to do that and panic. We've talked even about APOE, and there's so much attention around APOE, and oh, my gosh, and you're going to get Alzheimer's if you have-- It is true that it has been identified that there's a higher likelihood, especially and the reason for-- You get two copies. You get some from one parent and the other parent. With the four-four, if you have that or even three-four, yes, it's a higher risk. It's risk, but that's still a potential. Those are just older variants. Because they're older, what that means is it conferred benefits way back when and they haven't changed. They haven't adapted to this newer more modernized food that we're eating. And so, people who might have a three-four, four-four and are now eating a lot of grains, a lot of starch, and a lot of sugar, and have a lot of stress, and are drinking a lot alcohol, they just haven't adapted and it could potentially-- Again, we have to stress that potential, but also, again looking at maybe some other SNPs would be interesting to see if they have adaptations elsewhere.


Cynthia: Well, and it's interesting because my own experiences with the MTHFR, which I got to a point, where I just wanted to stop worrying about it, because I think if I weren't doing all the right things for me that it might have expressed or created other issues. I think this is really important to identify what are the things people do in their personal lives that can impact gene expression? Because there are probably people listening saying, “If this sounds like alphabet soup, I don't know how to make it relevant.” Let's make it really relevant, so that people understand. When we talk about doing the work, it is the most important work. It really, really is. I talk a lot about circadian rhythms, I talk a lot about circadian biology, a lot of this is around feeding and fasting windows, but in terms of relevance, what are the aspects of lifestyle that you feel make the largest net impact on whether or not that gene turns on or off?


Kristina: Well, it's a little bit reversed in that. Yael Joffe talks about this. She's a nutrigenomics expert and she talk about there's the insight. “Okay, now, you have all this data, you have all this knowledge about yourself, and then there's action. Now, what do I do with it? Now, that I know about all these genes, now, what can I do to your point to optimize my right lifestyle? What is my right eating window?” That's where the genes give you the data, the information. “Oh, you know what, you actually do just fine on a wider window.” This other person is glucose intolerant and not so insulin sensitive. With these particular variants they have they need to stop eating early. I've seen it, of course, you've seen it, too, in your practice, where you have people doing maybe a traditional 12 to 8 intermittent fasting window, but you move them to a nine to five and things start changing for them. All of that is based on their genetics. 


One of the most interesting family of, I really call them transcription factors. They're like switches is that PPAR-alpha. It's the whole PPAR family. Actually, because it's alpha, and gamma, and there's delta. There's all these [laughs] Greek letters that go with them. But it's P-P-A-R and it has a lot to do with your utilization of fat. For people who have difficulty with their PPAR, well, fasting doesn't feel great to them. They might need to do that traditional three meals a day, and just start their day with some protein, and then other people just have no issues. They can do all this extended fasting, and they feel amazing, and have all the energy in the world. Again, it's genetics. It's really, really fascinating. With low carb, there's also a lot of nuances, because in the whole low carb space, we can find people who are like, “Oh, it's high protein. Oh, it's higher fat. Oh, can you tolerate more carb cycling or not? Which carbs are we talking about, should you be doing more saturated fats, can you have dairy, should you not have dairy?” And again, it's genetics. So, a lot of those questions really can get answered with a test from a good company, of course.


Cynthia: Well, I know 23andMe, because I've actually run that and then this is before they made some changes. Then I ran the data through genetic genie, which I'm not even sure if that's even out there anymore. Even then with all the training I have, I remember saying, it looks like alphabet soup. 


Kristina: Yes.


Cynthia: So, I'm sure for people listening, they're like, “I don't know what any of this represents.”


Kristina: That's why I think it is important to take your data to a qualified professional to interpret it for you, and sit down with you, and ask you about your actual lifestyle because you want to put it into context. What is the family history, how do you live, do you sleep, do you have problems sleeping? Just because you have variants with melatonin and clock, maybe you don't have any sleep issues. Or, yes, I can validate that for you. I have your skates right here, and your genes, and so here maybe you do need to take some melatonin, maybe you do need to take some magnesium. 


It is important to sit down with someone and have them look at this, so that you're not looking at just the alphabets, because you aren't just a bunch of letters. You're a human being with a whole bunch of things going on in your world, and you want to look at it in context, and then additionally, which I think is really important is, if you can add other data to that, too, are you wearing a continuous glucose monitor? Example, Cynthia, I do tend to use low carb ketogenic protocols for a lot of the people that come and find me, because it’s stubborn weight loss or maybe, they're recovering from cancer and things like that. It is a protocol I tend to use. Those are the people that typically are finding me, but I've had people where it doesn't work. Then we run their genetic profiles and boy, they really shouldn't be eating red meat and saturated fat, and they don't have issues with the grains, and it changes the dietary approach.


Cynthia: Well, as I'm listening to you, I'm curious because obviously after our discussion, I'm going to reach out to you and say, “Hey, I'd love to get your professional opinion,” because I'll give everyone an example. I lean carnivore-ish. I do cycle my carbs, but I feel best eating meat and I'm able to maintain being healthy and healthy life stage, even though I'm now middle aged. But what's interesting is, we're a family of four and so, half of my family loves fatty meat and the other half doesn't. I can tell you, if I eat a large bolus of animal-based fat, let's say, I go to a restaurant and I've duck fat fries, I will be sick. I have a healthy gallbladder. That's not the issue. But for me, I do best with lean protein and plant-based fats, whereas half my family does really well with like, they have a ribeye, I have a fillet. They have a piece of salmon, generally, I’ll have a leaner piece of fish. It's almost to the point where my older son is the same way. There's something about the way that fat feels on our tongue that is so unappealing and I'm sure there's probably a genetic piece to all of this.


Kristina: Yes.


Cynthia: And so, I find it fascinating. Anyway, I just wanted to interject that clearly there are genetic influences that will gravitate us towards certain types of foods and away from others.


Kristina: A 100% and it sounds like you just like I did. You found it by default and then you could later validate the information with looking at your gene SNPs. But wouldn't it be nice for some of you out there listening to save yourself the time and the experimentation with looking at this first and saying, “Well, this would really be more ideal for me,” and then take it or leave it. Of course, there are going to be times when you're not eating that way, but wouldn't it be nice to know what is best for you? 


Cynthia: Absolutely. Yeah, and I think this whole optimization and personalization, I think that's where I see a lot of medicine going in that direction. The acknowledgement that-- I'll give you another example. I'm now in menopause. And so, the one size fits all that, once women hit a certain age, everyone needs the same hormone. Well, me going on HRT, I gained 10 pounds almost within two weeks. This speaks to a lot of things that weren't properly balanced, even though I was doing all these right things. I always remind people, it's like cooking. It's like trying to find that perfect balance for each one of us. It's why when I work with women, we never start with hormones first. It's always all the foundational work, because even then you can still run into these kinds of quandaries. 


I would imagine when you're working with women, you mentioned weight loss resistance. That seems to be a huge pain point for women in perimenopause and menopause in particular. And so, in your clinical experience, what are some of the big things? Because I think about FTO. If you look at the research-


Kristina: Yeah, I know. 


Cynthia: -and certain things. There isn't this genetic propensity, so, what are some of the more common alphabet soup, if you will, combinations that you will see? Sometimes that will lead you to believe like, it's not surprising this woman is experiencing this because maybe her body doesn't use fat properly. Maybe her genetics are set up that she's going to run like a lower basal metabolic rate than someone else. What are some of the more common things you will see that will increase the likelihood of being weight loss resistant?


Kristina: And keep in mind again. The science is still evolving. You are looking at a lot of different types of studies but here's what I can tell you with the information that I have to date. Coffee is a big point that people argue over and that is very easily determined with genotype. There's a fast metabolizer of coffee. It's alphabet soup of AA and the detoxification pathway, so liver detoxification and clearance of caffeine. Are you clearing it quickly or not quickly? Then the CC genotype is a slow metabolizer of caffeine and studies have shown that those slow metabolizers of caffeine, if they consume, if they're heavily consuming it, they're more likely to have a heart attack. But people may know this already about themselves if they having the heart palpitations, if they feel anxiety, but then there's the next layer, you want also look at COMT, which also has to do with metabolism of hormones, dopamine, estrogen, and with COMT, which also gets a lot of attention that can also drive anxiety or not lot depending on how quickly you're clearing things out.


But, yeah, detoxification is super, super interesting. You have a centenarian, who can live to be a hundred, and smoked pack of cigarettes a day, and then you have another person who never smoked, and gets lung cancer. The GST genes which are also in that detoxification pathway have been shown to respond very well to sulforaphane, to broccoli sprouts. And so that seems to be a really interesting nutrient and that's really what nutrigenomics is all about is how to impact your expression, again, by introducing the right nutrients. Then there's also the reverse too is, if you challenge the system with certain things, do your genes respond? There's some new research on AMY 1 and 2, that's amylase. It's the genes coding for enzymes that help you break down starch. With people who have multiple copies of that, that's shown that they can tolerate starch better if you have fewer copies than less so. That makes sense, because you're able to break it down better. So, yeah, it's really interesting stuff.


Cynthia: I'm thinking of my 16-year-old, who is a lacrosse and football player, and he's six feet tall and still growing. One of his favorite things in the world eat is a big bowl of bison or ground meat on top of a massive amount of white rice. My husband and I jokingly talk about the fact. We go through rice in our house, not because we eat it, but because he eats so much of it, but I would imagine he probably has--. I'm sure he has multiple copies because he's super lean, he’s also 16. So, he has time on his side.


Kristina: Yeah, he does.