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23MgVitamin.qxd 2/13/03 22 · February 23, 2003 12:44 PM Page 22 Illustration by Joseph Daniel Fiedler 23MgVitamin.qxd 2/13/03 12:46 PM Page 23 Singular supplements I t sounded plausible, especially in light of modern genetics: Take a DNA test to find out what vitamins you really need. I was reading an article on the connection between nutrition and genetics when I came across GeneLink of Margate, N.J., and its test. The claims GeneLink made were seductive. The DNA analysis, according to the company’s Web site (www.bankdna.com), “helps guide individuals in choosing the optimal combination of nutrients and vitamins, matched to their unique genetic makeup.” The idea that GeneLink could offer a simple test that would open a window onto my health future was irresistible — and, if something of a long shot, not inconceivable. Science now takes as a given that inherited genetic differences between one person and the next explain why some people can eat butter and steak, never come near a green, leafy vegetable, and still live a long, healthy life, while others who follow all the rules battle cancer or drop dead from a heart attack in middle age. The genetic code that each of us carries coiled in our cells is three billion characters long. Compare any two people, and the codes will look 99.9 percent identical.That still leaves thousands of places where the codes vary from one person to the next. But can we do anything with the knowledge? Scientists around the world are trying to A customized vitamin mix, based on your very own DNA. Shampoo and skin cream to match. A Margate company is already there. Is the science? pinpoint which of these variant genetic spellings influence our vulnerability to cancer, Alzheimer’s, osteoporosis, heart disease and other common scourges. The hope is that doctors will eventually test people and then use the results to steer them toward a course of preventive medicine, whether that means eating more spinach, running on the treadmill, or taking a daily aspirin. So why not vitamins? And why not a company in Margate? Somebody has to be first, after all. A t first I just wanted information, so I tried to contact GeneLink’s chief executive officer, John DePhillipo. David Closs, a public-relations man in New York, returned my phone calls and told me that DePhillipo was extremely busy and couldn’t see me for five months. I also tried to call GeneLink cofounder and advisory-board member Robert Ricciardi, a professor of cellular and molecular biology at the University of Pennsylvania. He was even busier, said Closs, who began to press me on what I expected to ask them. All this lack of availability made them even more intriguing. So I called NuGenix, the Berwyn-based company that distributes the vitamins, to see about ordering a test for myself. I found myself talking to DePhillipo’s son, Chris, and later to his daughter, Laura Sullicontinued on next page Faye Flam is a staff writer on The Inquirer’s science desk. By Faye Flam Inquirer Magazine · 23 23MgVitamin.qxd 2/14/03 10:08 AM Page 24 The company tested six genes, then colorcoded my vitamin needs on a scale from “basic support” to “extra added support.” VITAMIN continued from previous page van, NuGenix’s marketing director. (GeneLink’s CEO refers to NuGenix as its distributor, but the companies seem to be a family affair.) Chris DePhillipo explained: “We all sat down to figure out how we could utilize all the [genetic] information they’ve got, to come up with something fabulous, something wonderful.” And soon it will be more than nutrition, he said — GeneLink and NuGenix are branching into personal care. Soon they will be able to use my DNA to tell me what kind of shampoo and skin cream to use. “The possibilities are unlimited and endless — we believe that one size doesn’t fit all,” he said. I would need to pay $299 for the test, but that would include the first month’s worth of vitamins. Further supplies of vitamins would cost about $75 a month. (It certainly sounded like a lot of vitamins. All I take now are calcium and folic acid — and I’m not religious about the folic acid.) I read off my credit-card number, and they mailed me a kit that included six cotton swabs and a white envelope marked “sterile.” As instructed, I scraped the insides of my cheeks with the swabs and packed them up in the envelope. And off my DNA went. A bout a month later, I received a shoebox-size package in the mail. Inside were five white packets of pills, a can of powder, and a document called “Your Genetic Compass.” Things didn’t look so good for me: I had less-than-optimal versions of five of the six genes tested. The genetic compass didn’t, however, say which six genes were tested — only that two were related to “oxidative stress,” two to “heart and circulatory health,” one to “immune function,” and one to “detoxification.” My score was color-coded. Green means you need something 24 · February 23, 2003 called basic support, yellow means “added support,” red “extra added support.” I scored five yellows and a green. It wasn’t at all clear whether that was good, average or dismal. It would be $75 a month to continue with the program, which, the literature said, allows you to “use a more scientific approach to being proactive in doing your best to prevent health problems that might otherwise occur later in life.” As I studied the documentation, it appeared to me that GeneLink/NuGenix was working in the same arena as mainstream science. In the six unnamed genes, the companies looked for something called SNPs. SNP (pronounced snip) is a standard term in genetics. It stands for “single nucleotide polymorphism.” SNPs are simply places where the genetic code varies from person to person by a single letter. Unlike rare mutations that lead to problems such as cystic fibrosis and muscular dystrophy, most SNPs are just common variations — genes that in their healthy form can come in one or more flavors. Most SNPs don’t have any effect, but a few can influence a person’s biology or even personality, according to some studies. Scientists have found SNPs and other common variable genes that they believe influence memory, shyness, and the tendency to overeat, to become addicted to drugs or alcohol, or to develop anorexia. There is even a gene connected to devout religious worship. And, according to those practicing in a growing field known as nutritional genomics, there are SNPs that determine your dietary needs. “If the SNP test predicts that you might not be as efficient as possible in any given health area, you now can do something about it,” the GeneLink material said. But could I really have so many substandard genes? How did I know I would benefit from swallowing these things, which included such mysterious ingredients as Fo-ti root extract, cat’s claw bark extract, lycium berry extract, lutein, licorice root extract, natural policosanol, guercetin dihydrate, and indole-3-carbinol? I called NuGenix and peppered the younger generation of DePhillipos with questions. They suggested I submit written questions. I did, and within a day my phone was ringing — suddenly CEO DePhillipo’s calendar seemed to have cleared. Meet me at company headquarters, he said. Headquarters turned out to be in his house, about a block from the ocean in Margate. DePhillipo, 61, met me under a skylight in his thirdfloor office. “I’m a business guy, an entrepreneur,” he said. “The last deal I developed was a retrofit air bag.” He picked up some mechanical part from his desk. “That’s the sensor — I reinvented this and created a marketing company to sell it worldwide.” I confessed that I was disappointed with the vague information in my “genetic compass” and that I had hoped to find out which genes were tested. “We don’t do that — we’re the science company,” said DePhillipo. “We’ve got three companies . . . Lab21 . . . they make DNA cream sold at Bergdorf Goodman department stores in Manhattan. They’re rolling it out nationally,” he said. I told him I didn’t get any skin cream in my package. “No, that’s different,” he said, seeming exasperated. “That’s something else — anti-wrinkle cream. Let’s back up.” He said he founded GeneLink along with Dr. Edmund DelGursio. The two went back years, having been fellow lifeguards at the Shore. DelGursio brought along Ricciardi, the Penn professor. Is DelGursio a medical doctor? I asked. “Oh yeah!” At first, the fledgling company offered something called DNA banking. It took DePhillipo a full 10 minutes to explain why anyone would want to pay more than $200 to have his DNA stored somewhere. Given that a person’s DNA is everywhere — blood, saliva, hair, sweat, dandruff — I still don’t quite understand the point. He said that once the multibillion-dollar private and public under- taking known as the Human Genome Project was completed a few years ago, his company saw a new opportunity. “We were enamored of SNPs and pharmacogenomics and wanted to find a way for our company to get involved.” How did the genome allow for this vitamin thing? I asked. “They identified all the genes,” he explained, as if I must be an imbecile for asking. When I pointed out that the genome project did not identify the genes — it simply mapped the genes on the chromosomes and read out the genetic code characters — he replied, “That’s what we needed to do this.” The conversation turned circular, with DePhillipo invoking the “$40 billion business” of cosmetics and at one point saying, “I’ll make you a bet — if I win you have to buy me a present.” In the middle of the interview, the previously unreachable Robert Ricciardi of Penn called, and DePhillipo put him on the speaker phone. Ricciardi said he wanted to meet me at the restaurant at the Inn at Penn. I said I’d be happy to meet in his office. “Conflict of interest,” he said. “I’ll tell you about it later. . . . I’d prefer to meet you at the restaurant.” He hung up. DePhillipo was still stuck on face cream — “You can buy the face cream today if you want,” he said suddenly. “Go to lab21.com.” But I still wanted to know why they don’t tell customers which genes they test. “What are people going to do with that?” he said. “This is the kind of thing physicians are going to get. “Marie,” he called to his wife, “do you have any of that DNA cream? Let her see it, stick her finger in it.” The cream came in a little blue jar. I didn’t touch it. It looked like any other skin cream to me. I still had not gotten a clue from DePhillipo about vitamins and asked him who figured out which ones to recommend. Garden State Nutritionals, based in West Caldwell, N.J., continued on Page 26 FREE STAIR LIFT ESTIMATES - Stair Lifts - Wheel Chair Lifts - Residential Elevators • • • • 24 Hour Service Factory Certified Technicians 100% Customer Satisfaction Immediate Installation 1-800-651-5666 www.totalaccessco.com Domestic & International Adoption NJ (856) 665-5655 PA (610)642-7200 DE (302) 658-8883 www.adoptionsfromtheheart.org 26 · February 23, 2003 VITAMIN continued from Page 24 formulates the vitamins, he said, based on “golden pathways” supplied by GeneLink. “The golden pathways are printed,” he said. “You seem to think we invented these golden pathways.” As a matter of fact, I suspected that he made up the term. Pathways between what and what? I asked. “Let Ricciardi go through it,” he said. “You’re getting deep, deep, deep into the science. “Let him educate you tomorrow.” R icciardi is a small, balding man with a voice that barely carried over the restaurant table. By way of explanation for meeting off-campus, he said his office was too loud. He insisted there was evidence backing up the health significance of the GeneLink tests. As one example, he said, they tested me for a variation in the gene named for the enzyme superoxide dismutase (SOD), which is connected to the ability of cells to fight damaging compounds called free radicals. Free radicals are produced constantly by breathing and other basic life processes. All people have two copies of the gene — one from each parent. My SOD test came back with a yellow warning, because I had one of the “good” kind and one of the “bad” kind, Ricciardi said; he himself got a red alert, which meant he had two of the bad version. He said the bad version could also make skin get prematurely wrinkly. (Oh boy, another skin-cream promo, I thought.) Ricciardi argued that the people with two bad SOD genes were the ones who really need help. “Would you deny these people the chance to address this?” He cited a couple of papers that backed up the health significance of the GeneLink tests, but after poring over them, I found nothing convincing that any of the variations that GeneLink tested for directly influence my vulnerability to disease. In the case of SOD, one type of the related enzyme seems to work better than the other in ameliorating damage from those ubiquitous free radicals — in a test tube. A link to actual human disease has not been established. In all the literature that Ricciardi handed me, there was nothing that seemed to connect all the dots — associating the genetic variations they tested for with the need for ginkgo biloba leaf extract, lutein, quercetin dihydrate, Vitamin B-12, or anything else in the $75-a-month cornucopia NuGenix sent me. continued on Page 32 VITAMINS continued from Page 26 P atrick Stover of Cornell University’s Institute for Nutritional Genomics specializes in the connection between nutrition and genes and says it is absolutely true that my genetic makeup influences which nutrients I need. But, he says, I don’t need to bother with the five-pill cocktail and powder I got from NuGenix. The company makes much of the issue of oxidative stress, a process in which those free radicals damage cells. Antioxidants, such as Vitamins A, C and E, are supposed to be the great rescuers, helping prevent this damage. But the effectiveness of supplements has had mixed results in the scientific literature, Stover pointed out. In his lab, Stover has done some work on a gene called MTHFR, for methylenetetrahydrofolate reductase. This was the only test I had passed, getting a GeneLink green code. (When pressed, GeneLink did eventually tell me which six genes it tested for.) But Stover says I have no reason to cheer. Most people, like me, have at least one “good” version of MTHFR.What’s more, “good” and “bad” are not precise descriptions. People with the “bad” version of MTHFR actually seem at lower risk of colon cancer.Those with the “bad” version may have a higher risk of heart disease, and the women among them may have a higher risk of giving birth to children with neural-tube defects such as spina bifida. Both problems can be alleviated by the use of folic acid — while the colon-cancer risk with the “good” gene is not as easily remedied. “All of this is sort of silly,” Stover said. “The government put folic acid in the food supply five years ago — the whole country is very folate-replete already.” Stover said that in most of the other genes that GeneLink analyzed, there are some theoretical links with disease, or links established through test-tube studies. It’s plausible that people with one type of gene will have different vitamin and mineral needs, but to demonstrate this will require human studies. I read him the list of Fo-ti root, 224 South 15th Street Philadelphia, PA 19102 215.985.9600 CITY TAVERN EST. 1773 215-413-1443 138 S. 2nd St. at Walnut City Ave. & Monument Rd. ❦ 215-581-5010 16th & Spruce Nodding Head Philly’s BEST Brewpub 2000 “Philly’s Best”® award Friday Saturday Sunday Loves You Every Night! 261 South 21st Street. 215-546-4232 www.frisatsun.com 1516 Sansom • 2nd Floor 215.569.9525 • noddinghead.com 1029 Race St. Philadelphia, PA 19107 215.829.1400 www.indonesiarestaurant.com The East Coast’s Premier Moroccan Restaurant 517 S. Leithgow Street • 215.925.5929 610-277-4008 ASIAN GRILL SUSHI BAR Fine Japanese & Korean Cuisine 300 E. Main St., Norristown, PA 32 · February 23, 2003 AUGUST MOON • Contact Inquirer science writer Faye Flam at 215-854-4977 or fflam@phillynews.com. DINING GUIDE Enjoy the new cuisines of the Far East as the best Japanese and Korean cuisines (Teriyakis and famous Korean Grill) are fused. Master Sushi Chefs prepare delights never before experienced. Catering services and banquet seating for 250 (with Continental and Asian menus) add to their versatility. Awards: Best of Philly, Zagat Survey Highest Rating. 300 E. Main St., Norristown, PA. 610.277.4008. VMAD Enjoy 18th Century ambience and hospitality on the exact spot where our Founding Fathers did. Within this refined and elegant atmosphere of Colonial Philadelphia, our talented chefs and expert servers have prepared a memorable dining experience that is unequalled in modern America. Serving lunch and dinner daily indoors and in our outdoor garden from 11:30am. 138 S. 2nd St. at Walnut. 215.413.1443. VMAD FRANK CLEMENTS TAVERN 215.545.7005 monkscafe.com Every bottle $10 over cost T hough I had agreed only to pay for the test and one month’s supply of vitamins, I received two additional boxes of vitamins from NuGenix. “I hear you’re still taking the vitamins,” Laura Sullivan of NuGenix said when I called her with some questions. I explained that I had not at any time agreed to buy more vitamins, and she arranged for me to be refunded. The truth is that I haven’t swallowed a single pill. And may have no need to. Stover pointed out that, with the possible exception of the impoverished, drug addicts, people with anorexia nervosa, and sometimes the very elderly, most Americans get enough micronutrients. I also contacted Judy ChenCooper, a nutritionist at the Princeton Longevity Center, a new facility that specializes in preventive medicine. I filled out a questionnaire on my height, weight, activity level, and all that I ate for three days, which included fairly healthy but typical fare — steak, eggs, whole-wheat bagels, pasta, turkey sandwiches, salads, a couple of desserts. She ran the results through a computer program and sent back a bar graph showing how well I did in getting several dozen essential nutrients. The results — not bad at all. I get plenty of B vitamins, iron, and Vitamins A and C. I came up short on Vitamin D,Vitamin E, and calcium. Chen-Cooper explained that if I use cooking oils, which I didn’t include in my food diary, I’m probably getting more Vitamin E than it would appear. As for Vitamin D, people make their own if exposed to sunlight, so as an outdoor person I get more than enough. She suggested I take calcium. And folic acid, she said, is highly recommended for all women of childbearing age. Luckily, I have both in my medicine chest. INDONESIA Come enjoy the seductive flavors of Philadelphia’s best-kept secret! Our amazing salads, satay, noodles and soups explode with flavor of curry, peanuts, coconut & tropical fruit. Our entrees range from mild to spicy, providing a peek into the mysterious spices of traditional Indonesian cuisine. Our Rijsttafel, a multi-course feast, turns any meal into a special occasion. Lunch & dinner 7 days. Selamat makan! 1029 Race St. 215.829.1400. VMA NODDING HEAD Philadelphia’s award-winning brewery. Voted “Philly’s Best”® Brewpub year after year, serving an ever-changing selection of freshlybrewed, all-grain ales, including several GABF® medal-winners. Fresh seafood, prime steaks, vegan cuisine & fine wines & spirits. Dart boards, great jukebox and sports TV. Lunch & dinner 7 days, plus jazz brunch on Sunday. 1516 Sansom St. 215.569.9525. VMA CITY TAVERN Full Menu ‘til 1am nightly Wine at Friday Saturday Sunday astragalus root, cat’s claw bark extract, lutein, alpha-lipoic acid, Schizandra berry extract. . . . Stover burst out laughing. “Snake oil,” he said. AUTHENTIC INDONESIAN FOOD KEY TO SYMBOLS LIQUOR LICENSE RESERVATIONS RECOMMENDED HANDICAP ACCESSABLE SMOKING SECTION V=Visa M=MasterCard A=American Express D=Discover A Cheers-type, olde-tyme saloon with great food at great prices. Famous for filet mignon and hand-carved roast beef & pork. Best pub fare and friendliest service in Philly. Juke box with everything from Frank Sinatra to Limp Bizkit. Open M-Th 11:30am-midnight, Fri-Sat ’till 2am. “Upstairs at Clements” available for private parties. 224 S. 15th St., 215.985.9600. VMAD MANAYUNIK BREWERY & RESTAURANT Offering flavorful dining, a top-notch brewery, live Entertainment and the largest deck around. In our 6 dining rooms and 2 bars, everyone can find his niche. Try our Sunday jazz brunch. 4120 Main St. 215.482.8220. VMAD GENERAL LAFAYETTE INN & BREWERY Built & operating continuously since 1732, this cozy brewery & restaurant will quickly put you at ease. Quiet, secluded & rich with Victorian charm. Beer garden, Sunday brunch & Friday jazz. Freshbaked bread & top quality American cuisine. Photos & info at www.generallafayetyteinn.com. 646 Germantown Pike, Lafayette Hill. 610.941.0600. VMAD Executive chef, Frank Chiavaroli, asks, “What are you in the mood for?” Indulge in his Regional Italian interpretations from the menu, or a Mediterranean offering of the moment. One of the city’s “do a deal” lunch destinations. Tuscan Happy Hour, candlelight dining. Broad & Sansom. 215.735.8400. VMAD THE MARKER Zagat’s claims, “A Top Hotel Dining Room.” Best of Philly® says, “the Burbs Lunch Spot.” This “Hidden Treasure on the Main Line” combines the freshest seafoods & meats with Chef Vince Alberici’s flavors from gardens & farms both regional & global. Dinner, lunch & brunch. City Ave. & Monument Rd. 215.581.5000. VMAD FRIDAY SATURDAY SUNDAY Philadelphia Magazine called it the “best, tiny romantic restaurant.” Just a block from Rittenhouse Square, featuring dishes such as Jumbo Lump Crab Cakes & Grilled Double Thick Pork Chop w/Roasted Garlic Roquefort Sauce. All bottles on the outstanding wine list are priced just $10 above cost. Meet in the cozy Tank Bar upstairs. Lunch 11:30-2:20 weekdays; Dinner 5:30-10:30 Mon-Sat, 5-10 Sun. 261 South 21st St. 215-546-4232. VMAD POMPEII MARRAKESH Enjoy an authentic seven-course Moroccan feast served in traditional family settings. Group lunches, private rooms, belly dancers and vegetarian menus available on request. 517 S. Leithgow St. 215.925.5929. SOTTO VARALLI This stylish Italian seafood restaurant has a playful, yet sophisticated feel; from its handblown glass starfish pendants and waterwalls to its giant squid, which floats over the bustling bar. Seafood is the star here but there are many selections for the non-seafood lover. Try the Shrimp Dumplings or the famous pan-roasted whole lobster. You’ll never eat one boiled again. Enjoy live jazz in Sotto’s lounge Friday and Saturday evenings. www.varalliusa.com. Broad & Locust Sts. 215.546-6800. VMAD UPSTARES AT VARALLI MONK’S CAFÉ Casual, affordable, neighborhood bistro serving fresh seafood, steaks, vegan cuisine & fine wines & spirits. Internationally recognized as one of the world’s finest beer bars, with over 200 World Class beers and an extensive vintage selection. More than a dozen “Best of Philly”® and “Philly’s Best”® awards. Lunch & dinner 7 days, including full menu ’til 1am. 264 S. 16th St. 215.545.7005. VMAD For an elevated dining experience and a view of one of the city’s most interesting intersections, this Northern Italian restaurant has been pleasing locals, theatergoers and visitors for over fourteen years. The menu highlights freshly made pasta, risotto, seafood and bruschettas. Live music at the Piano Bar can be found Thursday through Sunday evenings. www.varalliusa.com. Broad & Locust Sts. 215.546.4200. VMAD