We are pursuing an NIH STTR R41 grant to study whether genomic nutrition guidance moves clinical outcomes in Alaska Native and urban Native American adults with Type 2 diabetes and NAFLD.
USDA MyPlate and ADA nutrition guidelines are population-average recommendations. They don't account for the genomic variants that change how nutrients are absorbed, converted, and metabolized — variants that vary significantly across ancestral populations.
Alaska Native adults develop Type 2 diabetes at 3× the national average. Non-alcoholic fatty liver disease (NAFLD) rates are similarly elevated. Both conditions are driven primarily by nutrition and metabolic dysfunction — yet the nutritional interventions deployed by IHS and ANTHC are generic, not personalized to the individual's biochemistry.
MTHFR variants reduce folate metabolism by 30–65%. FADS1 variants impair omega-3 conversion from plant sources. TCF7L2 elevates T2DM risk and changes carbohydrate response. PNPLA3 rs738409 is the strongest single genetic predictor of NAFLD and liver fibrosis. Standard guidelines ignore all of this.
Omeprazole (PPI) depletes B12, magnesium, and calcium. Metformin depletes B12. SSRIs affect sodium and folate. When a patient carries both a genomic variant and a medication that impair the same nutrient pathway, the clinical effect is compounded — and no existing tool flags this intersection.
Standalone DTC genomic tools (23andMe, Helix) exist, but none are embedded in the clinical workflow or cross-referenced with the patient's active medication list and live lab values. CareShield closes that gap by running inside the provider's existing EHR via SMART on FHIR.
A randomized feasibility study comparing CareShield genomic nutrition guidance to standard dietary counseling in Alaska Native and urban Native American adults with T2DM or NAFLD.
| Outcome | Measure | Timepoint | Type |
|---|---|---|---|
| Glycemic control | Hemoglobin A1C (%) | Baseline, 3mo, 6mo, 12mo | Primary |
| Liver health | ALT, AST (U/L) | Baseline, 6mo, 12mo | Primary |
| Metabolic markers | BMI, waist circumference, lipid panel | Baseline, 6mo, 12mo | Secondary |
| Dietary adherence | Patient-reported 24hr recall + food frequency questionnaire | Baseline, 3mo, 6mo, 12mo | Secondary |
| Provider adoption | CareShield MPage utilization rate per encounter | Throughout | Secondary |
STTR requires ≥30% of funded work at a research institution. We are actively establishing the institutional partner network ahead of the September 8, 2026 deadline.
Primary research institution candidate. Julia Rogers, recent hire at ANTHC, is our target contact for the institutional PI role. ANTHC also operates a Liver Disease and Hepatitis program — directly aligned with the NAFLD arm of the study.
Professor and Alaska INBRE Principal Investigator. Advising on bioinformatics and precision medicine. Has offered to help identify UAA/UAF health disparities researchers and facilitate introductions to ANTHC partners.
Sponsored Programs office identified as the entry point. Prior NIH research partnerships with KU Medical Center. IHS clinic provides clinical access to an urban Native American population distinct from the Alaska Native cohort — expanding the study's generalizability.
45 minutes from Haskell HINU. CTSA (Clinical and Translational Science Award) from NIH. Native health disparities research capacity. Potential co-investigator support for the urban Native American arm of the study.
The STTR mechanism funds collaborative research between a small business and a research institution. Phase 1 establishes feasibility and proof-of-concept.
NHGRI · Genomics, Health Disparities, Precision Medicine
An institutional PI at ≥30% FTE from a qualifying research institution (ANTHC, UAF, KUMC, or Haskell HINU). This is the single blocking item between the current state and a complete application. If you are a researcher in Native health disparities, genomics, clinical informatics, or hepatology — we want to talk.
If you are a faculty member or staff researcher at an IHS-affiliated institution, tribal health consortium, or university with Native health research capacity — and this study aligns with your work — we want to talk before September 2026.