patients are affected by adverse drug reactions every year and adverse drug events are the fourth leading cause of death. These adverse drug reactions result in an estimated economic cost of $136 billion per year. Polymorphisms (genetic variations) in individuals affect drug metabolism and therefore an individual's response to a medication. Examples of ways in which genetics may affect an individual's response to drugs include: drug transporters, metabolism and drug interactions. Pharmacogenetics may be used in the near future by public health practitioners to determine the best candidates for certain drugs, thereby reducing much of the guesswork in prescribing drugs. Such actions have the potential to improve the effectiveness of treatments and reduce adverse drug events. Nutrition and health Nutrition is very important in determining various states of health. The field of nutrigenomics is based on the idea that everything ingested into a person's body affects the genome of the individual. This may be through either upregulating or downregulating the expression of certain genes or by a number of other methods. While the field is quite young there are a number of companies that market directly to the public and promote the issue under the guise of public health. Yet many of these companies claim to benefit the consumer, the tests performed are either not applicable or often result in common sense recommendations. Such companies promote public distrust towards future medical tests that may test more appropriate and applicable agents. An example of the role of nutrition would be the methylation pathway involving methylene tetrahydrofolate reductase (MTHFR). An individual with the SNP may need increased supplementation of vitamin B12 and folate to override the effect of a variant SNP. Increased risk for neural tube defects and elevated homocysteine levels have been associated with the MTHFR C677T polymorphism. In 2002, researchers from the Johns Hopkins Bloomberg School of Public Health identified the blueprint of genes and enzymes in the body that enable sulforaphane, a compound found in broccoli and other vegetables, to prevent cancer and remove toxins from cells. The discovery was made using a "gene chip," which allows researchers to monitor the complex interactions of thousands of proteins on a whole genome rather than one at time. This study was the first gene profiling analysis of a cancer-preventing agent using this approach. University of Minnesota researcher Sabrina Peterson, coauthored a study with Johanna Lampe of the Fred Hutchinson Cancer Research