Do we Know Enough about Nutritional Genomics to Provide Counseling for Chronic Disease?

I believe we have adequate knowledge of nutritional genomics but not enough to provide appropriate nutritional counseling for chronic disease. The article answered a key question regarding this statement; Was the scientific evidence strong enough for entering “prime time? The article states on page 377 “we do not believe that nutrigenetics is a doorway to individualized genotyping for risk assessments and dietary counseling…”1. REVEAL (Risk Evaluation and education for Alzheimer’s Disease) provided a study on the diet-gene-health relationships and the behavioral responses to genotype-bases information to help gain more of an understanding to what they are trying to reach.

They examined the genotype APOE (apolipoprotein E) on behavior changes in adult offspring of parents with AD (Alzheimer’s disease). They tested three groups that all had an estimate of their risk for AD; group one (controls) was not given any genotypic information, group two was tested for APOE but was not given information (positive or negative), and group three was tested for APOE and was given information (positive or negative) to lean on. The results for group three that were positive for APOE reported twice as often for positive behavior changes then the other participants (group one and group two). However, the results of the study showed that the nutrigenomics research into personalized nutritional advise was immature and had limited evidence to prove that it works.

The Food4Me project tested more than 1,200 people from 7 participating European centers and were randomized to one of four different types of advice.2 Their results showed that providing personalized nutritional advise was better then not receiving any at all. They concluded that receiving any feedback will help people become healthier and limit their risks for diseases, but they haven’t pinpointed what feedback works the best.

Test have been studied around the world, but not enough evidence has been proven for the ethical standards of genomic medicine to be put out into the world to be used for personal dietary advice.

Why Is There a Need for Ethical Standards in Genomics Medicine?

Even though nutrigenomics studies are generally positive, there are many ethical issues to consider before using it as a tool for personal dietary advice. Dr R. Weggemans of Unilever states “there are many nutrients in the diet and many genes responsive to diet”3 If we were to consider personalized nutrition into clinical practices then there is a potential risk for people that carry other unrecognized genes than previous people which would take us back to square one. To produce positive health effects, we must first carefully select sufficiently strong evidence that it works for everyone.

An ethical standard in genomics medicine leads to a problem for regulatory authorities between food and drugs. Castle states “current regulations would not protect the public in the area of nutrigenetic health clams and will need a regulatory framework with agreement on a valid standard for interventions”.3 Health scientist are not agreeing for the genomics medicine to be used right now because they need to focus on supporting the differences of each individual before offering such advice.

Bibliography

1. Görman, U., Mathers, J., Grimaldi, K., Ahlgren, J. and Nordström, K. (2013). Do we know enough? A scientific and ethical analysis of the basis for genetic-based personalized nutrition. Genes & Nutrition, 8(4), pp.373-381.
2. Eufic.org. (2019). Personalized nutrition: Food4Me project: (EUFIC). [online] Available at: https://www.eufic.org/en/healthy-living/article/personalised-nutrition-food4me-project [Accessed 6 Feb. 2019].
3. CABI Nutrition and Food Sciences. (2003). Personalized Nutrition: Consumer Attitudes and Ethics Debated. [online] Available at: https://www.cabi.org/nutrition/news/12476 [Accessed 6 Feb. 2019].

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