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Singh V. Current challenges and future implications of exploiting the omics data into nutrigenetics and nutrigenomics for personalized diagnosis and nutrition-based care. Nutrition 2023; 110:112002. [PMID: 36940623 DOI: 10.1016/j.nut.2023.112002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 01/18/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
Nutrigenetics and nutrigenomics, combined with the omics technologies, are a demanding and an increasingly important field in personalizing nutrition-based care to understand an individual's response to nutrition-guided therapy. Omics is defined as the analysis of the large data sets of the biological system featuring transcriptomics, proteomics, and metabolomics and providing new insights into cell regulation. The effect of combining nutrigenetics and nutrigenomics with omics will give insight into molecular analysis, as human nutrition requirements vary per individual. Omics measures modest intraindividual variability and is critical to exploit these data for use in the development of precision nutrition. Omics, combined with nutrigenetics and nutrigenomics, is instrumental in the creation of goals for improving the accuracy of nutrition evaluations. Although dietary-based therapies are provided for various clinical conditions such as inborn errors of metabolism, limited advancement has been done to expand the omics data for a more mechanistic understanding of cellular networks dependent on nutrition-based expression and overall regulation of genes. The greatest challenge remains in the clinical sector to integrate the current data available, overcome the well-established limits of self-reported methods in research, and provide omics data, combined with nutrigenetics and nutrigenomics research, for each individual. Hence, the future seems promising if a design for personalized, nutrition-based diagnosis and care can be implemented practically in the health care sector.
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Affiliation(s)
- Varsha Singh
- Centre for Life Sciences, Chitkara School of Health Sciences, Chitkara University, Punjab, India.
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2
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Roosan D, Wu Y, Tran M, Huang Y, Baskys A, Roosan MR. Opportunities to integrate nutrigenomics into clinical practice and patient counseling. Eur J Clin Nutr 2023; 77:36-44. [PMID: 35444269 DOI: 10.1038/s41430-022-01146-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Little progress has been made in translating nutrigenomics knowledge into clinical counseling in the past decade. Currently, clinicians are overwhelmed by nutrigenomics information without the proper scientific guidelines on patient counseling. METHODS In this study, we conducted a scoping review of the primary literature to assess the current evidence of nutrigenomics counseling. A literature search using PRISMA guidelines identified the current challenges and opportunities facing nutrigenomics counseling in clinical practice. RESULTS We identified four main themes: inadequate training, lack of awareness, underdeveloped nutrigenomics counseling skills, and unreliable evidence-based practice information. Many clinicians did not have the necessary knowledge to perform nutrigenomic counseling and were unaware of the available scientific information source. Moreover, there are no guidelines in the scientific community to counsel patients on nutrigenomics testing. CONCLUSION Opportunities exist for government and non-government entities to create an evidence-based information platform using clinical guidelines to integrate nutrigenomics knowledge from bench to bedside successfully.
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Affiliation(s)
- Don Roosan
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA.
| | - Yanting Wu
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA
| | - Michael Tran
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA
| | - Ying Huang
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA
| | - Andrius Baskys
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, USA
| | - Moom R Roosan
- School of Pharmacy, Chapman University, Irvine, CA, USA
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3
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Keathley J, Garneau V, Marcil V, Mutch DM, Robitaille J, Rudkowska I, Sofian G, Desroches S, Vohl MC. Clinical Practice Guidelines Using GRADE and AGREE II for the Impact of Genetic Variants on Plasma Lipid/Lipoprotein/Apolipoprotein Responsiveness to Omega-3 Fatty Acids. Front Nutr 2022; 8:768474. [PMID: 35237638 PMCID: PMC8883048 DOI: 10.3389/fnut.2021.768474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Background A recent systematic review, which used the GRADE methodology, concluded that there is strong evidence for two gene-diet associations related to omega-3 and plasma triglyceride (TG) responses. Systematic reviews can be used to inform the development of clinical practice guidelines (CPGs). Objective To provide guidance for clinical practice related to genetic testing for evaluating responsiveness to dietary/supplemental omega-3s and their impact on plasma lipids/lipoproteins/apolipoproteins. Design Using the results of the abovementioned systematic review, the first CPGs in nutrigenetics were developed using the established GRADE methodology and AGREE II approach. Results Three clinical practice recommendations were developed. Most gene-diet associations identified in the literature lack adequate scientific and clinical validity to warrant consideration for implementing in a practice setting. However, two gene-diet associations with strong evidence (GRADE quality: moderate and high) can be considered for implementation into clinical practice in certain cases: male APOE-E4 carriers (rs429358, rs7412) and TG changes in response to the omega-3 fatty acids eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA) as well as a 31-SNP nutrigenetic risk score and TG changes in response to EPA+DHA among adults with overweight/obesity. Ethical and regulatory implications must be considered when providing APOE nutrigenetic tests given the well-established link between APOE genetic variation and Alzheimer's Disease. Conclusion Most of the evidence in this area is not ready for implementation into clinical practice primarily due to low scientific validity (low quality of evidence). However, the first CPGs in nutrigenetics have been developed for two nutrigenetic associations with strong scientific validity, related to dietary/supplemental omega-3 and TG responses.
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Affiliation(s)
- Justine Keathley
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC, Canada
- School of Nutrition, Université Laval, Québec City, QC, Canada
| | - Véronique Garneau
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC, Canada
- School of Nutrition, Université Laval, Québec City, QC, Canada
| | - Valérie Marcil
- Research Centre, Sainte-Justine University Health Centre, Montréal, QC, Canada
- Department of Nutrition, Université de Montréal, Montréal, QC, Canada
| | - David M. Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Julie Robitaille
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC, Canada
- School of Nutrition, Université Laval, Québec City, QC, Canada
| | - Iwona Rudkowska
- Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Québec City, QC, Canada
- Department of Kinesiology, Université Laval, Québec City, QC, Canada
| | | | - Sophie Desroches
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC, Canada
- School of Nutrition, Université Laval, Québec City, QC, Canada
| | - Marie-Claude Vohl
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC, Canada
- School of Nutrition, Université Laval, Québec City, QC, Canada
- *Correspondence: Marie-Claude Vohl
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Nacis JS, Galang MR, Labrador JPH, Gonzales MS, Dablo AMFD, Domalanta-Ronquillo DGA, Alfonso VFJ, Glorioso IG, Rodriguez MP. "Right diet for the right person": a focus group study of nutritionist-dietitians' perspectives on nutritional genomics and gene-based nutrition advice. J Community Genet 2022; 13:49-57. [PMID: 34705214 PMCID: PMC8799789 DOI: 10.1007/s12687-021-00560-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022] Open
Abstract
Advances in nutritional genomics are intended to revolutionize nutrition practice. A basic understanding of nutritional genomics among nutritionist-dietitians is critical for such advancements to occur. As a precedent to the development and integration of gene-based nutrition advice, this study aimed to assess hospital-based nutritionist-dietitians' perceptions of nutritional genomics. A total of ten focus group discussions (FGDs) with sixty-one registered nutritionist-dietitians (RNDs) from hospitals in the National Capital Region (NCR), Philippines, were conducted from October to November 2019. Data were collected using a pretested semistructured discussion guide, and thematic analysis was subsequently performed. Diverging perceptions about nutritional genomics were noted among the FGD participants. Five themes emerged relating to the enablers and barriers of gene-based nutrition advice: training and capacity building, the extent of information to be disclosed, cost, ethical considerations, and government support. Themes related to the desired features of the gene-based nutrition advice included being consent-driven, cost-effective, technology-oriented, and guided by standards. The results of this study suggest that training and continued learning will equip RNDs to provide nutrition advice based on genetic information. However, other factors, such as cost and ethical considerations, are critical dimensions that need to be acknowledged and addressed before integrating gene-based advice into nutrition practice.
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Affiliation(s)
- Jacus S Nacis
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines.
- Nutrition and Food Research and Development Division, Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), General Santos Avenue, Bicutan, 1631, Taguig City, Metro Manila, Philippines.
| | - Marilou R Galang
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | - Jason Paolo H Labrador
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | - Milflor S Gonzales
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | - Aurora Maria Francesca D Dablo
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | | | - Victor Franco J Alfonso
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | - Idelia G Glorioso
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
| | - Marietta P Rodriguez
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), 1631, Taguig City, Metro Manila, Philippines
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Horne JR, Nielsen DE, Madill J, Robitaille J, Vohl MC, Mutch DM. Guiding Global Best Practice in Personalized Nutrition Based on Genetics: The Development of a Nutrigenomics Care Map. J Acad Nutr Diet 2021; 122:259-269. [PMID: 33744236 DOI: 10.1016/j.jand.2021.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 12/13/2022]
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Karamanoglu I, Nielsen DE. Healthcare Professional Clinical Actions following Nutrigenomics Testing in Practice. Public Health Genomics 2020; 23:237-245. [DOI: 10.1159/000511785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/15/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> Clinical demand for nutrigenomics testing (NGT) is increasing, underscoring the importance of assessing healthcare professional (HCP) competence and clinical actions with NGT in practice. While previous studies have explored HCP perceptions of NGT, no study has examined real HCP experiences with NGT in practice. <b><i>Objective:</i></b> The objective of this study was to evaluate the clinical experience of providing NGT among early adopter HCPs who have used NGT in their practice. We hypothesized that HCP clinical actions after NGT would differ according to HCP personal experience undergoing genetic testing (GT) as well as years in practice. <b><i>Design:</i></b> An online survey questionnaire was administered to HCPs (<i>n</i> = 70) who have provided NGT in practice. χ<sup>2</sup> tests, tests for trend, and logistic regression were used to compare HCP characteristics with post-NGT outcomes. <b><i>Results:</i></b> HCPs with fewest years in practice (<5 years) comprised the lowest proportion of respondents (16%). Most HCPs reported good understanding of NGT results and 92% made genetic-based dietary recommendations to patients following NGT. HCP personal use of GT increased significantly with increasing years in practice (<5 years: 36%, 5–10 years: 53%, 11–20 years: 70%, and >20 years: 85%, <i>p</i> trend = 0.003). Requesting patient bloodwork because of NGT results increased significantly with HCP years in practice when HCPs with <5 years in practice were not considered (5–10 years: 19%, 11–20 years: 28%, and >20 years: 60%, <i>p</i> trend = 0.010). A near significant difference was observed where a greater proportion of HCPs who had personally undergone GT reported requesting patient bloodwork (personal use: 46% vs. no personal use: 23%, <i>p</i>-χ<sup>2</sup> = 0.066). <b><i>Conclusion:</i></b> Early HCP adopters of NGT utilize the test results to provide genetic-based dietary recommendations to patients. Clinical action after NGT currently appears to be driven by HCP years in practice, but HCP personal use of GT may also be a factor.
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Horne JR, Gilliland JA, O'Connor CP, Seabrook JA, Madill J. Change in Weight, BMI, and Body Composition in a Population-Based Intervention Versus Genetic-Based Intervention: The NOW Trial. Obesity (Silver Spring) 2020; 28:1419-1427. [PMID: 32935529 DOI: 10.1002/oby.22880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare changes in body fat percentage (BFP), weight, and BMI between a standard intervention and a nutrigenomics intervention. METHODS The Nutrigenomics, Overweight/Obesity and Weight Management (NOW) trial is a parallel-group, pragmatic, randomized controlled clinical trial incorporated into the Group Lifestyle BalanceTM (GLB) Program. Statistical analyses included two-way ANOVA and split-plot ANOVA. Inclusion criteria consisted of: BMI ≥ 25.0 kg/m2 , ≥18 years of age, English speaking, willing to undergo genetic testing, having internet access, and not seeing another health care provider for weight-loss advice outside of the study. Pregnancy and lactation were exclusion criteria. GLB groups were randomly assigned 1 to 1 (N = 140) so that participants received either the standard 12-month GLB program or a modified 12-month program (GLB plus nutrigenomics), which included the provision of nutrigenomics information and advice for weight management. The primary outcome was percent change in BFP. Secondary outcomes were change in weight and BMI. RESULTS The GLB plus nutrigenomics group experienced significantly (P < 0.05) greater reductions in percent and absolute BFP at the 3-month follow-up and percent BFP at the 6-month follow-up compared with the standard GLB group. CONCLUSIONS The nutrigenomics intervention used in the NOW trial can optimize change in body composition up to 6 months.
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Affiliation(s)
- Justine R Horne
- Graduate Program in Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
- The East Elgin Family Health Team, Aylmer, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
| | - Jason A Gilliland
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Department of Geography, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Colleen P O'Connor
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, The University of Western Ontario, London, Ontario, Canada
| | - Jamie A Seabrook
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, The University of Western Ontario, London, Ontario, Canada
| | - Janet Madill
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, The University of Western Ontario, London, Ontario, Canada
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Robinson K, Rozga M, Braakhuis A, Ellis A, Monnard CR, Sinley R, Wanner A, Vargas AJ. Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Dietary Intake: An Evidence Analysis Center Systematic Review-Part I. J Acad Nutr Diet 2020; 121:553-581.e3. [PMID: 32624394 DOI: 10.1016/j.jand.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Indexed: 12/15/2022]
Abstract
Consumer interest in personalized nutrition based on nutrigenetic testing is growing. Recently, multiple, randomized controlled trials have sought to understand whether incorporating genetic information into dietary counseling alters dietary outcomes. The objective of this systematic review was to examine how incorporating genetic information into nutrition counseling and care, compared to an alternative intervention or control group, impacts dietary outcomes. This is the first of a 2-part systematic review series. Part II reports anthropometric, biochemical, and disease-specific outcomes. Peer-reviewed randomized controlled trials were identified through a systematic literature search of multiple databases, screened for eligibility, and critically reviewed and synthesized. Conclusion statements were graded to determine quality of evidence for each dietary outcome reported. Reported outcomes include intake of total energy and macronutrients, micronutrients, foods, food groups, food components (added sugar, caffeine, and alcohol), and composite diet scores. Ten articles representing 8 unique randomized controlled trials met inclusion criteria. Of 15 conclusion statements (evidence grades: Weak to Moderate), 13 concluded there was no significant effect of incorporating genetic information into nutrition counseling/care on dietary outcomes. Limited data suggested that carriers of higher-risk gene variants were more likely than carriers of low-risk gene variants to significantly reduce intake of sodium and alcohol in response to nutrition counseling that incorporated genetic results. Included studies differed in quality, selected genetic variants, timing and intensity of intervention, sample size, dietary assessment tools, and population characteristics. Therefore, strong conclusions could not be drawn. Collaboration between the Academy of Nutrition and Dietetics and professional nutrigenetic societies would likely prove valuable in prioritizing which genetic variants and targeted nutrition messages have the most potential to alter dietary outcomes in a given patient subpopulation and, thus, should be the targets of future research.
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Affiliation(s)
- Katie Robinson
- Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
| | - Andrea Braakhuis
- Faculty of Medical and Health Science, Discipline of Nutrition, The University of Auckland, Grafton, Auckland, New Zealand
| | - Amy Ellis
- University of Alabama, Tuscaloosa, AL
| | | | | | | | - Ashley J Vargas
- National Institutes of Health, Office of Disease Prevention, Rockville, MD
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Horne J, Gilliland J, O'Connor C, Seabrook J, Madill J. Enhanced long-term dietary change and adherence in a nutrigenomics-guided lifestyle intervention compared to a population-based (GLB/DPP) lifestyle intervention for weight management: results from the NOW randomised controlled trial. BMJ Nutr Prev Health 2020; 3:49-59. [PMID: 33235971 PMCID: PMC7664486 DOI: 10.1136/bmjnph-2020-000073] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/30/2023] Open
Abstract
Background Adherence to nutritional guidelines for chronic disease prevention and management remains a challenge in clinical practice. Innovative strategies are needed to help optimise dietary behaviour change. Objective The objective of this study was to determine if a nutrigenomics-guided lifestyle intervention programme could be used to motivate greater dietary adherence and change in dietary intake short-term, moderate-term and long-term compared to the gold-standard population-based weight management intervention (Group Lifestyle Balance (GLB)/Diabetes Prevention Programme (DPP)). Design The Nutrigenomics, Overweight/Obesity, and Weight Management (NOW) randomised controlled trial is a pragmatic, parallel-group, superiority clinical trial (n=140), which was conducted at the East Elgin Family Health Team (EEFHT). GLB weight management groups were prerandomised 1:1 to receive either the standard GLB programme or a modified GLB+nutrigenomics (GLB+NGx) programme. Three 24-hour recalls were collected at baseline, 3, 6 and 12 months using the validated multiple pass method. Research assistants collecting the three 24-hour recalls were blinded to the participants’ group assignments. Statistical analyses included split plot analyses of variance (ANOVAs), two-way ANOVAs, binary logistic regression, χ2 and Fisher’s exact tests. Using the Theory of Planned Behaviour as guidance, key confounding factors of behaviour change were considered in the analyses. This study was registered with clinicaltrials.gov (NCT03015012). Results Only the GLB+NGx group significantly reduced their total fat intake from baseline to 12-month follow-up (from 36.0%±4.8% kcal to 30.2%±8.7% kcal, p=0.02). Long-term dietary adherence to total fat and saturated fat guidelines was also significantly (p<0.05) greater in the GLB+NGx group compared to the standard GLB group. Conclusions Weight management interventions guided by nutrigenomics can motivate long-term improvements in dietary fat intake above and beyond gold-standard population-based interventions.
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Affiliation(s)
- Justine Horne
- East Elgin Family Health Team, Aylmer, Ontario, Canada.,Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Jason Gilliland
- Department of Paediatrics, Western University, London, Ontario, Canada.,School of Health Studies, Western University, London, Ontario, Canada.,Department of Geography, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Colleen O'Connor
- Lawson Health Research Institute, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College (Western University), London, Ontario, Canada
| | - Jamie Seabrook
- Department of Paediatrics, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College (Western University), London, Ontario, Canada
| | - Janet Madill
- Lawson Health Research Institute, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College (Western University), London, Ontario, Canada
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Abrahams M, Frewer L, Bryant E, Stewart-Knox B. Personalised Nutrition Technologies and Innovations: A Cross-National Survey of Registered Dietitians. Public Health Genomics 2019; 22:119-131. [DOI: 10.1159/000502915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/25/2019] [Indexed: 11/19/2022] Open
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Vallée Marcotte B, Cormier H, Garneau V, Robitaille J, Desroches S, Vohl MC. Nutrigenetic Testing for Personalized Nutrition: An Evaluation of Public Perceptions, Attitudes, and Concerns in a Population of French Canadians. Lifestyle Genom 2019; 11:155-162. [DOI: 10.1159/000499626] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022] Open
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Vazquez-Vidal I, Desmarchelier C, Jones PJH. Nutrigenetics of Blood Cholesterol Concentrations: Towards Personalized Nutrition. Curr Cardiol Rep 2019; 21:38. [DOI: 10.1007/s11886-019-1124-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vallée Marcotte B, Cormier H, Garneau V, Robitaille J, Desroches S, Vohl MC. Current knowledge and interest of French Canadians regarding nutrigenetics. GENES AND NUTRITION 2019; 14:5. [PMID: 30820262 PMCID: PMC6380034 DOI: 10.1186/s12263-019-0629-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/01/2019] [Indexed: 01/19/2023]
Abstract
Objective The purpose of this study was to draw a global portrait of the current knowledge and interest regarding nutrigenetics in a population of French Canadians from the province of Quebec (Canada). Methods A total of 2238 residents from the province of Quebec, Canada, were recruited via social networks and from the Laval University employee/student lists to participate in a 37-question online survey on nutrigenetics. Results Most participants were not familiar with the term “nutrigenetics” (82.7%). Participants with good genetic literacy (26.8%) were less interested in nutrigenetic testing (p < 0.0001). The vast majority of participants (90.7%) reported to be willing to follow a personalised diet based on nutrigenetic testing, especially if they came to know themselves as carriers of a polymorphism increasing the risk of certain diseases. Participants had a higher interest in testing related to metabolic response to macronutrients (types of sugars, fats and proteins) than to micronutrients or other nutrients related to food intolerance. Conclusions The attitude of French Canadians about nutrigenetics is very consistent with the results from other surveys published in the literature. Although few individuals are familiar with nutrigenetics, the public’s attitude towards nutrigenetics is globally favourable. Electronic supplementary material The online version of this article (10.1186/s12263-019-0629-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bastien Vallée Marcotte
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
| | - Hubert Cormier
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
| | - Véronique Garneau
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
| | - Julie Robitaille
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
| | - Sophie Desroches
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
| | - Marie-Claude Vohl
- Institute of Nutrition and Functional Foods (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6 Canada
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Guest NS, Horne J, Vanderhout SM, El-Sohemy A. Sport Nutrigenomics: Personalized Nutrition for Athletic Performance. Front Nutr 2019; 6:8. [PMID: 30838211 PMCID: PMC6389634 DOI: 10.3389/fnut.2019.00008] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/18/2019] [Indexed: 12/14/2022] Open
Abstract
An individual's dietary and supplement strategies can influence markedly their physical performance. Personalized nutrition in athletic populations aims to optimize health, body composition, and exercise performance by targeting dietary recommendations to an individual's genetic profile. Sport dietitians and nutritionists have long been adept at placing additional scrutiny on the one-size-fits-all general population dietary guidelines to accommodate various sporting populations. However, generic "one-size-fits-all" recommendations still remain. Genetic differences are known to impact absorption, metabolism, uptake, utilization and excretion of nutrients and food bioactives, which ultimately affects a number of metabolic pathways. Nutrigenomics and nutrigenetics are experimental approaches that use genomic information and genetic testing technologies to examine the role of individual genetic differences in modifying an athlete's response to nutrients and other food components. Although there have been few randomized, controlled trials examining the effects of genetic variation on performance in response to an ergogenic aid, there is a growing foundation of research linking gene-diet interactions on biomarkers of nutritional status, which impact exercise and sport performance. This foundation forms the basis from which the field of sport nutrigenomics continues to develop. We review the science of genetic modifiers of various dietary factors that impact an athlete's nutritional status, body composition and, ultimately athletic performance.
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Affiliation(s)
- Nanci S Guest
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Nutrigenomix Inc., Toronto, ON, Canada
| | - Justine Horne
- Department of Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
| | - Shelley M Vanderhout
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Nutrigenomix Inc., Toronto, ON, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Nutrigenomix Inc., Toronto, ON, Canada
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16
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Tutty E, Hickerton C, Adamski MM, Metcalfe SA. Personal genomic testing for nutrition and wellness in Australia: A content analysis of online information. Nutr Diet 2019; 76:263-270. [PMID: 30693631 DOI: 10.1111/1747-0080.12516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/04/2018] [Accepted: 12/09/2018] [Indexed: 12/16/2022]
Abstract
AIM Personal genomic testing for nutrition and wellness (PGT-NG) offers a new service delivery model to nutritionists and dietitians. However, research indicates that this type of testing currently lacks sufficient clinical validity and utility to be commercially available. Despite Australian guidelines to the contrary, healthcare professionals are currently offering testing to clients, and promoting these services online. Thus, it is important to understand how PGT-NG is currently framed online to the public. METHODS A mixed methods content analysis was conducted to assess the content, quality and marketing approaches of websites offering PGT-NG to Australians. Websites were identified using popular search engines to mimic the behaviour of a consumer. A novel framework was developed for the purposes of the analysis. RESULTS Thirty-nine websites were analysed, comprising four nutritional genomic testing company websites and 35 healthcare provider websites. Healthcare providers relied on information from the testing companies. The content was emotive, and little attention was given to the scientific and ethical aspects of personal genomic testing. Websites appealed to consumer empowerment and framed testing as an essential and superior tool for optimising health. CONCLUSIONS Websites lacked the transparency necessary for informed consent. A basic checklist of key information was developed to aid healthcare providers when informing potential clients of PGT-NG online.
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Affiliation(s)
- Erin Tutty
- Murdoch Children's Research Institute, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Chriselle Hickerton
- Murdoch Children's Research Institute, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Melissa M Adamski
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Sylvia A Metcalfe
- Murdoch Children's Research Institute, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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17
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Maranhão PA, Bacelar-Silva GM, Ferreira DNG, Calhau C, Vieira-Marques P, Cruz-Correia RJ. Nutrigenomic Information in the openEHR Data Set. Appl Clin Inform 2018; 9:221-231. [PMID: 29590680 DOI: 10.1055/s-0038-1635115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed to help in better understanding the genetic variation influence on the dietary response and association between nutrients and gene expression. Hence, some challenges impaired the understanding about the nowadays important clinical data and about clinical data assumed to be important in the future. OBJECTIVE Finding the main clinical statements in the personalized nutrition field (nutrigenomics) to create the future-proof health information system to the openEHR server based on archetypes, as well as a specific nutrigenomic template. METHODS A systematic literature search was conducted in electronic databases such as PubMed. The aim of this systemic review was to list the chief clinical statements and create archetype and templates for openEHR modeling tools, namely, Ocean Archetype Editor and Ocean Template Design. RESULTS The literature search led to 51 articles; however, just 26 articles were analyzed after all the herein adopted inclusion criteria were assessed. Of these total, 117 clinical statements were identified, as well as 27 archetype-friendly concepts. Our group modeled four new archetypes (waist-to-height ratio, genetic test results, genetic summary, and diet plan) and finally created the specific nutrigenomic template for nutrition care. CONCLUSION The archetypes and the specific openEHR template developed in this study gave dieticians and other health professionals an important tool to their nutrigenomic clinical practices, besides a set of nutrigenomic data to clinical research.
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Affiliation(s)
- Priscila Alves Maranhão
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Gustavo Marísio Bacelar-Silva
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Duarte Nuno Gonçalves Ferreira
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Conceição Calhau
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal.,Faculty of Medical Science, Nova de Lisboa University, Nova Medical School, Lisboa, Portugal
| | - Pedro Vieira-Marques
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Ricardo João Cruz-Correia
- Faculty of Medicine, Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
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18
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Grimaldi KA, van Ommen B, Ordovas JM, Parnell LD, Mathers JC, Bendik I, Brennan L, Celis-Morales C, Cirillo E, Daniel H, de Kok B, El-Sohemy A, Fairweather-Tait SJ, Fallaize R, Fenech M, Ferguson LR, Gibney ER, Gibney M, Gjelstad IMF, Kaput J, Karlsen AS, Kolossa S, Lovegrove J, Macready AL, Marsaux CFM, Alfredo Martinez J, Milagro F, Navas-Carretero S, Roche HM, Saris WHM, Traczyk I, van Kranen H, Verschuren L, Virgili F, Weber P, Bouwman J. Proposed guidelines to evaluate scientific validity and evidence for genotype-based dietary advice. GENES & NUTRITION 2017; 12:35. [PMID: 29270237 PMCID: PMC5732517 DOI: 10.1186/s12263-017-0584-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 10/09/2017] [Indexed: 12/13/2022]
Abstract
Nutrigenetic research examines the effects of inter-individual differences in genotype on responses to nutrients and other food components, in the context of health and of nutrient requirements. A practical application of nutrigenetics is the use of personal genetic information to guide recommendations for dietary choices that are more efficacious at the individual or genetic subgroup level relative to generic dietary advice. Nutrigenetics is unregulated, with no defined standards, beyond some commercially adopted codes of practice. Only a few official nutrition-related professional bodies have embraced the subject, and, consequently, there is a lack of educational resources or guidance for implementation of the outcomes of nutrigenetic research. To avoid misuse and to protect the public, personalised nutrigenetic advice and information should be based on clear evidence of validity grounded in a careful and defensible interpretation of outcomes from nutrigenetic research studies. Evidence requirements are clearly stated and assessed within the context of state-of-the-art 'evidence-based nutrition'. We have developed and present here a draft framework that can be used to assess the strength of the evidence for scientific validity of nutrigenetic knowledge and whether 'actionable'. In addition, we propose that this framework be used as the basis for developing transparent and scientifically sound advice to the public based on nutrigenetic tests. We feel that although this area is still in its infancy, minimal guidelines are required. Though these guidelines are based on semi-quantitative data, they should stimulate debate on their utility. This framework will be revised biennially, as knowledge on the subject increases.
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Affiliation(s)
| | | | - Jose M. Ordovas
- JMUSDA-Human Nutrition Research Center on Aging at Tufts University, Boston, USA
- IMDEA Alimentacion, Madrid, Spain
| | - Laurence D. Parnell
- Agriculture Research Service, USDA, Human Nutrition Research Center on Aging, Boston, MA 02111 USA
| | - John C. Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL UK
| | - Igor Bendik
- DSM Nutritional Products, Kaiseraugst, Switzerland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL UK
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, G12 8TA UK
| | | | - Hannelore Daniel
- Nutritional Physiology, Technische Universität München, 85350 Freising, Germany
| | | | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, 150 College Street, 3rd Floor, Toronto, ON M5S 3E2 Canada
| | | | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, Berkshire RG6 6AP UK
| | - Michael Fenech
- CSIRO Health and Biosecurity, Gate 13, Kintore Avenue, Adelaide, SA 5000 Australia
| | - Lynnette R. Ferguson
- ACSRC and Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1184 New Zealand
| | - Eileen R. Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Mike Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Ingrid M. F. Gjelstad
- Department of Nutrition, Universitetet i Oslo, PO Box 1046, Blindern, N-0316 Oslo, Norway
| | - Jim Kaput
- Vydiant Inc, 2330 Gold Meadow Way, Gold River, 95670 CA USA
| | - Anette S. Karlsen
- Department of Nutrition, Universitetet i Oslo, PO Box 1046, Blindern, N-0316 Oslo, Norway
| | - Silvia Kolossa
- Nutritional Physiology, Technische Universität München, 85350 Freising, Germany
| | - Julie Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, Berkshire RG6 6AP UK
| | - Anna L. Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 226, Reading, Berkshire RG6 6AP UK
| | - Cyril F. M. Marsaux
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands
| | - J. Alfredo Martinez
- IMDEA Alimentacion, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Fermin Milagro
- Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Helen M. Roche
- Nutrigenomics Research Group, UCD Institute of Food and Health/UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Wim H. M. Saris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre + (MUMC+), Maastricht, The Netherlands
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty on Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Henk van Kranen
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | | | - Fabio Virgili
- Council for Agricultural Research and Economics, Food and Nutrition Research Centre, (CREA - AN), via Ardeatina 546, 00178 Rome, Italy
| | - Peter Weber
- DSM Nutritional Products, Kaiseraugst, Switzerland
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Horne J, Madill J, Gilliland J. Incorporating the 'Theory of Planned Behavior' into personalized healthcare behavior change research: a call to action. Per Med 2017; 14:521-529. [PMID: 29749859 DOI: 10.2217/pme-2017-0038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The 'Theory of Planned Behavior' (TPB) has been tested and validated in the scientific literature across multiple disciplines and is arguably the most widely accepted theory among behavior change academics. Despite this widespread acceptability, the TPB has yet to be incorporated into personalized healthcare behavior change research. Several prominent personalized healthcare researchers suggest that personalizing healthcare recommendations have a positive impact on changes in lifestyle habits. However, research in this area has demonstrated conflicting findings. We provide a scientific and theoretical basis to support a proposed expansion of the TPB to include personalization, and call to action-personalized healthcare behavior change researchers to test this expansion. Specific recommendations for study design are included.
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Affiliation(s)
- Justine Horne
- Faculty of Health Sciences, The University of Western Ontario, London, Canada.,Division of Food & Nutritional Sciences, Brescia University College, The University of Western Ontario, London, Canada
| | - Janet Madill
- Division of Food & Nutritional Sciences, Brescia University College, The University of Western Ontario, London, Canada
| | - Jason Gilliland
- Department of Geography, The University of Western Ontario, London, Canada.,Department of Paediatrics, The University of Western Ontario, London, Canada.,School of Health Studies, The University of Western Ontario, London, Canada.,Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Canada
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20
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Hurlimann T, Peña-Rosas JP, Saxena A, Zamora G, Godard B. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review. PLoS One 2017; 12:e0186897. [PMID: 29073186 PMCID: PMC5658098 DOI: 10.1371/journal.pone.0186897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/19/2017] [Indexed: 12/24/2022] Open
Abstract
Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions. Conclusion General ethical frameworks or recommendations–although useful–cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks.
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Affiliation(s)
- Thierry Hurlimann
- Public Health Research Institute of the University of Montreal (IRSPUM), Montreal, Canada
| | - Juan Pablo Peña-Rosas
- Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Abha Saxena
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Gerardo Zamora
- Evidence and Programme Guidance, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Béatrice Godard
- Public Health Research Institute of the University of Montreal (IRSPUM), Montreal, Canada
- * E-mail:
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21
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de Toro-Martín J, Arsenault BJ, Després JP, Vohl MC. Precision Nutrition: A Review of Personalized Nutritional Approaches for the Prevention and Management of Metabolic Syndrome. Nutrients 2017; 9:E913. [PMID: 28829397 PMCID: PMC5579706 DOI: 10.3390/nu9080913] [Citation(s) in RCA: 225] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 02/07/2023] Open
Abstract
The translation of the growing increase of findings emerging from basic nutritional science into meaningful and clinically relevant dietary advices represents nowadays one of the main challenges of clinical nutrition. From nutrigenomics to deep phenotyping, many factors need to be taken into account in designing personalized and unbiased nutritional solutions for individuals or population sub-groups. Likewise, a concerted effort among basic, clinical scientists and health professionals will be needed to establish a comprehensive framework allowing the implementation of these new findings at the population level. In a world characterized by an overwhelming increase in the prevalence of obesity and associated metabolic disturbances, such as type 2 diabetes and cardiovascular diseases, tailored nutrition prescription represents a promising approach for both the prevention and management of metabolic syndrome. This review aims to discuss recent works in the field of precision nutrition analyzing most relevant aspects affecting an individual response to lifestyle/nutritional interventions. Latest advances in the analysis and monitoring of dietary habits, food behaviors, physical activity/exercise and deep phenotyping will be discussed, as well as the relevance of novel applications of nutrigenomics, metabolomics and microbiota profiling. Recent findings in the development of precision nutrition are highlighted. Finally, results from published studies providing examples of new avenues to successfully implement innovative precision nutrition approaches will be reviewed.
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Affiliation(s)
- Juan de Toro-Martín
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Benoit J Arsenault
- Department of Medicine, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada.
- Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada.
| | - Jean-Pierre Després
- Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada.
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Marie-Claude Vohl
- Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Laval University, Quebec City, QC G1V 0A6, Canada.
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22
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Roke K, Walton K, Klingel SL, Harnett A, Subedi S, Haines J, Mutch DM. Evaluating Changes in Omega-3 Fatty Acid Intake after Receiving Personal FADS1 Genetic Information: A Randomized Nutrigenetic Intervention. Nutrients 2017; 9:nu9030240. [PMID: 28272299 PMCID: PMC5372903 DOI: 10.3390/nu9030240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/27/2017] [Accepted: 03/03/2017] [Indexed: 02/07/2023] Open
Abstract
Nutrigenetics research is anticipated to lay the foundation for personalized dietary recommendations; however, it remains unclear if providing individuals with their personal genetic information changes dietary behaviors. Our objective was to evaluate if providing information for a common variant in the fatty acid desaturase 1 (FADS1) gene changed omega-3 fatty acid (FA) intake and blood levels in young female adults (18–25 years). Participants were randomized into Genetic (intervention) and Non-Genetic (control) groups, with measurements taken at Baseline and Final (12 weeks). Dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) was assessed using an omega-3 food frequency questionnaire. Red blood cell (RBC) FA content was quantified by gas chromatography. Implications of participation in a nutrigenetics study and awareness of omega-3 FAs were assessed with online questionnaires. Upon completion of the study, EPA and DHA intake increased significantly (p = 1.0 × 10−4) in all participants. This change was reflected by small increases in RBC %EPA. Participants in the Genetic group showed increased awareness of omega-3 terminology by the end of the study, reported that the dietary recommendations were more useful, and rated cost as a barrier to omega-3 consumption less often than those in the Non-Genetic group. Providing participants FADS1 genetic information did not appear to influence omega-3 intake during the 12 weeks, but did change perceptions and behaviors related to omega-3 FAs in this timeframe.
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Affiliation(s)
- Kaitlin Roke
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Shannon L Klingel
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Amber Harnett
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Sanjeena Subedi
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
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23
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Factors determining the integration of nutritional genomics into clinical practice by registered dietitians. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2016.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hurlimann T, Robitaille J, Vohl MC, Godard B. Ethical considerations in the implementation of nutrigenetics/nutrigenomics. Per Med 2016; 14:75-83. [PMID: 29749825 DOI: 10.2217/pme-2016-0035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Awareness of ethical issues that may be raised by the implementation of nutrigenetic/nutrigenomic (NGx) testing and personalized nutrition, at an individual or a public health level, is crucial to ensure the latter's sound and effective implementation. NGx tests that are currently offered or developed have different natures and scopes. We provide an example of NGx testing on the MTHFR gene to illustrate the current challenges when it comes to grasp the meaning of the results of such testing. In addition, NGx testing is developed within an evolving landscape of new genomic technologies and occurs at a time when public health policies mainly focus on preventive and predictive healthcare, with an emphasis on increased individual responsibility. The ethical issues raised by such a context and the genetic nature of NGx testing both should be carefully evaluated.
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Affiliation(s)
- Thierry Hurlimann
- Public Health Research Institute - University of Montreal (IRSPUM), PO Box 6128, Station Centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Julie Robitaille
- Institute of Nutrition & Functional Foods (INAF) & School of Nutrition, Université Laval, 2440 Hochelaga Blvd, Room 2729-N, Quebec City, QC, Canada
| | - Marie-Claude Vohl
- Institute of Nutrition & Functional Foods (INAF) & School of Nutrition, Université Laval, 2440 Hochelaga Blvd, Room 2729-N, Quebec City, QC, Canada
| | - Béatrice Godard
- Public Health Research Institute - University of Montreal (IRSPUM), PO Box 6128, Station Centre-ville, Montreal, QC, H3C 3J7, Canada
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Kohlmeier M, De Caterina R, Ferguson LR, Görman U, Allayee H, Prasad C, Kang JX, Nicoletti CF, Martinez JA. Guide and Position of the International Society of Nutrigenetics/Nutrigenomics on Personalized Nutrition: Part 2 - Ethics, Challenges and Endeavors of Precision Nutrition. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2016; 9:28-46. [PMID: 27286972 DOI: 10.1159/000446347] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Nutrigenetics considers the influence of individual genetic variation on differences in response to dietary components, nutrient requirements and predisposition to disease. Nutrigenomics involves the study of interactions between the genome and diet, including how nutrients affect the transcription and translation process plus subsequent proteomic and metabolomic changes, and also differences in response to dietary factors based on the individual genetic makeup. Personalized characteristics such as age, gender, physical activity, physiological state and social status, and special conditions such as pregnancy and risk of disease can inform dietary advice that more closely meets individual needs. Precision nutrition has a promising future in treating the individual according to their phenotype and genetic characteristics, aimed at both the treatment and prevention of disease. However, many aspects are still in progress and remain as challenges for the future of nutrition. The integration of the human genotype and microbiome needs to be better understood. Further advances in data interpretation tools are also necessary, so that information obtained through newer tests and technologies can be properly transferred to consumers. Indeed, precision nutrition will integrate genetic data with phenotypical, social, cultural and personal preferences and lifestyles matters to provide a more individual nutrition, but considering public health perspectives, where ethical, legal and policy aspects need to be defined and implemented.
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Affiliation(s)
- Martin Kohlmeier
- Department of Nutrition, School of Public Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
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Bouchard-Mercier A, Desroches S, Robitaille J, Vohl MC. Factors Associated with the Intention of Registered Dietitians to Discuss Nutrigenetics with their Patients/Clients. CAN J DIET PRACT RES 2016; 77:163-169. [PMID: 27182816 DOI: 10.3148/cjdpr-2016-005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE The objective of this study was to investigate factors affecting the intention of Registered Dietitians (RDs) to discuss nutrigenetics with their patients/clients. METHODS A survey based on the theory of planned behaviour (TPB; attitude, subjective norm, and perceived behavioural control) was developed and sent by email to RD members of the Ordre professionnel des diététistes du Québec. Multiple regression analyses were performed to examine the determinants of intention and behaviour. RESULTS A total of 141 RDs completed the questionnaire (5.8% response rate). On a scale from -2 to 2 (from strongly disagree to strongly agree), the intention of discussing nutrigenetics with patients/clients was neutral (mean of -0.07 ± 0.92). The TPB construct of attitude was the most strongly associated with intention (β = 0.66, P < 0.0001) followed by perceived behavioural control (β = 0.33, P < 0.0001) and subjective norm (β = 0.21, P = 0.03). Finally, 13 out of 141 RDs (~9%) actually practiced the behaviour, which was to have discussed nutrigenetics with their patients/clients in the last 3 months. Only perceived behavioural control contributed to explain the behaviour (β = 0.17, P < 0.0001). CONCLUSIONS Main determinants of the intention of RDs to discuss nutrigenetics with their patients/clients were determined. This knowledge will help inform the design of future educational content about nutrigenetics.
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Affiliation(s)
- Annie Bouchard-Mercier
- a Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, QC.,b Department of Food Science and Nutrition, Laval University, Quebec, QC
| | - Sophie Desroches
- a Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, QC.,b Department of Food Science and Nutrition, Laval University, Quebec, QC
| | - Julie Robitaille
- a Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, QC.,b Department of Food Science and Nutrition, Laval University, Quebec, QC
| | - Marie-Claude Vohl
- a Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, QC.,b Department of Food Science and Nutrition, Laval University, Quebec, QC
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Nielsen DE, Shih S, El-Sohemy A. Perceptions of Genetic Testing for Personalized Nutrition: A Randomized Trial of DNA-Based Dietary Advice. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2014; 7:94-104. [DOI: 10.1159/000365508] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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