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Keathley J, Garneau V, Marcil V, Mutch DM, Robitaille J, Rudkowska I, Sofian GM, Desroches S, Vohl MC. Nutrigenetics, omega-3 and plasma lipids/lipoproteins/apolipoproteins with evidence evaluation using the GRADE approach: a systematic review. BMJ Open 2022; 12:e054417. [PMID: 35193914 PMCID: PMC8867311 DOI: 10.1136/bmjopen-2021-054417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Despite the uptake of nutrigenetic testing through direct-to-consumer services and healthcare professionals, systematic reviews determining scientific validity are limited in this field. The objective of this review was to: retrieve, synthesise and assess the quality of evidence (confidence) for nutrigenetic approaches related to the effect of genetic variation on plasma lipid, lipoprotein and apolipoprotein responsiveness to omega-3 fatty acid intake. DESIGN A systematic review was conducted using three search engines (Embase, Web of Science and Medline) for articles published up until 1 August 2020. We aimed to systematically search, identify (select) and provide a narrative synthesis of all studies that assessed nutrigenetic associations/interactions for genetic variants (comparators) influencing the plasma lipid, lipoprotein and/or apolipoprotein response (outcomes) to omega-3 fatty acid intake (intervention/exposure) in humans-both paediatric and adult populations (population). We further aimed to assess the overall quality of evidence for specific priority nutrigenetic associations/interactions based on the following inclusion criteria: nutrigenetic associations/interactions reported for the same genetic variants (comparators) influencing the same plasma lipid, lipoprotein and/or apolipoprotein response (outcomes) to omega-3 fatty acid intake (intervention/exposure) in humans-both paediatric and adult populations (population) in at least two independent studies, irrespective of the findings. Risk of bias was assessed in individual studies. Evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach with a modification to further consider biological plausibility. RESULTS Out of 1830 articles screened, 65 met the inclusion criteria for the narrative synthesis (n=23 observational, n=42 interventional); of these, 25 met the inclusion criteria for GRADE evidence evaluation. Overall, current evidence is insufficient for gene-diet associations related to omega-3 fatty acid intake on plasma apolipoproteins, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein (LDL)-cholesterol and LDL particle size. However, there is strong (GRADE rating: moderate quality) evidence to suggest that male APOE-E4 carriers (rs429358, rs7412) exhibit significant triglyceride reductions in response to omega-3-rich fish oil with a dose-response effect. Moreover, strong (GRADE rating: high quality) evidence suggests that a 31-SNP nutrigenetic risk score can predict plasma triglyceride responsiveness to omega-3-rich fish oil in adults with overweight/obesity from various ethnicities. CONCLUSIONS Most evidence in this area is weak, but two specific nutrigenetic interactions exhibited strong evidence, with generalisability limited to specific populations. PROSPERO REGISTRATION NUMBER CRD42020185087.
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Affiliation(s)
- Justine Keathley
- Université Laval, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF) Quebec, Quebec City, Quebec, Canada
- Universite Laval, School of Nutrition, Quebec City, Quebec, Canada
| | - Véronique Garneau
- Université Laval, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF) Quebec, Quebec City, Quebec, Canada
- Universite Laval, School of Nutrition, Quebec City, Quebec, Canada
| | - Valérie Marcil
- Department of Nutrition, University of Montréal, Montréal, Quebec, Canada
- Research Centre, Sainte-Justine University Health Centre, Montréal, Quebec, Canada
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Julie Robitaille
- Université Laval, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF) Quebec, Quebec City, Quebec, Canada
- Universite Laval, School of Nutrition, Quebec City, Quebec, Canada
| | - Iwona Rudkowska
- Department of Kinesiology, Université Laval, Quebec City, Quebec, Canada
- Endocrinology and Nephrology Unit, CHU de Québec - Université Laval Research Center, Quebec City, Quebec, Canada
| | | | - Sophie Desroches
- Université Laval, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF) Quebec, Quebec City, Quebec, Canada
- Universite Laval, School of Nutrition, Quebec City, Quebec, Canada
| | - Marie-Claude Vohl
- Université Laval, Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF) Quebec, Quebec City, Quebec, Canada
- Universite Laval, School of Nutrition, Quebec City, Quebec, Canada
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