What nutritionists need to know about nutrigenomics
To say that nutrigenomics is a hot topic is, to put it mildly, an understatement.
Direct-to-consumer DNA kits promising to personalize diets are fueling a global marketplace worth $250 million in 2017 and projected to grow 16.5% annually through 2025.1 Leading researchers are pursuing much-needed studies2 to help quantify the true scope of its healthcare potential. And medical practitioners are learning how to respond to the increasingly common question, "Can my genes really tell me what to eat?"
To get past the hype for some helpful insight, we sat down with Dr. Peter Nickless, dean of the School of Health Sciences and Education at Northeast College of Health Sciences.
What does the term nutrigenomics really mean?
According to Dr. Nickless, "Nutrigenomics specifically refers to the interaction between what you eat and the expression or regulation of your genes. It looks at your environment and how that impacts the movement from genomics to the practical outcome of your genetic makeup. That extends into the concept we call personalized nutrition -- and the heart of that is the fact that there's no such thing as a one-size-fits-all dietary approach."
Can genetic information help us provide a truly personalized diet?
The promise of a genetically based, unique-to-the-individual diet has obvious appeal -- but we wanted to explore if it also has scientific credibility. "This is where, in discussions of nutrigenomics, I always have to pause and throw in a caveat," Dr. Nickless replied.
"This is a rapidly expanding field, with breakthroughs in just the past few months that still need to be reviewed and assessed.
What I would say is that, for the majority of clients that you interact with, the standard tried-and-true methods that a nutritionist uses are still going to work. Nutrigenomics is a good way of going a step beyond, especially for those 10% to 15% of patients who don't respond to standard protocols as we might expect."
He added that,
In the future we will hit a point where nutrigenomics becomes the start of assessment and medical intervention in general.
What should people be looking for in terms of current ability to personalize nutrition?
As he proceeded to discuss what steps ordinary people should take to pursue a personalized diet, Dr. Nickless was quick to say, "The first step is, don't go to the internet, OK? The second is, if you're comfortable talking to your doctor, go for it -- but realize that you need a medical provider who's actually trained in diet and modifiable risk factors. Unfortunately, they say that fewer than 10% of medical doctors feel comfortable discussing genetic variants with their patients.
You're more likely to find this expertise in a nutritionist who's trained to read and interpret the testing and then use those findings in conjunction with everything that we would normally do nutritionally to create a series of interventional plans. So, we're not specifically taking your genetic testing and saying, 'Here, this is your diet and every morsel of food you should eat.'"
In short, genetic testing is not a nutritional silver bullet but, as Dr. Nickless said, "It's part of my nutritionist's toolkit."
How should healthcare providers be approaching nutrigenomics?
In an environment where, as noted above, barely one in ten doctors are comfortable addressing genetics, how can the individual professional best incorporate nutrigenomics into their own toolkit? "Get beyond the mysticism surrounding it," says Dr. Nickless, "and quit thinking of it as something far off into the future. It's having significant implications right now."
With that in mind, he says that the ideal course of action is more training, which is increasingly accessible. Dr. Nickless noted that as little as six or seven years ago, many master's degree programs in nutrition didn't cover nutrigenomics, but that the Northeast Master of Science in Applied Clinical Nutrition program was recently redesigned to provide a thorough grounding in it.
Nickless said, "When we recreated our program, we realigned it closely with the Certified Nutrition Specialists credentialing developed by the American Nutrition Association. That substantially increased our offerings in nutrigenomics, epigenetics and metabolomics, all to enable our graduates to look at genetic information and know what kinds of recommendation they can make based upon it."
Get trained, or get teamed up
And if a doctor isn't able or inclined to get the training? "You don't have to reinvent your practice," Dr. Nickless concluded. "Simply team up with the right nutritionist. In other words, if you don't want to learn the stuff, learn to refer."
Non-interview references:
Nutrigenomics Market Size, Grand View Research
Personalized Nutrition: The Latest on DNA-Based Diets, Scientific American