Opinion

Should we design our diet around our DNA?


Melissa Adamski


22/08/2018 11:19:17 AM

Dietitian Melissa Adamski looks at nutritional genomics and the possible relationship between diet and DNA.

News teaser
Dietitian Melissa Adamski says the complexity of this area of science means that recommending everyone follow a DNA diet is ‘a little way off’.

A ‘DNA diet’ that’s tailored to your genetics? No, it’s not science fiction.
 
The idea that diet and nutrition recommendations can be personalised to an individual’s genetic profile is becoming more mainstream, with both the public and healthcare professionals becoming more interested in the concept.
 
Let’s take a closer look at whether we can really use information from our genes to guide dietary recommendations for patients.
 
What’s new in genetics?
It has been 15 years since the human genome was mapped and during this time our knowledge of it has expanded considerably.
 
We have learned how genes may have an impact on health, including how they may affect nutrition requirements. We have also learned the extent of human genome variability, with millions of variations (or polymorphisms) having been identified.
 
So, while more than 99% of the human genome is identical in any two people, we know now that the (approximately) 0.1% of differences make each of us distinct individuals. Polymorphisms, such as single nucleotide polymorphisms (SNPs) play a role in different disease risks, metabolic rates and nutritional requirements between individuals.
 
We need to look at common polymorphisms differently from the more traditional view of genetics, where a ‘mutation’ in the genome can result in the development of a rare, and often serious, disease/condition transmitted to the progeny following the Mendelian pattern of inheritance.
 
Common polymorphisms are usually considered gene-environment (or gene-nutrient) interactions, which means the environment still plays an influencing role in an individual’s health.
 
This new knowledge of common polymorphisms highlights how individual we all are and – in relation to nutrition and diet – raises the question of whether ‘one-sized-fits-all nutrition guidelines’ are now appropriate, or if we need to tailor recommendations according to our genome.
 
What is nutritional genomics?
Nutritional genomics is the science that looks at the relationship between our genes and their variants, nutrition and health. This can be further broken down as follows:

  • Nutrigenetics – a branch of science that aims to identify how genetic variants influence the individual response to nutrients and a dietary pattern
  • Nutrigenomics – the application of genomics tools in nutrition science, with the aim of understanding how food components influence gene activity, resulting in homeostatic control of metabolism and nutrients
  • Epigenetics – looks at the chemical modifications on DNA and DNA-associated proteins (eg histones). We know now that these chemical modifications can affect the activity of genes and that they are regulated by the environment in which we live, including nutrition and exercise.
Should I be recommending a DNA diet to patients?
This is a very exciting time for nutrition science: it would be great to test a person’s genes, then be recommend an appropriate diet.
 
At this stage, however, the science is very complex and it is common for research to unearth more questions than answers. While there is a growing body of evidence to help inform our understanding of gene-nutrient interactions, less is known about the translation of this science into practise.
 
Patients can currently access information on their genes, including gene-nutrient interactions, through direct-to-consumer tests or tests conducted via a range of healthcare professionals (whose training in genetics may vary). Doctors need to be able to provide evidenced-based advice and information to patients who may be seeking clarification about tests already conducted or asking if they should have a test done.
 
When advising patients on nutrigenetic tests, a number of factors need to be considered, including:
  • scientific validity
  • clinical validity
  • clinical utility
  • ethical, legal and social issues.
Recent guidelines for examining scientific validity of gene-nutrient interactions are aimed at healthcare professionals, such as doctors and dietitians; however, there is less known about the clinical utility of these tests. There are some initial guidelines for utility of some nutrigenetic tests, which is a great start (refer reading list below for examples for methylenetetrahydrofolate reductase testing), and it will be good to see more of these developed in the future as the science continues to be explored.
 
So, while the evidence continues to show promise for informing nutrition information, at this stage the complexity of this area of science means that recommending everyone follow a DNA diet is a little way off.
 
While there could be some specific areas in which genetics may be able to provide some guidance for nutrition recommendations, we must first consider a range of factors, such as clinical utility and ethical issues, before recommending testing to patients.
 
Further reading



DNA diet Epigenetics Nutrigenetics Nutrigenomics Nutritional genomics





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