Personal genomic testing for nutrition and wellness in Australia: A content analysis of online information.

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.

Opportunities for training for nutritional professionals in nutritional genomics: What is out there?

AIM: To identify and profile training courses available to dietitians and nutritionists in the area of nutritional genomics. Genetic technology is progressing quickly, leading to increased public interest and requests from the public for personalised nutrition advice based on genetic background. Tertiary courses often lack specific curriculum in nutritional genomics, preventing graduates from discussing confidently with their clients the relationships between genetics, nutrition and health. This has increased the demand for professional development in this field. METHODS: The search strategy was intended to replicate real-life practice. Google and snowball searches were conducted using terms related to education and nutritional genomics. Results included online or face-to-face courses in any country providing content on nutritional genomics. One-off courses and those courses no longer accessible were excluded. A descriptive analysis of characteristics of courses was undertaken, reporting on mode of delivery, cost, duration, content, qualification awarded, target audience and affiliations. RESULTS: In total, 37 courses varying in duration, content and cost were identified: 4 postgraduate university degrees, 5 university course units, 4 recurring face-to-face workshops, 15 online short courses, 8 pre-recorded presentations and 1 service offering regular live webinars. Affiliations with food and pharmaceutical industry (e.g. genetic testing companies), professional organisations and research/education institutes were observed. CONCLUSIONS: Training courses identified were predominantly delivered online, enabling nutrition professionals worldwide to upskill in nutritional genomics and personalised nutrition. Additional courses exist. Those seeking training should scrutinise and compare cost, duration, mode, content and affiliations of course providers to ensure learning needs are met.

Translation of Nutritional Genomics into Nutrition Practice: The Next Step.

Genetics is an important piece of every individual health puzzle. The completion of the Human Genome Project sequence has deeply changed the research of life sciences including nutrition. The analysis of the genome is already part of clinical care in oncology, pharmacology, infectious disease and, rare and undiagnosed diseases. The implications of genetic variations in shaping individual nutritional requirements have been recognised and conclusively proven, yet routine use of genetic information in nutrition and dietetics practice is still far from being implemented. This article sets out the path that needs to be taken to build a framework to translate gene-nutrient interaction studies into best-practice guidelines, providing tools that health professionals can use to understand whether genetic variation affects nutritional requirements in their daily clinical practice.

Genetic Variations as Modifying Factors to Dietary Zinc Requirements-A Systematic Review.

Due to reduced cost and accessibility, the use of genetic testing has appealed to health professionals for personalising nutrition advice. However, translation of the evidence linking polymorphisms, dietary requirements, and pathology risk proves to be challenging for nutrition and dietetic practitioners. Zinc status and polymorphisms of genes coding for zinc-transporters have been associated with chronic diseases. The present study aimed to systematically review the literature to assess whether recommendations for zinc intake could be made according to genotype. Eighteen studies investigating 31 Single Nucleotide Polymorphisms (SNPs) in relation to zinc intake and/or status were identified. Five studies examined type 2 diabetes; zinc intake was found to interact independently with two polymorphisms in the zinc-transporter gene SLC30A8 to affect glucose metabolism indicators. While the outcomes were statistically significant, the small size of the effect and lack of replication raises issues regarding translation into nutrition and dietetic practice. Two studies assessed the relationship of polymorphisms and cognitive performance; seven studies assessed the association between a range of outcomes linked to chronic conditions in aging population; two papers described the analysis of the genetic contribution in determining zinc concentration in human milk; and two papers assessed zinc concentration in plasma without linking to clinical outcomes. The data extracted confirmed a connection between genetics and zinc requirements, although the direction and magnitude of the dietary modification for carriers of specific genotypes could not be defined. This study highlights the need to summarise nutrigenetics studies to enable health professionals to translate scientific evidence into dietary recommendations.