Recent advances in DNA sequencing technologies have led to significant developments in healthcare-focused research on precision medicine and diagnostics. Given the recent shift from the one-size-fits-all model to a more personalized mode of treatment, there has been a growing interest for identification and adoption of novel techniques. According to a study, around 20,000 genes are present in the human body, all of which interact with the nutrients in the food, either directly or indirectly. Therefore, in order to understand the physiology of any disease and develop an effective treatment, it is important to gain knowledge regarding genes and how they impact the usual human functions. Nutrigenomics is the science studying the relationship between human genome, nutrition and health. In part, the success of the Human Genome Project has also paved a path for the novel concept of nutrigenomics. At present, extensive studies are being conducted to understand the interaction between nutrients and gene expression at the molecular level, to determine the effect of a specific nutrient and dietary regime on human health.
Considering the growing focus on personalized diets and active initiatives being undertaken by players in this domain, we are led to believe that the opportunity for stakeholders in the nutrigenomics market is niche, but is likely to grow at a commendable pace in the foreseen future.
An Overview of Nutrigenomics
As mentioned earlier, nutrigenomics or nutritional genomics is the study of interaction of nutrients with human genome. It is worth mentioning that various components, such as glucose, amino acids, fatty acids, vitamins and minerals, are known to modulate the expression of several genes, resulting in the alteration of the phenotype of humans. Nutritional DNA testing helps in identifying foods that might lead to allergies or intolerance in an individual. For instance, carbohydrates increase the expression of genes responsible for the synthesis of enzymes and transporters involved in their metabolism. It is worth highlighting that nutrigenomics can be used for the treatment of inborn errors of metabolism by manipulating diet. For example, people affected by phenylketonuria must avoid consuming food containing phenylalanine amino acid. Similarly, people suffering from lactose intolerance must avoid milk products. Additionally, nutrigenomics helps in risk assessment of diet related disorders using the predictive power of single nucleotide polymorphism (SNP). Figure below presents an overview of nutrigenomics.
Nutrigenomics tests are capable of determining the influence of genes on nutrient requirements and metabolism. It further highlights the variation in the genome of patients and identify the sites of metabolic weakness. The nutrigenomic testing employs various techniques / tools to determine the effect of diet on genome; these tools have been described below:
Tools for Nutrigenomics Testing
Microarray Technologies: These types of technologies have enabled the study of physiological effect of different nutrition, such as proteins and other dietary components. Quantitative real time polymerase chain reaction (RT PCR) and DNA microarray technologies have been successfully used to evaluate the interactions between genes and diet, which is measured in terms of changes in the genetic expression.
Proteomics Tools: It includes two-dimensional electrophoresis, which is generally employed in order to identify the alterations in expression of polypeptides and post translational modifications.
Metabolomic Analysis: This type of analysis is used for the detection of changes in biochemical profiles in body fluids, such as plasma and urine. This analysis is generally used for the determination of various metabolites in body fluids.
Applications of Nutrigenomics
Even though the field of nutritional genomics is still in a nascent stage, it has the ability to help unfold the role of various components of nutrients on gene expression, as well as lay down the foundation for personalized nutrition offerings. Further, a growing interest in the field of nutrigenomics is being supported by the rising awareness regarding the influence of diet on human health and its potential, with respect to minimizing the risk of various diet-related diseases, including diabetes, cardiovascular disorders, chronic respiratory diseases and oncological disorders. Figure below presents the various applications of nutrigenomics.
Weight Loss / Weight Management: Nutrigenomics plays a very significant role in weight loss and weight management journey by providing personalized diet recommendations based on genetic assessments. It is worth mentioning that more than 50 genes in a human body are associated with obesity. In this context, nutrigenomics studies have demonstrated that individuals who have genetic risk alleles for obesity can hasten the weight loss with the help of some dietary modifications.
Personalized Lifestyle Management: Every individual’s body is distinct, and a particular exercise routine may not reap the same benefits to all. Moreover, it has been known that physical lifestyle influences methylation patterns in the body. Genetic testing can assist individuals in identifying which exercise regime, short and intense or long and consistent, is likely to work the best for them.
Current Approaches / Processes for Offering Genomic Tests
Presently, owing to the significant reduction in the cost of genotyping and sequencing, there has been a significant rise in the number of nutrigenomics companies offering genetic testing services directly to the consumers without the involvement of clinicians. It is worth mentioning that online companies claim to offer DNA testing kits and at home sample collection facilities to their clients. In addition, they offer recommendations on diseases risk assessment and lifestyle management. Moreover, several companies currently provide nutrigenetics services and information on etiology of chronic diseases. Figure below presents steps of direct-to-consumer nutrigenomic testing.
Challenges Associated with Nutrigenomics
Although scientists have conducted extensive research on interaction of genes and nutrition, the science of nutrigenomics is still in its infancy stage. It has been observed that genomic assessment cannot be the sole criteria for nutrient recommendations and diet modifications. The lifestyle, health history, personal preferences and cultural identity of the patient should also be considered. Various challenges associated with nutrigenomic test are discussed below.
Inadequate Interpretation of Nutrigenomics Data: Nutrigenomics data is often not interpreted by qualified healthcare providers, specifically in case of companies that operate via the direct-to-consumer business model. This could lead to inadequate interpretation of the genetic tests, eventually resulting in incorrect recommendations to the customer.
Premature Health Claims: This is one of the major challenges in the domain of nutrigenomics. Considering the growing popularity and awareness related to personalized nutrition, a number of players may join the market with the aim to make financial profit. Companies may sell genetic test kits, having unfounded claims of personalized nutrition and speedy weight loss, to attract customers.
Ethical and Legal Implications: One of the primary challenges in nutrigenomics domain is the management of genetic information and potential misuse of personal data. Nutrigenomics testing is one of the first applications of the human genome project which was made public. Therefore, it raises many ethical and legal issues associated with the protection of consumers from unreliable tests, false claims, unproven dietary supplements and direct-to-consumer marketing of nutrigenetic tests for nutritional and lifestyle recommendation.
Future Perspectives Presently, more than 100 companies are engaged in providing various types of nutrigenomic tests / services, including those focused on nutritional deficiency, food intolerance / sensitivity, nutrient metabolism, disease risk assessment, diet customization, lifestyle management and weight management, worldwide. These companies provide their offerings directly to the consumer, through online genetic test kits and at-home sample collection facilities. In addition, there is extensive research activity in the field of nutrigenomics, as researchers and industry players aim to enhance their existing offerings. At present, there are some ethical and regulatory challenges associated with nutrigenomics, including the potential misuse of personal data, as well as uncertainty related to genetic phenotypic predispositions, for conditions where no proven treatment exists. However, the benefits offered by nutrigenomics outweigh the uncertainty associated with its adoption. Considering the growing focus on personalized diets and active initiatives being undertaken by players in this domain, we are led to believe that the opportunity for stakeholders in this niche, but upcoming, industry is likely to grow at a commendable pace in the foreseen future.
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