Abstract
In recent years, literature examining implementation of nutritional genomics into
clinical practice has increased, including publication of several randomized controlled
trials (RCTs). This systematic review addressed the following question: In children
and adults, what is the effect of incorporating results of genetic testing into nutrition
counseling and care compared with an alternative intervention or control group, on
nutrition-related health outcomes? A literature search of MEDLINE, Embase, PsycINFO,
CINAHL, and other databases was conducted for peer-reviewed RCTs published from January
2008 until December 2018. An international workgroup consisting of registered dietitian
nutritionists, systematic review methodologists, and evidence analysts screened and
reviewed articles, summarized data, conducted meta-analyses, and graded conclusion
statements. The second in a two-part series, this article specifically summarizes
evidence from RCTs that examined health outcomes (ie, quality of life, disease incidence
and prevention of disease progression, or mortality), intermediate health outcomes
(ie, anthropometric measures, body composition, or relevant laboratory measures routinely
collected in practice), and adverse events as reported by study authors. Analysis
of 11 articles from nine RCTs resulted in 16 graded conclusion statements. Among participants
with nonalcoholic fatty liver disease, a diet tailored to genotype resulted in a greater
reduction of percent body fat compared with a customary diet for nonalcoholic fatty
liver disease. However, meta-analyses for the outcomes of total cholesterol, low-density
lipoprotein cholesterol, body mass index, and weight yielded null results. Heterogeneity
between studies and low certainty of evidence precluded development of strong conclusions
about the incorporation of genetic information into nutrition practice. Although there
are still relatively few well-designed RCTs to inform integration of genetic information
into the Nutrition Care Process, the field of nutritional genomics is evolving rapidly,
and gaps in the literature identified by this systematic review can inform future
studies.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Inborn errors of metabolism in the 21(st) century: Past to present.Ann Transl Med. 2018; 6: 467
- The genetic basis of Mendelian phenotypes: Discoveries, challenges, and opportunities.Am J Hum Genet. 2015; 97: 199-215
- 10 Years of GWAS discovery: Biology, function, and translation.Am J Hum Genet. 2017; 101: 5-22
- The NHGRI-EBI Catalog of Published Genome-wide Association Studies. The European Bioinformatics Institute, Cambridge, UK2019
- Power and predictive accuracy of polygenic risk scores.PLoS Genet. 2013; 9e1003348
- Academy of Nutrition and Dietetics: Revised 2019 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition in Integrative and Functional Medicine.J Acad Nutr Diet. 2019; 119: 1019-1036 e1047
- Genome-wide polygenic scores for common diseases identify individuals with risk equivalent to monogenic mutations.Nat Genet. 2018; 50: 1219-1224
- Has the genome granted our wish yet?.N Engl J Med. 2019; 380: 2391-2393
- Towards clinical utility of polygenic risk scores.Hum Mol Genet. 2019; 28: R133-R142
- Proposed guidelines to evaluate scientific validity and evidence for genotype-based dietary advice.Genes Nutr. 2017; 12: 35
- Nutrigenetics/nutrigenomics.Annu Rev Public Health. 2010; 31: 53-68
- Nutritional genomics and direct-to-consumer genetic testing: An overview.Adv Nutr. 2018; 9: 128-135
- Nutritional genomics in precision nutrition: An evidence analysis center scoping review.J Acad Nutr Diet. 2019; 119: 507-515 e507
- Update on the methods of the U.S. Preventive Services Task Force: Linking intermediate outcomes and health outcomes in prevention.Am J Prev Med. 2018; 54: S4-S10
- Academy of Nutrition and Dietetics methodology for conducting systematic reviews for the Evidence Analysis Library.J Acad Nutr Diet. 2016; 116: 311-318
- Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.PLoS Med. 2009; 6e1000097
Rozga M, Handu D, Vargas A, et al. Use of genetic information in precision nutrition care: A systematic review. PROSPERO 2019;CRD42019119953. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019119953. Accessed March 25, 2020.
- Evidence Analysis Library.https://www.andeal.orgDate accessed: March 4, 2020
- Rayyan-a web and mobile app for systematic reviews.Syst Rev. 2016; 5: 210
- Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process.Academy of Nutrition and Dietetics, Chicago, IL2016
- RStudio: Integrated Development for R [computer program]. RStudio, Inc, Boston, MA2016
- Closing the gap between methodologists and end-users: R as a computational back-end.J Stat Softw. 2012; 49: 5
- GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394
- GRADEpro GDT: GRADEpro Guideline Development Tool [computer software]. McMaster University (developed by Evidence Prime Inc), Hamilton, Ontario2015
- Effect of personalized nutrition on health-related behaviour change: Evidence from the Food4Me European randomized controlled trial.Int J Epidemiol. 2017; 46: 578-588
- Can genetic-based advice help you lose weight? Findings from the Food4Me European randomized controlled trial.Am J Clin Nutr. 2017; 105: 1204-1213
- Disclosing pleiotropic effects during genetic risk assessment for Alzheimer disease: A randomized trial.Ann Intern Med. 2016; 164: 155-163
- The effect of the apolipoprotein E genotype on response to personalized dietary advice intervention: Findings from the Food4Me randomized controlled trial.Am J Clin Nutr. 2016; 104: 827-836
- Personalized genetic risk counseling to motivate diabetes prevention: A randomized trial.Diabetes Care. 2013; 36: 13-19
- incorporating a genetic risk score into coronary heart disease risk estimates: Effect on low-density lipoprotein cholesterol levels (the MI-GENES Clinical Trial).Circulation. 2016; 133: 1181-1188
- Evaluating changes in omega-3 fatty acid intake after receiving personal FADS1 genetic information: A randomized nutrigenetic intervention.Nutrients. 2017; 9
- South Asian Heart Risk Assessment (SAHARA): Randomized controlled trial design and pilot study.JMIR Res Protoc. 2013; 2: e33
- Nutritional strategies for the individualized treatment of non-alcoholic fatty liver disease (NAFLD) based on the nutrient-induced insulin output ratio (NIOR).Int J Mol Sci. 2016; 17
- Does type 2 diabetes genetic testing and counseling reduce modifiable risk factors? A randomized controlled trial of veterans.J Gen Intern Med. 2015; 30: 1591-1598
- Impact of genetic testing and family health history based risk counseling on behavior change and cognitive precursors for type 2 diabetes.J Genet Couns. 2017; 26: 133-140
- Evaluation of genetic predisposition to insulin resistance by nutrient-induced insulin output ratio (NIOR).Clin Chem Lab Med. 2007; 45: 1124-1132
- Nutritional genomics.https://www.andeal.org/genomicsDate accessed: March 4, 2020
- Design and baseline characteristics of the Food4Me study: A web-based randomised controlled trial of personalised nutrition in seven European countries.Genes Nutr. 2015; 10: 450
- Nutrition Care Process and Model update: Toward realizing people-centered care and outcomes management.J Acad Nutr Diet. 2017; 117: 2003-2014
- Lessons learned from the POUNDS lost study: Genetic, metabolic, and behavioral factors affecting changes in body weight, body composition, and cardiometabolic risk.Curr Obes Rep. 2019; 8: 262-283
- Obesity-related polymorphisms and their associations with the ability to regulate fat oxidation in obese Europeans: The NUGENOB study.Obesity (Silver Spring). 2010; 18: 1369-1377
- Effect of low-fat vs low-carbohydrate diet on 12-month weight loss in overweight adults and the association with genotype pattern or insulin secretion: The DIETFITS randomized clinical trial.JAMA. 2018; 319: 667-679
- Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: The diet, obesity, and genes (DiOGenes) study: A randomized, controlled trial.Circulation. 2011; 124: 2829-2838
- Personalised nutrition and health.BMJ. 2018; 361: bmj.k2173
- The stepped wedge cluster randomised trial: Rationale, design, analysis, and reporting.BMJ. 2015; 350: h391
- Study protocol of a pragmatic randomized controlled trial incorporated into the Group Lifestyle Balance program: The nutrigenomics, overweight/obesity and weight management trial (the NOW trial).BMC Public Health. 2019; 19: 310
- A guide to applying the sex-gender perspective to nutritional genomics.Nutrients. 2018; 11
- Consideration of sex as a biological variable in NIH-funded research.https://orwh.od.nih.gov/sex-gender/nih-policy-sex-biological-variableDate accessed: March 4, 2020
- Genomics, health disparities, and missed opportunities for the nation's research agenda.JAMA. 2017; 317: 1831-1832
- The many faces of pleiotropy.Trends Genet. 2013; 29: 66-73
- Gene-diet interactions and plasma lipoproteins: Role of apolipoprotein E and habitual saturated fat intake.Genet Epidemiol. 2001; 20: 117-128
- Genetic counseling and testing for Alzheimer disease: Joint practice guidelines of the American College of Medical Genetics and the National Society of Genetic Counselors.Genet Med. 2011; 13: 597-605
- FTO genotype and 2-year change in body composition and fat distribution in response to weight-loss diets: The POUNDS LOST Trial.Diabetes. 2012; 61: 3005-3011
- Systems biology of personalized nutrition.Nutr Rev. 2017; 75: 579-599
Biography
A. Ellis is an associate professor, University of Alabama, Tuscaloosa.
Biography
M. Rozga is a nutrition researcher, Academy of Nutrition and Dietetics Evidence Analysis Center, Chicago, IL.
Biography
A. Braakhuis is academic director, Faculty of Medical and Health Science, Discipline of Nutrition, The University of Auckland, Grafton, Auckland, New Zealand.
Biography
C. R. Monnard is a specialist in infant nutrition, Société des Produits Nestlé SA, Nestlé Research, Lausanne, Switzerland; at the time of the study, she was a postdoctoral fellow, University of Fribourg, Fribourg, Switzerland.
Biography
K. Robinson is a medical science liaison, Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH; at the time of the study, she was a postdoctoral researcher, Department of Internal Medicine, University of Iowa, Iowa City.
Biography
R. Sinley is an assistant professor, Metropolitan State University of Denver, Denver, CO.
Biography
A. Wanner is an information specialist consultant, Kelowna, British Columbia, Canada.
Biography
A. J. Vargas is a scientist, Office of Disease Prevention, National Institutes of Health, Rockville, MD.
Article Info
Publication History
Published online: July 03, 2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST A. Ellis received grant funding from the American Heart Association; registered as an authorized provider of Nutrigenomix services (no compensation). A. Wanner is a consultant information specialist who works with a variety of research institutions but was not involved in data analysis or interpretation. The conclusions expressed in this article are K. Robinson’s and do not represent the views of Abbott Nutrition. No potential conflict of interest was reported by the remaining authors.
FUNDING/SUPPORT This systematic review was funded by the Academy of Nutrition and Dietetics , Academy of Nutrition and Dietetics Foundation , and the Academy of Nutrition and Dietetics Dietitians in Integrative and Functional Medicine Dietetic Practice Group.
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Response to the Consensus Report of the Academy of Nutrition and Dietetics: Incorporating Genetic Testing into Nutrition CareJournal of the Academy of Nutrition and DieteticsVol. 120Issue 12
- PreviewIt is our pleasure to engage with the Academy of Nutrition and Dietetics in this important discussion on the impact of incorporating genetic testing into nutrition care. We reviewed, with interest, the Academy’s Consensus Report and companion papers detailing the conducted scoping and systematic reviews on the impact of genetic testing on dietary change and health outcomes.1-4 This work is of great importance, and we applaud the authors for encouraging registered dietitians to become involved in the research process1 in an effort to optimize pragmatic research in precision nutrition.
- Full-Text
- Preview
