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.
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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.
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- 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.
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