Sustainability Issue #1 January 2009

Even as work on charting the human genome was in progress, researchers in genetics already started a new wave of postgenomic research, with questions such as: What do genes do? How can information on the human genome be managed? How can this knowledge be used to improve human living conditions? Nutritional genomics, or nutrigenomics, is a branch of research which developed in this context and studies the relationship between genes, foods and health. Some of the long term goals are to improve health and help prevent diseases associated with our eating habits, such as diabetes, obesity, cardiovascular diseases and cancer. In this way, nutrigenomics can open up new possibilities for food research, food producers and consumers. One future scenario is a new generation of functional foods. The application which has attracted the most attention, however, is personalised nutrition, i.e. the idea to customise dietary advice on the basis of individual genetic tests. 

Genetic information is generally seen as sensitive, intrusive and difficult to interpret. Individual genetic tests may also involve relations who, after all, share the same genes. It is therefore very important to study the ethical issues that are raised when nutrigenomic knowledge is to be applied. 

Precise knowledge of metabolism 

Research on nutrigenomics is still in its infancy, but it can in future be expected to provide knowledge about our metabolism at an entirely new level of precision. This opens up the possibilities for improved dietary advice for the general public and for groups with special needs. As far as the food industry is concerned, there may be new opportunities to develop and market healthy foods. A lot of work however remains before this can be realised. 

A few years ago, when human genes were still to be charted, much of the interest focused on using the new knowledge for individual genetic tests. This also applied to the pioneers in nutrigenomics who predicted that  personalised nutrition, i.e. customising dietary advice on the basis of individual genetic tests, would be the primary use of nutrigenomics. This vision raises a number of ethical issues. 

Genes and lifestyle 

Food is much more than nutrition. It is an essential part of our wellbeing, cultural and social identity, pleasure and social life, not only a tool for health. There may be a risk that personalised nutrition will help medicalise our dietary habits and will reinforce a tendency on the part of certain groups in modern society which some researchers have described as "healthism", i.e. an exaggerated and potentially harmful focus on health.

There is already convincing proof that genetic variation affects the way we react to foods. But there are great differences between monogenic diseases that are caused by a single gene, and polygenic diseases which have a complex relationship with both lifestyle and several genes. As regards polygenic diseases, the scientific basis for judging individual risks of disease in relation to foods, on the basis of genetic tests, is very limited. Information concerning family history, lifestyle and individual medical history is still a much more effective instrument for this purpose.

Today, a number of firms (26 according to a count made in November 2007) offer genetic analyses in combination with dietary advice direct to consumers. A report to the United States Government Accountability Office shows that the tests of all the investigated firms are misleading, their predictions are medically unfounded, their dietary advice largely agrees with traditional general recommendations, and they recommend costly dietary additives of dubious value. 

From the ethical standpoint, individual genetic tests should be handled with care. Individual genetic tests for dietary purposes are especially problematic as long as we lack sufficiently robust knowledge. As regards polygenic diseases, our knowledge is as yet not sufficiently robust to justify the use of genetic tests as the basis for dietary advice. 

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