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Opportunities to integrate nutrigenomics into clinical practice and patient counseling

Abstract

Background

Little progress has been made in translating nutrigenomics knowledge into clinical counseling in the past decade. Currently, clinicians are overwhelmed by nutrigenomics information without the proper scientific guidelines on patient counseling.

Methods

In this study, we conducted a scoping review of the primary literature to assess the current evidence of nutrigenomics counseling. A literature search using PRISMA guidelines identified the current challenges and opportunities facing nutrigenomics counseling in clinical practice.

Results

We identified four main themes: inadequate training, lack of awareness, underdeveloped nutrigenomics counseling skills, and unreliable evidence-based practice information. Many clinicians did not have the necessary knowledge to perform nutrigenomic counseling and were unaware of the available scientific information source. Moreover, there are no guidelines in the scientific community to counsel patients on nutrigenomics testing.

Conclusion

Opportunities exist for government and non-government entities to create an evidence-based information platform using clinical guidelines to integrate nutrigenomics knowledge from bench to bedside successfully.

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References

  1. Fenech M, El-Sohemy A, Cahill L, Ferguson LR, French TA, Tai ES, et al. Nutrigenetics and nutrigenomics: viewpoints on the current status and applications in nutrition research and practice. J Nutr Nutr [Internet]. 2011;4:69–89. http://www.ncbi.nlm.nih.gov/pubmed/21625170.

    CAS  Google Scholar 

  2. Mathers JC. Nutrigenomics in the modern era. Proc Nutr Soc. 2017;76:265–75.

    Article  Google Scholar 

  3. Trujillo E, Davis C, Milner J. Nutrigenomics, proteomics, metabolomics, and the practice of dietetics. J Am Diet Assoc [Internet]. 2006 Mar 1 [cited 2021 Sep 17];106:403–13. Available from: https://www.sciencedirect.com/science/article/pii/S0002822305021085.

  4. Aneesh TP, Sonal Sekhar M, Asha J, Lekshmi C, Zachariah SM. Pharmacogenomics: the right drug to the right person. J Clin Med Res. 2009;1:191–4.

    CAS  Google Scholar 

  5. Ghosh D, Skinner MA, Laing WA. Pharmacogenomics and nutrigenomics: synergies and differences. Eur J Clin Nutr. 2007;61:567–74.

    Article  CAS  Google Scholar 

  6. Solas M, Milagro FI, Martínez-Urbistondo D, Ramirez MJ, Martínez JA. Precision obesity treatments including pharmacogenetic and nutrigenetic approaches. Trends Pharm Sci. 2016;37:575–93.

    Article  CAS  Google Scholar 

  7. Sales NMR, Pelegrini PB, Goersch MC. Nutrigenomics: definitions and advances of this new science. J Nutr Metab [Internet]. 2014 [cited 2021 Mar 28];2014. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984860/.

  8. Riscuta G. Nutrigenomics at the Interface of Aging, Lifespan, and Cancer Prevention. J Nutr [Internet] 2016;146:1931–9. https://doi.org/10.3945/jn.116.235119. [cited 2022 Feb 4]Available from

    Article  CAS  Google Scholar 

  9. Dongiovanni P, Valenti L. A nutrigenomic approach to non-alcoholic fatty liver disease. Int J Mol Sci [Internet]. 2017;18:1534. https://www.mdpi.com/1422-0067/18/7/1534.

  10. Robinson K, Rozga M, Braakhuis A, Ellis A, Monnard CR, Sinley R, et al. Effect of incorporating genetic testing results into nutrition counseling and care on dietary intake: an evidence analysis center systematic review—Part I. J Acad Nutr Diet [Internet]. 2020 Jul [cited 2020 Nov 9]; Available from: http://www.sciencedirect.com/science/article/pii/S2212267220303361.

  11. Our Science [Internet]. Viome. [cited 2020 Dec 10]. Available from: https://www.viome.com/our-science.

  12. Ferguson JF, Allayee H, Gerszten RE, Ideraabdullah F, Kris-Etherton PM, Ordovás JM, et al. Nutrigenomics, the microbiome, and gene-environment interactions: new directions in cardiovascular disease research, prevention, and treatment: a scientific statement from the American Heart Association. Circ Cardiovasc Genet. 2016;9:291–313.

    Article  CAS  Google Scholar 

  13. Di Renzo L, Cioccoloni G, Sinibaldi Salimei P, Ceravolo I, De Lorenzo A, Gratteri S. Alcoholic beverage and meal choices for the prevention of noncommunicable diseases: a randomized nutrigenomic trial. Oxid Med Cell Longev. 2018;2018:1–13.

    Article  Google Scholar 

  14. McMorrow AM, Connaughton RM, Magalhães TR, McGillicuddy FC, Hughes MF, Cheishvili D, et al. Personalized cardio-metabolic responses to an anti-inflammatory nutrition intervention in obese adolescents: a randomized controlled crossover trial. Mol Nutr Food Res. 2018;62:1701008.

    Article  Google Scholar 

  15. Brett GR, Wilkins EJ, Creed ET, West K, Jarmolowicz A, Valente GM, et al. Genetic Counseling in the Era of Genomics: What’s all the Fuss about? J Genet Couns [Internet] 2018;27:1010–21. https://doi.org/10.1007/s10897-018-0216-x.

    Article  Google Scholar 

  16. Stenner SP, Rice W, Nelson SD. A viewpoint on the information sharing paradox. Appl Clin Inform [Internet]. 2020 May [cited 2021 Sep 29];11:460–3. Available from: http://www.thieme-connect.de/https://doi.org/10.1055/s-0040-1713413.

  17. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med [Internet]. 2018 Oct [cited 2021 Sep 29];169:467–73. Available from: https://www.acpjournals.org/doi/full/https://doi.org/10.7326/M18-0850.

  18. Joffe Y, Herholdt H. What will it take to build an expert group of nutrigenomic practitioners? Lifestyle genomics [Internet]. 2020 [cited 2021 Apr 17];13:122–8. Available from: https://www.karger.com/Article/FullText/507252.

  19. Kaufman-Shriqui V, Salem H, Boaz M, Birk R. Knowledge and attitudes towards nutrigenetics: findings from the 2019 Unified Forces Preventive Nutrition Conference (UFPN). Nutrients [Internet]. 2020 Jan [cited 2021 Apr 17];12:335. Available from: https://www.mdpi.com/2072-6643/12/2/335.

  20. Vogel E, DeBusk R, Ryan-Harshman M. Advancing knowledge translation in nutritional genomics by addressing knowledge, skills and confidence gaps of registered dietitians. In: Nutrition and Genomics [Internet]. Elsevier; 2009 [cited 2021 Apr 17]. p. 161–86. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780123741257000096.

  21. Rosen R, Earthman C, Marquart L, Reicks M. Continuing education needs of registered dietitians regarding nutrigenomics. J Am Diet Assoc [Internet] 2006;106:1242–5. https://linkinghub.elsevier.com/retrieve/pii/S0002822306008832.

    Article  Google Scholar 

  22. Cormier H, Tremblay BL, Paradis A-M, Garneau V, Desroches S, Robitaille J, et al. Nutrigenomics - perspectives from registered dietitians: a report from the Quebec-wide e-consultation on nutrigenomics among registered dietitians. J Hum Nutr Diet [Internet]. 2014 Aug [cited 2021 Apr 17];27:391–400. Available from: http://doi.wiley.com/10.1111/jhn.12194.

  23. Collins J, Bertrand B, Hayes V, Li SX, Thomas J, Truby H, et al. The application of genetics and nutritional genomics in practice: an international survey of knowledge, involvement and confidence among dietitians in the US, Australia and the UK. Genes Nutr [Internet]. 2013 Nov [cited 2021 Apr 17];8:523–33. Available from: http://link.springer.com/10.1007/s12263-013-0351-9.

  24. Shiyab, A. S. (2019). Knowledge and Perception of Nutritional Genomics Among Registered Dietitian Nutritionists. [Master’s thesis, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1563187321042113.

  25. Abrahams M, Frewer LJ, Bryant E, Stewart-Knox B. Perceptions and experiences of early-adopting registered dietitians in integrating nutrigenomics into practice. Br Food J [Internet]. 2018 Apr [cited 2021 Apr 17];120:763–76. Available from: https://www.emerald.com/insight/content/; https://doi.org/10.1108/BFJ-08-2017-0464/full/html.

  26. Sinani M. Factors affecting dieticians in the provision of advice relating to personalized nutrition (Nutritional Genomics). Br J Med Med Res [Internet]. 2016 Jan [cited 2021 Apr 17];16:1–7. Available from: http://sciencedomain.org/abstract/15104.

  27. Widyawaty N, Tan CK, Tan ESS, Seghayat MS, Normina AB. Awareness, knowledge and attitude towards nutrigenomics among health care workers in Indonesia: a preliminary exploration. Indian J Public Health Res Dev [Internet]. 2019 [cited 2021 Apr 17];10:1289. Available from: http://www.indianjournals.com/ijor.aspx?target=ijor:ijphrd&volume=10&issue=4&article=236.

  28. San-Cristobal R, Milagro FI, Martínez JA. Future challenges and present ethical considerations in the use of personalized nutrition based on genetic advice. J Acad Nutr Diet [Internet]. 2013 Nov [cited 2021 Apr 17];113:1447–54. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2212267213006771.

  29. Laddu D, Hauser M. Addressing the nutritional phenotype through personalized nutrition for chronic disease prevention and management. Prog Cardiovasc Dis [Internet]. 2019 Jan [cited 2021 Apr 17];62:9–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0033062018302470.

  30. Quinonez SC, O’Connor BC, Jacobs MF, Mekonnen Tekleab A, Marye A, Bekele D, et al. The introduction of genetic counseling in Ethiopia: results of a training workshop and lessons learned. PLoS ONE [Internet]. 2021 Jul [cited 2021 Sep 17];16:e0255278. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301664/.

  31. Camp KM, Trujillo E. Position of the Academy of Nutrition and Dietetics: Nutritional Genomics. J Acad Nutr Diet [Internet]. 2014 Feb [cited 2021 Apr 4];114:299–312. Available from: https://www.sciencedirect.com/science/article/pii/S2212267213017838.

  32. Abrahams M, Frewer LJ, Bryant E, Stewart-Knox B. Factors determining the integration of nutritional genomics into clinical practice by registered dietitians. Trends Food Sci Technol [Internet]. 2017 Jan [cited 2021 Apr 17];59:139–47. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0924224415301400.

  33. Aruoma OI, Hausman-Cohen S, Pizano J, Schmidt MA, Minich DM, Joffe Y, et al. Personalized nutrition: translating the science of NutriGenomics into practice: Proceedings from the 2018 American College of Nutrition Meeting. J Am Coll Nutr. 2019;38:287–301.

    Article  Google Scholar 

  34. Castle D, Ries NA. Ethical, legal and social issues in nutrigenomics: The challenges of regulating service delivery and building health professional capacity. Mutat Res-Fundam Mol Mech Mutagen. 2007;622:138–43.

    Article  CAS  Google Scholar 

  35. Horne JR. Strengthening the reporting of nutritional genomics research to inform knowledge translation in personalized nutrition. Lifestyle Genom. 2021;14:43–8.

    Article  Google Scholar 

  36. Graves KD, Hall MJ, Tercyak KP. Introduction to the Special Issue on Clinical and Public Health Genomics: Opportunities for translational behavioral medicine research, practice, and policy. Transl Behav Med [Internet] 2018;8:4–6. https://doi.org/10.1093/tbm/ibx068.

    Article  Google Scholar 

  37. Relling MV, Klein TE, Gammal RS, Whirl‐Carrillo M, Hoffman JM, Caudle KE. The clinical pharmacogenetics implementation consortium: 10 years later. Clin Pharm Ther. 2020;107:171–5.

    Article  Google Scholar 

  38. Thorn CF, Klein TE, Altman RB. PharmGKB: The pharmacogenomics knowledge base. In: Innocenti F, van Schaik RHN, editors. Pharmacogenomics [Internet]. Totowa, NJ: Humana Press; 2013 [cited 2020 Dec 11]. p. 311–20. (Methods in Molecular Biology; vol. 1015). Available from: http://link.springer.com/10.1007/978-1-62703-435-7_20.

  39. Barbarino JM, Whirl-Carrillo M, Altman RB, Klein TE. PharmGKB: A worldwide resource for pharmacogenomic information. Wiley Interdiscip Rev Syst Biol Med. 2018;10:e1417.

  40. Kim E, Baskys A, Law AV, Roosan MR, Li Y, Roosan D Scoping review: the empowerment of Alzheimer’s Disease caregivers with mHealth applications. Npj Digit Med [Internet]. 2021 Sep [cited 2021 Sep 29];4:1–8. Available from: https://www.nature.com/articles/s41746-021-00506-4.

  41. Sayer M, Duche A, Nguyen TJT, Le M, Patel K, Vu J, et al. Clinical implications of combinatorial pharmacogenomic tests based on cytochrome P450 variant selection. Front Genet [Internet]. 2021 [cited 2021 Sep 29];12:1628. Available from: https://www.frontiersin.org/article/https://doi.org/10.3389/fgene.2021.719671.

  42. Roosan D, Del Fiol G, Butler J, Livnat Y, Mayer J, Samore M, et al. Feasibility of population health analytics and data visualization for decision support in the infectious diseases domain. A pilot study. Appl Clin Inf [Internet]. 2016;7:604–23. https://doi.org/10.4338/ACI-2015-12-RA-0182.

    Article  Google Scholar 

  43. Roosan D, Karim M, Chok J, Roosan MR. Operationalizing Healthcare Big Data in the Electronic Health Records using a Heatmap Visualization Technique.In Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 5: HEALTHINF, 2020; pp. 361–368. https://doi.org/10.5220/0008912503610368.

  44. Roosan D, Hwang A, Roosan MR. Pharmacogenomics cascade testing (PhaCT): a novel approach for preemptive pharmacogenomics testing to optimize medication therapy. Pharmacogenomics J [Internet]. 2020 Aug; Available from: https://doi.org/10.1038/s41397-020-00182-9.

  45. Roosan D, Law AV, Karim M, Roosan M. Improving team-based decision making using data analytics and informatics: protocol for a collaborative decision support design. JMIR Res Protoc [Internet]. 2019 Nov;8:e16047. Available from: http://www.researchprotocols.org/2019/11/e16047/.

  46. Roosan D, Li Y, Law A, Truong H, Karim M, Chok J, et al. Improving medication information presentation through interactive visualization in mobile apps: human factors design. JMIR Mhealth Uhealth [Internet]. 2019;7:e15940 http://mhealth.jmir.org/2019/11/e15940/.

  47. Roosan D, Chok J, Karim M, Law AV, Baskys A, Hwang A, et al. Artificial intelligence–powered smartphone app to facilitate medication adherence: protocol for a human factors design study. JMIR Res Protoc [Internet]. 2020;9:e21659 http://www.researchprotocols.org/2020/11/e21659/.

  48. Roosan D, Hwang A, Law AV, Chok J, Roosan MR. The inclusion of health data standards in the implementation of pharmacogenomics systems: a scoping review. Pharmacogenomics [Internet]. 2020 Oct [cited 2020 Oct 30]; Available from: https://www.futuremedicine.com/https://doi.org/10.2217/pgs-2020-0066.

  49. Islam R, Weir C, Jones M, Del Fiol G, Samore M. Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design. BMC Med Inf Decis Mak [Internet]. 2015;15:101 http://www.biomedcentral.com/1472-6947/15/101.

  50. Islam R, Weir C, Del Fiol G. Clinical complexity in medicine: a measurement model of task and patient complexity. Methods Inf Med [Internet]. 2016;55:14–22. https://doi.org/10.3414/ME15-01-0031.

    Article  CAS  Google Scholar 

  51. Islam R, Mayer J, Clutter J. Supporting novice clinicians cognitive strategies: System design perspective. 2016:509–12.

  52. Roosan D, Samore M, Jones M, Livnat Y, Clutter J. Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition. In: 2016 IEEE International Conference on Healthcare Informatics (ICHI). 2016. p. 285–8.

  53. Roosan D, Weir C, Samore M, Jones M, Rahman M, Stoddard GJ, et al. Identifying complexity in infectious diseases inpatient settings: an observation study. Theory Innov Cogn Support Health Care Decis-Mak [Internet]. 2017 Jul;71:S13–21. Available from: http://www.sciencedirect.com/science/article/pii/S1532046416301551.

  54. Roosan D, Chok J, Baskys A, Roosan MR. PGxKnow: a pharmacogenomics educational HoloLens application of augmented reality and artificial intelligence. Pharmacogenomics [Internet]. 2022 Jan [cited 2022 Jan 30]; Available from: https://doi.org/10.2217/pgs-2021-0120.

  55. Roosan D, Tatla V, Li Y, Kugler A, Chok J, Roosan MR. Framework to enable pharmacist access to healthcare data using blockchain technology and artificial intelligence. J Am Pharm Assoc [Internet]. 2022 Feb; Available from: https://www.sciencedirect.com/science/article/pii/S1544319122000711.

  56. Islam R, Weir C, Del Fiol G. Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making. IEEE Int Conf Healthc Inform. 2014;2014:186–93.

  57. Clemente JC, Ursell LK, Parfrey LW, Knight R. The Impact of the Gut Microbiota on Human Health: An Integrative View. Cell. 2012;148:1258–70.

  58. Bajaj JS, Thacker LR, Fagan A, White MB, Gavis EA, Hylemon PB, et al. Gut microbial RNA and DNA analysis predicts hospitalizations in cirrhosis. JCI Insight. 2018;3:98019.

  59. Doestzada M, Vila AV, Zhernakova A, Koonen DPY, Weersma RK, Touw DJ, et al. Pharmacomicrobiomics: a novel route towards personalized medicine? Protein Cell. 2018;9:432–45.

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Acknowledgements

We are grateful to pharmacy professional students for their support at the Western University of Health Sciences.

Funding

This work was supported by the Western University of Health Sciences College of Pharmacy.

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Conceptualizations: DR, YW, MT, MRR. Data acquisition and curation: YW, MT. Methodology: DR, YW, MT. Writing original draft: DR, YW, MT, MRR. Writing, reviewing and edition: all authors.

Corresponding author

Correspondence to Don Roosan.

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Roosan, D., Wu, Y., Tran, M. et al. Opportunities to integrate nutrigenomics into clinical practice and patient counseling. Eur J Clin Nutr 77, 36–44 (2023). https://doi.org/10.1038/s41430-022-01146-x

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