Nutrigenomics and the Future of Nutrition Proceedings of a Workshop (2018) / Chapter Skim
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6 Rethinking the Relationship Between Diet and Health: Can Nutrigenomics Help?
6 Rethinking the Relationship Between Diet and Health: Can Nutrigenomics Help?
Pages 107-116
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From page 107... ...
He noted that a recent National Academies publication on chronic disease outcomes calls for grading evidence such that nutrition recommendations would have to have at least moderate evidence (NASEM, 2017a)
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From page 108... ...
Zeisel did not answer the question immediately but stressed that now is a critical time to introduce nutrition into precision medicine, as major medical centers are beginning to establish data collection systems upon which precision medicine will be based. Yet, he said he was unaware of anyone who was thinking seriously about the nutrition information that would be collected, adding that this information is often viewed as being too difficult to collect.
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From page 109... ...
Given that the goal of precision medicine is to try to do better than this 30 percent, he asserted that if personalized nutrition guidelines could be developed for a reasonably sized subpopulation with the understanding that the guidelines could be wrong for any given individual, "you'd be d oing really well." In that respect, Janssens said, the term "precision nutrition" is misleading. She suggested instead "stratified nutrition," which she believes presents a more realistic picture of what can be expected.
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From page 110... ...
With respect to precision nutrition, he imagined someone having a recommended precision diet based on genetic information, but then attending a family Thanksgiving dinner. He reminded the audience that people eat food in social settings, and suggested that precision nutrition could inadvertently impose a level of social isolation by not taking that fact into account.
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From page 111... ...
The microbiome is much further behind, he added, given that it attracted little attention until about 10 years ago, and the problem with epigenetics is that target tissues cannot be collected, only blood samples. "I think it is a mistake," he argued, "to try to push too hard when you don't have the toolset yet." Wallace wondered how metabolomic biomarkers in particular will be found in the future, given the inherent variability of humans.
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From page 112... ...
Additionally, he and his research team have been very interested in studying Asian Americans in California, but have spent almost all of their budget just assembling a population that would be representative of both first- and secondgeneration Asian Americans. "I think this is important," he said, "but there are also constraints, and I don't know how we are going to manage that." Another point to be made, Wallace continued, is that there is an inherent assumption that a person of lower socioeconomic status has a clinical problem because of his or her socioeconomic status.
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From page 113... ...
'" Ordovás asserted that "most of the time, the people who are missing from this discussion are the policy makers." He mentioned how the policy of subsidizing meat, for example, is known to have affected the nutritional health of certain neighborhoods. Additionally, he observed, it is known from human breastfeeding data that the quality of milk varies among neighborhoods depending on socioeconomic status.
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From page 114... ...
He cited the example of his own research team, which, especially with studies pertaining to genetic testing, solicits input from a community advisory board. He described the members of the board as members of the local community who can provide perspectives that the researcher may not be able to perceive.
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From page 115... ...
He added that traditional breeding is a form of genetic manipulation. In the past, farmers chose plants with the largest fruits, for example, and bred those plants, whereas with the new techniques available today, they are making plants artificially instead of breeding.
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