Nutritional Genomics

Position of the Academy of Nutrition and Dietetics

Sherie Schjolin
NFS-2000
Professional Issues in Dietetics
Position Statement
It is the position of the Academy of Nutrition and Dietetics that
nutritional genomics provides insight into how diet and genotype
interactions affect phenotype. The practical application of nutritional
genomics for complex chronic disease is an emerging science and the
use of nutrigenetic testing to provide dietary advice is not ready for
routine dietetics practice. Registered dietitian nutritionists need basic
competency in genetics as a foundation for understanding nutritional
genomics; proficiency requires advanced knowledge and skills.
What is Nutritional Genomics
Nutritional Genomics is the study of how nutrients and genes interact and
influence gene expression, and various disorders and diseases. This
emerging science is still new and being studied extensively. It is a broad
area of study, and includes the following specific areas of study:

Nutrigenetics
Nutrigenomics
Nutritional Epigenetics
Nutrigenetics
Explores genetic variations and the impact that dietary
intake has on specific disease states. Targets specific
genes and disorders.
PKU = inherited genetic disorder that causes build-up
of amino acid phenylalinine
Early testing identifies disorder, treated with low
phenylalanine diet = avoid severe complications
RDN application = Can identify specific genes linked
to obesity and treat by reducing energy intake or
increasing activity levels
Nutrigenomics
Focuses on how nutrients influence genome, and changes in protein synthesis and
metabolism.
Prostate Cancer = disease developed, treated with nutrition and lifestyle
interventions, turned tumor genes off
Nutritional Epigenetics
Field of study focused on nutrition,
metabolism and specific diseases,
including cancer, metabolic syndrome and
diabetes.
Views food as an important factor in the
prevention of chronic diseases and
regulation of metabolism
Trials studying the decrease in chronic
inflammation through low calorie diets
What does this mean for Registered
Dietitian Nutritionists?
Genetic Testing = typically done through primary care physician, results
delivered by them. Used to identify inherited genetic disorders
DTC Tests = independent genetic testing companies offering nutritional
advice through mail order test results
Diet and Supplement interventions based on other data collected, such as family
history and lab work

RDNs recommend nutrition interventions based on evidence-based

practices. Not enough research done with genetic testing and
nutrition to establish these routine dietary practices.
Currently RDNs report low confidence in integrating genetic testing
into practice
What is Evidence-Based Practice?
Evidence-Based Dietetics Practice involves the process of asking
questions, systematically finding research evidence, and assessing
its validity, applicability and importance to food and nutrition
practice decisions; and includes applying relevant evidence in the
context of the practice situation and the values of clients,
customers and communities to achieve positive outcomes.
http://www.eatrightpro.org/~/media/eatrightpro%20files/practi
ce/scope%20standards%20of%20practice/academy-definition-of-te
rms-list.ashx
Recommendation of The Academy
Currently, undergraduate
curriculum includes very little
genetic education
In order to become more
proficient in nutritional
genomics, it has been
recommended that stand alone
genetics courses be included in
undergraduate studies for
RDNs
RDNs role is not yet defined
Conclusion
Exciting area of study that has the potential of becoming a major
part of an RDNs scope of practice.
More research and more education to build evidence-based
practices that RDNs can feel confident integrating into
interventions for patients and clients
Agree with the position of the Academy at this time regarding
Nutritional Genomics