, Volume 8, Issue 4, pp 373-381
Date: 08 Mar 2013

Do we know enough? A scientific and ethical analysis of the basis for genetic-based personalized nutrition

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Abstract

This article discusses the prospects and limitations of the scientific basis for offering personalized nutrition advice based upon individual genetic information. Two divergent scientific positions are presented, with an ethical comment. The crucial question is whether the current knowledge base is sufficiently strong for taking an ethically responsible decision to offer personalized nutrition advice based upon gene–diet–health interaction. According to the first position, the evidence base for translating the outcomes of nutrigenomics research into personalized nutritional advice is as yet immature. There is also limited evidence that genotype-based dietary advice will motivate appropriate behavior changes. Filling the gaps in our knowledge will require larger and better randomized controlled trials. According to the second position, personalized nutrition must be evaluated in relation to generally accepted standard dietary advice—partly derived from epidemiological observations and usually not proven by clinical trials. With personalized nutrition, we cannot demand stronger evidence. In several specific cases of gene–diet interaction, it may be more beneficial for individuals with specific genotypes to follow personalized advice rather than general dietary recommendations. The ethical comment, finally, considers the ethical aspects of deciding how to proceed in the face of such uncertainty. Two approaches for an ethically responsible way forward are proposed. Arguing from a precautionary approach, it is suggested that personalized dietary advice should be offered only when there is strong scientific evidence for health effects, followed by stepwise evaluation of unforeseen behavioral and psychological effects. Arguing from theoretical and applied ethics as well as psychology, it is also suggested that personalized advice should avoid paternalism and instead focus on supporting the autonomous choice of each person.

The study was conducted on behalf of the Food4Me project. Food4Me is the acronym of the EU FP7 project: “Personalised nutrition: an integrated analysis of opportunities and challenges” (Contract No. KBBE.2010.2.3-02, Project No. 265494). The parties involved in the project are listed on the project’s Web site http://www.food4me.org/ Project coordination was carried out at Institute of Food and Health, University College Dublin, Ireland, ; Project Coordinator: Professor Michael J Gibney; Project Manager: Dr. Marianne Walsh. For overall correspondence regarding the Food4Me project: Professor Michael J Gibney, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland, Tel: +353 (1) 716 2824, e-mail: mike.gibney@ucd.ie.