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

Görman, Ulf LU ; Mathers, John C. ; Grimaldi, Keith A. ; Ahlgren, Jennie LU and Nordström, Karin LU (2013) In Genes & Nutrition 8(4). p.373-381
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... (More)
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. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ethics, personalized nutrition, nutrigenetics, evidence, paternalism, autonomy
in
Genes & Nutrition
volume
8
issue
4
pages
373 - 381
publisher
BioMed Central (BMC)
external identifiers
  • wos:000320733200006
  • scopus:84879689001
  • pmid:23471854
ISSN
1555-8932
DOI
10.1007/s12263-013-0338-6
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Centre for Theology and Religious Studies (015017000)
id
57deeeeb-5089-456c-9cec-760bea53d34a (old id 3563474)
date added to LUP
2016-04-01 10:31:54
date last changed
2022-04-20 03:07:34
@article{57deeeeb-5089-456c-9cec-760bea53d34a,
  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.}},
  author       = {{Görman, Ulf and Mathers, John C. and Grimaldi, Keith A. and Ahlgren, Jennie and Nordström, Karin}},
  issn         = {{1555-8932}},
  keywords     = {{ethics; personalized nutrition; nutrigenetics; evidence; paternalism; autonomy}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{373--381}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Genes & Nutrition}},
  title        = {{Do we know enough? A scientific and ethical analysis of the basis for genetic-based personalized nutrition}},
  url          = {{http://dx.doi.org/10.1007/s12263-013-0338-6}},
  doi          = {{10.1007/s12263-013-0338-6}},
  volume       = {{8}},
  year         = {{2013}},
}