Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-15T01:29:50.523Z Has data issue: false hasContentIssue false
  • English
  • Français

Public health nutrition and genetics: implications for nutrition policy and promotion

Published online by Cambridge University Press:  07 March 2007

Ian Darnton-Hill ,
Barrie Margetts  and
Richard Deckelbaum
Ian Darnton-Hill*
Affiliation:
Institute of Human Nutrition, Columbia University, PH15 East-Room 1512, 630 West 168th Street, New York, NY10032, USA
Barrie Margetts
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
Richard Deckelbaum
Affiliation:
Institute of Human Nutrition, Columbia University, PH15 East-Room 1512, 630 West 168th Street, New York, NY10032, USA
*
*Corresponding author: Professor Ian Darnton-Hill, fax +1 212 735 4405, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The unravelling of the human genome has the potential to radically extend many of the strategies used in public health nutrition to improve health and to increase food availability, accessibility and utilization. The present paper divides nutrigenomics into two broad but differing areas in asking about possible public health applications: (1) the increasing mismatch between population growth and global food security, on top of the already approximately 800 million of the world population who are food insecure; (2) possible responses to the rising prevalence of non-communicable diseases as the Western diet becomes increasingly inappropriate to the needs of those consuming it. It is clear that complex interactions of multiple polymorphisms play a role in how individuals and sub-populations respond to dietary interventions. All these applications present public health and ethical challenges, particularly in ensuring that any benefits that do come from nutrigenomics are not restricted to the wealthy minority of only the affluent nations. The present paper concludes that the public health applications of nutrigenomics are probably at least a decade away, especially for developing countries. Clinical applications are likely to be more immediate, probably resulting in ‘designer diets’ for individuals with particular polymorphisms, but unless governments take on the role of ensuring some extent of equity in access, any benefits are most likely to go to those who can afford the screening, tests and treatment. At the same time, greatly increased international efforts are needed towards the continuing, and in some cases worsening, global malnutrition, as genetic manipulation of crops is unlikely to provide more than part of the solution.

Keywords

GM organismsMicronutrientsNon-communicable diseasesNutrigenomicsPublic health nutrition
Type
Meeting Report
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 1 , February 2004 , pp. 173 - 185
Copyright
Copyright © The Nutrition Society 2004

References

ACC/SCN (2000) Fourth Report on the World Nutrition Situation. Geneva: WHO.Google Scholar
Allison, DB, Matz, PE, Pietrobelli, A, Zannolli, R & Faith, MS (2001) Genetic and environmental influences on obesity. In Primary and Secondary Preventive Nutrition, pp. 147–164 [Bendich, A and Deckelbaum, RJ, editors]. Totowa, NJ: Humana Press.CrossRefGoogle Scholar
Ambrosone, CB, Freudenheim, JL, Thompson, PA, Bowman, E, Vena, JE, Marshall, JR, Graham, S, Laughlin, R, Nemoto, T & Shields, PG (1999) Manganese superoxide dismutase (MnSOD) genetic polymorphisms, dietary antioxidants and risk of breast cancer. Cancer Research 59, 602–606.Google ScholarPubMed
Ames, BN (1998) Micronutrients prevent cancer and delay ageing. Toxicology Letters 102–103, 5–18.CrossRefGoogle Scholar
Andersson, M, de Benoist, B, Darnton-Hill, I & Delange, F (2004) Iodine Deficiency in Europe: A Continuing Public Health Problem. Geneva: WHO.Google Scholar
Beauchamp, TL & Childress, JF (1994) Principles of Biomedical Ethics. 4th ed. New York: Oxford University Press.Google Scholar
Bhargava, A, Bouis, H & Scrimshaw, N (2001) Dietary intakes and socioeconomic factors are associated with the haemoglobin concentration of Bangladeshi women. Journal of Nutrition 131, 758–764.CrossRefGoogle ScholarPubMed
Black, RE, Morris, SS & Bryce, J (2003) Where and why are 10 million children dying every year? Lancet 361, 2226–2234.CrossRefGoogle ScholarPubMed
Borlaug, N, Swaminathan, M & Khush, G et al. (2004) Securing global food production. Proceedings of the Congress 'In the Wake of the Double Helix: From the Green Revolution to the Gene Revolution' (In the Press).Google Scholar
Bouis, H (2002a) Three criteria for establishing the usefulness of biotechnology for reducing micronutrient malnutrition. Food and Nutrition Bulletin 23, 351–353.CrossRefGoogle ScholarPubMed
Bouis, HE (2002b) Plant breeding: a new tool for fighting micronutrient malnutrition. Journal of Nutrition 132, 491S–494S.CrossRefGoogle ScholarPubMed
Bouis, HE, Lineback, D & Schneeman, B (2002) Bio-technology-derived nutritious foods for Developing Countries: needs, opportunities, and barriers. Food and Nutrition Bulletin 23, 342–383.CrossRefGoogle Scholar
Brown, LR (2001) Eco-Economy: Building an Economy for the Earth 145 – 167 Earth Policy Institute. New York: WW Norton & Co.Google Scholar
Crop Biotech Net (2003a) New applications for agro-biotech. http://www.isaaa.org/kc/CBTNews/2003_Issue/Feb/CBT_Feb_21.htm#newGoogle Scholar
Crop Biotech Net (2003b) Spinach in anthrax vaccine production. http://www.isaaa.org/kc/CBTNews/2003_Issue/March/CBT_March_14htm#spi (for more information, [email protected])Google Scholar
Crop Biotech Net (2003c) ICSU report on new genetics, food and agriculture. http://www.isaaa.org/kc/CBTNews/2003_Issue/June/CBT_June_12htm#icsGoogle Scholar
Darnton-Hill, I (1998) Control and prevention of micronutrient malnutrition. Asia Pacific. Journal of Clinical Nutrition 7, 2–7.Google ScholarPubMed
Darnton-Hill, I, Bloem, MW, de Benoist, B & Brown, LR (2002) Micronutrient restoration and fortification: communicating change, benefits and risks. Asia Pacific Journal of Clinical Nutrition 11, Suppl. 6, S184 –S196.CrossRefGoogle Scholar
Darnton-Hill, I & Coyne, ET (1998) Feast and famine: socioeconomic disparities in global nutrition and health. Public Health Nutrition 1, 23–31.CrossRefGoogle ScholarPubMed
Darnton-Hill, I, Nishida, C, James, PWT (2004) A life course approach to diet, nutrition and the prevention of chronic disease. Public Health Nutrition 7, 107–128.CrossRefGoogle Scholar
Davey Smith, G & Ebrahim, S (2003) 'Mendelian randomization': can genetic epidemiology contribute to understanding environmental determinants of disease?. International Journal of Epidemiology 32, 1–22.CrossRefGoogle Scholar
Dellapenna, D (1999) Nutritional genomics: manipulating plant micronutrients to improve human health. Science 285, 375–379.CrossRefGoogle ScholarPubMed
Eaton, L (2003) Commission warns against selling genetic tests direct to the public. British Medical Journal 326, 781.CrossRefGoogle ScholarPubMed
Fenech, M (2003) Nutritional treatment of genome instability: a paradigm shift in disease prevention and in the setting of recommended dietary allowances. Nutrition Research Reviews 16, 109–122.CrossRefGoogle ScholarPubMed
Finucane, ML (2002) Mad cows, mad corn and mad communities: the role of socio-cultural factors in the perceived risk of genetically-modified food. Proceedings of the Nutrition Society 61, 31–37.CrossRefGoogle ScholarPubMed
Food Standards Agency (2003) GM Food: Opening up the Debate. London: Food Standards Agency.Google Scholar
Fresco, LO (2003) Which Road to Take? Harnessing Genetic Resources and Making Use of Life Sciences, a New Contract for Sustainable Agriculture. EU Discussion Forum Towards Sustainable Agriculture for Developing Countries. Brussels: European Commission.Google Scholar
Haan, EA (2003) The clinical geneticist and the 'new genetics'. Medical Journal of Australia 178, 458–462.CrossRefGoogle ScholarPubMed
Haddad, L (2000) A conceptual framework for assessing agriculture-nutrition linkages. Food and Nutrition Bulletin 21, 367–373.CrossRefGoogle Scholar
Heath, A-LM & Fairweather-Tait, SJ (2003) Health implications of iron overload: the role of diet and genotype. Nutrition Reviews 61, 45–62.CrossRefGoogle ScholarPubMed
Heng, C-K Saha, N, Low, P-S (1997) Dyslipidaemia in Asia: is there an ethnic difference? Medical Progress December issue 7–13.Google Scholar
Hernandez-Diaz, S, Martinez-Losa, E, Fernandez-Jarne, E, Serrano-Martinez, M & Martinez-Gonzalez, MA (2002) Dietary folate and the risk of nonfatal myocardial infarction. Epidemiology 13, 700–706.CrossRefGoogle ScholarPubMed
International Council for Science (2003) New genetics, food and agriculture: scientific discoveries – societal dilemmas. Executive summary. http://iscudqba.alias.domicile.fr/Library/reviews/GMOs/GMO_Exec Summary.pdfGoogle Scholar
Jackson, AA (2003) Genetically modified organisms. Discussion Notes Prepared for British Medical Association Round Table Meeting June 1–3.Google Scholar
Karter, AJ (2002) Commentary: race, genes, and health?–?in search of a middle ground. International Journal of Epidemiology 32, 26–28.CrossRefGoogle Scholar
Kavalier, F & Kent, A (2003) Genetics and the general practitioner. White paper takes the first steps down a long road (editorial). British Medical Journal 327, 2–3.CrossRefGoogle Scholar
Keys, A, Anderson, JT & Grande, F (1965) Serum cholesterol response to changes in the diet. III. Differences among individuals. Metabolism 14, 766–775.CrossRefGoogle ScholarPubMed
Khush, GS (2001) Challenges for meeting the global food and nutrient needs in the new millennium. Proceedings of the Nutrition Society 60, 15–26.CrossRefGoogle ScholarPubMed
Khush, GS (2002) The promise of biotechnology in addressing current nutritional problems in developing countries. Food and Nutrition Bulletin 23, 354–357.CrossRefGoogle ScholarPubMed
Krauss, RM (2000) Genetic recipes for heart-healthy diets. American Journal of Clinical Nutrition 71, 668–669.CrossRefGoogle ScholarPubMed
Lancet, (1994) Structural adjustment too painful? (editorial). Lancet 344, 1377–1378.Google Scholar
Larsen, J (2003) Population growth leading to land hunger. http:www.earth-policy.org/Updates/Update21.htm (accessed 23 January, 2003).Google Scholar
Lonnerdal, B (2003) Genetically modified plants for improved trace element nutrition. Journal of Nutrition 133, 1490S–1493S.CrossRefGoogle ScholarPubMed
Martinez, JA (2000) Body-weight regulation: causes of obesity. Proceedings of the Nutrition Society 59, 337–345.CrossRefGoogle ScholarPubMed
Masson, LF, McNeill, G & Avenell, A (2003) Genetic variation and the lipid response to dietary intervention: a systematic review. American Journal of Clinical Nutrition 77, 1098–1111.CrossRefGoogle ScholarPubMed
Maziya-Dixon, B, Kling, JG, Menkir, A & Dixon, A (2000) Genetic variation in total carotene, iron, and zinc contents of maize and cassava genotypes. Food and Nutrition Bulletin 21, 419–422.CrossRefGoogle Scholar
Mensink, RP & Plat, J (2002) Post-genomic opportunities for understanding nutrition: the nutritionist's perspective. Proceedings of the Nutrition Society 61, 401–404.CrossRefGoogle ScholarPubMed
Murdur, G (2003) Controversy grows over India's genetically-modified potato. British Medical Journal 326, 1351.CrossRefGoogle Scholar
Neff, LM (2003) Current directions in hemochromatosis research: towards an understanding of the role of iron overload and the HFE gene mutations in the development of clinical disease. Nutrition Reviews 61, 38–42.Google ScholarPubMed
Nestle, M & Jacobson, MF (2000) Halting the obesity epidemic: a public health policy approach. Public Health Reports 115, 12–24.CrossRefGoogle ScholarPubMed
Ordovas, JM (2004) The quest for cardiovascular health in the genomic era: nutrigenics and plasma phospholipids. Proceedings of the Nutrition Society 63, 145–152.CrossRefGoogle Scholar
Paddock, W & Paddock, P (1967) Times of Famines. Boston, MA: Little Brown and Company.Google Scholar
Pinstrup-Andersen, P (2000) Improving human nutrition through agricultural research: overview and objectives. Food and Nutrition Bulletin 21, 352–355.CrossRefGoogle Scholar
Popkin, BM (2002) An overview on the nutrition transition and its health implications: the Bellagio Meeting. Public Health Nutrition 5, 93–103.Google ScholarPubMed
Rowland, IR (2002) Genetically modified foods, science, consumers and the media. Proceedings of the Nutrition Society 61, 25–29.CrossRefGoogle ScholarPubMed
Saha, N, Heng, CK, Mozoomdar, BP, Reuben, EM, Soh, HT, Low, PS, Tay, JSH, Liu, Y & Hong, S (1995) Racial variation of factor VII activity and their correlates in healthy Chinese and Indians at low and high risk for coronary artery disease. Atherosclerosis 117, 33–42.CrossRefGoogle ScholarPubMed
Simopoulos, AP (2002) Genetic variation and dietary response: nutrigenetics/nutrigenomics. Asia Pacific Journal of Clinical Nutrition 11, Suppl. 6, S117–S128.CrossRefGoogle Scholar
Singer, PA & Daar, AS (2001) Harnessing genomics and biotechnology to improve global health equity. Science 294, 87–89.CrossRefGoogle ScholarPubMed
Stevens, J & Nowicki, EM (2003) Body mass index and mortality in Asian populations: implications for obesity cut-points. Nutrition Reviews 61, 104–113.Google ScholarPubMed
Stoltzfus, RJ (2001) Summary: implications for research and programs. Journal of Nutrition 131, Suppl. 2, 697S–701S.CrossRefGoogle ScholarPubMed
Stover, PJ & Garza, C (2002a) Bringing individuality to public health recommendations. Journal of Nutrition 132, 2476S–2480S.CrossRefGoogle ScholarPubMed
Stover, PJ & Garza, C (2002b) Molecular and genetic considerations for long-term nutrition interventions. Asia Pacific Journal of Clinical Nutrition 11, Suppl. 6, S129–S136.CrossRefGoogle Scholar
Svetkey, LP, Moore, TJ, Simons-Mortorf, DG, Appel, LJ, Bray, GA, Sacks, FM, Ard, JD, Moretensen, RM, Mitchell, SR, Contin, PR, Kesari, M for the DASH Collaborative Research Group (2001) Angiotensinogen genotype and blood pressure response in the Dietary Approaches to Stop Hypertension (DASH) study. Journal of Hypertension 19, 1949–1956.CrossRefGoogle ScholarPubMed
Talmud, PJ (2004) How to identify gene–environment interactions in a multifactorial disease: CHD as an example. Proceedings of the Nutrition Society 63, 5–10.CrossRefGoogle Scholar
Tiret, L (2002) Gene–environment interaction: a central concept in multifactorial diseases. Proceedings of the Nutrition Society 61, 457–463.CrossRefGoogle ScholarPubMed
Toumani Touré, A & Compaoré, B (2003) Africa needs a level playing field for trade. International Herald Tribune 12 July issue 4.Google Scholar
Trayhurn, P (2003) Nutritional genomics – 'Nutrigenomics'. British Journal of Nutrition 89, 1–2.CrossRefGoogle ScholarPubMed
United Nations (2000) UN Millennium Declaration – September 2000. http://www.un.org/millennium/declaration/ares552e.htmGoogle Scholar
United Nations (2003) Human Development Report 2003. United Nations Development Programme. New York: Oxford University Press.Google Scholar
Vincent, S, Planells, R, Defoort, C, Bernard, M-C, Gerber, M, Prudhomme, J, Vague, P & Lairon, D (2002) Genetic polymorphisms and lipoprotein responses to diets. Proceedings of the Nutrition Society 61, 427–434.CrossRefGoogle ScholarPubMed
Wahlqvist, ML (2002) Focusing on novel foods: their role, potential and safety. Asia Pacific Journal of Clinical Nutrition 11, Suppl. 6, S598–S599.CrossRefGoogle Scholar
Walter, P, Hornig, D & Moser, U (editors) (2001) A conceptual approach for scientifically based guidelines. In Functions of Vitamins Beyond Recommended Dietary Allowances, pp. 1–3 Basel: Karger.Google Scholar
Welch, RM & Graham, RD (2000) A new paradigm for world agriculture: productive, sustainable, nutritious, healthful food systems. Food and Nutrition Bulletin 21, 361–366.CrossRefGoogle Scholar
Wells, JM & Bennik, MHJ (2003) Genomics of food-borne bacterial pathogens. Nutrition Research Reviews 16, 21–35.CrossRefGoogle ScholarPubMed
Whincup, PH, Gilg, JA, Papacosta, O, Seymour, C, Miller, GJ, Alberti, KGMM & Cook, DG (2002) Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children. British Medical Journal 324, 1–6.CrossRefGoogle ScholarPubMed
World Health Organization (2002a) Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series no. 894 Geneva: WHO.Google Scholar
World Health Organization (2002b) Programming of Chronic Disease by Impaired Fetal Nutrition: Evidence and Implications for Research and Intervention Strategies. WHO/NHD/02.3, WHO/NPH/02.1 Geneva: WHO.Google Scholar
World Health Organization (2002c) The World Health Report 2002. Reducing Risks, Promoting Healthy Life. Geneva: WHO.Google Scholar
World Health Organization (2002d) Genomics and World Health. Summary. Geneva: WHO.Google Scholar
World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Disease. Report of a WHO/FAO Technical Consultation. Geneva: WHO.Google Scholar
World Health Organization (2004) Report of a WHO Expert Consultation on Appropriate BMI for Asian Populations and Its Implications for Policy and Intervention Strategies. Geneva: WHO.Google Scholar
Yajnik, CS (2002) The lifecycle effects of nutrition and body size on adult obesity, diabetes and cardiovascular disease. Obesity Reviews 3, 217–224.CrossRefGoogle ScholarPubMed
Zhang, Y, Proenca, R, Maffei, M, Barone, M, Leopald, L & Friedman, JM (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372, 425–432.CrossRefGoogle ScholarPubMed