Nutrigenomics--2006 update

Nutrigenetics and nutrigenomics: viewpoints on the current status and applications in nutrition research and practice

Nutrigenetics and nutrigenomics hold much promise for providing better nutritional advice to the public generally, genetic subgroups and individuals. Because nutrigenetics and nutrigenomics require a deep understanding of nutrition, genetics and biochemistry and ever new 'omic' technologies, it is often difficult, even for educated professionals, to appreciate their relevance to the practice of preventive approaches for optimising health, delaying onset of disease and diminishing its severity. This review discusses (i) the basic concepts, technical terms and technology involved in nutrigenetics and nutrigenomics; (ii) how this emerging knowledge can be applied to optimise health, prevent and treat diseases; (iii) how to read, understand and interpret nutrigenetic and nutrigenomic research results, and (iv) how this knowledge may potentially transform nutrition and dietetic practice, and the implications of such a transformation. This is in effect an up-to-date overview of the various aspects of nutrigenetics and nutrigenomics relevant to health practitioners who are seeking a better understanding of this new frontier in nutrition research and its potential application to dietetic practice.

Knowledge and attitudes of Canadian consumers and health care professionals regarding nutritional genomics

With advances in the field of nutrigenomics, commercial laboratories have begun marketing genotyping services, nutritional advice, and dietary supplements "tailored" to match individual genetic predispositions. Although primarily offered by American companies, these services are available to Canadian consumers via the Internet. Qualitative research in the form of focus groups with members of the Canadian public was undertaken to assess the current level of understanding of and receptivity toward this new genomic application. Additionally, focus groups with health care professionals (physicians, pharmacists, dieticians, nutritionists, and naturopaths) investigated their interest in integrating nutrigenomics into health care delivery, and their capacity to do so. Gauging knowledge and attitudes early in the introduction of a new technology serves to identify potential "blind spots" regarding the ethical, legal, and social implications. Preliminary results indicate consumers believe potential benefits of nutrigenomics outweigh risks, while health care professionals express more skepticism. Both groups agree that more public education about nutrigenomics is needed and that regulatory oversight should ensure consumer protection.

Oxidative stress-induced risk factors associated with the metabolic syndrome: a unifying hypothesis

Although the biochemical steps linking insulin resistance with the metabolic syndrome have not been completely clarified, mounting experimental and clinical evidence indicate oxidative stress as an attractive candidate for a central pathogenic role since it potentially explains the appearance of all risk factors and supports the clinical manifestations. In fact, metabolic syndrome patients exhibit activation of biochemical pathways leading to increased delivery of reactive oxygen species, decreased antioxidant protection and increased lipid peroxidation. The described associations between increased abdominal fat storage, liver steatosis and systemic oxidative stress, the diminished concentration of nitric oxide derivatives and antioxidant vitamins and the endothelial oxidative damages observed in subjects with the metabolic syndrome definitively support oxidative stress as the common second-level event in a unifying pathogenic view. Moreover, it has been observed that oxidative stress regulates the expression of genes governing lipid and glucose metabolism through activation or inhibition of intracellular sensors. Diet constituents can modulate redox reactions and the oxidative stress extent, thus also acting on nuclear gene expression. As a consequence of the food-gene interaction, metabolic syndrome patients may express different disease features and extents according to the different pathways activated by oxidative stress-modulated effectors. This view could also explain family differences and interethnic variations in determining risk factor appearance. This review mechanistically focused on oxidative stress events leading to individual disease factor appearance in metabolic syndrome patients and their setting for a more helpful clinical approach.