Guiding Global Best Practice in Personalized Nutrition Based on Genetics: The Development of a Nutrigenomics Care Map
This article was published in the Journal of the Academy of Nutrition and Dietetics.
Introduction
Health care providers (HCPs) globally, including dietitians, are encountering genetic testing for personalized nutrition (ie, nutrigenomics) in their clinical practice. Although considerable basic research examining diet–gene interactions exists in the literature, comparatively less knowledge is available regarding the use of nutrigenomics in clinical practice to alter dietary outcomes. Despite this, patients are bringing direct-to-consumer nutrigenomics reports to HCPs for interpretation, and more HCPs are now offering nutrigenomics tests to their patients. However, HCPs currently lack clinical guidance documents in nutrigenomics and several steps are needed before full clinical practice guidelines are developed. As a first step in these efforts, our objective was to develop a care map to provide HCPs with a tool for considering nutrigenomics in clinical practice based on the current state of knowledge. An Expert Advisory Panel consisting of 6 nutrigenomics researchers, 3 of whom are also registered dietitians (RDs), developed a care map draft while consulting nutrigenomics literature and incorporating the 3 key pillars of personalized nutrition. To optimize generalizability, the draft was reviewed by 12 HCPs with representation from 6 continents (Africa, Asia, Australia, Europe, North America, and South America) who have experience using nutrigenomics in their clinical practice. The Expert Advisory Panel revised the care map based on HCP feedback and all members of the Expert Advisory Panel approved the final version. A 4-step care map was developed, with sections related to HCP training in nutrigenomics (Step 1), patient screening, assessment and informed consent (Step 2), providing nutrigenomics in clinical practice (Step 3), and patient follow-up (Step 4). Continuing education was incorporated throughout the care map. A nutrigenomics care map was successfully developed and should be used as a starting point to guide clinical practice. This care map is generalizable to dietetics practice globally.
