Nutrigenomics for Global Health: Ethical Challenges for Underserved Populations

Abstract

Nutrigenomics covers disparate fields of nutrition science and has been defined in many different ways. In fact, this emerging field of science has multiple facets, many of which do not generate the same ethical issues. In particular, different ethical issues emerge concerning the extent to which nutrigenomics may actually improve global health, i.e., in terms of worldwide improvement of health, reduction of disparities, and protection against global threats that disregard national borders. Nutrigenomics raises many hopes and expectations on that score. However it remains unclear and controversial whether nutrigenomics studies and their actual or potential applications will actually benefit developing countries and their populations. Different forces may drive the choice of research priorities and shape the claims that are made when communicating the goals or the results of nutrigenomics studies and applications. This article proposes to assess expectations and claims in nutrigenomics, with respect to their respective potential impact on global health and the ethical issues they raise. Nutrigenomics is and should be more than premature claims and much debated promises about personalized nutritional interventions on individuals. Beyond questionable commercial claims, nutrigenomics is also knowledge about and recognition of the considerable impacts of underfeeding and malnutrition on the genome (and epigenome) integrity and stability. As such, nutrigenomics research is a valuable opportunity to revive and give strength to the debate about the unacceptable consequences of hunger and malnutrition worldwide, and to support a newly and potentially significant convergence in research priorities that could benefit both developed and developing countries. 3 IntroductionNutrigenomics is a new application context for genomics technologies that focuses on the bidirectional study of genetic factors influencing host (individuals' or populations') responses to diet as well as effects of bioactive constituents in food on host genome and gene expression [1, 2]. This bidirectional approach to the study of genome-diet interaction creates a dual avenue for tangible nutrigenomics applications.Nutrigenomics is often described as one of the latest applications of genomics technologies in the field of personalized health interventions or personalized medicine, following the science of pharmacogenetics and pharmacogenomics. Yet, as it will be shown in this article, nutrigenomics goes beyond personalized health interventions. It covers disparate fields of nutrition science, which may pursue different goals and thus have multiple facets. Consequently, different ethical issues emerge, particularly in regard to the extent to which nutrigenomics may improve global health.There is no common understanding of the term "global health" [3]. Global health "is a field that encompasses […], processes, and institutions needed to create the conditions for people throughout the world to attain the highest possible level of physical and mental h...

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