I recently came across many advertisements dealing with nutrigenomics and how it is going to revolutionize personalised medicine. So, i decided to dig further into them and found that what it basically contains is a jungle of half-baked claims, untested presumptions and sometimes dangerous prescriptions doled out to unsuspecting patients based on them.
Here is what one clinic prescribing nutrigenomics says:
Nutrigenomics seeks to unravel these medical mysteries by providing personalized genetics-based treatment. Even so, it will take decades to confirm what we already understand; that replacing specific nutrients and/or chemicals in existing pathways allows more efficient gene expression, particularly with genetic vulnerabilities and mutations.
The key phrase here is – ” It will decades to confirm what we already understand”. This is the main essence of pseudoscience – using science to confirm what one already “knows.” Obviously this is backwards, of course. Science is never done by “confirming” but by determining if a hypothesis is true or not.
Before going any further, let me put a disclaimer: I am not against the study of metabolomics or understanding the effects of foods and food constituents on gene expression, but what i am against are the claims put forth by various pharma clinics saying that by analyzing one’s genes a personalized regimen of specific nutrients can be developed to help their gene’s function at optimal efficiency !!
So, lets start with understanding what nutrigenomics is? It deals with the study of one’s genes in order to personalize therapy, in this case nutrition. Scientifically speaking, this particular area of research is quite legitimate, as with research based stem cell therapy. We already are using genetic analysis to diagnose various diseases, and targeting chemotherapy. Recent research is beginning to identify specific genes that affect how different individuals metabolize and respond to specific drugs. Though our genes do exert a powerful influence over our health, but the environment in which we live and grow up also plays a considerable influence. Already gene based therapies are becoming an important part of science-based medicine.
As genetic analysis via high-throughput sequencing become more rapid and cost-effective, there is an ever-increasing potential that it can be used as part of a routine screening and health evaluation in order to identify disease susceptibilities, target various preventive treatments, adjusting behaviors to target risks, and guide therapy. However, similar to stem cell treatments, our current knowledge with respect to genetic predispositions is still in its infancy. What is well established is already incorporated into mainstream medical practice. The rest is a matter for research, not current practice.
This creates an opportunity for exploitation of , using current cutting edge research to make clinical claims that are years or decades premature by pretending to have knowledge that simply does not exist. This type of medical pseudoscience is increasingly becoming a common practice by various quacks and is a manifestation of one common tactic – basing clinical claims on pre-clinical scientific research. This is especially insidious and difficult for the non-expert to properly evaluate (which makes for effective pseudoscientific marketing).
There is a great deal of basic science research going on , which asks questions about how the body works and how it is affected by all kinds of different factors- genetic or environmental. There is also a lot of translational or clinical research which looks forward to apply this knowledge to specific medical interventions. Biology is highly complex, so it is extremely difficult to extrapolate from basic science knowledge to tangible clinical effects. Most initial results that come from basic science research turn out to be wrong in a clinical setting. The only way to progress further is to conduct careful rigorous clinical research to measure the actual effects of a specific intervention in a specific population.This last point is specifically important since different interventions may have different effects on different populations.
As basic science research is quite vast , it is quite possible to find studies that may seem to support almost any conceivable intervention you wish. To the unsuspecting public this can make any medical intervention seem as if it is science-based and hence legitimate, even when the treatment is nothing but deception.
One nutrigenomics website, for example, claims to treat the following conditions:
Welcome to Genetics Based Integrative Medicine (GBIM), a telemedicine practice dedicated to the education, treatment, and recovery of those with autism spectrum disorders, ADD/ADHD, and PANDAS as well as highly complex & disabling disorders affecting adults such as CFS/ME/FM, Multiple Sclerosis, ALS, Parkinson’s and mitochondrial dysfunction.
Now to start of with, there is no compelling evidence for any nutritional treatment for the above diseases, let alone for personalized nutritional treatment based on specific genetic types. How the practitioners of GBIM came by the knowledge they are claiming to have is quite a mystery. As with the stem cell treatments I discussed previously, such clinical claims, if legitimate, would have a paper trail of hundreds of published studies in the literature. Further, if such studies existed such practice would be standard of care, not isolated to one or a few special clinics.
Thus it would be quite safe to add “nutrigenomics” to the list of red flags for dangerous quackery. However, for me personally it is quite a shame because, like stem cells, it is a legitimate field of research, and the current level of quackery is likely to taint the reputation of what in the future might be a promising approach.
In the end I would like to finish, by quoting a line on scientists vs quacks:
Scientists are still working out the ‘syntax’, ‘morphology’,’phonology’,and ‘semantics’, while the pseudoscientists pretend that they not only have the dictionary,but also encyclopedias and novels written in those yet un-deciphered languages.
- Center of Excellence for Nutritional Genomics (CENG) at the University of California, Davis
- Consumers Not Ready For Tailor-Made Nutrition?, Science Daily, 2008.
- Personalised nutrition: ready for practice?, Proceedings of the Nutrition Society, 2012.
- Personalised nutrition: status and perspectives, British Journal of Nutrition, 2007.