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Diet, genes and disease: implications for nutrition policy

Published online by Cambridge University Press:  07 March 2007

Michael J. Gibney  and
Eileen R. Gibney
Michael J. Gibney*
Affiliation:
Institute of European Food Studies, Department of Clinical Medicine, Trinity College, Dublin, Republic of Ireland
Eileen R. Gibney
Affiliation:
Institute of European Food Studies, Department of Biochemistry, Trinity College, Dublin, Republic of Ireland
*
Corresponding author: Professor M. Gibney, fax +353 1 454 2043, email mgibney@tcd.ie
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Abstract

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There is extensive evidence to show that there is considerable variation in diet and disease patterns in Europe and that many of the dietary patterns are predictive of chronic disease. Increasingly, there is evidence that this dietary effect is mediated by genetic background. The present paper examines the role of polymorphisms within three genes, those responsible for the synthesis of apoE, 5,10-methylenetetrahydrofolate reductase (MTHFR) and PPARγ. There is clear evidence to support the concept that the diet–disease link is moderated by genetic variation. The paper then considers whether this moderating effect will have implications for dietary recommendations. In the formulation of dietary reference values it has long been recognized that these values cannot cover the needs of all individuals. By setting the upper level at the mean value +2 sd, the needs of 97·5% of the population are covered. Setting a hypothetical scenario of a nutrient requirement of 200 mg\d and a polymorphism with an allelic frequency in the general population in the range of 0, 10, 20 and 30% that causes an increased nutrient requirement of 25%, there was no evidence that the traditional approach requires revision. Whilst it is recognized that genetic variability may not influence population goals, genetic variability will have to be taken into account in the clinical nutrition management of disease. To knowingly assign a patient to life-long treatment with a diet that for genetic reasons will have no success is both unethical and uneconomical. Once accepted in clinical nutrition, the diet–gene interaction will filter into the prevention of disease in public health nutrition.

Keywords

DietGenesDiseaseNutrition policy
Type
Symposium on ‘Implications for dietary guidelines of genetic influences on requirements’
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 3 , August 2004 , pp. 491 - 500
Copyright
Copyright © The Nutrition Society 2004

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