Social and ethical issues arising from Nutrigenomics

1. Social and ethical issues arising from Nutrigenomics Julian Heyes

2. The essence of nutrigenomics • Genetic risk factors plus environmental factors lead to physiological outcomes • health and wellbeing • disease • Our lifestyle choices (diet, exercise, smoking etc) are very important

3. Genetic risk factors • Small modifications to our genes and chromosomes: • single nucleotide polymorphisms • copy number variants • epigenetic alterations such as methylation; exercise reducing telomere shortening • Powerful new technique: • Genome-wide association scan • pinpoint genetic risk factors • type 2 diabetes, rheumatoid arthritis, breast cancer...

4. Dietary modification of risk • Our lifestyle choices (diet, exercise, smoking etc) are very important: • both for ourselves • and for our children (epigenetics) Agouti mice: yellow fur, prone to obesity and diabetes Added genistein to mother’s diet, led to increased gene methylation and increased frequency of normal offspring Dolinoy et al. 2006

5. Centre of Excellence in Nutrigenomics Nutrigenomics New Zealand is a strategic collaboration between AgResearch Limited, The University of Auckland, and Plant & Food Research. With a scientific programme addressing the key areas of nutrigenomics, the Centre performs high-quality research and knowledge transfer in an international context. Nutrigenomics NEW ZEALAND Tailoring New Zealand foods to match people’s genes www.nutrigenomics.org.nz

6. Nutrigenomics New Zealand Functional SNP, L503F, in Na-dependent Organic Cation Transporter (OCTN1) is risk factor for Crohn’s in some populations Substrate = ergothioneine; particularly high in mushrooms

7. Dietary preference questionnaires Petermann et al. 2009

8. Genotype matters... Frequency of Crohn’s disease cases with specific genotypes reporting adverse effects from mushrooms Petermann et al. 2009

9. Summary so far • Different individuals respond to foods in different ways • May affect risk of developing serious maturity-onset diseases • Maternal diet may alter children’s disease risk • At present: only a handful of strong associations known • Guarantee there will be rapid growth in our knowledge of this area

10. A public health issue Apolipoprotein A1 (APOA1) participates in the reverse transport of cholesterol from tissues to the liver • Individualized nutritional • advice (822 women): • Carriers of the A allele: • PUFA intake to  HDL and reduce CVD risk whereas G/G women should receive the opposite advice! Ordovas et al. Am. J. Clin. Nutr. (2002)

11. Some social or ethical issues • Who will advise people about their genetic risk and possible dietary modifications? • Will employers or insurers want to know and use this information? • What if screening becomes common: • parents’ response at or before birth? • right not to be informed... unless risk of ‘serious and imminent harm’ • whose genome? my knowledge affects the whanau

12. Commercial gain • Who will benefit from nutrigenomics research? • Proprietary foods: who profits? • Are companies overstating current knowledge? The burden of knowledge Will (partial) knowledge lead to unnecessary lifestyle impoverishment? Pregnant mums: fetal alcohol syndrome ‘My mother made me a type II diabetic’

13. Our response?

14. Acknowledgements • Donald Evans, 2005: Ethics and nutrigenomics; oral paper at International Conference on Nutrigenomics and Gut Health, May 1-3 2006. • David Castle and Nola Ries, 2007: Ethical, legal and social issues in nutrigenomics: the challenges of regulating service delivery and building health professional capacity. Mutation Research 622: 138-143.

15. The New Zealand Institute for Plant & Food Research Limited www.plantandfood.com