FRIDAY, Nov. 7, 2003 (HealthDayNews) -- Health experts are predicting that a whole new economy centered on genetic profiling is about to become reality.
But they caution that the issue needs to be looked at seriously, starting now, while it's still manageable.
Corporations, for instance, might be as interested as doctors in knowing that you have a higher genetic risk of getting a health condition.
"We could see, for example, food companies, which are very powerful, who might say, 'Hey, buy this because it might help you genetically,'" says Dr. Abdallah Daar, a professor of public health sciences at the University of Toronto. "Or they could even start marketing specifically to certain genetic profiles. It's in the future, but it has the potential to be very big."
"We think that now's a good time to begin to look at this and get some feedback," he adds.
Experts meeting at the 2nd International Nutrigenomics Conference in the Netherlands this week are set to focus on the particular issue of genetics and diet, or nutritional genomics (nutrigenomics), a growing field of research on how nutrients and genes interact and how genetic variations may cause people to respond differently to food nutrients.
Research in this field is becoming an important area of study for scientists, who are already predicting it could bring about radical changes in how food is grown, processed and consumed. They also believe it won't be long before the arrival of personalized diets that are tailored to a person's genetic makeup.
Some experts warn against such a headlong rush into nutrigenomics before there's been a more detailed examination of its ethical implications in open discussions, both within the bioethic communities and with the public at large.
A report titled Nutrition and Genes: Science, Society and the Supermarket, prepared by a panel of experts for presentation at the conference, attempts to foster just such a debate by setting out issues that must be considered as consumers begin customizing diets to mitigate chronic health conditions.
The report, a joint undertaking by the University of Toronto Joint Centre for Bioethics (JCB) and the philosophy department at the University of Guelph, both in Ontario, stops short of prescribing any specific guidelines for the development of the field.
"If even part of its promise is realized, nutrigenomic testing and the labeling of foods for specific subpopulations on the basis of their genetic makeup could become highly important public health tools," Peter A. Singer, director of the Joint Centre for Bioethics, says in the report. "But this research raises many of the ethical concerns now associated with genetic testing."
Almost weekly, science is uncovering more and more about the role of genetics in the development of diseases such as diabetes, obesity, birth defects and food allergies. They also discover how chemicals in foods can affect genes -- or even how genes can predict whether particular foods are likely to cause health problems.
Studies show that some of the variations in, for example, a person's blood pressure and bone density are also genetically determined. In some people, food may even cause genes to malfunction; among people who consume the same diet, some may not suffer from a given disease, while others might show higher disease levels.
"In future we may choose, for example, a breakfast cereal based on our genes," Singer wrote in the paper. "It is hypothetical today, but a possibility, that if you have a particular gene, you will be advised to use a cereal that decreases your chance of heart disease and avoid another that would increase your chance of colon cancer."
Tests to determine genetic risk profiles are currently being offered by several companies in Canada, the United States, and England. At least two of the companies say the tests will help people choose diets that will improve their health.
"These tests are quite common now," says David Castle, a professor of philosophy at the University of Guelph. "It used to be that, at least in the U.K., you could take these tests independent of a health-care professional, but I think now you have to go through a physician. But I do know that you can also get them over the Internet."
An online search nets more than a dozen companies that pay to list their services along certain keywords.
Anybody can order a genetic test kit online, take a cheek swab, fill in a lifestyle questionnaire, and send it off to one of several companies around the world. Then for a fee, the companies will send you back a list of genetic indicators and a set of corresponding nutritional guidelines, according to literature on several of the sites.
"It's a transaction between the individual and the company, and basically that information would be in the hands of the private company," Castle says. "And there are not any laws that I know of to prevent this."
However, as genetic profiling is still in its infancy, not all experts agree with confidence on the capability of current knowledge to actually recommend dietary changes.
"There are laws now in the U.K. to protect the samples and genetic data from being passing on to other companies," said Helen Wallace, deputy director of GeneWatch UK. "But there are some problems with it, we feel, such as a kind of direct marketing using your data. We are concerned about a kind of 'marketing of fear' of other products linked with those tests."
The report adds that "there is also a concern that employers or insurers could use genetic information to the unfair disadvantage of some people."
As a result of concerns about potential misuse of information, several government agencies are enacting or trying to enact some form of 'genetic anti-discrimination legislation.' Some localities now prohibit insurers from requiring genetic tests or test information as a condition of insurance. In England, there is a temporary moratorium on requiring genetic tests or test information.
At the same time, many insurance companies, especially in the private sector, say that, since they are in the business of managing risk, both the insurer and the insured ought to have access to the same risk information.
As an example of this sort of advance, this week an Icelandic company, Decode Genetics, reported that it has identified a gene linked to osteoporosis.
This means that a person with any of three specific variants of the gene could have triple the risk of developing the bone-brittling disease.
A genetic test is being developed that could be taken only once in a lifetime, and if a variant of that gene were found, a high-calcium diet and plenty of exercise could be prescribed, according to the company literature.
More information
Visit the Joint Center for Bioethics or, for a skeptical view, GeneWatch UK.
