From Farm to Pharma: public health challenges of nutrigenomics Minakshi Bhardwaj, PhD Cardiff University, UK

Genomics: the promises Many of the promises of the post genome era tend to be promoted in terms of benefits to the individuals, e.g. ‘personal pills’ and personalised diet

DH White paper 2003 “We will learn more about the genetic features of common diseases such as heart disease and diabetes and the way external factors such as diet and smoking interact with our genes to increase likelihood of developing a given disease”

The context Public health concerns. e.g obesity, diabetes Novel foods. eg GM, nutriceuticals, functional foods Understanding of genetics Ethical paradigms –Individual and choice

Nutrition genomics Nutrigenetics The study of individual differences at genetic level (SNPs) influencing response to diet. –i.e effects of individual genetic variation in response to diet –Personalised nutrition; genetic testing –Potential benefit and harm

Contd Nutrigenomics The application of genomics in nutrition research, enabling associations to be made between specific nutrients and genetic factors. –Study of nutrient-gene interactions –Systems biology –Research ethics; funding allocations

Acquisition of information Association studies –Population groups –Specific disorders National dietary surveys Genetic databases

Information leading to applications Understanding how nutrition affects metabolic pathways Understanding how this influences diet related diseases The role of individual genotypes

Personalisation project Personalisation as a policy tool Personalisation as an objective of genomic research Commercial exploitation As an ethical argument- reducing genomic divide (Getting Personal report :Food Ethics Council 2005)

‘public good model’ Susceptibility testing -Pharmacogenomics -Nutrigenomics Framing risk -Individual, joint and relative risk -Serious/not serious

Public health Will nutrigenomics have significant public health benefits? Differences between nutrigenomics and pharmacogenomics

Contextual issues -What counts as public health? -Determinants of health -Individual vs. collective benefits -Images of food -Individualism and choice -Target groups; basis of groups -The ‘value impact’ of genomics -Personalisation of what?

Aspirations or promises? Accuracy of claims Screening vs. testing Determinism vs. probability Empowerment vs. exploitation

Acknowledgments Prof. Ruth Chadwick Prof. Søren Holm

A Lancaster – Cardiff collaboration