Nutritional Genomics and the Nutrigenomics Practitioner

Ruth M. DeBusk, PhD, RD - ruthdebusk@comcast.net

Geneticist and Registered Dietitian, Private Practice, USA

Among the most anticipated aspects of nutritional genomics are its potential applications, from health promotion and disease prevention to maximizing genetic potential. Knowledge of the underlying mechanisms by which genes are influenced by particular dietary and other lifestyle factors is expected to take nutrition-related practice to a new level. What will such a practice look like for the nutrigenomics practitioner?

Once the scientific underpinnings are in place and have been converted into the practical tools needed - nutrigenetic testing, nutritional interventions for disease management, and nutritional approaches to health promotion/ disease prevention - nutrition practice will change significantly. Nutrigenetic testing and interpretation will become a routine part of the total client assessment and both intervention and prevention will be increasingly targeted to the underlying genetic basis, with the expectation that outcomes will improve considerably. The nutrigenomics practitioner will develop gene-directed nutrition approaches and coach people in how to use food, dietary supplements and lifestyle choices in general in ways that are most appropriate for their genetic makeup. Disease management is expected to become increasingly effective as nutritional genomics is integrated into practice. Even more eagerly anticipated is the opening up of new horizons for health care professionals in terms of expertise in health promotion. The ability to identify disease susceptibilities for an individual (or the major susceptibilities that characterize a population) provides a solid foundation for effective health promotion efforts in ways never before possible. 

In considering the type of advanced training that a nutrigenomics practitioner will need in order to become proficient in nutritional genomics, it’s becoming obvious that a solid base in the foundational sciences critical to understanding human biology, courses specific to food science and nutrition science and their related research, and clinical nutrition experience is essential. Additionally, expertise in genetics, molecular biology, biochemistry, and nutritional genomics plus excellent counseling skills are needed. Not all health care professionals will have this base. The obvious base upon which to develop nutrigenomics practitioners is the nutrition professional. However, the term “nutrition professional” is not regulated and encompasses a wide variety of backgrounds, from those who have had some courses in nutrition to those with advanced degrees and postgraduate training in nutrition.  In many countries, nutrition professionals who focus on diet from a health promotion or therapeutic intervention standpoint typically have the additional qualification of being a registered dietitian (e.g. Registered Dieticians as in the US, UK, EU and South Africa or, in Australia, APD for accredited practicing dietitian). The registered dietician (also accredited practicing dietician) designation is strictly regulated and requires successful completion of a nationally-regulated undergraduate curriculum and subsequent practice internship, followed by passing a national examination.

Many registered dieticians continue to develop specialized expertise at the master’s, doctoral, and postgraduate levels. In the US, the registered dietician credential is the preferred basis for licensure as a nutrition professional in numerous states.

The depth and breadth of scientific training, clinical experience, and counseling skills of the registered/accredited dietitian make this health care professional uniquely qualified to translate food and nutrition scientific information into practical dietary advice. Progressive registered dieticians have already begun to develop the needed expertise in nutrigenomics in anticipation of changing practice demands and the opportunities for nutrigenomics practitioners. South Africa has been a leader in expanding the education and skills of the registered dietitian for the past three years, targeted at training master’s level dietitians in nutritional genomics. Upon completion of their training, these dietitians are capable of developing a clinical practice that incorporates nutrigenetic testing and associated gene-based diet and lifestyle recommendations. The US and other countries are beginning to address the needs for a career path for the registered dietician nutrigenomics practitioner.

Clearly nutrigenomics is fundamental to the effective use of nutrition for disease management and health promotion. No longer will nutritionists “own” nutrition or geneticists “own” genetics. The time has come for these disciplines to be integrated into a variety of health-related fields and into the practices of virtually all health professionals. In the same way that study designs need to include nutritional and genetic parameters in order to generate meaningful and significant results, so will health professionals need to embrace nutritional genomics. The registered dietitian may be the logical health care professional to lead the charge into this new era of nutrigenomics but most health care professionals have the solid science base upon which nutrition and genetic education and experience can be added to generate nutrigenomic practitioners with different skill sets, an endpoint that will surely benefit clients.