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Factors determining the integration of nutritional genomics into clinical practice by registered dietitians

Abrahams, Mariëtte, Frewer, Lynn J., Bryant, Eleanor, Stewart-Knox, Barbara
Trends in food science & technology 2017 v.59 pp. 139-147
National Library of Medicine, consumer attitudes, databases, dietitians, health services, lifestyle, nutrigenomics, phenotype, public health, working conditions
Personalized nutrition has the potential to improve health, prevent disease and reduce healthcare expenditure. Whilst research hints at positive consumer attitudes towards personalized nutrition that draws upon lifestyle, phenotypic and genotypic data, little is known about the degree to which registered dietitians (RD) are engaged in the delivery of such services. This review sought to determine possible factors associated with the integration of the emerging science of Nutritional Genomics (NGx) into the clinical practice setting by practicing registered dietitians.Search of online databases (Pubmed; National Library of Medicine; Cochrane Library; Ovid Medline) was conducted on material published from January 2000 to December 2014. Studies that sampled practicing dietitians and investigated integration or application of NGx and genetics knowledge into practice were eligible. Articles were assessed according to the American Dietetic Association Quality Criteria Checklist.Application of nutritional genomics in practice has been limited. Reluctance to integrate NGx into practice is associated with low awareness of NGx, a lack of confidence in the science surrounding NGx and skepticism toward Direct to consumer (DTC) products. Successful application to practice was associated with knowledge about NGx, having confidence in the science, a positive attitude toward NGx, access to DTC products, a supportive working environment, working in the clinical setting rather than the public health domain and being in private rather than public practice.There is a need to provide RGs with a supportive working environment that provides ongoing training in NGx and which is integrated with clinical practice.