Background: Clinical demand for nutrigenomics testing (NGT) is increasing, underscoring the importance of assessing healthcare professional (HCP) competence and clinical actions with NGT in practice. While previous studies have explored HCP perceptions of NGT, no study has examined real HCP experiences with NGT in practice. Objective: The objective of this study was to evaluate the clinical experience of providing NGT among early adopter HCPs who have used NGT in their practice. We hypothesized that HCP clinical actions after NGT would differ according to HCP personal experience undergoing genetic testing (GT) as well as years in practice. Design: An online survey questionnaire was administered to HCPs (n = 70) who have provided NGT in practice. χ2 tests, tests for trend, and logistic regression were used to compare HCP characteristics with post-NGT outcomes. Results: HCPs with fewest years in practice (<5 years) comprised the lowest proportion of respondents (16%). Most HCPs reported good understanding of NGT results and 92% made genetic-based dietary recommendations to patients following NGT. HCP personal use of GT increased significantly with increasing years in practice (<5 years: 36%, 5–10 years: 53%, 11–20 years: 70%, and >20 years: 85%, p trend = 0.003). Requesting patient bloodwork because of NGT results increased significantly with HCP years in practice when HCPs with <5 years in practice were not considered (5–10 years: 19%, 11–20 years: 28%, and >20 years: 60%, p trend = 0.010). A near significant difference was observed where a greater proportion of HCPs who had personally undergone GT reported requesting patient bloodwork (personal use: 46% vs. no personal use: 23%, p2 = 0.066). Conclusion: Early HCP adopters of NGT utilize the test results to provide genetic-based dietary recommendations to patients. Clinical action after NGT currently appears to be driven by HCP years in practice, but HCP personal use of GT may also be a factor.

1.
Camp
KM
,
Trujillo
E
.
Position of the Academy of Nutrition and Dietetics: nutritional genomics
.
J Acad Nutr Diet
.
2014
;
114
(
2
):
299
312
. .
2.
Weir
M
,
Morin
K
,
Ries
N
,
Castle
D
.
Canadian health care professionals’ knowledge, attitudes and perceptions of nutritional genomics
.
Br J Nutr
.
2010
;
104
(
8
):
1112
9
. .
3.
Horne
J
,
Gilliland
J
,
O’Connor
C
,
Seabrook
J
,
Madill
J
.
Enhanced long-term dietary change and adherence in a nutrigenomics-guided lifestyle intervention compared to a population-based (GLB/DPP) lifestyle intervention for weight management: results from the NOW randomised controlled trial
.
BMJ Nutr Prev Health
.
2020
;
3
(
1
):
49
59
.
4.
Livingstone
KM
,
Celis-Morales
C
,
Navas-Carretero
S
,
San-Cristobal
R
,
Forster
H
,
Woolhead
C
, et al.
Characteristics of participants who benefit most from personalised nutrition: findings from the pan-European Food4Me randomised controlled trial
.
Br J Nutr
.
2020
;
123
(
12
):
1396
405
. .
5.
Celis-Morales
C
,
Livingstone
KM
,
Marsaux
CF
,
Macready
AL
,
Fallaize
R
,
O’Donovan
CB
, et al.
Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial
.
Int J Epidemiol
.
2017
;
46
(
2
):
578
88
. .
6.
Nielsen
DE
,
El-Sohemy
A
.
Disclosure of genetic information and change in dietary intake: a randomized controlled trial
.
PLoS One
.
2014
;
9
(
11
):
e112665
. .
7.
Hietaranta-Luoma
HL
,
Tahvonen
R
,
Iso-Touru
T
,
Puolijoki
H
,
Hopia
A
.
An intervention study of individual, apoE genotype-based dietary and physical-activity advice: impact on health behavior
.
J Nutrigenet Nutrigenomics
.
2014
;
7
(
3
):
161
74
. .
8.
Castle
D
,
Ries
NM
.
Ethical, legal and social issues in nutrigenomics: the challenges of regulating service delivery and building health professional capacity
.
Mutat Res
.
2007
;
622
(
1–2
):
138
43
. .
9.
De
S
,
Pietilä
AM
,
Iso-Touru
T
,
Hopia
A
,
Tahvonen
R
,
Vähäkangas
K
.
Information provided to consumers about direct-to-consumer nutrigenetic testing
.
Public Health Genomics
.
2019
;
22
(
5–6
):
162
73
. .
10.
Araujo Almeida
V
,
Littlejohn
P
,
Cop
I
,
Brown
E
,
Afroze
R
,
Davison
KM
.
Comparison of nutrigenomics technology interface tools for consumers and health professionals: a sequential explanatory mixed methods investigation
.
J Med Internet Res
.
2019
;
21
(
6
):
e12580
. .
11.
Aruoma
OI
,
Hausman-Cohen
S
,
Pizano
J
,
Schmidt
MA
,
Minich
DM
,
Joffe
Y
, et al.
Personalized nutrition: translating the science of nutrigenomics into practice: proceedings from the 2018 American College of Nutrition Meeting
.
J Am Coll Nutr
.
2019 May–Jun
;
38
(
4
):
287
301
. .
12.
Bouchard-Mercier
A
,
Desroches
S
,
Robitaille
J
,
Vohl
MC
.
Factors sssociated with the intention of registered dietitians to discuss nutrigenetics with their patients/clients
.
Can J Diet Pract Res
.
2016
;
77
(
4
):
163
9
. .
13.
Nielsen
DE
,
Shih
S
,
El-Sohemy
A
.
Perceptions of genetic testing for personalized nutrition: a randomized trial of DNA-based dietary advice
.
J Nutrigenet Nutrigenomics
.
2014
;
7
(
2
):
94
104
. .
14.
Jonas
MC
,
Suwannarat
P
,
Burnett-Hartman
A
,
Carroll
N
,
Turner
M
,
Janes
K
, et al.
Physician experience with direct-to-consumer genetic testing in Kaiser Permanente
.
J Pers Med
.
2019
;
9
(
4
):
47
. .
15.
Haga
SB
,
Kim
E
,
Myers
RA
,
Ginsburg
GS
.
Primary care physicians’ knowledge, attitudes, and experience with personal genetic testing
.
J Pers Med
.
2019
;
9
(
2
):
29
.
16.
McGrath
SP
,
Walton
N
,
Williams
MS
,
Kim
KK
,
Bastola
K
.
Are providers prepared for genomic medicine: interpretation of direct-to-consumer genetic testing (DTC-GT) results and genetic self-efficacy by medical professionals
.
BMC Health Serv Res
.
2019
;
19
(
1
):
844
. .
17.
VanBuren
C
,
Imrhan
V
,
Vijayagopal
P
,
Solis-Pérez
E
,
López-Cabanillas Lomelí
M
,
Gonzalez-Garza
R
, et al.
“Omics” education in dietetic curricula: a comparison between two institutions in the USA and Mexico
.
Lifestyle Genom
.
2018
;
11
(
3–6
):
136
46
. .
18.
Horne
J
,
Madill
J
,
O’Connor
C
.
Exploring knowledge and attitudes of personal nutrigenomics testing among dietetic students and its value as a component of dietetic education and practice
.
Can J Clin Nutr
.
2016
;
4
(
1
):
50
62
. .
19.
Whelan
K
,
McCarthy
S
,
Pufulete
M
.
Genetics and diet-gene interactions: involvement, confidence and knowledge of dietitians
.
Br J Nutr
.
2008
;
99
(
1
):
23
8
.
20.
McCarthy
S
,
Pufulete
M
,
Whelan
K
.
Factors associated with knowledge of genetics and nutritional genomics among dietitians
.
J Hum Nutr Diet
.
2008
;
21
(
6
):
547
54
. .
21.
Feero
WG
,
Green
ED
.
Genomics education for health care professionals in the 21st century
.
JAMA
.
2011
;
306
(
9
):
989
90
. .
22.
Pavlidis
C
,
Karamitri
A
,
Barakou
A
,
Cooper
DN
,
Poulas
K
,
Topouzis
S
, et al.
Ascertainment and critical assessment of the views of the general public and healthcare professionals on nutrigenomics in Greece
.
Per Med
.
2012
;
9
(
2
):
201
10
. .
23.
Braakhuis
A
,
Monnard
CR
,
Ellis
A
,
Rozga
M
.
Consensus report of the Academy of Nutrition and Dietetics: incorporating genetic testing into nutrition care
.
J Acad Nutr Diet
.
2020
. .
24.
Rankin
A
,
Kuznesof
S
,
Frewer
LJ
,
Orr
K
,
Davison
J
,
de Almeida
MD
, et al.
Public perceptions of personalised nutrition through the lens of social cognitive theory
.
J Health Psychol
.
2017
;
22
(
10
):
1233
42
. .
25.
Vallee Marcotte
B
,
Cormier
H
,
Garneau
V
,
Robitaille
J
,
Desroches
S
,
Vohl
MC
.
Nutrigenetic testing for personalized nutrition: an evaluation of public perceptions, attitudes, and concerns in a population of French Canadians
.
Lifestyle Genom
.
2018
;
11
(
3–6
):
155
62
.
26.
Vallée Marcotte
B
,
Cormier
H
,
Garneau
V
,
Robitaille
J
,
Desroches
S
,
Vohl
MC
.
Current knowledge and interest of French Canadians regarding nutrigenetics
.
Genes Nutr
.
2019
;
14
:
5
.
27.
Roberts
S
,
Singer
D
,
Solway
E
,
Kirch
M
,
Kullgren
J
,
Malani
P
.
Older adults’ views on genetic testing
.
University of Michigan National Poll on Healthy Aging
.
2018
.
[Retrieved from 2020 Jul 15]. Available at: http://hdl.handle.net/2027.42/145710
.
28.
Carroll
NM
,
Blum-Barnett
E
,
Madrid
SD
,
Jonas
C
,
Janes
K
,
Alvarado
M
, et al.
Demographic differences in the utilization of clinical and direct-to-consumer genetic testing
.
J Genet Couns
.
2020
;
29
(
4
):
634
43
.
29.
Linderman
MD
,
Sanderson
SC
,
Bashir
A
,
Diaz
GA
,
Kasarskis
A
,
Zinberg
R
, et al.
Impacts of incorporating personal genome sequencing into graduate genomics education: a longitudinal study over three course years
.
BMC Med Genomics
.
2018
;
11
(
1
):
5
. .
30.
Heuer
AJ
,
Geisler
S
,
Kamienski
M
,
Langevin
D
,
O’Sullivan Maillet
J
.
Introducing medical students to the interdisciplinary health care team: piloting a case-based approach
.
J Allied Health
.
2010
;
39
(
2
):
76
81
.
31.
Cormier
H
,
Tremblay
BL
,
Paradis
AM
,
Garneau
V
,
Desroches
S
,
Robitaille
J
, et al.
Nutrigenomics: perspectives from registered dietitians: a report from the Quebec-wide e-consultation on nutrigenomics among registered dietitians
.
J Hum Nutr Diet
.
2014
;
27
(
4
):
391
400
. .
32.
Collins
J
,
Adamski
MM
,
Twohig
C
,
Murgia
C
.
Opportunities for training for nutritional professionals in nutritional genomics: What is out there?
Nutr Diet
.
2018
;
75
(
2
):
206
18
. .
33.
Twohig
C
,
Adamski
M
,
Murgia
C
,
Collins
J
.
Nutritional genomics for nutrition professionals: Who undertakes online training and are they more knowledgeable, confident and involved?
Nutr Diet
.
2019
;
76
(
3
):
363
5
. .
34.
Brown
HD
,
Boonme
K
,
Imrhan
V
,
Juma
S
,
Vijayagopal
P
,
Prasad
C
.
Should “omics” education be a part of allied health profession curricula?
Genomics
.
2020
;
112
(
1
):
169
73
. .
35.
Mlodzik-Czyzewska
MA
,
Chmurzynska
A
.
The state of nutrigenomic education in Poland
.
Lifestyle Genom
.
2018
;
11
(
2
):
90
8
. .
36.
Tutty
E
,
Hickerton
C
,
Adamski
MM
,
Metcalfe
SA
.
Personal genomic testing for nutrition and wellness in Australia: a content analysis of online information
.
Nutr Diet
.
2019
;
76
(
3
):
263
70
. .
37.
Slater
NA
,
Rager
ML
,
Havrda
DE
,
Harralson
AF
.
Genetic variation in CYP2R1 and GC genes associated with vitamin D deficiency status
.
J Pharm Pract
.
2017
;
30
(
1
):
31
6
. .
38.
Wang
TJ
,
Zhang
F
,
Richards
JB
,
Kestenbaum
B
,
van Meurs
JB
,
Berry
D
, et al.
Common genetic determinants of vitamin D insufficiency: a genome-wide association study
.
Lancet
.
2010
;
376
(
9736
):
180
8
. .
39.
Bahrami
A
,
Sadeghnia
HR
,
Tabatabaeizadeh
SA
,
Bahrami-Taghanaki
H
,
Behboodi
N
,
Esmaeili
H
, et al.
Genetic and epigenetic factors influencing vitamin D status
.
J Cell Physiol
.
2018
;
233
(
5
):
4033
43
. .
40.
Pichler
I
,
Minelli
C
,
Sanna
S
,
Tanaka
T
,
Schwienbacher
C
,
Naitza
S
, et al.
Identification of a common variant in the TFR2 gene implicated in the physiological regulation of serum iron levels
.
Hum Mol Genet
.
2011
;
20
(
6
):
1232
40
. .
41.
Ganesh
SK
,
Zakai
NA
,
van Rooij
FJ
,
Soranzo
N
,
Smith
AV
,
Nalls
MA
, et al.
Multiple loci influence erythrocyte phenotypes in the CHARGE consortium
.
Nat Genet
.
2009
;
41
(
11
):
1191
8
. .
42.
Soranzo
N
,
Spector
TD
,
Mangino
M
,
Kühnel
B
,
Rendon
A
,
Teumer
A
, et al.
A genome-wide meta-analysis identifies 22 loci associated with eight hematological parameters in the HaemGen consortium
.
Nat Genet
.
2009
;
41
(
11
):
1182
90
. .
43.
Benyamin
B
,
McRae
AF
,
Zhu
G
,
Gordon
S
,
Henders
AK
,
Palotie
A
, et al.
Variants in TF and HFE explain approximately 40% of genetic variation in serum-transferrin levels
.
Am J Hum Genet
.
2009
;
84
(
1
):
60
5
. .
44.
Benyamin
B
,
Esko
T
,
Ried
JS
,
Radhakrishnan
A
,
Vermeulen
SH
,
Traglia
M
, et al.
Novel loci affecting iron homeostasis and their effects in individuals at risk for hemochromatosis
.
Nat Commun
.
2014
;
5
:
4926
. .
45.
Living systematic reviews Cochrane Community [Retrieved 2020 Jul 15]. Available from: https://community.cochrane.org/review-production/production-resources/living-systematic-reviews
.
46.
Grimaldi
KA
,
van Ommen
B
,
Ordovas
JM
,
Parnell
LD
,
Mathers
JC
,
Bendik
I
, et al.
Proposed guidelines to evaluate scientific validity and evidence for genotype-based dietary advice
.
Genes Nutr
.
2017
;
12
:
35
. .
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