Personalized analysis of the genome is a rapidly expanding market. Initially focused on the determination of some risk marker genes, especially cancer, the offer now extends to nutrition in the broad sense. Progress in sequencing has lowered the price of an individual’s entire genome sequencing from $ 100 million in 2001 to $ 10 million in 2006 and about $ 1,000 today (1). Illumina, a startup specializing in sequencing, announced in early 2017 a test for about $ 100 “for soon” (2).
Actual available consumer offers propose a partial analysis of the genome and focus on ancestors, risk factors for disease or response to drugs. Prices range from a few tens of dollars to several hundred, for analysis of a sample of saliva and 3 weeks waiting before the results.
Nutrition offers have arise and are targeted at two types of people: people who want to lose weight and people who want to optimize their lifestyle for better performance. The genes analyzed are supposed to give information about the body’s ability to develop muscles, burn fat or improve physical training efficiency. For example, Fitnessgenes summarizes the genes analyzed and the functions they “control” on their website.
To give you a rough idea, here is an excerpt of the information given on the AKT1 gene:
The AKT1 gene encodes an enzyme involved in muscle building and metabolism. Some of us carry a particular version of this gene linked to metabolic factors involved in recovery, as well as VO2 max in response to aerobic exercise. The results of your FitnessGenes indicate which version of this gene you are wearing.
The AKT1 gene contributes to the expression of the enzyme AKT1 (also known as PKB-α), an important molecule involved in the regulation of many processes including muscle growth and metabolism. It is thought to be a mediator of insulin function and increases the absorption of glucose by muscle, fat cells and liver cells, among others. A particular version of this gene is believed to influence our basic metabolic processes and in response to stress.
Experiments have shown that an increase in the expression of the AKT1 gene has an anabolic (growth) effect on muscle and bone and that a decrease in the expression of this gene has a catabolic (degradation) effect on fats.
FitnessGenes offers formulas that range from simple analysis ($199 – €187) to a 20-week coaching program to “build muscle” at $449 (€423), including genetic analysis. Other companies offer genome analysis coupled with personalized advice based on customer expectations: Nutrigenomix, an Ontario company, promises to analyze 45 health-related genes (Personalized Nutrition) or Sport (Optimize Performance), but works through health professionals who set the prices of their accompaniment. DNAFit, based in London, proposes the analysis of 23 genes, and the formulas range from £99 (€120/$128) for food-related information only to £249 (€294/$322) for feed-related information and physical activity.
If the consumer market of nutrigenomics still seems very immature, a lot is written on it. The testimonies of users are multiplying on the Internet and the enthusiasm of the media does not give way, at least in the Anglo-Saxon countries.
In 2013, the FDA banned 23 & Me from commercializing its tests and health-related results, which temporarily halted the expansion of this market, but in 2015 the company resumed this activity and, as we have seen, others also. In France, the National Consultative Ethics Committee examined this question as early as 1991. The resulting recommendations indicate that “the sampling should remain a medical procedure and be covered only by a medically recognized indication”, “the communication of the results in the context of a medical diagnosis should be made via ‘A doctor who can give all the information on their meaning’.
In 2016, a new opinion of the CCNE completed these recommendations, emphasizing the weak link between the presence of genes and the reality of a characteristic: genotype is not the phenotype, and the influence of epigenetics, intestinal microbiota and other external factors on metabolism have been widely discussed in the scientific community.
The current French legislation, based on the laws Relating to bioethics in 1994, does not allow this market to develop on French soil: genetic tests are limited to medical and scientific research. Nevertheless, it is very easy to go through a US or British company to carry out the tests, if you can read English. The Anglo-Saxon market is developing very strongly, in a much more permissive legal framework, and the databases accumulated by some American companies leave room for thought about the possibilities of calculations of correlations between genotype and metabolism.
While there is hope of a rapid improvement of knowledge in this field, there is a risk of developing services that have little scientific basis for making recommendations to consumers about their diet and lifestyle, or that will not respect their fundamental rights, particularly in terms of data confidentiality and privacy.
(1) Wetterstrand KA. DNA Sequencing Costs: Data from the NHGRI Genome Sequencing Program (GSP). Date of consultation April 2017.
(2) StatNews, Illumina says it can deliver a $100 genome — soon, Date of consultation July 2017
(3) National Advisory Committee on Ethics, 1991, Opinion on the Application of Genetic Tests Individual studies, family studies and population studies, Date of consultation April 2017