The New Food Frontier

Instructor’s Comment: Each quarter, our new team of journalism students brainstorms ideas and strategies for their “best story ever.” Mr. Lavine picked a terrific untold story that wasn’t easy to tell. The team loved the idea, but experts wouldn’t call David back or discuss the controversy over the future of food. So what do you do? Find other experts—even if they’re across the country—and keep calling. Through polite persistence and adherance to one of our mantras, “the harder you work, the luckier you get,” he got a key scientist at NYU who helped put the story in context. Then he told a clear, balanced, dramatic tale full of news we can use. And in keeping with another of our mantras, he made it both interesting and fun to read. Congratulations, David!
—Stephen T. Magagnini, Sacramento Bee, University Writing Program

It’s the year 2025 and the old adage “you are what you eat” is more personally meaningful than ever before.

You report for a routine medical exam and submit a saliva sample for lab analysis. After a few days, you get the results: among other things, you have a hard time processing caffeine; consumption of coffee might lead to a greater risk of heart disease. You have difficulty metabolizing sugar; a diet high in sweets will increase your chance of developing Type 2 diabetes. You lack the ability to digest dairy protein; drinking milk might raise your risk for schizophrenia.

Possessing a diet plan tailored to your individual DNA, you now hold the secret to your long-term health and wellness.

Along with your analysis, you are sent a scannable “DNA Card.” With that card, you head for the supermarket. At a kiosk outside the grocery store, you swipe it. Out pops a personalized shopping list that suggests customized food commodities tailored specifically to your genetics.

The science is complex and its future application multifaceted and controversial, but the premise is simple: eat right for your genotype.
Synopsis

In the scientific community, food is often no longer viewed just as a means to provide human energy and essential nutrients.
“The first wave of nutrition research was largely an effort to identify vitamins and essential nutrients all based on trying to prevent malnutrition,” said Dr. M. R. C. Greenwood, Director of the Foods for Health Institute at UC Davis. “But now that we understand how to prevent nutrition disease, there is a real push to optimize health. And this is a much more personal and individualized effort.”

According to Professor Raymond Rodriguez, Director of the Center for Nutritional Genomics at UC Davis, research in the last six years has shown convincing evidence that your diet interacts directly with your DNA and uniquely makes you . . . you.

“It’s now clear that nutrition and food are important aspects of an individual’s health and wellbeing,” Rodriguez said. “It’s the most common interaction with our environment—second only to the air we breathe.”

On February 14, 2009, scientists from the University of California at Davis, among others, discussed the future of food and diet during the annual meeting of the American Association for the Advancement of Science, held in Chicago. Greenwood helped organize the conference, and Professor Bruce German, UC Davis Food Science and Technology faculty member, was a key speaker.

“The future of the food industry is in personalized food commodities,” German said. “There will be an industrialization of personalized commodities that utilize our increasing understanding of new science on an individual basis. The plate is going to get personal.”
Consider this example.

Chances are, you know him. He’s the guy who can eat whatever he wants; the breakfast of champions—five eggs, four pieces of bacon and a stack of pancakes with butter and syrup. He doesn’t gain a pound or see the slightest symptoms of ill health, nor does his family history suggest it.

Then, most likely, there’s you. For breakfast, you eat a bowl of oatmeal and an apple. But somehow you’re 15 pounds overweight and the doctor tells you you’re at risk for heart disease.

“Individual difference in dietary response has been known for hundreds of years,” Rodriguez said. “But what was once thought of as folk wisdom and common knowledge is now supported by scientific research.”

The food industry has acknowledged a strong interest in applying this science to personal food commodities.

In a report released on November 6, 2008, researchers of the Nestlé Research Institute in Switzerland, a division of one of the largest food corporations in the world, recognized the potential impact the science of personalized nutrition would have on their food industry and future products.

Similarly, Emily Korns, Manager of Communications of Health and Nutrition for Mars Inc., a giant in the snack foods industry, says “the industry is enthusiastic about the development of foods that will optimize personal health and wellbeing.”

Even today, the supermarket sells products geared towards vastly different groups of people; for example, sports recovery drinks for athletes, gluten-free bread for those with a gluten allergy, and sugar-free products for diabetics or those trying to cut down on calories.

“It isn’t wild to imagine a mass customized food system,” German said. “The supermarket has vastly changed in the last 10 years and it will continue to do so.”

Food personalization isn’t revolutionary. The difference in the future, however, will be the method used for customization. And though promising in theory, this next generation science may encounter ethical problems in the food industry, due to hasty exaggeration in health claims. Additionally, formidable concerns within academia regarding the ramifications of the science exist as well.

The Science
The science called nutritional genomics is a second-generation progression that evolved from the Human Genome Project in the 1990s.
According to Professor Rodriguez, the human genome is the complete set of instructions for all biological processes that occur from conception to death.

“It’s the information inherited from our parents and passed on to our children,” he said. “It’s what makes humans so similar but also vastly different from each other.”

In 2003, the Human Genome Project was completed, human DNA was sequenced, and the coding was identified.

The project established that the human genome contains an estimated 20,000–25,000 genes, which are elements that contain biological coding information. Of these genes, humans share more than 99.9% of the same DNA. Yet, clearly, people are all very different.
It was this revelation that prompted further investigation.

“We came to realize that the remaining variance in everyone’s biological code is responsible for different reactions to their nutritional environment,” Rodriguez said.

“Our genes all interact and respond in different ways to things like pollution in the air, medicine and, of course, nutrition.”
These individual responses result from small differences in our genetic code called “single nucleotide polymorphisms” (SNPs).

Nutritional genomics is an umbrella term that refers to both nutrigenomics and nutrigenetics. Nutrigenomics is the study of how nutrition influences the physical expression of our genes in the context of our individual genotypes (the genetic makeup of an individual). It seeks to explain cause and effect relationships, such as how certain dietary factors can reduce one’s risk of cancer and heart disease. Nutrigenetics, similarly but differently, seeks to identify why our individual DNA responds to dietary components uniquely based on our SNPs. For example, it seeks to explain why some people can eat all the saturated fats and carbohydrates they want and not gain a pound or experience an increase in blood cholesterol.

“Ultimately, our goal is to help people better manage their health through nutrition by matching their diets to their unique genetic makeup,” Rodriguez said.

The Controversy
Dr. Marian Nestle (no relation to Nestlé), Professor of Nutrition, Food Studies, Public Health, and Sociology at New York University and author of Food Politics: How the Food Industry Influences Nutrition and Health, sees nutritional genomics as more hype than promise.

“I think nutritional genomics is about developing new added value products,” Nestle said in an e-mail interview. “It’s about marketing, not health. We already have all the foods we need to eat healthfully.”

Nestle also believes that even if the science succeeds it will contribute to a schism between the haves and have-nots.

“The people who need [personalized nutrition] most will not be able to afford it,” she said. “The people who love the approach most are the ones who need it least.”

But Professor Rodriguez respectfully disagrees.

“Dr. Nestle’s perspective is from the traditional nature versus nurture debate,” he said. “The traditional view was that chronic diseases like heart disease and Type 2 diabetes were due to poor nutrition. Now we know that there are genetic factors (SNPs) that, in response to diet, can make these diseases worse in some people. Nutritional genomics integrates both nutrition (nurture) and genetics (nature) and it is our job at the Center to provide the scientific basis for this interaction.”

Rodriguez also maintains that the research at the Center for Nutritional Genomics is objective and unbiased, because it does not receive funding from any food or genetic testing companies.

“There will always be a commercial extension and controversy will undoubtedly follow,” he said. “But, as we do more research, I believe it will become more clear that the future of nutrition will include nutritional genomics. Those now opposed will eventually realize it will be a very cost-effective means for preventative health.”

Similarly, Dr. Wylie Burke, Professor and Chair of the Department of Bioethics and Humanities at the University of Washington, says that the most important test for nutritional genomics will be establishing efficacy through research and clinical practice.

“The biggest ethical concern at this point in time is to assure that the necessary research is done to gather good quality evidence on the benefits and risks of nutritional genomic testing,” Burke said in an e-mail interview.

Like all things new, there are those who will provide support and those who won’t until convinced otherwise. And while nutritional genomics is largely supported in academia, there are still those who worry about its consumer application for reasons beyond science.

Toby Citrin, Professor of Health Management and Policy, and Director of the Center for Public Health and Community Genomics at the University of Michigan, says there are many more ethical issues in nutritional genomics than just the problems in its application.

“Nutritional genomics is a promising and exciting field,” he said. “But it has the potential to have devastating social implications.”

Citrin says that while the academic community will be able to consider individual genetic differences in purely scientific terms, “there will be those who will use it to define genetic divides in race and ethnicity to a social detriment.”

Nutritional genomics has already recognized genes that create racial distinction. This is seen in the gene responsible for milk digestion, for example. Adults with Northern European blood most likely can digest milk sugar, while adults with Southeast Asian and African ancestry most likely can’t.

Among those sensitive to racial and ethnic stereotyping in a social context, this type of definitive genetic division is problematic—a distinction that can potentially lead to both social and marketing discrimination by exploiting misled consumers.

“Nutritional genomics is a science sold directly to the consumer,” he said. “And unregulated marketing that makes unsubstantiated claims about product efficacy and purpose can discriminatorily target ethnic groups, as well as others, who aren’t properly educated about the science.”
Despite the ethical implications, Citrin supports genomics research.

“The key is in a balancing act between the potential benefit in the science and the management in the availability, regulation, and ethics of it as well,” he said. “And this responsibility is with the government.”

The government has acknowledged the potential in genomics science and has already established a role in its regulation, but only moderately.

According to www.genome.gov, on May 21, 2008, President George W. Bush signed the Genetic Information Nondiscrimination Act. The act aims to “protect Americans against discrimination based on their genetic information when it comes to health insurance and employment . . . . It will pave the way for people to take full advantage of the promise of personalized medicine without fear of discrimination.”

According to Rodriguez, this was a big step for the future of genomics. “This was a milestone. [It] creates a lot of protection for the public and therefore more opportunity for the science of human genomics.”

The government has also taken a role in regulating direct-to-consumer nutritional genetics tests available through companies on the Internet.

On July 27, 2006, the U.S. Government Accountability Office released an analysis, “Nutrigenetic Testing: Tests Purchased from Four Web Sites Mislead Consumers,” that concluded the service provided by four unidentified direct-to-consumer genetics companies “mislead consumers by making predictions that are medically unproven and so ambiguous that they do not provide meaningful information to consumers.”

For the potential in genomic science to be achieved, policy must establish a means “to assure that test developers provide honest and clear information for consumers about the substantial uncertainties about benefit and harm in this use of genetics,” Dr. Wylie Burke explained.

Direct-to-consumer genetic services, however, are common throughout the country, unregulated due to a technicality in company classification.

GeneWize Life Sciences is one such company. A Florida-based business established in August of 2008, although new to the market since the government review, arguably offers the same over-the-Internet direct-to-consumer services that the government called “unproven” and “ambiguous.”

According to Robert Hoekstra, Director of Corporate Culture and Compliance for GeneWize Life Sciences, the company sells their LifeMap Nutrition™ System for $199.99, “a technologically advanced, DNA-guided, customized nutritional system based on your own unique genetic code.”

The process is simple.

After the company receives your one-time payment of $199.99, they send you a DNA collection kit. Once you receive the kit, you swab the inside of your mouth and mail the swabs back to their laboratory for analysis.

Sound familiar? It’s nutritional genomics of tomorrow, available today.

Once your DNA is analyzed, “GeneWize will send you a one-month supply of a supplement formulated to your individual genetics,” Hoekstra said.
After the initial supply, the supplements cost $99.99 for each month supply—roughly a cost of three dollars per day.

According to the GeneWize website, “GeneWize offers the only patented, FDA-reviewed, non-invasive, self-administered DNA collection system available.”

But GeneWize classifies itself as a nutritional supplement company, explained Hoekstra; therefore, despite the language on the website, its product’s efficacy is not subject to regulation by the FDA.

“The ingredients we use in our products are regulated,” Hoekstra said. “But we are not.”

The FDA website states, “Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.”

GeneWize also provides an explicit disclaimer for its service—“our products are not intended to diagnose, treat, cure or prevent any disease.”

For these reasons, GeneWize legitimately provides a lawful service in terms of current government policy. And Hoekstra does not consider GeneWize misleading in the least.

“Like a caterpillar who needs all its essential nutrients and nutrition to morph into a beautiful butterfly, we all need good nutrition to reach our potential,” Hoekstra said. “It all comes down to intuition. Does eating right make you healthier? I think so. And we provide those needed nutrients specifically for you.”

Professor Toby Citrin believes, in ethical terms, this type of marketing ploy is problematic for the science and its future.

“This is where the government policy falls short,” he said. “This is the type of misinformation that will continue to surround the science until it’s regulated.”

Professor Ray Rodriguez, however, does not believe it is as bad as it might seem.

“This type of product is not any less safe than any other supplement you can buy,” he said. “There is always a tendency for the private sector to jump in too early and this is seen in all technology. MacWrite was an early effort for word processing software and it was terrible compared to what’s now available. But today Microsoft Word exists and it’s great. With proper oversight, this type of industry has the potential to be tremendously successful despite the early entry.”

The Application

Ethics and controversy aside, the food industry is eager to apply this personalized nutrition to future food commodities.

Emily Korns of Mars Inc. is enthusiastic about the development of personalized foods for health and wellbeing.

“We are really excited about the future and already developing products with specific health application for the benefit of the individual consumer,” Korns said. “We’re already getting into the game by developing bioactive compounds for personal health.”

Similarly, Nestlé’s Martin Kussmann and Laurent Fay released a report on November 6, 2008, “Nutrigenomics and Personalized Nutrition: Science and Concept,” that addressed nutritional genomics and its influence on the industry.

“Today’s power of [nutritional genomics] lies in improving our understanding of diet–gene interactions,” said Kussmann and Fay in their report. “Tomorrow, these tools may become applicable to consumer assessment and advice. Eventually, the Nutrigenomics-rooted concept of personalized nutrition may translate into the development of new food products that target, if not individuals, at least groups of people with similar metabolic [conditions] and genetic risks.”

Bruce German, Professor of Food Science and Technology at UC Davis, agrees that personalization of food is the future of the industry.
“Food companies can’t discuss future product details for proprietary reasons,” he said. “But you don’t need detailed plans to realize there is already a definitive trend towards personalization of products. And it will only continue.”

“Over the next ten years, there will be a real push from industry and a large collaborative effort with research institutions to develop these products,” Korns said.

German uses Starbucks as an example.

“When you buy a cup of coffee from Starbucks, you pay for the experience as well as the ability to change it to your personal preference,” he said. “It’s just a cup of coffee. But what distinguishes one cup of Starbucks coffee from the next is you. You can customize the ingredients; you can customize the temperature; and you get your name on it.”

While this service has nothing to do with personalized health, it’s a concept that is vastly different from the uniformity in food commodities or the “McDonalds-ization” of the food products in the past years, he explained.

When the technology is ready to incorporate personalized nutrition, delight (e.g., taste), and food safety, “it’s a model that can be applied,” he said.

But the application won’t be an easy road, either.

“Food is very personal and it’s as much a sensory and emotional experience as it is a functional one,” German said. “It will be a challenge to develop personalized products that integrate health and delight; otherwise consumers will be disinterested.”

And even if these products are effectively developed, they need to be affordable to the average buyer. Otherwise the development is in vain.
“The real difficulty for food manufacturers will be engineering customized food products that are accessible for the normal person,” Korns said. “There are already products available that address certain genetic disorders, but they are very expensive. That’s not ideal.”

Food and nutrition policy will also present a challenge.

“When food manufacturers want to introduce a new product with a health claim, it’s their responsibility to provide definitive research and clinical data that’s subject to stringent review by the FDA,” Dr. Greenwood of UC Davis said. “And this is difficult and expensive.”

Food was once hunted and gathered, later farmed and cultivated. It has overcome scarcity and drought and seen both small and large-scale industrialization—greatly evolving over time.

The next notch on the food timeline seems simple in theory: eat right for your genotype. But before this promising science of personalized nutrition reaches a widespread consumer market, it faces a long road. The end of that road, however, is hopeful for human health and delight.

Personalized nutrition is the new food frontier.