Genetic testing hasn’t been around long, but nutrition and diets have. When combining the two, a personalized nutrition plan can be created. Nutrigenomics is a multidisciplinary science that studies the interaction of nutrition and human genes. Nutrigenomics and its application have great potential to change health care and individuals’ lives. (German, 2011) An individual’s results from genetic testing give a list of possibilities for the future of that individual. After an individual knows their risk factors and gene variants, he or she can make choices that can alter their gene expression. (Hunt, 2015) Individuals’ gene expression is strongly shaped by the environment, which can be altered by choices such as diet. (Grayson, 2010) Various questions arise from the idea of using genetic testing and using the results to create a personally tailored diet.

Nutrition begins to affect gene expression even before birth. According to Patricia Queen Samour, MMSc, RD and Kathy King, RD, LD, what mothers consume and what children consume in the early, developmental stages of life have a direct impact on the child’s gene expression. In the book titled “Pediatric Nutrition,” Samour and King discuss child nutritional assessments. Along with Susan Bessler’s research input, chapter three claims all children receive an in-depth nutritional assessment and the assessment is not practical nor efficient for aiding the trained personnel in providing quality, prenatal nutrition care. The authors suggested that instead, a well-designed nutritional screening should be administered. The chapter claims this screening compares to be much more effective for identifying children’s nutritional care needs. Each child needs to be screened to assess nutrition risk. (Samour, P. Q., & King, K. ,2012) The application of genetic testing for Pediatric nutrition and health care would drastically aid trained personnel in this process. Health care personnel could use genetic testing and its results to see if a child will be at nutrition risk or risk for disease. Genetic testing has the ability to predict. This testing is completed to identify a person’s current disease status or if he or she will develop a certain disease. This testing can determine if a person could pass a disease onto offspring. Genetic tests also establish whether couples are at a greater risk than the general population for having a child born with a genetic disorder. (Hunt, 2015) (The Columbia Encyclopedia, 2016).

Humans are 99.5% the same. The 0.5% is what makes individuals different. The genetic code is a sequence of nucleotides and the 0.5% makes up a large amount. (German, 2011) According to King and Samour, genetic code can influence an individual’s health status. As previously explained, the beginning of life is crucial for growth and development, and what mothers and children eat can affect the individual’s genes. During this time, what individuals eat can also regulate traits including the development of diseases even decades later. (King and Samour, 2012) Data collected during the WWII Dutch Famine showed a strong correlation between nutrition and gene expression. The study exhibited that malnourished mouthers’ children showed to be at much higher risk for obesity, breast cancer, and cardiovascular disease later in life. (Roseboom, Tessa J., Ravelli, Anita C.J., Osmond, Clive, 2003)

Nutrient deficiencies can affect genes but there are various other factors that have influence. Samour and King claim that nutrient deficiencies or excess, dietary components, toxins, bacteria and viruses, exercise and activity, alcohol and other drugs, circadian rhythms, and others we haven’t yet discovered all have an effect on gene expression. Some genes can tell how food is metabolized. Others can tell us whether carcinogens in cooked meats will influence the development of colon and prostate cancers. And others can predict inflammatory response and efficiency of DNA repair/replication. If individuals know more about their own unique risk factors, they might be more likely to make healthier choices; choices that could improve genetic expression. (Grayson, 2010)

Gluten-free diets have become a hot topic of interest in Americans in 2016. A study investigated a specific human gene that appeared to correlate with gluten intolerance. Furthermore, this study examines the presence of an antibody in patients by using genetic testing. Through research, it was found that genetic testing was useful in the early diagnosis of gluten genetic intolerance in individuals. Researchers concluded that the testing and searching of a specific antigen may help physicians diagnose patients who may or may not be feeling ill and do not currently meet Celiac Disease diagnosis criteria but are at high risk for expressing the disease in the future. (Quaglia, S., De Leo, L., Ziberna, F., Vatta, S., Villanacci, V., Granzotto, M., … Not, T., 2014)

The testing process, itself, is not invasive. Genetic testing can be performed via cheek swab, blood, or another tissue sampling. Any sample that contains human cell nuclei can be used for testing since all cells have the same genes. DNA is extracted from the sample, then amplified, sequenced, and assembled into a readable format for the patient. Researchers can then test genes or the full genome. Once genetically screened, individuals can use the results to receive their own tailored dietary prescription. (Grayson, 2010)

Depending on the type of insurance, an insurer may not cover the cost of genetic testing. Private insurance companies infrequently cover the cost of genetic testing if the results show a rare disease. However, a mass amount of the time public and private health insurers will not cover the cost of genetic testing. (Genetics Home Reference, 2017). Full genome sequencing is relatively too expensive for most Americans. According to Genetics Home Reference, full genome testing and sequencing may cost upwards of $10,000. Most genetic testing services only test a select number of genes. Testing only certain genes can range from $100 to $2000 depending on the type and complexity of testing. (Genetics Home Reference, 2017)

Worldview

Now that we have a thorough background on the science behind genetic testing and its implications, let’s take a closer look at the Christian viewpoint on nutrigenomics, genetic testing, and the use of sequencing results to generate a personalized nutrition prescription.

Understandably, many individuals considering genetic testing are concerned about what happens to their genetic information and results once they are given. Fortunately, if you reside in the United States you and your genetic information are protected in many ways. Americans are protected by the Genetic Information Non-discrimination Act (GINA), which prevents health insurance establishments as well as employers from discriminating based on the individual’s genetic information. Specific legislation around how someone’s genetic information is used and protected varies by jurisdiction. One organization efficiently protects individuals. That organization is known as UNESCO (the United Nations Educational Scientific and Cultural Organization). A summarization of the organization’s mission to protect individuals is as follows:  ‘heredity and the passing of genetic information is who we are. It is what we all have in common and yet still makes us unique. We should not be harmed nor constrained because of our genetic information.’ (Farr, 2016)

I was happy to find that Americans are protected in various ways. With technologies, such as genetic testing, I always fear how far medical professionals and health care owners will take testing. Medical technology has advanced a tremendous amount in the past 50 years, but where do we draw the ethical line? I believe we are to continue progressing in medical technology and it is up to the professionals and authority to decide not to use technology to cross ethical boundaries. Genetic testing enables us to test for good and bad. We should pursue it. And we should pursue good and know that our genetic information isn’t going to get us dropped from our health insurance.

There is one exemption. Life insurance is not required to follow the guidelines of the previously listed acts and organizations.  As genetic testing explodes, health insurers are banned from denying coverage based on results. The same doesn’t apply for life insurance. You could very well be an ideal candidate for life insurance with no current medical concerns but your application for life insurance can be declined. The Center for Genetics and Society published an article titled “If You Want Life Insurance, Think Twice Before Getting A Genetic Test.” This article illuminates a real-life story about a thirty-six-year-old woman who applied for life insurance. Not long after submitting her application, she found that she was denied life insurance because of genetic testing results. She was currently healthy, employed, and had no concerning medical issues but was denied life insurance because she tested positive for BCRA 1 gene. One in four-hundred women in the United States have the BCRA 1 or 2 gene, which is associated with a high risk of breast and ovarian cancer. (Farr, 2016)

While there is a strong correlation with individuals having the harmful BCRA gene 1 mutation and breast and ovarian cancer, it still does not mean that the individual will certainly develop cancer. Therefore, should a life insurance agency be able to deny a person with possible future disease onset from an ethical standpoint? It appears they can, legally. Coming from a Christian perspective, I see this to be a problem. I am seeing that not all insurance is created equal and I acknowledge that the industry makes it so that insurance businesses model would likely not survive if the insurers are forced to accept individuals with high risk and various genetic diseases. In “Genetic Secrets” the author, Mark A. Rohstein, explains that insurances engage is a certain degree of “discrimination between claims” even though there are limits. For example, insurers distinguish claims between men and women because women often live longer than men. This is ethically acceptable if this “discrimination” isn’t taken to a further degree. (Rothstein, 2000). As a Christian, I believe insurance agencies should still be held to a high moral responsibility when distinguishing between claims.

For the genetic testing information portion of this, my faith brings me to address several questions and state my stance. Should genetic testing be allowed? Yes, I strongly believe that genetic testing should be an available option. God is sovereign over all and knows the future. He allows us free-will but He also gave us the capability to invent technology such as genetic testing. I believe we are to use it to our advantage. When someone knows their gene variants and risk factors, they have the opportunity to make choices to alter their gene expression. Knowledge is power. Laura Esserman, a surgeon and breast cancer oncology specialist at UC San Fransisco, says that people who get their genes tested and find a mutation can do something about it. Esserman also says that individuals in this situation can use the results to “drastically reduce their risk.” (JAMA, 2010) I side with Essermna’s optimism toward genetic testing. It can be used for great things and advance health care a tremendous amount. However, there is more controversy yet to discuss.

First off, genetic testing cannot tell us as much as we would like. Testing can tell us how effective certain lifestyle interventions will be for you. It can identify a rare disease and show a risk of future diseases, such as arrhythmias, cancers, heart failure, Alzheimer’s, aneurysms and strokes, Type 2 diabetes, etc. Results can also show current diseases. However, we should be aware that some associations between gene variants and diseases are based on older genetic research. We need to further our research. Genetic testing can also identify diseases that you carry but which don’t affect you. This mainly pertains to individuals wishing to know if they are a carrier and their likelihood of passing on a gene mutation to offspring. Couples can use genetic screening to predict the potential diseases and traits of their offspring. Along with shaping potential food choices, genetic screening may also be useful in exercise prescriptions. Specific genes have been identified with athletic performance. Newer studies show evidence of gene expression and its correlation behavioral traits.

As I previously stated, genetic testing can be valuable in specific situations but cannot tell us as much as we would like. It cannot do the wonders we wish it could because knowing our DNA sequence alone is simply not enough. The human genome is complex and the 0.5% that makes us unique is not the only source of genetic variation. As I explained earlier, our environment strongly influences gene expression. And while certain gene variants show a certain correlation to a specific illness or disease, you can still become ill from illness even if you are not a carrier with a genetic predisposition. For example, while we know about two gene variants (BRCA1 and BRCA2) that contribute to breast and ovarian cancer, most breast cancer patients don’t have those gene variants. Only about 5-10% of diagnosed breast cancer individuals actually possess these variants. At this point, we simply haven’t identified all possible gene variants. Having one given gene variant isn’t necessarily a death sentence, nor is possessing another gene variant your “set for life” card.

What would you do? I firmly believe that genetic testing can and should be used to tell people what lifestyles will be effective for them. God gave us these bodies (our temple) for our life here on earth and we need to take care of them. In the same way, I believe it is important to use the set of possibilities generated from genetic testing to see whether we might possibly have a disease. This allows us to lessen our risk and make responsible decisions. The same goes for couples using genetic testing. Depending on the results, couples may or may not chose to have children. Or they may choose to abort a pregnancy if the fetus because of genetic screening results revealing a concerning genetic predisposition. This is where the use of genetic testing gets extremely controversial. Should people have access to genetic testing for gene mutations? The controversy starts here. The results will be given to individuals who received screening and they then decide to act upon the information.

Will this make people act differently and encourage different decisions that affect the course of that person’s life and the lives of those around them? Personally, I say that genetic testing should be available as an option to screen for various things and an individual receiving results has the freedom to act how they wish with some exceptions. As a Christian, I follow my faith firmly. In this aspect, I find most decisions people make in reaction to genetic screening findings are acceptable. I draw the line at abortion and the taking of one’s own life. A parent or individual receiving findings that predict or diagnose a disease or illness may believe it is best to end life before the illness progresses or is expressed. This is not an acceptable decision to make. God frowns on this and I do not find it acceptable in any way.

While genetic screening can give us some useful information, it cannot predict how we will feel about the results. This is about whether or not we should have access to this kind of knowledge. I believe we should because having access to knowledge of what our genome possesses can aid us in improving our health. And good health often coincides with happiness and God wishes to see his children happy.

Some might argue that this information is the same as “seeing into the future” or “playing God.” First off, the future is unknown, and therefore to us, it is not set and neither are pre-diagnoses because the results only allot a set of possibilities. God is the only one who knows the future. As for individuals who see this testing as “playing God,” I say that they are giving themselves far too much credit. We are simply incomparable to God. He is the one and only God. We cannot do as he does in this capacity.

Genetic testing also brings up controversy directly toward Christianity. Some argue that genetic testing can show evidence that leads to the conclusion that not everyone on this earth originated from Adam and Eve. There may be some validity to this but the argument cannot directly support its claim. I do not side with this viewpoint. My support is that Biblical parameters can explain human genetics. It takes a lot of background to explain but it comes back to the fact that humans are 99.5% genetically similar. The opposition claims that humanity has a primate ancestry and has participated in evolution. They have ignored the possibility of a historical Adam from the outset. An article I found explains it well by saying, “but if Adam was created with DNA variations, then one would not have to postulate astronomical mutation rates.” This article discusses both sides of the issue as the science supports evolution and Biblical parameters support my perspective. However, later in the article, it is examined that when a practical Adam and Eve model is tested, it matches the genetics of the human race today. This clearly supports the idea that humans today are distant ancestors of Adam and Eve, which credits the Bible and the existence of God. (Thomas, 2011)

And lastly, I further support my Christian perspective on this topic with two Biblical references. Other than the popular verse which describes how God expects us to care for our temple/body, I found a verse in Psalms that speak toward the use of genetic testing. Psalm 127:3-5 reads, “Behold, children are a heritage from the Lord, the fruit of the womb a reward. Like arrows in the hand of a warrior are the children of one’s youth. Blessed is the man who fills his quiver with them! He shall not be put to shame when he speaks with his enemies in the gate.” The other verse is Genesis 1:28. This verse strongly supports my perspective in that God blesses man and instructs him to “be fruitful and multiply and fill the earth and subdue it, and have common dominion…over every living thing that moves on the earth.” The fallen nature of the world as a result of the consequences of sin is seen in sickness, disease, war, injustice, etc. Since we are created in the image of God, each of us has been given gifts to use for the glory of God. Therefore, using genetic testing to provide a list of possibilities for individuals is the application of having dominion over every living thing and acting in a redemptive way for good. (Crossway Bibles, 2007)

Recent advancements in the field of genetics have opened up major opportunities for medical progress, including earlier detection of disease and specifically personalized treatments that could wring savings from the lengthy healthcare expense list. This aligns with my Christian perspective and faith. From the Christian perspective, I see nutrigenomics and genetic testing to raise questions and controversy. I believe we should have access to retrieving genetic test results. It’s hard to predict how we’ll act when given potentially life-changing information. We all must keep in mind that having access to knowledge about our genotype brings a new level of self-responsibility. It is up to us to take care of our body (temple) to the best of our ability and make healthy choices that affect our genetic expression.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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