Claims-making in nutrigenomics: A policy-driven analysis of marketing and media (2006-2009)
Affiliated staffMatt Reed and Steve Hughes (Egenis), David Melzer and Nicky Britten (Penisula Medical School)
Co-funded by the Wellcome Trust, Biomedical Ethics Programme
Nutrigenomics — the study of the interactions between nutrition and the genome — promises to give genotype based dietary advice. Some commercial companies are selling nutrigenetic tests online and in select retail outlets. Policy-makers and scientists have accused the companies of misleading the public about the validity of tests. It has been suggested that information provided to the public about nutrigenetic tests should be regulated.
- To analyse marketing, media and scientific messages about commercial nutrigenetic tests and nutrigenomics more generally in order to assess what exactly what is being claimed about these tests and the science more generally.
- To explore what cultural symbols around food, genes, medicine, science and lifestyle are associated with nutrigenomics.
- To examine broader social and political agendas, such as notions of individual responsibility and individuals’ right to “choose” health-care and products they want, that are being supported in discourses on nutrigenomics.
MethodsIn the first phase we have analysed the websites of seven commercial companies selling nutrigenetic tests online. We also analysed UK and US media coverage of nutrigenomics between 2001 and 2007.
The second phase of the study will involve interviews with key scientists and stakeholders in nutrigenomics.
The study will also involve attendance at select nutrigenomics conferences and policy events to contextualise the media, marketing and interview material.
- On their websites commercial companies emphasise that they are testing for polygenic susceptibilities, merely indicating a risk of disease, not for single gene disorders that determine health and illness. Critics in the media accuse the companies for selling tests of poor validity and predictive power.
- Commercial companies frame the purchase of nutrigenetic tests as increasing consumers’ power to decide about their own health. Critics charge the companies for misleading the public, arguing genetic information is too complex to be understood without the guidance of a qualified clinical professional.
- Many nutrigenetic companies recommend their customers to follow rather broad healthy eating guidelines, allegedly based on individuals’ genotype, such as eating plenty of vegetables and avoiding saturated fats, some companies offer vitamin supplements, plant extracts or combinations of vitamins and over the counter drugs, for example, aspirin and folic acid. Critics have argued that the advice provided is too general to be meaningful and that companies are charging prices that are too high for vitamin supplements.
In general, the marketing and media discourses indicate that nutrigenetic tests have become a struggle over the boundary between “medicine” and “lifestyle,” which indicates its resonance with wider issues of contemporary health and health-care policy.
Policy implicationsThe debates around nutrigenomics highlight a generally important political issue on preventive genomics.
- If the science produces tests, which can detect unspecific susceptibilities to heart disease and cancer with associated general advice about eating healthy foods, getting exercise and avoiding toxins these are seen as too “woolly.” At the same time, unspecific tests are less likely to unduly worry people and may blend into general healthy lifestyle advice.
- If the science produces tests, which are specific and offer specific treatments, such as a particular preventive drug, this may seem more of an achievement. However, such test also carry the potential of medicalising people, leading to a situation where people are taking a variety of medications for diseases they would never develop.
- It is uncertain, whether research on genetic susceptibilities will produce predominantly “lifestyle” or “medical” tests. Selling lifestyle tests that merely recommend good eating habits are not the most problematic kind, and medical diagnostic tests for single gene disorders are currently largely regulated by clinical governance. Policy should, however, make sure that unspecific lifestyle genetic tests are not used to sell unnecessary drugs to people.
- It is an open question whether they should be special regulation on marketing of tests and medications under the umbrella term “genetic”. The problem of selling tests and drugs is broader, as evidenced in the proliferation of whole body scans and online sales of Viagra and other drugs. . Policy-makers maybe should devise ways of regulating this widening market of quasi-medical products in general terms.
Saukko, P., Reed, M., Britten, N. & Hogarth, S. , Negotiating the boundary between medicine and consumer culture: Online marketing of nutrigenetic tests, Social Science & Medicine, 2010, 70, 5, 744-753.
Saukko, P., Pitching products, pitching ethics: Selling nutrigenetic tests as lifestyle or medicine. In D. Castle & N. Ries (eds.), Nutrition and Genomics: Issues of Ethics, Law, Regulation and Communication (pp. 205-222). New York: Academic Press, 2009.