In 2021, the nutrigenomics market raked in $150 million in annual revenue, according to Market Research Future. With experts forecasting growth of 15.7% from 2023 to 2032, the industry is projected to reach $660 million in annual revenue by 2032. Continual increases in obesity and common conditions such as cardiovascular diseases have become major undercurrents driving the industry’s growth, and various organizations have followed suit. For example, in June 2017, at-home DNA test company DNAFit and hospitality industry expert Vita Mojo joined forces to design the world’s most personalized restaurant menu—a menu uniquely designed for each customer’s DNA. In 2018, 23andMe began collaborating with GlaxoSmithKline to explore ways to use genetics to treat health conditions while simultaneously launching investigations into the effects of genetics in communities historically underrepresented in clinical research.
“Right now, the most surprising thing about the nutrigenomics industry is how many new genetic testing companies there are that come out each day,” said Natalie Samson, a board-certified genetic counselor and the founder of Golden Genetics, an integrative genetic counseling company in Newport Beach, California. “I think the problem is that many practitioners do not know which labs to choose, but overall, it’s amazing how we’re able to understand each gene and turn it into actionable steps for personalized health optimization.”
Counselor and Founder
Golden Genetics
For Coco Uribe, a dietician and community outreach manager at NOVA ScriptsCentral in Falls Church, Virginia, the intrigue lies in how uniquely individuals respond to the same foods based on their genetic makeup.
“For example, one person may thrive on a high-carb diet, while another gains weight due to genetic variations affecting metabolism,” she said. “It’s also remarkable how diet can influence gene expression through epigenetics, showing that what we eat doesn’t just fuel our bodies but can shape our biology.
Yet, nutrigenomics, or the science of eating based on an individual’s genetic predisposition to how the body metabolizes and responds to various nutrients, has become an increasingly debated topic. Samson, Uribe, and another expert shared their insights on the science’s validity, potential contribution to healthcare, and future directions.
Unearthing the history of “food as medicine” warrants investigating whether food really offers medicinal benefits
The increased public interest in nutrigenomics and other facets of integrative medicine have likely evolved in response to growing public distrust in the pharmaceutical industry and U.S. healthcare system. Reasons for increased public distrust include public perception of pharmaceutical manufacturers as being profit-driven or greedy and concerns regarding off-label marketing, inflated government programs, and concealed data, according to a 2023 cross-sectional study published in the Journal of the American Medical Association. Meanwhile, the nutraceuticals market has exploded from $383 billion in 2016 to $591.1 billion in 2024, based on recent reports and analyses.
Yet, the concept that nutrients from food, plants, and other natural products offer medicinal benefits is no recent trend. Rather, it dates back millennia to ancient Chinese medicine, Ayurvedic principles, and the Hippocratic and Galenic diets.
Often regarded as the father of modern-day medicine, even ancient Greek physician and philosopher Hippocrates has landed posthumously amidst food-derived medicinal controversy. His name has become synonymous with several variations of the adages “Let thy medicine be thy food” and its modern predecessor, “Food is medicine.”
Science Communicator, McGill University
Notwithstanding, researchers have yet to uncover any evidence in the literature that he ever made such a statement. According to Diana Cardenas, MD, PhD, the author of a 2013 opinion paper, the concept of food serving as medicine has given rise to various misconceptions regarding the correlation between poor diet and disease. While food definitely contributes to overall health and wellness, Cardenas makes the argument that Hippocrates never intended for food to serve a prescriptive purpose. The quote’s origin and Hippocrates’ association with it remain a mystery. In addition, as one expert pointed out, many potential medicinal benefits food offers are often mitigated by human nature.
“We know more than we really do about the impact of food on our genes and that improving our health is as simple as getting the right information,” said Jonathan Jarry, science communicator at McGill Office for Science and Society at McGill University in Montreal, Quebec, and podcaster at The Body of Evidence. “Unfortunately, changing health behavior has been shown to be very difficult, and we tend to choose our diet based on convenience, appearance, price, taste, and social considerations much more than any health information we have about it.”
Separating fact from fiction: Poorly substantiated studies and weak claims contribute to embellished statements in the media and common misconceptions undermining nutrigenomics’ value
Some experts have labeled nutrigenomics as a “pseudoscience,” citing baseless claims that bear little to no effect on patient outcomes. Conversely, recent years have seen a surge of medical professionals such as chiropractors and pharmacists engaged in functional medicine who have incorporated nutrigenomics into their practices. Some have even built entire business models around it. Despite the growing popularity among integrative medicine practitioners and, to a lesser extent, some conventional healthcare professionals, not every stakeholder in the medical field shares the same level of enthusiasm.
Jarry, who has researched and written about the topic, warns people to proceed with caution.
“It’s a classic case of scienceploitation, where preliminary findings from a genuine field of research are spun off into a product that isn’t ready for primetime,” he told Inside Precision Medicine. “We see this with stem cell clinics, with cancer immunotherapy, and of course with the microbiome—all are cases where real research has delivered a few proven applications for now, but these fields get turned into profitable panaceas before the results are in.”
Jarry describes the field of nutrigenomics as no different.
However, Jarry maintains that not all information regarding the impact of food on health is dismissible. In fact, he asserts that current data allows the medical community to draw several conclusions.
Regarding the utility of current data, Jarry pointed out that clear applications for nutrigenetic information already exist. For example, people with phenylketonuria need to monitor their phenylalanine intake, while lactose intolerant individuals should either avoid dairy or take lactase caplets before a meal to counter the potential consequences of ingesting lactose.
Uribe stated that another misconception is that nutrigenomics testing can provide immediate and precise dietary recommendations and specific diet plans for every individual.
“Many people assume that these tests replace general healthy eating principles, when in fact, they are meant to complement [and] not serve as a standalone solution,” she cautioned.
In addition to knowing what genes to interrogate, stakeholders should vet nutrigenomics companies for quality
To help mitigate the potential for pseudoscience or poor lab quality, Samson recommends that healthcare organizations vet sources. For example, Samson verifies whether nutrigenomics testing companies hold certain certifications such as the Clinical Laboratory Improvement Amendments certification that compliance with federal standards for laboratory testing. The College of American Pathologists offers another important certification, assessing lab quality through rigorous inspections. Validation also plays an important role. These include analytical validity, which confirms that the test accurately and reliably measures the genetic variants it claims to detect, and clinical validity, which evaluates whether the detected variants are clinically significant and correlate with the disease or condition.
Samson emphasizes that the lab should provide comprehensive information about their tests, including methodologies, limitations, and the clinical relevance of detected variants. Such information should either be accessible on the laboratory’s website or readily available. In addition, credible companies will have robust policies to protect patient data and comply with relevant privacy laws. Ideally, a short turnaround time and reliable customer support are critical, but some users may find such resources to be cost-prohibitive for their patients, with price tags ranging from $500 to $1,000 for various tests. Most insurances generally do not cover nutrigenomic testing.
Also, for patients who can afford to pay for nutrigenomic testing, the practicality and accessibility of complementary resources may still limit the potential impact.
“In my opinion, eating according to a nutrigenomic profile is feasible for some patients, but access to reliable genetic testing and personalized dietary guidance can be costly and are not universally available, which can make it challenging for most individuals,” Uribe warned.
Experts weigh in on the applications of nutrigenomics in healthcare
Samson said that nutrigenomics offers medical professionals and other stakeholders important information to help understand each gene and turn that information into actionable steps to optimize a patient’s health. However, that comes with the caveat of understanding how to use nutrigenomics. However, to optimize the data provided by nutrigenomics, Samson says that people need to understand not only the information it provides but its true utility and value.
“I hear that nutrigenomics is not accurate enough to create rigid diet plans, but that’s actually not what it’s even about,” she said. “What makes nutrigenomics so powerful though is its ability to get really specific about what to include more or less of in your diet based on their results.”
Samson reminds her patients that many factors influence diet. For example, compounds like the sulfur-based phytochemical sulforaphane—found in broccoli, Brussels sprouts, and other cruciferous vegetables—can influence the expression of genes involved in inflammatory pathways. Examples include the C-reactive protein gene implicated in heart attack and the transcription factor gene FOXO3. Sulforaphane plays an important role in the Nrf2 pathway, which increases the production of antioxidant and anti-inflammatory enzymes. It also downregulates pro-inflammatory pathways like NF-κB. This helps reduce the production of inflammatory markers like IL-6 and TNF-a, providing a targeted way to support health through diet.
Samson integrates nutrigenomic testing with high-penetrance, high-risk genetic testing in her practice. She finds that doing so allows her to provide her patients with a comprehensive view of health. In addition, she stated that understanding various biological pathways such as the inflammation pathway in someone at a high risk for developing cancer can open doors to proactive strategies to help manage the risk.
Experts have conflicting views on the future of nutrigenomics in conventional medicine
While experts agree that diet plays an important role in overall health, they have varying visions of how nutrigenomics might ultimately contribute.
Samson maintains that the impact of nutrient-focused eating can be significant, particularly for patients with a genetic predisposition to conditions like heart disease or cancer.
“Aligning nutrition with genetics supports better health outcomes by targeting root causes and optimizing pathways,” she said.
In clinical applications, Uribe anticipates that the nutrigenomics has significant potential to enhance personalized treatment and preventive care. She believes that a diet plan based on a nutrigenomic profile can significantly impact a patient’s health outcomes, with its most important benefits lying in preventing or managing chronic diseases. In such cases, incorporating nutrigenomics can help personalize dietary strategies by optimizing metabolic processes and addressing genetic predispositions to chronic conditions such as diabetes. However, the benefits of such resources remain limited by access. In addition, such testing requires additional guidance and support, which convey costs that not everyone can afford.
“It could allow physicians to tailor dietary recommendations and interventions based on an individual’s genetic predispositions, improving outcomes for chronic conditions such as diabetes or cardiovascular disease,” Uribe told Inside Precision Medicine. “It has the potential to become an essential component of a holistic approach to patient care, integrating nutrition and genetics within a clinical context.”
From Jarry’s perspective, these aspirations seem a bit ambitious. He forecasts a narrow future for nutrigenomics, both as an auxiliary to conventional medicine and as a field itself.
“I don’t know what future nutrigenomics has in conventional medicine, but I suspect very little,” he said. “But given that only a minority of people get enough fruits and vegetables every day, exercise enough, or get sufficient quality sleep, I don’t believe the answer to improving health at large lies in nutrigenomics.”
Jarry also disagrees with the sentiment that dietary supplementation based on nutrigenomics testing can compensate for a growing public belief that perpetual mineral depletion of soil results in nutrient-deficient whole foods.
However, a 2017 review article authored by a Health Canada researcher concluded that “… the small estimated declines in content of certain mineral nutrients that have been observed in high-yielding crops can be addressed easily by consuming the recommended number of servings per day of vegetables, fruit, and whole grains.”
Jarry describes the perpetuation of the idea that people need to take dietary supplements to compensate for nutrient deficiencies in their food as “fearmongering … used to scare people into buying dietary supplements, which are poorly regulated and are not infrequently contaminated or adulterated.”
The science communicator stands firm on the idea that healthy lifestyle habits and practices are the key pillars to health and nutrition.
“Based on the knowledge we have now, I would say that nutrigenomics at best could perhaps improve your health a tiny bit,” Jarry said.
He also stated that the real sea change comes from adopting well-known practices—all of which are free. These are to eat a healthy, balanced diet, exercise rigorously and regularly, stop smoking, and get enough quality sleep.
“It’s easy to get lost in a labyrinth of cutting-edge promises, but the big picture of health is simple and free for all to learn about,” Jarry said. “As much as we love a personalized intervention, when it comes to health, we’re not that different overall.”
Frieda Wiley, PharmD, is an award-winning medical writer, best-selling author, speaker, and pharmacist who has written for O, The Oprah Magazine, the National Institutes of Health, American History, Pfizer, Merck, AstraZeneca, and many more notable organizations.
