Inclusion and exclusion in nutrigenetics clinical research: ethical and scientific challenges.
OBJECTIVE
There are compelling reasons to ensure the participation of ethnic minorities and populations of all ages worldwide in nutrigenetics clinical research. If findings in such research are valid for some individuals, groups, or communities, and not for others, then ethical questions of justice--and not only issues of methodology and external validity--arise. This paper aims to examine inclusion in nutrigenetics clinical research and its scientific and ethical challenges.


METHODS
In total, 173 publications were identified through a systematic review of clinical studies in nutrigenetics published between 1998 and 2007. Data such as participants' demographics as well as eligibility criteria were extracted.


RESULTS
There is no consistency in the way participants' origins (ancestry, ethnicity, or race) and ages are described in publications. A vast majority of the studies identified was conducted in North America and Europe and focused on 'white' participants. Our results show that pregnant women (and fetuses), minors, and the elderly (≥ 75 years old) remain underrepresented.


CONCLUSIONS
Representativeness in nutrigenetics research is a challenging ethical and scientific issue. Yet, if nutrigenetics is to benefit whole populations and be used in public and global health agendas, fair representation as well as clear descriptions of participants in publications are crucial.
Department of Social and Preventive Medicine, Bioethics Programmes, Faculty of Medicine, University of Montreal, Montreal, Que., Canada.
T
T
Hurlimann
R
R
Stenne
V
V
Menuz
B
B
Godard
D015982:Bias; D035843:Biomedical Research / Q000941:ethics* / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data; D054647:Nutrigenomics / Q000941:ethics* / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D018579:Patient Selection / Q000941:ethics; D011247:Pregnancy; D011643:Publishing / Q000706:statistics & numerical data