For proof that the U.S. is in the midst of an obesity epidemic, all that you need to do is link here and view the rise in obesity by state across the country using data collected by the CDC. This is a superb illustration of the use of the graphic capabilities of the web to illustrate an important teaching point.
So what role can the lab possibly play in the diagnosis of obesity? You may be thinking that an obese patient is obvious to even the most casual observer and that the clinical lab plays no role in this process. Obesity is a nutritional problem and the lab's role in nutrition is on the rise. On the front page of the July, 2006, issue of the AACC monthly publication, Clinical Laboratory News, is a story entitled: The Era of Personalized Nutrition. Has the Nutrigenomics Revolution Begun? This publication is not available on-line, but here's the money quote from the first paragraph of the story:
While personalized medicine promises that clinicians will be able to prescribe the right drugs at doses best suited to individual patients based on genotyping tests, personalized nutrition will use similar technologies to determine which foods an individual should consume in order to stay healthy. This new science of nutritional genomics, or "nutrigenomics," may be in its infancy, but it could have a profound impact in the battle against major metabolic diseases. And according to its advocates, the rise of nutrigenomics could mean a big increase in molecular tests performed by clinical labs.
I agree with these ideas and believe that nutrigenomics, although now only in its infancy, could evolve into a major driver for clinical lab testing and analysis. In the process of writing this note, I came across a web page dedicated to the field of nutrigenomics (link here) developed by the Center of Excellence for Nutritional Genomics at the University of California, Davis. Here are the five tenets of nutrigenomics from that same site:
- Under certain circumstances and in some individuals, diet can be a serious risk factor for a number of diseases.
- Common dietary chemicals can act on the human genome, either directly or indirectly, to alter gene expression or structure.
- The degree to which diet influences the balance between healthy and disease states may depend on an individual’s genetic makeup.
- Some diet-regulated genes (and their normal, common variants) are likely to play a role in the onset, incidence, progression, and/or severity of chronic diseases.
- Dietary intervention based on knowledge of nutritional requirement, nutritional status, and genotype (i.e., "personalized nutrition") can be used to prevent, mitigate or cure chronic disease.
Here is a link to a previous note about complementary medicine from Lab Soft News with a description about how Bio-Reference Lab, a major reference lab, is beginning to focus on this area of healthcare. Nutrition is one of the major touchstones of complementary medicine. I have every confidence that this field is rapidly moving into the mainstream of healthcare and lab testing.