In recent years, literature examining implementation of nutritional genomics into clinical practice has increased, including publication of several randomized controlled trials (RCTs). This systematic review addressed the following question: In children and adults, what is the effect of incorporating results of genetic testing into nutrition counseling and care compared with an alternative intervention or control group, on nutrition-related health outcomes? A literature search of MEDLINE, Embase, PsycINFO, CINAHL, and other databases was conducted for peer-reviewed RCTs published from January 2008 until December 2018. An international workgroup consisting of registered dietitian nutritionists, systematic review methodologists, and evidence analysts screened and reviewed articles, summarized data, conducted meta-analyses, and graded conclusion statements. The second in a two-part series, this article specifically summarizes evidence from RCTs that examined health outcomes (ie, quality of life, disease incidence and prevention of disease progression, or mortality), intermediate health outcomes (ie, anthropometric measures, body composition, or relevant laboratory measures routinely collected in practice), and adverse events as reported by study authors. Analysis of 11 articles from nine RCTs resulted in 16 graded conclusion statements. Among participants with nonalcoholic fatty liver disease, a diet tailored to genotype resulted in a greater reduction of percent body fat compared with a customary diet for nonalcoholic fatty liver disease. However, meta-analyses for the outcomes of total cholesterol, low-density lipoprotein cholesterol, body mass index, and weight yielded null results. Heterogeneity between studies and low certainty of evidence precluded development of strong conclusions about the incorporation of genetic information into nutrition practice. Although there are still relatively few well-designed RCTs to inform integration of genetic information into the Nutrition Care Process, the field of nutritional genomics is evolving rapidly, and gaps in the literature identified by this systematic review can inform future studies.

中文翻译：

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将基因检测结果纳入营养咨询和护理对健康结果的影响：证据分析中心系统评价 - 第二部分

近年来，研究将营养基因组学应用于临床实践的文献有所增加，包括发表了几项随机对照试验 (RCT)。本系统评价解决了以下问题：在儿童和成人中，与替代干预或对照组相比，将基因检测结果纳入营养咨询和护理对营养相关健康结果有何影响？对 2008 年 1 月至 2018 年 12 月发表的同行评审 RCT 对 MEDLINE、Embase、PsycINFO、CINAHL 和其他数据库进行了文献检索。由注册营养师、系统评价方法学家和证据分析师组成的国际工作组筛选和审查了文章，汇总数据，进行荟萃分析，和分级结论陈述。本文是两部分系列中的第二部分，专门总结了 RCT 的证据，这些 RCT 检查了健康结果（即生活质量、疾病发生率和疾病进展的预防或死亡率）、中间健康结果（即人体测量、身体成分） ，或在实践中常规收集的相关实验室测量），以及研究作者报告的不良事件。对来自 9 个 RCT 的 11 篇文章的分析得出了 16 个分级结论陈述。在患有非酒精性脂肪性肝病的参与者中，与非酒精性脂肪性肝病的常规饮食相比，针对基因型量身定制的饮食导致体脂百分比降低更多。然而，对总胆固醇、低密度脂蛋白胆固醇、体重指数、和权重产生空结果。研究之间的异质性和证据的低确定性阻碍了将遗传信息纳入营养实践的有力结论。尽管设计良好的 RCT 来告知将遗传信息整合到营养护理过程中的数量仍然相对较少，但营养基因组学领域正在迅速发展，本系统评价确定的文献空白可以为未来的研究提供信息。