The overall aim is to improve
lifestyle and prevent or delay the onset of common, complex, chronic
diseases such as diabetes, cardiovascular disease, osteoporosis,
inflammatory disorders (e.g. Arthritis) and cancer. The genetic test is NOT
a diagnostic of disease, nor is it a predictor of disease. All of the above
mentioned illnesses are caused by a mixture of genetics and lifestyle. A
white person will not get skin cancer without exposure to UV rays. An
individual with lactose intolerance (due to a genetic variation) will not
have gastric problems if he/she avoids dairy products. Similarly,
environmental components (the major environmental exposure is diet) are
required, as well as a particular genetic background, for the development of
the major chronic diseases. So the genetic test itself cannot be predictive
since genotype alone is not sufficient to determine whether or not a
particular disease will develop. Genetic information can though allow useful
advice to be given to help with avoiding the development of disease. Genes
cannot be changed but the environment can (especially diet and physical
activity) and making changes guided by individual genotype has been
demonstrated to lead to improved health benefits (such as reduced levels of
LDL cholesterol, homocysteine, blood pressure, DNA damage, a better glucose
/ insulin balance, etc) which should improve the prospects of avoiding /
delaying onset of the diseases related to these components.
likely use of the service in Europe will be via healthcare practitioners and
the target end users include individuals taking a proactive role in their
health, wellness, and disease prevention on one hand and their practitioners
on the other.
The benefits of the service include delivery of
personalized diet and lifestyle recommendations to individuals in a timely
and secure manner with the goal of helping them attain their health and
wellness objectives. Compared to the present situation, the service will be
greatly improved, with much wider distribution and multilingual solutions to
overcome language barriers, and with a decreased price.
The major health
problems of the near future will be those of preventable conditions
associated with obesity, type-II diabetes and cardiovascular disease. The
economic burden on society of these conditions is already being felt and is
expected to reach near crisis proportions over the next 10-20 years. To
address these coming epidemics healthcare will require a change from
curative to preventative and key to this will be fostering changes in
lifestyle, principally nutrition and physical activity. A major benefit of
the service is that it targets individuals before health conditions
materialize and is supported by evidence that personalizing diet and
lifestyle through analysis of genetic variation increases motivation and
adherence to healthier lifestyles. A further benefit is that in individuals
who are already overweight or who suffer from type-II diabetes or
cardiovascular disease, diet and physical activity changes can reduce and
even reverse symptoms, lessening the need for expensive pharmaceutical
interventions and the burden on the medical system & physician time,
benefiting both the patient and the physician.
The service will provide
practitioners with electronic tools to continually monitor progress of
patients, picking up early warning signs and enabling the possibility of
effective intervention to improve the patient’s condition. The tools will
allow the practitioner to work more efficiently and effectively, saving
valuable time and resources. The improved preventive healthcare services
will benefit individuals and society as a whole by also reducing absence
from work due to poor health.
The EUROGENE project aims to offer the current
service at a pan-European level targeting to generate the strongest impact
both at social and economic level, eventually encompassing the entire EU27
area. The various possibilities offered nowadays by the new technological
advances is easing the offering of EUROGENE like services reinforcing the
liaison and coherence of services offered within the various regions and
countries of the European Union.
One of the major features to be
implemented in EUROGENE is that of multilingualism, in order for the service
to generate the best results, also taking in consideration the
trans-European perspective of the project. A wide set of services will be
provided by EUROGENE able to satisfy each of the needs of the end-users
giving as much value add as possible.
The EUROGENE service will be
deployed by extending the pilots implemented as part of the Phase A project.
As described in the technical annex these services will be localised as
required and will involve electronic methods of data delivery. A
practitioner portal will be a key part of the service that will be scalable
and applicable to clinics throughout Europe. The service will continue to
evolve of course from the moment of first deployment, even at the pilot
level. Issues will be identified and addressed to continually improve the
service itself and its take-up.
Education and communication will be
important to achieve success. The majority of healthcare practitioners will
be unfamiliar with nutrigenomics and the benefits of nutrigenomics based
services. The prevalent mindset among healthcare practitioners, and
patients, is one of therapy rather than prevention. The purpose of personal
genomics services is prevention, the “patient” will ideally be healthy and
will use personal genetic information to make diet & lifestyle adjustments
which will help maintain good health and delay the onset of disease. In this
respect the practitioner portal will be a conduit for more than just data
exchange as it will also provide a platform for dissemination and education.
Practitioners will be able to request specific information and clarify
issues where needed. It will also be possible to allow practitioners to
register for freely accessible areas of the portal even before they actively
provide the EUROGENE service – they will be invited to join the portal,
study the information, take part in discussions and hopefully move on to
become a EUROGENE supplier.
It will also be important to provide
information to the consumer and a similar portal type approach may be
implemented in a more consumer oriented fashion. Education of the consumer
on the benefits of nutrigenomics and preventative healthcare will help to
create a consumer demand for the services. Consumers will be encouraged to
inform their own practitioners about the services and introduce them to
nutrigenomics if they are not already aware.
The nature of the services,
using portal and e-communication to engage both practitioners and “patients”
will enable a level of continued interaction to be deployed. Keeping both
patient and practitioner up to date with advances & new services, and
keeping the patient regularly informed of his/her progress by giving access
to his/her records has the benefit that it is likely to increase motivation
and compliance. The software behind the portal will be written in a way to
support integration or exchange of data with patient medical records –
standards such as HL7 will be used.
The benefits, both economic and
social, are potentially very significant. All of the common complex diseases
(cardiovascular, diabetes, cancer, arthritis, osteoporosis, etc) involve
genetics and environment and above all are highly preventable with early
lifestyle modifications. These are the diseases whose incidence is
increasing and which are an ever growing drain on all EU economies through
spiralling healthcare costs and work days lost due to poor health.
Throughout the EU there are government and health organisation projects to
improve lifestyle and to promote preventative healthcare thinking. The
EUROGENE service fits very well within these initiatives and will work with
them to promote the benefits in the attempt to reverse the current rise
towards epidemics proportions of diseases such as diabetes and conditions
such as obesity.