The study of gene-diet interactions, or nutrigenomics, is becoming more widely acknowledged as a key component of precision nutrition. Sub-Saharan Africa (SSA) is underrepresented despite its unparalleled genomic diversity and pressing nutrition issues, whereas high-income nations have produced significant evidence connecting genetic variation with dietary responses. Using peer-reviewed research, WHO and African Union (AU) policy documents, and H3Africa governance reports, this review methodically synthesizes evidence published in 12 SSA countries between 2018 and March 2025. 68 studies in all satisfied the inclusion requirements, with more than 70% of publications coming from South Africa, Nigeria, Kenya, and Ghana.
The results are grouped into five thematic areas: (1) Micronutrient–gene interactions; (2) Noncommunicable diseases (NCDs), especially obesity and diabetes, where FTO, APOE, and TCF7L2 variants interact with Westernized and carbohydrate-rich diets; (3) HIV/AIDS, where VDR variants influence ART outcomes and micronutrient responsiveness; (4) Maternal and child health, highlighting FADS1 and MTHFR polymorphisms in pregnancy outcomes; and (5) Indigenous diets, where heritage food patterns (cassava, palm oil, and millet-based diets) exhibit protective metabolic profiles. All of these are examples of micronutrient–gene interactions. The evidence base is constrained in all areas by methodological flaws, including cross-sectional designs, small sample sizes, and limited laboratory capacity.
Financing shortages, issues with biobank governance, underrepresentation in international cohorts, a lack of policy integration, and equity concerns regarding data sovereignty are some of the obstacles to advancement. However, there is hope for the integration of policies. Pilot projects in ANC, PMTCT, HIV, and NCD clinics are among the short-term priorities; multi-country longitudinal cohorts and biofortification connected to nutrigenomic evidence are among the medium-term objectives; and long-term plans call for the establishment of a continental nutrigenomics institute headed by AU/WHO AFRO.
According to this review, nutrigenomics presents SSA with a game-changing chance to bring genetic diversity, traditional diets, and contemporary science into harmony. SSA has the potential to rise from underrepresentation to become a global model of equitable precision public-health nutrition with audacious investment, unified governance, and African-led research leadership.