Every human being is unique. Our genetic makeup, our race, our gender, our medical history, our microbiome, our metabolism, our lifestyle choices. Given we are all so fundamentally different, how will we ever find a one-size-fits-all diet for optimal health? Spoiler alert, we can’t and we won’t. That is where precision nutrition comes in.
Precision nutrition is a component of precision medicine, an approach to personalize medical treatment based on an individual’s unique characteristics in order to more effectively target and treat disease [i]. Precision nutrition does just that, but in the context of diet, taking into account the fact that each individual may respond differently to certain foods, nutrients, and dietary patterns. Dramatic technological advancements in recent years, including proteomics, metabolomics, genomics, and mobile health technology as well as powerful tools that utilize AI/machine learning to analyze large and complex data sets has, for the first time, made precision nutrition an attainable prospect [i].
You might be thinking, but don’t we already know that it’s best to eat mostly fruits, vegetables, and whole grains, and limit processed foods and added sugars? Yes, there is ample high-quality evidence suggesting that, for most people, following a healthier dietary pattern and maintaining a healthy weight may reduce the risk of multiple chronic diseases and improve health outcomes. However, recent research has begun to study individuals rather than groups, and has uncovered that there may be significant variations in the body’s response to nutrients (like sugar and fat) in identical meals [ii, iii]. While precision nutrition is still in its early stages, it shows great promise to optimize health, and research is currently underway in cancer, diabetes, obesity, and other conditions [iv].
But, it’s not all sunshine and rainbows from here. This field has a number of challenges to tackle before it will be a mainstream component of medical nutrition therapy. First, we need MANY well-designed clinical trials, which are incredibly complex and expensive to execute. On top of this, the methods and results of these studies will need to be consistent enough to allow broad application for individuals. To address this, the U.S. National Institutes of Health (NIH) is making a huge effort to dedicate $156 million over 5 years to execute research on how 10,000 Americans respond to different foods and diets. A study of this magnitude could play a major role in laying the foundation for the future of precision nutrition.
Additionally, there will need to be a shift in the mindset of healthcare teams to trust and utilize precision nutrition principles and technologies in their practice. Access to tools to assess genetics, sequence the microbiome, continually monitor blood glucose, and track diet and lifestyle factors will be essential. Finally, there are several ethical considerations, such as ensuring data privacy and acknowledging that personalized nutrition may not be accessible to broad populations, exacerbating the dramatic healthcare disparities that already exist in the U.S. [iv].
So, will precision nutrition revolutionize the field of nutrition? There is still a lot to learn, but in my opinion, with time (a lot of it), well-designed research, advancing technologies with broader access, and buy-in from the medical community–it will. However, it is equally important to continue the work by healthcare workers and policymakers to improve access to high quality food and evidence-based nutrition information to inform choices for the general population. The COVID-19 pandemic has further exposed the prevalence of cardiometabolic risk factors, food insecurity and the many shortcomings of our food system [v]. It is time for policymakers to take action and use nutrition as a lever to reduce healthcare disparities before precision nutrition can take off.
References:
[i] Collins FS, Varmus H. A new initiative on precision medicine. New England journal of medicine. 2015 Feb 26;372(9):793-5.
[ii] Berry SE, Valdes AM, Drew DA, et al. Human postprandial responses to food and potential for precision nutrition. Nature Medicine. 2020 Jun 11:1-0.
[iii] Zeevi D, Korem T, Zmora N, et al. Personalized nutrition by prediction of glycemic responses. Cell. 2015 Nov 19;163(5):1079-94.
[iv] The Nutrition Source: Precision Nutrition. Harvard School of Public Health website. Accessed March 10, 2021. https://www.hsph.harvard.edu/nutritionsource/precision-nutrition/
[v] Mozaffarian D. It’s time for a second Conference on Food, Nutrition and Health. The Hill. Published Feb 26, 2021. Accessed March 10, 2021. https://thehill.com/opinion/energy-environment/540683-biden-its-time-for-a-second-conference-on-food-nutrition-and