The thrill is in the purpose, he said. During her three two-week stays, Hamdorf asked the question that has plagued nearly everyone who puts a fork to their mouth: “What happens in my body after I eat this food?” agreed to become a research subject in a project that seeks to answer the following questions. Will it make me fat, raise my cholesterol, disrupt my gut microbiome, or extend my life?
The Nutrition for Precision Health Study is a $170 million national research project targeting 10,000 participants across the country to develop ways to precisely identify the optimal diet for everyone. The study is being conducted at six clinical centers across the country, including the New England Clinical Center run by Tufts University and Massachusetts General Hospital.
Current nutritional advice is based on averages and is considered to be most effective for most people. But in many studies, people who consume the exact same combination of nutrients respond differently on measures like blood sugar and blood pressure, explains Holly Nicatoro, program director for the national study. .
This study attempts to find out exactly why. By doing so, it is hoped that someday people will be able to consume a diet tailored to their unique ecology.
The study also seeks to overcome a long-standing challenge in nutritional research. Nutritional data is usually based on asking people to remember what they ate. But memory is notoriously inaccurate, and is often biased by, say, embarrassment over eating an entire Oreo. Nutrition for Precision Health is testing other ways to record what people eat, including apps, surveys or tiny cameras attached to glasses that are activated by chewing.
“We actually have the technology to break free from our dependence on memory,” says Sarah L. Booth, director of the Jean Mayer USDA Center for Aging and Human Nutrition Research at Tufts University. “This is one of the interesting aspects of this research. We may be on the verge of completely transforming the way we study nutrition.”
Participants first complete a “module” in which they eat a normal diet for 10 days and report what they eat. If they want to continue, they have the option of buying prepackaged meals and eating them at home, or enrolling in a “live-in diet” module, a strictly controlled stay chosen by Hamdorf. By keeping people indoors and under surveillance, researchers can accurately and reliably track what people eat and how those foods affect their entire bodies.
Ms. Hamdorf was one of the first group of four participants in the live-in diet phase in Boston. All had previously enrolled in the National Institutes of Health’s All of Us Research Program, which has enrolled more than 1 million participants and provided health data, including genetics, and provided thousands of The aim is to build a database that can inform research. Only existing All of Us members are invited to participate in the nutrition survey.
On the first day, participants had blood and saliva samples taken, bone scans, metabolic rates measured, and fat-to-muscle ratios recorded. They were also equipped with a blood sugar monitor attached to their waist to continuously track fluctuations in blood sugar levels, and a wristband to track activity and sleep.
The next day, the daily routine began. Weight and vital signs will be taken at 6:30am. 8am, breakfast. Lunch at 12pm. Snack at 3pm. Dinner at 6pm. Lights out at 11pm.
Hamdorf said the strict schedule proved more liberating than being confined. “It feels really good to be structured like this,” he said. “You don’t have to go shopping or anything, just go out to eat.”
In between meals and tests, participants are free to use the exercise equipment on the 13th floor, stretch on mats in the yoga room, gather in the game room, or relax in spacious private rooms with picture windows. is completed. They loved interacting with the many 150 people who work in the offices, labs, and kitchens of the Human Nutrition and Aging Research Center.
Sometimes they went for a walk outside, but only if a staff member could accompany them to avoid the urge to eat an ice cream cone. Researchers must be able to prove that participants only ate what was provided inside.
And what were they offered?
At noon, near the end of their first two-week assignment, the four participants headed to the 11th-floor dining room, accompanied by clinical research manager Paul J. Fass. Fass remained to watch during the meal.
The kitchen staff brought out plates wrapped in plastic with their names written on them. Each meal is tailored to your individual caloric needs. Participants must not gain or lose weight.
Each one has a small rubber spatula to scoop up all the crumbs. “Most of the time we’re asking them to lick the plate without licking the plate,” says nutritionist Kayla Airagi. If you can’t finish it all, our staff will weigh your leftovers and track your consumption to the tenth of a gram.
That day, Andover resident Lori Mathis, 60, got a hamburger, peaches and chips. Her husband, Tim Carter, 63, was served two hamburger sliders. President Clinton’s Jane Cashel, 75, ate broccoli, chicken nuggets, and macaroni and cheese. Hamdorf received Spanish rice, chicken taco seasoning, and cheddar cheese.
“It’s not the food we normally eat,” Mathis said. “I’m eating things I didn’t eat as a kid.” Other days, I was yodeling, Kool-Aid, canned fruit cocktail, and drinking Fritos.
During this two-week session, participants consumed what they called the traditional American diet. But researchers resist labeling it. The official explanation is simply that it’s high in refined grains and sugary drinks, and low in fruits, vegetables, whole grains, and fish.
During the second and third two-week visits, separated by at least two weeks, participants consumed a high-fat, high-protein diet, ending with fruits, vegetables, beans, nuts, whole grains, and fish ( 4 of us liked this the best).
The three diets were chosen not because they are recommended, but because they are among the most common in the United States, said Sai Krupa Das, a senior researcher at the center and principal investigator for the study’s New England branch. He said this is because of their typical eating patterns. “They reflect what we consume as a nation,” she said.
And the goal is not to determine which diet is best, but to measure different responses of individuals to different ingredients.
Researchers acknowledge that attracting a diverse group of people to this stage of the project will be difficult. How many people can put their lives on hold for two weeks at a time? Carter and Mattis, who trade stocks online, are working while they’re there, and other remote workers can do the same. Maybe. But what about the bus driver? A restaurant owner? Are you a parent of young children? Even his $6,200 stipend for completing all three two-week sessions may not be enough to make up for lost work.
Despite the challenges, NIH’s Nicatoro said, “We have ambitious diversity goals,” and he believes they can be met, at least in “Module 1,” in which participants eat and record what they normally eat. He said he was looking forward to it. But even for more demanding modules, such as prepackaged meals and live-in meals, the institute works with churches, barbershops, community centers, and other locations to enroll people in All of Us and provide nutritional support. We strive to involve them in research. said Nicatoro.
Rafael Pérez Escamilla, a professor at the Yale School of Public Health who was not involved in the study, believes that nutrition for precision health will likely answer some interesting scientific questions, but that there is little to no improvement. He says it doesn’t do much to harm people’s health or reach out to those who suffer from the worst effects of poor diet.
“In the country we live in, around 70% of adults are overweight or obese, and more than 70% of our calories come from junk food such as ultra-processed foods and sugary drinks,” he said. Ta. “The problem is concentrated among the poor.”
Perez-Escamilla hopes similar investments will be made in efforts to increase access to healthy foods, such as “creating prescription programs” that offer debit cards to buy fresh fruits and vegetables. There is.
Christopher Gardner, a professor at Stanford University who studies the health benefits of dietary components but was not involved in the Nutrition for Precision Health study, called it an “incredibly ambitious” project. called. He predicted that researchers would identify the important good and bad bacteria in the gut and which foods promote them.
Mr. Gardner serves on the scientific advisory board of Zoe, a private company that provides personalized nutritional advice based on biological information. People take tests at home and receive instructions on what to eat based on their results.
This is exactly what the NIH study hopes to ultimately provide, but Boston’s lead researcher Das said the results may have stronger scientific support. When she asked about Zoe, she said, “The market is always ahead of science.”
At the end of their two-week stay, participants will face two full days of testing in which every aspect of their biology will be measured. On the final day, you drink two cups of Vanilla Ensure, sit in a chair from 8 a.m. to 1 p.m., and have blood samples taken at regular intervals to measure how nutrients are metabolized.
The “live-in diet” sessions are scheduled to end in mid-2026. Then, by multiplying the large amount of data from each individual across thousands of participants, the project deploys artificial intelligence to come up with a proposed algorithm to decide who should eat what. But this is not the end. A series of studies must be conducted to validate these algorithms.
Nicatoro wants to know what factors are driving an individual’s response. “It could be genetics, it could be the microbiome, it could be something about the environment, or it could probably be a mix of many of these things,” she says. The ultimate goal is to allow doctors and nutritionists to test for specific factors and create personalized meal plans.
Meanwhile, the first four participants returned home with lime-green souvenir water bottles and already found themselves changing their eating habits. Cashel liked her third diet so much that she’s trying to recreate the recipe in her kitchen. Hamdorf never felt hungry once during the experiment and found himself looking forward to each meal, realizing he needed to eat more and drink more water. Mathies and Carter are trying to eat less at night and eat more fruit and nuts.
All were happy to participate in the study.
“There aren’t many opportunities to contribute to important scientific research,” Carter said. “And I feel lucky to be able to do that.”
Felice J. Freyer can be reached at felice.freyer@globe.com.follow her @felicejfreyer.
