what is that?
Precision nutrition may sound like a new fad diet, but it’s actually a credible emerging field of research supported by the National Institutes of Health under the umbrella of precision medicine. [1,2] Precision medicine aims to improve the individualized treatment of disease, while precision nutrition focuses on dietary intake. Both develop interventions to prevent or treat chronic diseases based on an individual’s unique characteristics, such as DNA, race, sex, health history, and lifestyle habits. Both aim to provide safer and more effective ways to prevent and treat disease by providing more precise and targeted strategies. Precision nutrition recognizes that different people may respond differently to certain foods and nutrients, so the best diet for one individual may be very different from the best diet for another. How often have you been tempted to follow a fancy diet that a celebrity or friend touted as helping them lose 20 pounds or “cure” diabetes? The concept of precision nutrition discourages such practices, as your personal blueprint may require a unique eating plan to be successful.
Precision nutrition also takes into account the microbiome – the trillions of bacteria that live in our bodies and play a vital role in many internal functions every day. The types and amounts of bacteria we have vary from person to person. Our diet determines the types of bacteria that live in our digestive tract, but precision nutrition says the opposite is also true: the types of bacteria that live in our bodies may determine how we break down certain foods and what types of foods are most beneficial for our body.
How does it work?
Precision nutrition, also known as personalized nutrition, focuses on individuals rather than populations. Many studies on nutrition and dietary types provide useful information for communities and the general public. Quality nutrition studies have shown that for the average person, consuming more vegetables, whole grains, and lean protein and less highly processed foods with added sugar and salt can reduce the risk of a variety of diseases. However, when studies such as the PREDICT 1 trial focus on an individual’s response to food, they find that there is considerable variability in blood glucose and triglyceride responses, even when individuals are consuming identical diets. [3] Fluctuations in blood triglyceride levels after a meal were found to be driven by the human microbiome, and factors other than food, such as sleep, physical activity, and mealtime, also play a role in causing fluctuations in blood glucose and triglyceride levels after a meal. [3] Therefore, beyond general health recommendations, individuals may derive additional benefits from following personalized nutritional guidance. Precision nutrition involves evaluating DNA, microbiome, and metabolic responses to specific foods and dietary patterns to determine the most effective eating plan to prevent or treat disease.
Applying precision nutrition to disease management
For example, traditional management of type 2 diabetes targets healthy lifestyle elements (exercise, diet, achieving a healthy weight) and often also includes pharmacotherapy. Precision nutrition allows for further customization of diabetes management by taking a closer look at the following areas: [4,5]
- It looks at how DNA is related to the intake and metabolism of certain nutrients, which can then predict how a person will respond to a particular diet.
- Measuring metabolites (small molecules produced during the breakdown and digestion of food) can reveal a person’s long-term dietary patterns, such as whether they eat fruits and vegetables regularly or consume meat and butter daily and are high in saturated fats. Precision nutrition examines whether there is an association between a person’s metabolic “signature” created by these dietary patterns and their risk of developing type 2 diabetes. Metabolic tests used in precision nutrition can help determine how a person’s body responds to a particular diet.
- Discover the types of gut bacteria that help improve blood sugar control and implement dietary patterns that change your microbiome to support the growth and maintenance of these specific gut bacteria.
Applying precision nutrition to specific foods
Other factors being studied include whether a high intake of saturated fat makes you more likely to gain weight, or whether a high intake of salt increases your risk of developing high blood pressure. [7] However, the results of these studies have not been replicated in different populations.
Issues and Considerations
The field of precision nutrition has yet to take off due to a variety of challenges, including a lack of well-designed clinical trials that show consistent results, as well as the expensive technology required to collect and study an individual’s DNA, gut microbiome, and response to food intake. [4] Such dietary interventions require high-quality evidence of their effectiveness and consistency before they can be recommended in conjunction with or as an alternative to conventional interventions for a specific disease. Also, clinical trial results on an individual’s metabolic response to a particular dietary intervention may vary depending on the type of testing used, which may result in variability in the individualized nutritional recommendations provided.
Primary care physicians, registered dietitians, and other health care providers who work directly with individuals need to be educated about precision nutrition, as it requires a collaborative effort of the entire health care team. Although metabolic responses to foods vary from person to person, personalized dietary advice should be aligned with general nutritional principles (e.g., eating more fruits and vegetables, limiting added sugars from sweetened beverages, and limiting sodium). Private companies are beginning to offer genetic and microbiome tests to the public to customize diets, but more research needs to be done on the validity and accuracy of these tests.
Ethical and legal aspects of implementing precision nutrition must also be considered. This includes protecting consumer privacy in the use of precision nutrition technologies and tests. It is also important to recognize that personalized approaches may only be accessible to a small portion of the population, potentially widening health disparities. We must not forget to improve the broader food environment through effective policies, regulations, and other population-based approaches that help make healthy food choices the default.
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