Precision nutrition, sometimes referred to as personalized nutrition, has to do with diet, but it’s far from a fad, and in fact, may well be the wave of the future when it comes to how nutrition is studied and how clinical recommendations are made for what and how people eat. Precision nutrition may also lead to a change in food policy, including regulation, nutrition labeling and allowable product claims. But we’re getting ahead of ourselves.
The concept of precision nutrition grew out of the field of precision medicine, both of which are disciplines that theorize that one size does not necessarily fit all. Precision medicine aims to take an innovative approach for those patients and conditions for which the current approach toward disease prevention and treatment based on “the expected response of an average patient” doesn’t work. Instead, precision medicine “is an innovative approach that takes into account individual differences in patients’ genes, environments, and lifestyles” according to the National Institutes of Health (NIH).
Both precision medicine and precision nutrition are in their formative stages, with science for the former leading to biomedical research that has already touched millions, according to NIH.
The discipline of precision nutrition is also still emerging—and picking up steam. In a paper published at the end of 2019 in the Journal of the American College of Nutrition, a group of scientists representing the American Nutrition Association, a non-profit organization, put forward this definition for personalized nutrition: a field that leverages human individuality to drive nutrition strategies that prevent, manage, and treat disease and optimal health.
That’s just one such definition as scientists attempt to corral the potential power of this exciting discipline. For example, this article, suggests that while precision and personalized nutrition are closely tied, there are specific differences between the two. The piece notes that personalized nutrition covers the application of “omics” technologies, including nutrigenomics, metagenomics, and metabolomics to the prescription of individualized diets for health and wellbeing.
For the purposes of this blog, we’ll use the terms “precision” and “personalized” interchangeably as some experts do, noting that the “omics” technologies play an important role when conducting research on macronutrients, micronutrients, dietary habits and behaviors and social determinants of diet and health.
According to this post from the Harvard T.H. Chan School of Public Health, precision nutrition looks at an individual’s DNA, microbiome, metabolic response to specific foods or dietary patterns to determine the most effective plan to prevent or treat disease. Research is studying the application of precision nutrition for obesity, metabolic syndrome, certain cancers and type 2 diabetes.
And this definition: precision nutrition (PN) is an approach to developing comprehensive and dynamic nutritional recommendations based on individual variables, including genetics, microbiome, metabolic profile, health status, physical activity, dietary pattern, food environment as well as socioeconomic and psychosocial characteristics.
If you’ve ever heard the joke about how many scientists are needed to change a lightbulb, you’ll understand the variety of definitions for precision nutrition. The good news: all the definitions seem to focus in the same areas, more or less. What’s more exciting: the number of scientists interested in studying precision nutrition.
Benefits of Precision Nutrition
Precision nutrition is not meant to throw out scientific research that focuses on groups of people rather than the individual, but rather build on that research and evolve. Indeed, well-established scientific studies based on traditional cohort groups have demonstrated that the average person’s health can benefit from dietary practices, such as choosing mono- and polyunsaturated fats over saturated and trans-fats, or by reducing added sugars and simple carbohydrates in favor of fruits and complex carbs like whole grains and brown rice.
But what scientists engaged in precision nutrition research are finding is that individual responses to food also matter, and perhaps, not surprisingly, emerging science is showing that there are significant variations in, say, glucose and triglycerides even among individuals eating identical meals. One such study is the Personalized Responses to Dietary Composition Trial-1 (PREDICT1), which found substantial variations in blood responses to glucose and triglycerides even when individuals are eating identical meals.
The PREDICT studies are conducted by ZOE, a for-profit, member-based company that offers wellness advice through its personalized nutrition program. ZOE’s PREDICT research trials are run in partnership with scientists from institutions such as Massachusetts General Hospital, Stanford Medicine, Harvard T.H. Chan School of Public Health, and King’s College London.
The first study from PREDICT-1 was published in 2020 and looked to assess postprandial (during or relating to the period after dinner or lunch) metabolic responses in a population of approximately 1,000 healthy adults, drawn from the TwinsUK cohort and the general population in the UK.
The study was designed with the objective of predicting glucose, insulin, lipid and other postprandial responses to foods based on the individual’s characteristics, such as molecular biomarkers and lifestyle factors as well as the nutritional composition of the food.
The authors noted an observation of large inter-individual variability in postprandial responses of blood triglyceride (103%), glucose (68%) and insulin (59%) after individuals consumed identical meals. The person-specific factors (for example, the gut microbiome) had a greater influence than did the meal macronutrients for some findings such as postprandial lipemia, but not for others like glucose. The findings were independently validated in a U.S. cohort of 100 individuals. The findings may be informative for developing personalized diet strategies, said the study authors.
Following PREDICT-1, ZOE set into motion PREDICT-2 and PREDICT-3, with more anticipated publications to follow, which should provide additional discoveries for precision nutrition. You can learn more about the other PREDICT research here.
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The Role of NIH in Precision Nutrition
One potential challenge for studying the benefits of precision nutrition is to ensure that there is sufficient funding support. In its ambitious 2020-2030 Strategic Plan, the NIH announced its plan to accelerate nutrition research over the next 10 years with a focus on precision nutrition and a Nutrition Research Task Force with a hefty research budget. The plan calls for a multidisciplinary approach through expanded collaboration across NIH Institutes and Centers to speed up nutrition science and uncover the role of human nutrition in improving public health and reducing disease.
The strategic plan is organized around four strategic goals that answer key questions in nutrition research:
- spur discovery and innovation through foundational research: what do we eat and how does it affect us?
- investigate the role of dietary patterns and behaviors for optimal health: what and when should we eat?
- define the role of nutrition across the lifespan: how does what we eat promote health across our lifespan?
- reduce the burden of disease in clinical settings: how can we improve the use of food as medicine?
To that end, recent announcements from NIH focused on its determination to fund meaningful research in the area of precision nutrition. In 2022, the NIH announced $170 million to be spent on research over five years, for a new study developing algorithms to predict individual responses to food and dietary routines.
The Nutrition for Precision Health (NPH) project powered by the All of Us Research Program, will recruit a pool of 10,000 diverse participants to inform more personalized nutrition recommendations. The initiative includes 11 new awards and further funds three existing All of Us Research Program awards.
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Earlier this year, the NIH launched what it calls “the largest precision nutrition research effort of its kind” by opening enrollment across 14 sites in 6 states.
The six clinical centers conducing the study will research how nutrition can be tailored to each person’s genes, culture and environment to improve health. The NPH project aims to make good on the premise that the foods we eat can help prevent and fight conditions like high blood pressure, diabetes, stroke and cancer.
NIH’s efforts in precision nutrition has been compared in its scope and potential impact to The Human Genome Project, an ambitious research effort aimed at deciphering the chemical make-up of the entire human genetic code.
This article shares some of the other science that’s been taking place in the discipline of precision nutrition.
Is There a Role for Supplements in Precision Nutrition?
In addition to studying foods, will there be a role for dietary supplements in precision nutrition? One certainly hopes so, and many companies in the supplement industry have started touting the personalized approach to taking supplements, as many researchers have discussed the need to expand the scientific study of vitamins. For example, preeminent nutrition researcher, Jeffrey B. Blumberg, Ph.D., nutrition professor emeritus, Tufts University Friedman School of Nutrition, discussed the role of “omics” in this article from an industry trade publication.
He said, “Machines can take massive amounts of data from massive amounts of people and look for patterns. People are building these tools now and trying to understand how only a limited set of biomarkers are needed to tell you something about the state of your health and wellness to make an impactful prediction. This will work for vitamins and other nutrients.”
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In other words, the advances in sophisticated algorithms and scientific approaches may also help inform not only the role of macronutrients, but also how micronutrients can best work for individually tailored solutions.
Given the knowledge that many people fall short of key micronutrients and that supplements can enhance nutrient status, and further given the popularity of dietary supplements—a recent annual survey from the Council for Responsible Nutrition found that 74% of U.S. adults take dietary supplements—the hope is that supplements will not be forgotten as grants are awarded under the NIH NPH research projects.
The Future: Precision Nutrition & Dietary Advice
So, where does the future of precision nutrition stand? According to this article precision nutrition holds “great promise as a tool to improve healthspan and reduce healthcare costs.” But there are challenges along the way. The authors believe that accelerating advancement in precision nutrition will require these three steps:
- investment in multidisciplinary collaborations to enable the development of user-friendly tools applying technological advances in omics, sensors, artificial intelligence, big data management and analytics;
- engagement of healthcare professionals and payers to support equitable and broader adoption of precision nutrition as medicine shifts toward preventive and personalized approaches; and,
- system-wide collaboration between stakeholders to advocate for continued support for evidence-based precision nutrition, develop a regulatory framework to maintain consumer trust and engagement, and allow precision nutrition to reach its full potential.
In other words, while precision nutrition still has a long way to go, reaching the destination may be well worth the journey as precision nutrition has the potential to revolutionize the way we approach our eating habits and overall health—for the better.
