Personalized Nutrition For Health

Our heath is inextricably linked to what we eat. Poor nutrition can increase our susceptibility to disease, exacerbate symptoms, or even be the root cause. This issue is highlighted by the global burden of malnutrition, predicted to increase to one in two people by 2025, which causes poor health outcomes and an increased prevalence of disease:

• Cardiometabolic disease: Globally, obesity has tripled since 1975, bringing an associated increase in cardiometabolic diseases, including type 2 diabetes and cardiovascular issues (e.g. heart failure, stroke). These cause significant health and economic burden, regardless of a country’s economic status (AHA, 2016; BMC Public Health, 2018; WHO, 2020).
• Other non-communicable diseases: Poor nutrition is also linked to an increased prevalence of inflammatory diseases (e.g. ulcerative colitis, Crohn’s disease, asthma, allergies) and some cancers. The direct causative agents are complex and not well understood, although dysbiosis (alteration of gut microbiome) and nutrient deficiencies have been highlighted as contributing factors (Nutrients, 2017; Science, 2020).
• Infectious disease: Malnutrition increases the risk of morbidity and mortality from infectious disease, which is a major health problem, particularly among infants and children (WHO, 2010). The current COVID-19 pandemic clearly demonstrates the links between health and diet; being undernourished or having poor metabolic health increases the risk of worse outcomes, including hospitalization and death (Glob. Nut. Rep., 2020).

Decades of nutritional advice has had limited impact on public health. While it would be easy to blame non-compliance, generalized recommendations are flawed because they take a “one diet for all” strategy. Individuals respond differently to the same foods, so a more personalized approach has been hailed as one solution to the current global health crisis. However, research in this area is currently hindered by the lack of sophisticated understanding about the composition of food and how it links to health. The Periodic Table of Food Initiative will be key to providing the robust data needed to understand the complex factors that govern our body’s response to what we eat.

“Our food is comprised of hundreds of thousands of biochemical components, most of which are not understood or recorded. Of those that we do know about, evidence now suggests that people respond differently to them,” says Dr. Sophie Hawkesworth, Portfolio Manager of Population Health at the Wellcome Trust, whose work aims to improve global public health through research funding.

“The health effects of the food we eat are a result of many complex factors interacting with each other including our genome, microbiome, and metabolism. Personalized nutrition, sometimes referred to as precision nutrition, integrates different kinds of large sets of data to expand our understanding of the complexity and diversity of the human metabolism in response to diet. This allows a much more nuanced understanding of how individuals respond physically to food, and how this is determined by interactions between biology, their environment and behavior,” she explains.

“Personalized nutrition could revolutionize our diets for better health,” explains Dr. Lindsay Keir, Innovations Partner at the Wellcome Trust, and a Trustee of Crohn’s & Colitis UK. “A  major study in this area revealed that people respond differently to the same meal, and an array of factors, such as blood parameters, dietary habits, body measurements, physical activity, and gut microbiota can be used to predict how an individual’s blood sugar levels respond. This is important because when these levels are elevated in response to eating, it is believed to be an indicator of diabetes risk.”

She continues, “Studies have shown that personalization can foster changes in dietary behavior, leading to greater improvements in diet than universal approaches, however, much more research is needed. Evidence for personalized advice are often based on observational studies that suggest health implications by association, rather than direct cause. Also, factors that govern individualized responses are still largely unknown, although our microbiome is thought to play a leading role. Having better data about the food that we eat will greatly facilitate research on the mechanisms that underpin diet-disease connections and may also reveal new prevention or treatment opportunities.”

Proposed Solution: A Periodic Table of Food

Research questions that endeavor to understand how individuals respond to diets are limited by the lack of understanding of the detailed composition of our food. Currently only a fraction of the total component parts of a relatively small number of foods have been recorded and the analytical methods used to categorize these components vary, which reduces the reliability and comparability of the data. Having this level of information would enable researchers to understand in much more detail how individuals respond to dietary components, including the scale and potential causes of variability. This knowledge is crucial for scaling out personalized nutrition and increasing its impact.

The Periodic Table of Food Initiative is a global effort to greatly expand our understanding of the biochemical components of our food. The initiative will create standardized kits and methods that will allow researchers to easily categorize the thousands of compounds found in foods, culminating in a large set of data housed in a publicly accessible database. This data will allow diet to be related to health outcomes with greater confidence and further, guide evidence-based dietary advice so we can move towards a personalized system that mitigates and ultimately helps to prevent disease.