The future of food is precision

The answer could be precision nutrition, which aims to understand the health effects of the complex interplay between genetics, our microbiome (the bacteria that live in our gut), our diet and level of physical activity, and other social characteristics. and behavioral.

This means that everyone could have their own unique set of nutritional requirements.

How is it possible? I asked three experts who conduct precision nutrition research: Dr. Frank Hu, professor of nutrition and epidemiology and chair of the nutrition department at Harvard TH Chan School of Public Health, and Martha Field and Angela Poole, both assistant professors of the division of nutritional sciences at Cornell University’s College of Human Ecology.

Below is an edited version of our conversation.

CNN: How is precision nutrition different from current nutrition advice?

Dr. Frank Hu

Dr. Frank Hu: The idea of ​​precision feeding is to have the right food, in the right quantity, for the right person. Instead of providing general dietary recommendations for everyone, this precision approach adapts nutritional recommendations to individual characteristics, including genetic background, microbiome, social and environmental factors, and more. This can help you achieve better health outcomes.

CNN: Why is there no one-size-fits-all recipe when it comes to what we should eat?

Hu: Not everyone responds to the same diet in the same way. For example, given the weight loss diet itself, some people can lose a lot of weight; other people may gain weight. A recent study in JAMA randomized a few hundred overweight individuals to a healthy low-carb or low-fat diet. After a year, there was nearly identical weight loss for the two groups, but there was huge variation between individuals within each group – some lost 20 pounds. Others gained 10 lbs.
Marta Campo

Marta Campo: Individuals have unique responses to diet, and the “fine tuning” of precision nutrition is understanding those responses. This means understanding the interactions between genetics, individual differences in metabolism and responses to exercise.

CNN: How do we eat now based on precision nutrition principles?

Hu: There are some examples of personalized diets for managing disease, such as a gluten-free diet for managing celiac disease, or a lactose-free diet if you are lactose intolerant. For people with a condition known as PKU (phenylketonuria), they should consume (a) a phenylalanine-free diet. It’s a rare condition but a classic example of how your genes can influence the type of diets you should be consuming.

Angela Poole

Angela Poole: If I had a family history of high cholesterol, diabetes, or colon cancer, I would increase my dietary fiber intake by eating many different sources, including a variety of vegetables.

Field: If you have high blood pressure, you should be more aware of your sodium intake. Anyone with a malabsorption problem may need higher levels of micronutrients such as B vitamins and some minerals.

CNN: There is Research showing that people metabolize coffee differently. What are the implications here?
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Hu: Some people carry genes that metabolize caffeine quickly; others carry slow genes. If you carry fast (metabolizing) genotypes, you can drink a lot of caffeinated coffee because caffeine is broken down quickly. If you are a slow metabolizer, you get nervous and may not be able to sleep if you drink coffee in the afternoon. If so, you can drink decaf coffee and still get the benefits of coffee polyphenols, which are associated with a reduced risk of heart disease and diabetes without the effects of caffeine.

CNN: What is the role of our individual genes in disease risk? And can our behavior mitigate our risk of disease?

Hu: Our health is affected by both genes and diets, which constantly interact with each other because certain dietary factors can turn certain disease-related genes on or off. We have published research showing that reducing the consumption of sugary drinks can offset the negative effects of obesity genes. This is really good news. Our genes are not our destiny.
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Another area of ​​precision nutrition is measuring metabolites in blood or urine, small molecules produced during the breakdown and ingestion of food. For example, having a higher concentration of branched-chain amino acids (BCAAs) strongly predicts one’s future risk of diabetes and cardiovascular disease. Blood levels of BCAAs depend on the diet, genes, and gut microbiome of individuals. We have found that a healthy (Mediterranean-style) diet can mitigate the harmful effects of BCAAs on cardiovascular disease. So measuring BCAAs in your blood can help assess your risk of developing diabetes and cardiovascular disease, and encourage dietary changes that can reduce your risk of chronic disease down the road.

Field: The environmental effects can sometimes be of the same magnitude as the genetic effects compared to the risk of disease.

CNN: Our individual microbiomes may be able to dictate what kind of diet we should consume. Can you tell us about this emerging research? And what do you think about microbiome tests?

Poole: Research has shown that in some people the blood sugar level rises if they eat bananas than if they eat biscuits, and this has been associated with the composition of the microbiome. Scientists have used microbiome data to build algorithms that can predict an individual’s glucose response, and that’s a big step forward. But that’s no excuse for me to throw down cookies instead of bananas. Likewise, if the algorithm suggests eating white bread instead of wholemeal bread due to the blood sugar responses, I wouldn’t eat just white bread all the time.

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At the moment, I’m not ready to spend a lot of money to see what’s in my gut microbiome … and the microbiome changes over time.

Hu: Microbiome testing isn’t cheap, and the promise that this test can help develop a personalized meal plan that can improve blood sugar and blood cholesterol … at this point the data is inconclusive.

CNN: How will nutrition advice be different in 10 years?

Poole: I think you’ll get a personalized shopping list on an app – foods you want to buy and foods you want to avoid, based on your blood sugar responses to foods, your physical activity level, and more.

New technology cannot replace general nutritional principles such as eating healthier plant foods.

Hu: We will have more and better biomarkers and more affordable and accurate nutrigenomics and microbiome tests, as well as better computer algorithms that predict your response to food intake.

But these technologies cannot replace general nutritional principles such as limiting sodium and added sugars and eating healthier plant foods. In a few years, you may be able to get a more helpful answer from Alexa if you ask her what you should eat, but like other Alexa answers, you’ll have to take it with a grain of salt.

Lisa Drayer is a nutritionist, author, and CNN health and nutrition contributor.

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