Precision nutrition: Tailored diet assessments to become a mainstay in medical care by 2030

22 Mar 2021 --- Precision nutrition is taking the personalization trend to the next level, with the US National Institutes of Health (NIH) predicting it will become a mainstay in medical care by 2030. 

The NIH is supporting a new program called Nutrition for Precision Health, which aims to inform more personalized nutrition recommendations based on individual differences. 

Replacing dietary assessments with data linkages to grocery stores, digital uploads from restaurants, laboratory and microbiome assessments, or machine learning applied to food imaging would provide “more feasible, comprehensive capture of dietary habits.”

“We define precision nutrition as the goal of individualized, actionable dietary recommendations that help people decide what, when, why, and how to eat to optimize their health and quality of life,” Dr. Holly Nicastro, program director of Nutrition for Precision Health, tells NutritionInsight.

Through Nutrition for Precision Health, powered by the All of Us Research Program, the NIH also seeks to make study population demographics more diverse and inclusive.

Data linkages to grocery stores or digital uploads from restaurants would help provide a “more feasible, comprehensive capture of dietary habits.”“The fundamental idea is that more diversity in research – be it diversity in ethnicity, environment or life circumstances – will help close information gaps and pave the way for more tailored and effective health care approaches down the line,” Nicastro explains. 

Overlooking nutrition?
Diet and nutrition are complex exposures that have historically been difficult to capture. Despite clear evidence of nutrition’s impact on health, the NIH affirms diets are an environmental exposure often ignored in much of clinical practice and many research studies. 

Even when it is assessed, it is often through episodic and cumbersome surveys or perfunctory summative questions in most clinical settings. 

“A commitment to rigorous and consistently applied methodologies for studying nutrition and capturing dietary intake will help provide a better understanding of how diet as an environmental exposure influences health outcomes,” Nicastro details.

New assessment technologies
Environmental influences on health are currently measured through patient reports on habits and exposures. However, these should be complemented with precision nutrition, along with geocode-based exposure linkage and real time monitoring of multiple environmental exposures.

Testing innovative approaches to dietary assessment are strategic to the NIH’s Strategic Plan for Nutrition Research. “However, it will take time to know how much investment is needed to deploy them at scale,” comments Nicastro.

“The program aims to fund a Dietary Assessment Center that will be responsible for improving dietary assessment methodologies through validation, evaluation and modeling efforts and testing two side-by-side innovative approaches to assess dietary intake.”

Specific innovative approaches to be used in the study have not yet been determined, as applicants to the program will compete with their best ideas.

More diversity in population cohorts
One of the biggest challenges (and opportunities) before the biomedical enterprise today is the lack of diversity in populations involved in research studies. 

Less than 3 percent of the participants in published, genome-wide association studies are of African or Hispanic or Latin American ancestries, while 86 percent of clinical trial participants are white.

With a growing depth of data, there is an opportunity to replace adjustments for race and ethnicity with more specific measures. For precision nutrition to work, research demographics cannot be limited to those with European backgrounds. The NIH aims to assure over half of population demographics in 2030 research applications will hail from non-European ancestries.

“With a growing depth of data, we have an opportunity to replace adjustments for race and ethnicity with more specific measures. In particular, ‘race’ conflates a plethora of social, cultural, political, geographic and biologic factors together and can perpetuate systemic racism,” states the NIH. 

Opportunities afoot
When asked about the commercial opportunities of increased diversity, Nicastro responds: “For drug companies, that may mean more targeted therapies. For health care organizations, that may mean better screening programs or improved diagnostics that ultimately bring about efficiencies and cut costs.”

Educating consumers from traditionally understudied or underrepresented groups will further ensure people can follow the recommendations.

The Nutrition for Precision Health study will enroll approximately 10,000 participants from the All of Us research program. It will collect a comprehensive set of measures that may be potential predictors of interindividual variability in response to certain foods or diet patterns. 

Last year alone, the NIH invested over US$1.9 billion in the form of grants, contracts and other funding mechanisms in precision nutrition.

In light of both the UN Day of Women in Science and International Women’s Day this year, NutritionInsight looked into how gender and racial representation can drive long-term industry growth.

By Anni Schleicher