Personalized Nutrition: Hype or Hope?

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Just about everywhere you look, tailor-made products and services are transforming the consumer experience. Personalization is the name of the game, whether it’s getting e-mail offers for flights seemingly hand-picked for you, or scrolling through a Facebook feed that’s designed to show you exactly what you want to see. For supplement firms, it means offering consumers more tools that allow them to make the best dietary decisions for themselves, rather than handing out “one-size-fits-all” recommendations.

“Personalization is all about consumers no longer trusting the ‘experts’ and wanting to become more empowered and confident to create their own healthy eating patterns,” says Joana Maricato, research manager at New Nutrition Business. She adds that “consumers no longer see dietitians and health professionals as the experts on food and health, and their beliefs are becoming more fragmented.”

Food and supplement companies big and small are taking notice. Last October, Campbell Soup invested $32 million in personalized nutrition start-up Habit, which aims to offer a variety of tailored approaches to nutrition, including DNA testing, consumer-specific dietary advice, and customized ready-to-eat meals delivered straight to consumers’ doors. And in the supplements space, Maricato points to the “small, but growing, number of companies with personalization concepts.”

“Most large and medium-size players in the market have started to form teams focused on [personalized nutrition], have designed and developed pilots, and started to look for opportunities to participate or win in that space,” Rony Sellam, CEO of personalized health-analytics firm Segterra (Cambridge, MA), tells Nutritional Outlook. Segterra is the company behind InsideTracker, a personalized nutrition service that encourages users to assess the effectiveness of their diet with at-home tests and an online analytics platform buoyed by the advice of health professionals.

Blood testing, wearable devices, apps, and DNA testing are among the many forms personalized nutrition can take today, but which concepts are backed by research, and which are driven primarily by hype? 

The Challenge of Nutrigenetics

One aspect of personalized nutrition that’s attracted plenty of attention in recent years is nutrigenetics, the concept of using some degree of DNA testing to arrive at dietary recommendations specific to an individual’s genetic makeup. In theory, nutrigenetics would allow firms to perform a full or partial DNA analysis of an individual and identify single-nucleotide polymorphisms (SNPs)-variations in the genetic code that can sometimes suggest susceptibility to certain diseases, explains Raymond Rodriguez, PhD, professor, Department of Molecular and Cellular Biology at the University of California, Davis (Davis, CA). Then, based on that analysis, the firm would provide dietary recommendations that are optimized for the genetic predispositions of that person. 

“Many of the companies in the personalized nutrition market are relying on a small number of SNPs in a small number of genes to make assumptions about diets that can minimize risk for some future disease or disorder,” Rodriguez explains.

But as compelling as the idea of nutrigenetics is, and as affordable as it has become (most commercial tests range from $99–$300 nowadays), do we actually have the published research to back it up? Studies have long found that different people respond differently to the same diet, and that DNA may be associated with those different responses. For instance, a 2014 study found that individuals with a higher number of obesity-associated genetic variants who also consumed high levels of saturated fats were more likely to have a higher body mass intake (BMI).¹

But as with many such studies, researchers relied on self-reported dietary information to construct this trial. Meanwhile, the kind of research most needed for nutrigenetics to really get the approval of the broader scientific community-long-term, dietary-intervention clinical studies-is sorely lacking at the moment.

“There are no large-scale clinical studies in relation to personalized nutrition,” says José M. Ordovás, PhD, director, Nutrition and Genomics, and professor, Nutrition and Genetics, at the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University (Boston). “What we have is a smorgasbord of small, inconclusive, irreproducible studies scattered in the scientific literature that are cherry-picked by the interested parties to support their individual claims.” He adds that he has seen promising early DNA-based research in the areas of weight management and cardiovascular health for certain specific foods and nutrients, but that overall, “we don’t have validated evidence from the perspective of nutrigenetics that the approach really works.”

One reason for the scarcity of clinical research is the difficult nature of studying the relationship between genetics and diet. Hooman Allayee, professor, Departments of Preventive Medicine & Biochemistry and Molecular Medicine, at the Keck School of Medicine, University of Southern California (Los Angeles), explains that while it’s now become relatively easy to obtain high-quality genetic data, it’s much tougher and more costly to build a large-scale, long-term study where the participants are held to a controlled diet. Even then, if an association is found between one or more genetic variants and dietary intake, more rigorous research that controls for both the diet and the particular genetic variant would still be necessary to replicate the findings, says Allayee.

“That kind of rigor is what I think is missing in the field,” Allayee says. “That’s where the hang-up is. People haven’t gone and validated these gene-dietary interactions.”

Bright Future for Nutrigenetics

Still, despite the need for more research, all of the experts interviewed for this article agreed there is promise for DNA testing within the world of personalized nutrition. “I don’t believe it’s just hype,” UC Davis’s Rodriguez says. “It is sound scientific technology that’s being applied and used probably prematurely.”

Similarly, USC’s Allayee believes we are headed toward a global panel of nutrigenetics, which, if research progresses, may soon be able to offer recommendations based on genetics and diet. Allayee is also president-elect of the International Society of Nutrigenetics/Nutrigenomics, which counts among its goals the creation of a standardized definition of nutrigenetics.

“Maybe within five years we might have a personalized nutrition recommendation for fatty liver and a particular genetic variant and dietary sugars,” he says. “Maybe in ten years we might have something for inflammation or weight management.” He adds that while consumers are “probably wasting [their] money” if they purchase supplements today based only on recommendations a firm gives them as a result of DNA testing, it could still be a net positive if the idea of a tailored nutrition plan encourages them to adhere to a healthier diet. It gets to be harmful, however, if consumers decide they don’t need key nutrients based on recommendations from such firms, Allayee cautions.

From the perspective of an actual brand working with DNA, Mehdi Maghsoodnia, CEO of nutrigenetics company Vitagene, says that “as of right now, there are a lot of clinical studies connecting disease symptom management to supplements, but the clinical studies connecting genetics directly to supplements is still an emerging field.” He explains that DNA testing can already tell us important things related to personalized nutrition, such as how a person’s body performs during exercise. That information may still help in crafting a tailored nutrition plan, even as more rigorous research on nutrigenetics is still evolving.

“By pairing DNA analysis alongside lifestyle factors, an individual can understand their DNA, what it says about their health, and then create actionable recommendations for diet, exercise, and supplementation to achieve their optimal health,” Maghsoodnia says. 

Beyond DNA

Personalized nutrition comes in plenty of forms besides DNA testing, chief among them blood testing. InsideTracker uses routine blood tests in conjunction with demographic and lifestyle information to help consumers monitor and adjust their dietary intake.

“Our approach is to be agnostic to the type of input and instead include and combine any and all inputs that do present strong evidence in the literature,” says Segterra’s Sellam. “We don’t see genetic testing as the only input; a routine blood test during an annual check-up can sometimes be more informative.”

BASF Nutrition & Health (Florham Park, NJ) actually allows its employees in the United States and Asia to participate in InsideTracker’s program. The service begins with simple blood tests participants can conduct themselves at home, and personal profiles that include age, gender, ethnicity, and physical activity level. Participants create goals, and they then receive a nutrition plan of dietary restrictions and preferences tailored to the lifestyle.

“Unlike genetic testing, blood tests offer biological markers which provide dynamic insight in a person’s make-up,” explains John Helfrick, director of human nutrition at BASF Nutrition & Health, North America. “These biomarkers can then be modified by simple interventions such as diet, supplementation, exercise, and lifestyle changes.”

Beyond the logistics of the program, InsideTracker has also found custom consumer goals and regular feedback to be an essential component of its personalized nutrition plan. Each plan is built based on the subjective health desires of the consumer, even if it’s a short-term goal of looking good rather than a long-term goal of being healthy, Sellam explains. It’s all about what the consumer wants, rather than telling them what they should be doing. And to keep its consumers engaged, InsideTracker provides them with regular feedback via its online platform so they can check the results of their monthly blood tests whenever they want.

InsideTracker’s constant updates is definitely a different approach from that of many nutrigenetics firms, which often offer a one-time DNA analysis followed by a supplement plan or dietary recommendations. And as the research progresses, it’s easy to see how both approaches, as well as data from wearable devices and more, could complement each other. But at least one thing is clear right now: consumers are looking to step beyond blanket recommendations about nutrition and seek out the nutrition regimens that are just right for them.

“For dietary supplement companies, they must realize now that their traditional product portfolio may need updating as personalized nutrition evolves,” concludes BASF’s Helfrick. “Growing their business will require differentiated products and brands based on consumer insights.” 

References

1. Casas-Agustench P et al., “Saturated fat intake modulates the association between an obesity genetic risk score and body mass index in two US populations,” Journal of the Academy of Nutrition and Dietetics, vol. 114, no. 12 (December 2014): 1954-1966

Michael Crane is the former associate editor of Nutritional Outlook magazine.

Also read:

Nutrigenetics, Weight Management, and Dietary Supplements

The Value of Nutrigenomic Supplements. (Hint: It doesn’t involve genetic testing.)