The answer may 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 physical activity level, and other social characteristics and behavioral.
That means everyone could have their own unique set of nutritional requirements.
Below is an edited version of our conversation.
CNN: How is precision nutrition different from current nutrition advice?
Dr Frank Hu: The idea of precision nutrition is to have the right food, in the right amount, for the right person. Instead of providing blanket dietary recommendations for everyone, this precision approach tailors nutritional recommendations to individual characteristics, including genetic background, microbiome, social and environmental factors, and more. This can help achieve better health outcomes.
CNN: Why isn’t there a one-size-fits-all recipe when it comes to what we should be eating?
Martha Field: People 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?
Huh: There are some examples of personalized diets for disease management, such as a gluten-free diet for celiac disease management or a lactose-free diet if you are lactose intolerant. For people with a condition known as PKU (phenylketonuria), they should eat (a) a phenylalanine-free diet. It’s a rare condition, but a classic example of how your genes can influence the type of diet you should eat.
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.
Countryside: If you have high blood pressure, you need to be more mindful of your sodium intake. Anyone with a malabsorption problem may need higher levels of micronutrients, such as B vitamins and some minerals.
Huh: Some people carry genes that rapidly metabolize caffeine; others carry slow genes. If you have fast (metabolizing) genotypes, you can drink a lot of caffeinated coffee because caffeine breaks 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 that’s the case, you can drink decaf coffee and still get the benefits of coffee polyphenols, which are associated with a lower risk of heart disease and diabetes without the effects of caffeine.
CNN: What role do our individual genes play in our disease risk? And can our behavior mitigate our risk of disease?
Countryside: Environmental effects can sometimes be of the same magnitude as genetic effects with respect to disease risk.
CNN: Our individual microbiomes can dictate what kind of diet we should eat. Can you tell us about this emerging research? And what do you think of microbiome tests?
Poole: Research has shown that in some people, their blood sugar will rise more from eating bananas than from eating cookies, and this has been associated with the composition of the microbiome. Scientists have used data from the microbiome to create algorithms that can predict an individual’s glucose response, and this is a breakthrough. But that’s not an excuse to eat cookies instead of bananas. Similarly, if the algorithm suggests eating white bread instead of whole grain bread because of blood glucose responses, I wouldn’t eat white bread all the time.
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.
Huh: Microbiome tests don’t come cheap, and the promise that this test can help develop a personalized eating 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 in one app: foods you want to buy and foods you want to avoid, based on your blood sugar responses to foods, your level of physical activity, and more.
Huh: We will have more and better biomarkers and more affordable and accurate microbiome and nutrigenomics tests, as well as better computer algorithms that predict your response to food intake.
But these technologies cannot replace general nutrition principles, such as limiting sodium and added sugar and eating healthier plant foods. In a few years, you may be able to get a more helpful response from Alexa if you ask what you should eat, but like other Alexa responses, you’ll have to take it with a grain of salt.
Lisa Drayer She is a nutritionist, author, and health and nutrition contributor for CNN.
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