Personalized Nutrition
This article was written by staff writer Jenna Bensko. Read about Jenna here.
We are beyond the “one size fits all” approach at this point. And I’m not talking about one size swimsuits, or diet apps like Fitness Pal that give you the option to input your weight and height to get “personalized advice”. There has been an increasing number of companies that have engineered algorithms which can suggest the best dietary plan to lower your glucose response to a meal, or analyze the makeup of your individual microbiome and can make dietary recommendations that boost the health of your gut microbiota. That said, the increased popularity of these “individualized” programs is no surprise.
There has been longstanding frustration with the poor efficacy of the national dietary guidelines, and I believe that’s partially due to their population-based approach. One of the issues with this approach is the plethora of barriers that consumers face in their efforts to acquire and consume recommended foods (monetary restraints, transportation, time constraints, cooking appliance access, etc.). The national guidelines don’t address these barriers. Furthermore, we all digest and absorb our food differently, according to the composition of our gut microbiota. Research on the microbiome has surged in the last decade, as evidenced by the numerous food companies jumping on the probiotic bandwagon with claims that certain bacteria are beneficial for gut health. However, not all personalized nutrition companies focus on the gut microbiome. With all of this nuance finally falling under the public eye, it's no wonder personalized nutrition has become so widely sought after. But what is personalized nutrition? Is it another nutrition hoax? Can these companies be trusted? Should you really be dishing out large sums of money for the latest health food trend (like $4 on a bottle of kombucha)?
Personalized Nutrition Technology
Personalized nutrition goes beyond recommending a low-carbohydrate diet for diabetics or an anti-inflammatory diet for someone with an autoimmune disease (i.e. Rheumatoid Arthritis). This novel intervention uses a combination of machine learning and “omics” (genomics, metabolomics, and proteomics) data to individualize dietary recommendations. Typically, some data is collected on the individual (anthropometric measurements, lifestyle factors, blood biomarkers, stool samples, etc.) that is fed into the “machine” which shoots out predicted responses to a variety of foods, according to that data. Health professionals can then analyze this output and recommend specific dietary changes according to an individual’s health goals. Increasingly, this technology is being used by companies to sell services and products. This includes individually recommended nutritional supplements, apps that use the machine learning to provide dietary recommendations based on a blood sample, and stool-sample tests whose results are used to create customized dietary advice that promises to promote gut health.
Company Spotlight: Day Two
Stool sample tests that measure gut microbiome composition and diversity are among the fastest growing sector in the market. Companies take the results and use them to provide customized diets and advice designed to improve gut health. One such company is DayTwo, a “microbiome-based precision nutrition for metabolic disease”. The goal of DayTwo is to provide personalized diet recommendations for managing blood glucose responses to meals, using data from your microbiome (via stool sample).
The gut microbiome houses trillions of microbes that play a role in how we metabolize the food we digest and the microbiome diversity of each person is highly variable. This might help explain individual responses to the same diet - the theory that DayTwo is built off of. The gut microbiome data they collect is analyzed and the app recommends specific dietary plans according to the bacteria composition. Recommendations aim to decrease your blood glucose response and increase the quantity of healthy bacteria in your gut. Because of the focus on glucose, DayTwo is specifically marketed for those that live with diabetes, but can be utilized by anyone hoping to build the health of their gut.
A major concern I have with capitalizing on this specific technology is that the microbiome composition can change very rapidly. Several studies have explored the rate at which dietary changes can alter your gut microbiota makeup - noticeable changes can occur within three to four day of a dietary shift. This includes not only variation in the abundance of bacteria, but also in the rates of gene expression they impact. This is good news for those of us hoping to make up for years of bad bacteria buildup, as a few diet changes can produce pretty immediate positive impacts. However, this is bad news for the efficacy of DayTwo. If our gut microbiota is constantly changing - how can we know if a snapshot of our stomach from one stool sample is reflective of our average bacteria composition? A few days of drinking or a weekend of eating out may alter your gut bacteria and give an inaccurate representation of your normal makeup. I think this technology is headed in the right direction, but I would caution those interested in companies like DayTwo to be mindful of the limitations of their methods.
Company Spotlight: Inside Tracker
A company that is constantly showing up on my social media feed and in my web browser is Inside Tracker. They seem to primarily target athletes, but anyone could benefit from their services. Inside Tracker collects personalized data via blood draw and then makes individualized recommendations after blood analysis via a mobile app. Rather than working from microbiome data, InsideTracker tests up to 46 different blood biomarkers (i.e. ferritin, vitamin d, cortisol, cholesterol) and analyzes which biomarkers are in the normal, low, or high range. Based off this analysis, the app recommends dietary changes that should optimize your biomarker levels, along with lifestyle changes like physical activity. The company sponsors a lot of athletes that may want to keep track of data like their iron levels and cortisol, but all of this information is useful for the average person.
I have personally tried the Inside Tracker app myself and found the information to be extraordinarily useful. When I first moved to Colorado (i.e. high altitude) from sea level, I had a really hard time adjusting to the lack of oxygen. As a competitive runner, I felt like my training was taking 10 steps back, and I was unsure why. I scheduled a blood draw with Inside Tracker to see if any of my blood markers were out of the normal range. My results led me to the issue: I had extremely low ferritin (storage form of iron) levels. Extreme fatigue is a common symptom of low iron and moving to altitude makes you more at risk of developing low iron. By simply adding an iron supplement to my daily routine, I remedied my fatigue during training. Inside Tracker also gave me personalized nutrition recommendations based on my blood draw results. In addition to recommending a high iron diet (i.e. additions of spinach and sprouted beans), I was also advised to start adding more nuts into my routine (to improve my magnesium levels), and to incorporate more olive oil into my diet (to lower LDL levels). However, it should be noted that blood biomarkers don’t always give us the most accurate picture of how much of a said biomarker is in our body. The amount of a vitamin or mineral in your blood may not always represent the amount stored (or not stored) in your body. For example, iron is found in a variety of forms depending on if it’s being transported or stored, and what tissue it is in. This makes ferritin a sometimes unreliable measure of whole body iron stores.
A Note on Probiotics
While personalized nutrition doesn’t have to involve analysis of the gut microbiome, several companies use the microbiome as their foundation for data collection and food companies consistently push the gut health trend. I hope to write up a more robust article on probiotics in the coming weeks, but here is an appetizer to wet your palette. The benefits of probiotics have been studied for several years now. Probiotics are “good” bacteria for your gut and companies like DayTwo may even suggest you start eating probiotic foods. However, there are many other probiotic foods outside of kombucha. For example, yogurt and other fermented foods like sauerkraut and kimchi confer the same probiotic benefits.
Kombucha is a nice option if you prefer to drink your probiotics, but it does get expensive and companies often load up the drink with lots of sugar. If you’re on a kombucha kick, I might suggest you try making your own to control the sugar content and save on your grocery bill. Additionally, the importance of prebiotics is often overlooked in favor of the probiotic trend. Prebiotics are essentially the bacteria that feed the probiotic community and keep them alive and well. I would suggest taking a prebiotic supplement if you’re really into probiotic foods for their health benefit.
The Access Issue
Before signing off, I want to acknowledge a major limitation of this technology. This information is expensive. As it stands, personalized nutrition is a luxury amenity. Unfortunately, it seems like most companies require $300-$900 to provide you with their services. My hope is that when more companies adopt this technology, the technology will get fine-tuned for mass production, we will see a drop in the associated costs.
This article was written by staff writer Jenna Bensko. Read about Jenna here.
