Nutrigenomic and personalized health companies started springing up in the wake of the Human Genome Project’s completion in 2003, but the technological costs involved in those early days – as well as some intense attention from regulators about the claims being made – meant that many of those early innovators did not survive.
The last couple of years have seen a new rush to launch into the personalized space, with companies like Habit, Arivale, InsideTracker, DNAfit, DayTwo, and Nutrigenomix to name but a handful capturing headlines.
These companies stand a greater chance of succeeding because of parallel progress across multiple disciplines. “Many of the individual components that make up an aligned ecosystem are already in place,” said John Helfrick, Director, BASF Human Nutrition. “The science of nutritional products is advancing in parallel to the rise of activity trackers, diagnostics, analytics and other technologies. With these components in place and interest in wellbeing and longevity on the rise, the time has come for personalized nutrition.”
“We absolutely need to be considering what is the best nutrition for each person”
One of the key lessons from the past 20 years is that the impact of genetic coding on whole body metabolism isn't as rigid, or predictable, as we imagined, and that epigenetic factors introduce a lot of variability, explained Timothy Morck, PhD, founder/president of Spectrum Nutrition LLC.
“Also, the human organism is incredibly capable of adapting to disturbances, and compensating in other areas, when something doesn't work quite as well as planned,” added Dr Morck, who was previously VP of scientific and regulatory affairs in Nestlé’s Washington Corporate Affairs office, and prior to that he was president of DSM Personalized Nutrition.
“Probably one of the greatest uncertainties yet to be conquered is the massive impact of the microbiome, and all its genetic/metabolic/competitive survival dimensions which we haven't even scratched the surface on by now. Without more precise markers/indicators of nutritional adequacy, inadequacy, excess to the point of toxicity, and sub-optimal versus frank nutrient deficiency indicators... we really don't have a good enough tool set to measure how other metabolic processes affect the ‘nutritional status of the organism’. Cause and effect proofs are woefully lacking, and epidemiology can't help us sort out individual differences,” said Dr Morck.
“Despite the above, however, we absolutely need to be considering what is the best way to recommend an “optimal nutritional approach” for each person, in order to maximize realization of their 'health potential'.”
Consumer awareness and confidence in the companies playing in the space today are strong, but the ultimate goal should be to make this kind of health advice available to as many people as possible: The early adopters of these programs are more likely to be already health-conscious, whether that’s staying healthy or re-gaining lost health once they realize they don't like living with consequences of poor diet and lifestyle choices or poor genes.
Dr Morck said he believes it will take better, validated, metabolomic testing capable of sending up warning flares early enough to change the course that might be leading to disease, rather than what’s more prevalent today: wait until you receive the diagnosis of a disease, and now must be faced with the sobering reality impactful enough to instigate behavior change.
“There will continue to be the ethical dilemma of ‘should we test everyone for genetic susceptibility for developing chronic disease so we can force them into submission to an artificially-mandated healthy lifestyle to save global healthcare costs?’” he added.
“Alternatively, if the data eventually becomes so clear and compelling that we do have confidence in personal recommendations, and appropriate biomarkers to show progress towards improved metabolic outcomes that perpetuate compliance with new behaviors, leading to better habits, perhaps the sales pitch for embracing better health will voluntarily be embraced,” he said.
Dr Morck added that the cost of the tests, the precision of interpretation of results, and the proven efficacy of interventions approaching that required to get drugs approved are all needed before real policy and compelling public messages can be developed, even for their personalized application.
BASF’s Helfrick said that it remains to be seen if healthcare systems will start personalizing nutrition advice according to physical characteristics, blood biomarkers, and diet-responsive genetic variants.
“Scientific advances will evolve to address the gap between the potential and reality of personalized nutrition by persuading more and more people the idea is more than just hype. Yet, doing so will likely increase our understanding of the complexity of the body, reconfirming the need for an aligned ecosystem of personalized nutrition players,” he said.
Data from the European Food4me trial showed that personalized nutrition advice resulted in larger and more appropriate changes in dietary behavior versus a conventional approach (Celis-Morales, 2017, Int J Epidemiol, Vol. 46, pp. 578–588).
“Tailor-made interventions are not just improving the quality of life; they are also gaining traction as an innovative approach to prevent diseases,” says BASF's John Helfrick.
And for there to be success in this field, collaboration across disciplines and among companies is essential, said BASF’s Helfrick. “Companies offering personalized nutrition services tend to operate in silos so the industry is a bit fragmented. Some focus on testing, smart wearables, or analysis, but for the puzzle to be complete, we need a consumer offering that combines all pieces and each of five key elements.”
BASF believes five key elements together comprise beneficial, comprehensive personalized nutrition programs: An individual’s profile based on testing of their DNA, blood, saliva and microbiome; measurement of nutritional intake; interpretation of data; personalized nutrition recommendations; and feedback so participants can follow their personalized plans, track their progress and measure the effectiveness of their actions. When they experience results ranging from improved energy to healthier cholesterol levels, they’ll be more likely to maintain their personalized nutrition programs, he said.
And here is the crux of the issue: At the end of the day, humans must be willing to change their lifestyles in a meaningful way. “Human behavior still trumps knowledge of good/bad, as we see so many disregarding proven guidance about ‘healthy weight’ management, smoking and drinking to excess, and abusing drugs even when they are well known to be harmful,” noted Dr Morck.
“It will take a stronger internal drive for purity, self-fulfillment, self-worth/satisfaction, and social acceptance to overcome the siren's call to pursue self-indulgence, escapism, avoidance of pain, or general loss of ambition to make something positive out of one's life.”