Defining personalized nutrition – from personal preference to personal health
Personal preference has dictated nutritional choices throughout contemporary history. Ever since people gained access to enough food to move beyond subsistence nutrition, they have based their dietary decisions mainly on taste and general health trends. Yet a growing body of evidence shows there is no one-size-fits-all approach to nutrition. Our responses to different nutrients are unique, and by recognizing and monitoring this we can potentially extend our healthy life expectancy.
In recent decades, a sizable proportion of people in Western countries have adapted their diets to prevailing health trends. Magazine articles, blogs and social media have driven changes in food and dietary supplement habits, leading to surges in sales of products such as kale and omega-3 supplements.
Some of these sales surges are underpinned by solid science, while others are built on shakier evidence bases or food trends. What they have in common is a population-scale approach to nutrition. Foods and ingredients are either good or bad for everyone, regardless of their personal characteristics and priorities.
More recently, this black-and-white view of nutrition has been upended by research showing each of us responds differently to foods and supplements. My body processes a banana differently than your body. Consequently, while bananas are broadly seen as a healthy food, I may benefit more from eating one than you, or vice versa. This knowledge has emerged in parallel to new sources of health data and tailored dietary advice, transitioning food and nutrition from personal preference to personal health.
“Nowadays you really have the possibility to individualize or personalize nutrition, and have the right nutrients, for the right people, at the right time,” Martin Stahljans, director, adaptive business networks at BASF SE, nutrition and health, said.
Stahljans’ definition and vision of personalized nutrition is made possible by a range of advances in multiple industries. Personalized nutrition is the result of three trends: advances in nutritional science have improved understanding of how diet affects health; new diagnostics and devices have opened up ways to measure and monitor health and fitness; and the rise of analytics tools and self-learning algorithms have turned the data they generate into real-world insights.
Until recently, people only gained access to health data and insights when they visited the doctor. Day-to-day dietary choices were dictated by taste and individual interpretations of generalized advice. Now, anyone can generate data on their genetics and metabolism while simultaneously tracking how their health metrics respond to dietary changes in real time.
The personalized nutrition ecosystem
Camilla Stice, research analyst at Lux Research, categorizes personalized nutrition services on two axes. The first axis assesses personalization specificity. At the near end is personal preference-type advice based on physical traits and lifestyle. At the other extreme is the tailored advice enabled by genetic or blood and microbiome testing. The second axis covers frequency of recommendation. At one end are one-off recommendations, such as those provided by genetic tests. At the other end is the continual feedback delivered by wearables.
The move toward personalized nutrition began with the emergence of blood and genetic tests that generated individualized dietary recommendations. Such tests look at a single aspect of a person’s health and generate one-time or, if the analysis is repeated, periodic recommendations about which foods they should eat more. The development of these diagnostic tests marked a big step in the move toward personalized nutrition, but the days of them being the primary way to inform dietary recommendations are already over.
“We call them personalized nutrition 1.0,” Nard Clabbers, senior business developer personalized nutrition and health at TNO, said.
The current iteration of personalized nutrition pairs data from one-time genetic tests or periodic blood analyses or microbiome tests to a continual stream of health feedback from digital devices. To date, no service has combined these sources of health data to deliver comprehensive health recommendations.
Fitness trackers, mobile apps and other connected devices are enabling people to monitor their weight, activity, sleep patterns, blood pressure and heart rate at a hitherto-impossible frequency. The upshot is that health consequences of dietary changes are evident sooner than ever before. This near-real-time feedback can create virtuous cycles, in which evidence of improvement drives behavioral change.
“Seeing small improvements is very important in enabling people to maintain that behavior,” Clabbers said.
Enabling positive feedback loops
The quality and breadth of health data generated by diagnostics and digital devices will continue to improve in the years to come. This will create opportunities. More data should mean more accurate recommendations, and it will enable people to track those metrics that matter most to them. If someone wants to focus on metabolic fitness because they are a marathon runner who is genetically predisposed to heart disease — but not cognitive problems — they will be able to pick and track the most appropriate metrics.
Yet this scenario also shows how improved diagnostics and devices will put additional strain on the positive feedback loop.
“There is no end to what you could measure. That is a big challenge,” Clabbers said.
Data are useless unless they are interpreted correctly. Consumers can interpret step counts — if you did 8,000 steps today you need to do more tomorrow — but will struggle to make sense of the torrent of information next-generation wearables will unleash. Most people will need support from dietary data specialists and technologies to integrate and interpret their health metrics.
Today, this integration and interpretation part of the personalized nutrition process is underdeveloped, in part because the industry itself is fragmented.
“Right now, a lot of companies are focusing on one specific area, so they're either focusing in the nutrigenetics part or they're a wearable sensor company,” Lux Research’s Stice said.
Some companies, such as Habit, have responded to the fragmentation by creating more comprehensive services that guide consumers through multiple steps of the process. Others are trying to connect different parts of the ecosystem so companies work together to drive the field forward, rather than view each other solely as competitors. Both strategies are designed to lessen the effort consumers need to put in to design and monitor a personalized nutrition program.
Clearing barriers to adoption
Simplifying how consumers access personalized nutrition would go some way to enabling more people to adopt individualized dietary practices. However, the complexity and fragmentation of the market are far from the only barriers. BASF’s Stahljans sees the cost of diagnostic tests as prohibitive to mainstream use. At $100 a time, a twice-annual blood testing regime is beyond the budget of many people. Consequently, these services are primarily used by the wealthy and individuals who have a particular interest in their health and fitness, such as athletes.
Stahljans sees opportunities for companies that can bring down the cost of testing. A BASF survey of 1,000 US citizens found roughly half of respondents would prefer at-home tests and a further one-quarter would rather visit a lab to have blood taken. Only one-quarter would opt for less invasive, but less insightful, online questionnaires over blood tests. Stahljans views the data as evidence of pent-up demand for lower-cost personalized nutrition tests.
When paired to the anticipated improvements to wearable devices, the survey data suggest more and more people will adopt highly-individualized, continually-monitored regimes. Such regimes play an outsized role in discussions about the future of nutrition, but some see them as just one part of a more varied range of nutrition advice and monitoring offerings.
Stice expects some consumers to move along the aforementioned axes and adopt more personalized, closely-monitored approaches, but thinks today’s less-tailored options will remain a key part of the market.
“It's really not one size fits all. Depending on what you're looking for, different levels of personalized nutrition ... are going to be applicable,” Stice said.
If the industry is to persuade people to move from diets based on personal preference to personal health, it must convince them of the value in doing so. Given many people are unaware bananas and other foods may be more beneficial for one person than another, education will be needed.
The potential of personalized nutrition
The challenge of changing habits can be daunting, but the personalized nutrition sector has factors in its favor. Notably, the science and technology of personalized nutrition have advanced to the point they can support world-changing predictions about the future of health. Stahljans foresees personalized nutrition having a big impact on healthy life expectancy.
“Normally you have this plateau in your life. Look at myself: As a typical male at the age of 30, 35 you start to come into the plateau and then it gets worse and worse and worse and worse, and some day you die,” Stahljans said. “Our vision is you reach the age of 90+ in good health and then suddenly die painlessly in your sleep. You can avoid costly and unpleasant nursing care due to your personalized nutrition and health regime and thus have an active and healthy life to the very end.”
To realize this vision, the food companies, device makers, testing services and other groups that make up the personalized nutrition sector must work together to help consumers transition from dietary choices driven by personal preference to regimes underpinned by personal health.