CHAPTER ONE

INTRODUCTION

Precision nutrition is a cutting-edge approach to optimizing health and well-being by tailoring

dietary recommendations to individual needs. It recognizes that each person is unique, with

distinct physiological, genetic, and lifestyle factors that influence their nutritional requirements.

This personalized approach aims to navigate the intricate landscape of individual dietary needs,

acknowledging that a one-size-fits-all approach to nutrition may not be effective for everyone.

Fiamoncini J, Rundle M, (2018)

In the pursuit of precision nutrition, various factors are taken into account, such as genetics,

metabolism, body composition, medical history, and lifestyle choices. Advances in technology,

including genetic testing and other biomarker assessments, play a crucial role in gathering

relevant information to create highly personalized nutrition plans.

The fundamental principle of precision nutrition is to move beyond generic dietary guidelines

and instead focus on tailoring nutritional advice to address the specific needs and goals of each

individual. Lopez-Miranda J, Williams C, Lairon D. (2007 This approach recognizes that what

works for one person may not work for another, even if they share similar demographics.

Precision nutrition involves the collaboration of nutritionists, healthcare professionals, and

individuals themselves to gather comprehensive data and design a personalized roadmap for

optimal nutrition. This may include identifying specific nutrient deficiencies, understanding

individual responses to certain foods, and considering lifestyle factors that impact dietary

choices.
The ultimate goal of precision nutrition is to enhance overall health, support weight

management, optimize athletic performance, and mitigate the risk of chronic diseases. Ordovas

JM, Corella D. (2004) By embracing this individualized approach, individuals can make

informed choices about their nutrition, leading to more sustainable and effective results.

Dietary information is also collected independent of genetics, as a feature in its own right.

Information on diet is particularly important in precision nutrition approaches to bodyweight

management Zeevi D, Korem T, Zmora N, et al. (2015). In some cases, not only dietary features

in the long term but also the content of an individual meal and the timing features of the meal

(e.g., timing of the meal, time elapsed since the previous meal, etc.) are required to be known.

This is the case in research investigating postprandial meal responses, where the composition of

an individual meal in relation to its postprandial effect is relevant to know. Meal timing features

are relevant due to their impact on health. Metabolomics is an increasingly popular field that

quantifies the presence of small molecules in a sample with high accuracy using sophisticated

techniques such as nuclear magnetic resonance and mass spectrometry Rodgers GP, Collins FS.

(2020). As the field of metabolomics develops further and these techniques become more

frequently used, metabolomics will have a role to play in precision nutrition such as by

investigating how different individuals metabolize foods and by establishing phenotypes.

However, the measurement of clinically relevant biochemical parameters measured with

traditional methods (i.e., not assessed from a metabolomics perspective) is currently more

commonly seen and represents features in the group of clinical biochemical parameters. Included

here are common clinical measures such as blood-sugar, hormonal levels, blood counts, and

other parameters deemed to be relevant for a given precision nutrition intervention. other

precision nutrition features are the microbiome, due to its emerging role in health and
relationship with nutritional intake Ordovas JM, Ferguson LR, Tai ES, Mathers JC (2018);

activity parameters (PA amount and intensity, sedentary behavior, and energy expenditure (EE)),

due to their established interaction with health and disease; anthropometric features, such as

height, weight, body mass index (BMI), etc.; and personal features, which includes information

about individuals that can have an impact on model outcome such age, medical information and

disease status, medication use, socioeconomic status, stress, and sleep.

Nutrition is a fundamental pillar of health, and diet is the modifiable factor that exerts the

greatest impact on human health and wellbeing (1). Dietary recommendations have traditionally

been based on a one-size-fits-all approach which assumes that individual nutritional

requirements and responses mimic the average response observed in study populations (2). The

advancement of personalized nutrition or precision nutrition (precision nutrition) strategies has

improved our understanding of how factors such as genetic, microbiome, and metabolic

signatures, may predict whether what we eat supports or harms our health and to what degree

Berry SE, Valdes AM, et al. (2020).

Studies in the field of nutritional genomics have unveiled associations between genetic factors

and metabolic responses to food, nutrient requirements, dietary preferences, and disease

outcomes. Advances in this and other areas of precision nutrition have added new dimensions

that help explain the variability in responses observed in otherwise well-controlled trials of diet

and nutrients. In particular, promising research results support the predictive potential of

assessments of the gut microbiome and metabolome—among other factors—and showcase the

individual but malleable qualities of our biology Perez-Martinez P, Phillips. (2013).

As we bring new perspectives to the multiple dimensions of food and health, we are also

overcoming some of the barriers created by previous reductionistic thinking about nutrition. It is
in this context that precision nutrition is driving the scientific journey toward a more

personalized, predictive, and integrative systems approach to understanding how nature and

nurture interact to shape our health and wellbeing.

Precision nutrition can be considered as occurring at three levels: (1) conventional nutrition

based on general guidelines for population groups by age, gender and social determinants; (2)

individualized nutrition that adds phenotypic information about the person's current nutritional

status (e.g. anthropometry, biochemical and metabolic analysis, physical activity, among others),

and (3) genotype-directed nutrition based on rare or common gene variation Gibney MJ, Walsh

MC (2013). The ultimate goal is to integrate such sources of information to ensure that health-

care professionals, including dietitians, physicians, pharmacists and genetic counselors, know

sufficient concepts about nutrigenetics and nutrigenomics to decide on the most appropriate level

of care to achieve a precision nutrition which integrates phenotypical and genotypical issues as

well as social, environmental and metabolic factors Juma S, Imrham V, Vijayagopal P, Prasad C

(2014).

Precision nutrition is founded upon the concept of biological variability between individuals in

response to nutrition Ordovas JM, Ferguson LR, Tai ES, Mathers JC (2018). Thus, if the

variables responsible for causing this variation and their effect on a desired outcome variable can

be known, the outcome variable can be predicted, and this can be translated into nutrition advice.

What, then, are these variables? The answer to this question depends on the desired outcome

variable. There is no set of fixed variables that will provide any given output. Instead, features

thought to be of importance to predicting the outcome are selected on a per situation basis. In

some cases, this can reach to large numbers of individual features. however, they can be

separated into groups, here referred to as precision nutrition elements. one common precision
nutrition element is genetics. genetics is understood as a reason for many obvious examples of

variation, such as eye color and hair color, and this is extended to response to nutrition. indeed,

in some circumstances such as pku, genetics is an extremely relevant feature for precision

nutrition approaches. there is also some known relationships between genetics and weight

management, lactose (as in the case of lactose intolerance), metabolic syndrome , and more.

however, unlike with eye and hair color, what has become clear is that genetics can rarely

explain nutritional response entirely. in some cases, the genetic contribution is virtually absent,

as berry et al. witnessed when predicting postprandial triglycerides. another relevant factor is not

only genes alone but also their interaction with nutritional intake, termed nutrigenomics. genetic

variation impacts metabolism of dietary components, but also dietary components regulate gene

expression and signaling. failing to account for this interaction will naturally lead to

compromised accuracy of precision nutrition models, meaning dietary information is often

collected in precision nutrition approaches. gene-diet interactions for various chronic conditions

are known and as more continue to be discovered, precision nutrition approaches considering

nutrigenomics can be improved Zeevi D, Korem T, Zmora N, et al. (2015).

 REFERENCES

Ordovas JM, Corella D. (2004) Nutritional genomics. Annu Rev Genomics Hum Genet. (2004)

5:71–118. doi: 10.1146/annurev.genom.5.061903.180008

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary

Guidelines for Americans, 2020-2025. (2020). Available online at: www.DietaryGuidelines.gov

(accessed June 9, 2022).

Berry SE, Valdes AM, et al. (2020) Human postprandial responses to food and potential for

precision nutrition. Nat Med. (2020) 26:264–73. doi: 10.1038/s41591-020-0934-0

Lopez-Miranda J, Williams C, Lairon D. (2007) Dietary, physiological, genetic and pathological

influences on postprandial lipid metabolism. Br J Nutr. (2007) 98:458–73. doi:

10.1017/S000711450774268X

Ordovas JM, Ferguson LR, Tai ES, Mathers JC (2018). Personalised nutrition and health. BMJ.

(2018) 13:361:bmj.k2173. doi: 10.1136/bmj.k2173

Berciano S, Lai CQ, Herranz J, et al. (2017) Behavior related genes, dietary preferences and

anthropometric traits. FASEB J. (2017) 31:299.1. doi: 10.1096/fasebj.31.1_supplement.299.1

Perez-Martinez P, Phillips. (2013) Nutrigenetics, metabolic syndrome risk and personalized

nutrition. Curr Vasc Pharmacol. (2013) 11:946–53. doi: 10.2174/157016111106140128120911

Rodgers GP, Collins FS. (2020) Precision nutrition—the answer to “What to Eat to Stay

Healthy”. JAMA. (2020) 324:735–6. doi: 10.1001/jama.2020.13601

Zeevi D, Korem T, Zmora N, et al. (2015) Personalized nutrition by prediction of glycemic

responses. Cell. (2015) 163:1079–94. doi: 10.1016/j.cell.2015.11.001

Fiamoncini J, Rundle M, (2018) Plasma metabolome analysis identifies distinct human

metabotypes in the postprandial state with different susceptibility to weight loss-mediated

metabolic improvements. FASEB J. (2018) 32:5447–58. doi: 10.1096/fj.201800330R

Gibney MJ, Walsh MC (2013) The future direction of personalised nutrition: my diet, my

phenotype, my genes. Proc Nutr Soc 2013;72:219-225.

Martínez JA (2014) Perspectives on personalized nutrition for obesity. J Nutrigenet

Nutrigenomics 2014;7:188-190.

Juma S, Imrham V, Vijayagopal P, Prasad C (2014) Prescribing personalized nutrition for

cardiovascular health: are we ready? J Nutrigenet Nutrigenomics 2014;7:153-160.