Health and healthcare is one of the biggest issues in public policy – and one where the right application of technology has the potential to revolutionise our approach. In the 20th century the goal was to expand our healthcare infrastructure, to care for the sick and treat disease. In the 21st century the focus needs to shift toward maintaining a good state of health for as many people as possible.
This sort of change will require a more preventative, personalised and participatory approach, with people supported to take greater responsibility based on their individual profiles. It is also about more than exercise regimes and medication programmes. What we eat is a key factor in maintaining good health, and advances in precision nutrition are therefore an important opportunity for policymakers to explore.
Nutrition and health are linked
Despite a seeming obsession with dieting and fitness fads, the global population is getting less healthy. Nutrition-related non-communicable diseases are on the rise. One in five children are now overweight or obese, and obesity is one of the leading risk factors for early death globally (not just in the developed world). This has taken on a new dimension in the pandemic, with Covid-19 patients who are overweight at much higher risk.
Maintaining good public health and nutrition is not only desirable because it takes the strain off healthcare systems and economies, but also because it can improve the quality of individual lives.
Thanks to years of scientific research, an improved understanding of the human microbiome and advances in technology, we now have a much better knowledge of nutrition than in previous eras. Based on this, it’s increasingly apparent that the way we approach health and nutrition has significant room for improvement.
We know, for example, that different people respond differently to different food types and diets. Our microbiome and DNA variation can determine our responses to the food we eat and the supplements we take. Individual differences affect the rate of absorption, distribution, metabolism or excretion of almost everything we consume.
At the same time, breakthroughs in areas of science such as metabolomics and microbiomics, and new technologies such as apps and wearables enable us to more easily measure the factors that affect nutrition. These devices, in combination with algorithms, theoretically enable us to tailor nutritional advice to each person based on their individual profile.
Case study: the PREDICT program
The PREDICT program is the world’s largest ongoing nutritional science study of its kind. As part of PREDICT, researchers recently set out to understand how individuals respond to different foods. Wearable technologies such as continuous blood glucose monitors and digital activity trackers were used to measure a range of individual makers of nutritional responses – such as blood glucose, sleep, exercise and microbiome diversity – over a period of two weeks. The measurements were then analysed using machine learning techniques to spot patterns and make predictions.
Initial results demonstrated that there is large variation in people’s metabolic response to foods, but genetics only played a minor role in determining this response. Other factors such as the gut microbiome, exercise, sleep and food timing play an important role. The research also showed that a person’s response to the same meals was often similar and therefore predictable.
The study was supported by the health science company ZOE, which is launching a test kit and AI powered app that will allow individuals to learn how their body responds to food and better inform food choices.
Key questions for policymakers
Studies like PREDICT highlight the importance of the development of more personalised approaches to nutrition. The application of technologies to quantify traits and capture large amounts of data are expanding capabilities in this field of research, while apps such as ZOE demonstrate the potential of technology to easily interact with individuals to provide more personalised and participatory healthcare.
Governments around the world should be thinking about precision nutrition as part of their healthcare models. As they move forward there are three key questions for policymakers to address:
What further research and investment is required in this space?
Precision nutrition research and innovations are still in relatively early stages, and – despite exciting studies such as PREDICT – there is still much we don’t know about what, when and how we should eat. There has been a lack of funding in nutritional science from both governmental agencies and the private sector. Given its importance to people’s health and wellbeing, there is a strong case to identify gaps in our knowledge and accelerate the necessary research to close them.
How can precision nutrition innovations be deployed at scale?
Although there is a consensus that more research is needed before precision nutrition can deliver its expected benefits, policymakers should start to consider what it will take for innovations to be deployed effectively at population scale. For the general public to benefit from precision nutrition innovations, they must be simple to use and accessible, as well as effective. Systems must be designed to give users greater personal autonomy for their health and nutrition. This will require working in partnership with scientists and technologists. In the UK, for example, the government could start to evaluate whether and how precision nutrition apps like ZOE could be deployed in GP practices. Trials could assess whether personalised approaches encourage changes in behaviour and whether health and wellbeing actually improve.
How should guidelines and regulations be updated based on the latest evidence?
Historically, government nutritional guidelines have been ‘one-size-fits-all’ – but precision nutrition is about helping people make smart decisions that are specific to them. Policymakers will need to consider how – based on current evidence – guidelines and labelling can be updated to better accommodate different people and circumstances, and find the best approach to collaborating with industry.
Although precision nutrition is an emerging field, it is clear that technology gives us the potential to move away from blanket advice toward more personalised support for people to maintain a good state of health. Harnessing the innovations in this space will be a critical part of the journey to revolutionise our approach to health.