Most people prize their individuality yet hold a relatively rigid view about what constitutes a healthy diet. But new research indicates that a nutritious diet for one person may be less so for another. Scientists in the emerging field of personalized nutrition are decoding the cellular and molecular impact of diet on individual health, and they’re finding that food is more than simple sustenance. Its ingredients and nutrients can be customized to support a diet that helps prevent or treat diseases such obesity, diabetes, and cardiovascular disease.
This winter Nestlé convened global experts in human and animal health to talk about the future of nutrition science, and personalized nutrition was central to the discussion. At the Nestlé Institute of Health Sciences in Lausanne, Switzerland, scientists are mapping the relationship between personalized nutrition and individual health. Their basic research and translational and clinical trials could inform a new generation of nutritional concepts and solutions that could have a lasting impact on global health.
Renee Morad (R.M.) recently caught up with Dr. Jörg Hager (J.H.), Head of Nutrition and Metabolic Health Unit of the Nestlé Institute of Health Sciences, to learn more about personalized nutrition and how it could speed the transition from a health care system designed to treat disease to one designed to prevent it.
R.M.: The Nestlé Institute of Health Sciences was founded in 2010. Why would Nestlé dedicate so much time and money to this sort of science?
J.H.: We strongly believe that the food we consume on a daily basis comprises the largest single influence on our health yet we still don’t understand exactly how. To figure this out, we need to dissect the molecular composition of food: not only the nutritional composition, but also the biological molecules, chemicals, proteins, lipids and small molecules. Since its inception, the premise of the Nestlé Institute of Health Sciences has been to better understand how food functions in our body so we can use that knowledge to maintain and improve health.
R.M.: What is the best independent study you’ve seen recently that supports the idea that food has a profound impact on health?
J.H.: Scientists at Tufts Friedman School of Nutrition Science and Policy in Boston, University of Cambridge in the U.K. and Montefiore Medical Center in the Bronx recently published interesting work in the March 7th issue of the Journal of the American Medical Association. Their study looked at hundreds of thousands of people from 2002 to 2012, monitoring what they ate and correlating it with their incidence of stroke, heart attack or type 2 diabetes. The scientists found that what we eat and drink on a regular basis has a significant impact on the likelihood of contracting cardio metabolic diseases. For example, they found if you eat more than 2,000 milligrams of salt a day, you have a much higher incidence of cardiometabolic deaths. If you do not eat enough nuts or seeds, you also have a higher incidence of cardiometabolic deaths.
R.M.: Why is a more personalized approach to nutrition so important to managing health?
J.H.: Humans are unique. We have a unique set of genes, we express them in a unique way based on our environment, and as a result, we have unique metabolisms. All of this impacts how we respond to food — how we metabolize it, how we absorb it, which vitamins we get in high concentrations, which ones we don’t, what our individual microbiomes do to the foods we eat, and how that affects our physiology. That’s why being able to understand the intersection between lifestyle, dietary intake and genetics is so helpful. All of those things play into whether or not we’re healthy or moving towards disease.
R.M.: Can you tell us more about the idea of food as medicine?
J.H: Food is the biggest medicine that we take every day, but because we all metabolize it differently, many of us are probably missing essential nutrients — even if we think we’re eating healthfully. If we had some way to monitor and identify those deficiencies in the general population before disease set in, we could perhaps design and clinically test nutritional interventions as preventatives, stopping disease before it starts. That kind of data doesn’t exist now, and gathering it would be an extensive undertaking, but it could make an impactful difference in the lives of people around the world.
R.M.: In addition to the need for more scientific data, what holds back the development of medicinal foods?
J.H.: Supplements are a multi-billion-dollar industry but almost none have strong clinical evidence backing their claims. That’s partly due to a misunderstanding of nutritional medicines. If we say that consuming certain foods or supplements on a regular basis will have a beneficial effect on diabetes, obesity or cognition, those nutritional medicines need to pass through a drug-based, regulatory route. But nutritional medicines are not the same as new pharmaceuticals. Many of these products are already in our diets, so we’re talking about how changes in amount, timing, and composition impact health outcomes—not the introduction of new chemical entities.
R.M.: What are some of the most interesting findings that have come from the institute’s work in targeted health science nutrition?
J.H.: We’ve looked at various clinical populations to determine if there are distinct nutritional deficits that exist in certain disease states or health states. We have found this to be the case in gastrointestinal disease, and we are now validating those findings. We’ve also made discoveries in understanding the profiles of individuals who become insulin insensitive when they lose weight. Designing a product to help those individuals lose weight without becoming glucose intolerant could have a big impact on obesity. Finally, we’re in the process of studying combinations of dietary intakes that could stimulate autophagy. That process cleans up dying and dead cells in the body, and could, if stimulated, promote greater metabolic health and disease resistance. We know the process could be controlled through diet.
R.M.: What kinds of nutritional medicines are you investigating and how are you progressing?
J.H.: In some regards, we’re already there. In infant formula that Nestlé makes today, we’ve integrated L. reuteri, a probiotic that helps with gastrointestinal distress and colicky babies. We’re also testing the impact of polyphenols from fruits and vegetables on weight management in clinical studies. We have preclinical studies testing molecules, also from our regular diets, that might have profound effects on adipose tissue and the loss of fat mass. This could take six years to get out. In the next five to ten years, we’ll likely see some of these products get into the marketplace as medical foods or through the drug regulatory process as food-based drug products.
R.M.: What will accelerate the development of personalized nutritional products?
J.H.: As I mentioned, reliable dietary data doesn’t exist for the general population. We’re developing applications to monitor dietary intake with image, voice and barcode capture. We are now able to measure, quantitatively, the large numbers nutrients in our bloodstreams. Then we will provide this information to the medical and consumer communities. If everyone is better educated on the scientific underpinnings of nutrition, it could immensely benefit our collective health and empower individuals to better manage their nutritional health.