Is precision nutrition ready for prime time, or does the hype outweigh the science?

Paul W. Franks, PhD, and Kevin D. Hall, PhD,  will present arguments for and against precision nutrition during the Scientific Sessions debate Precision Nutrition—Are We There Yet? The session will begin at 8:00 a.m. ET on Tuesday, June 29.

Ready for prime time

Dr. Franks, an investigator at Lund University Diabetes Centre, Sweden, and Co-chair of the ADA/European Association for the Study of Diabetes (EASD) Precision Medicine in Diabetes Initiative, will make the case that precision nutrition is ready for prime time. His rationale relies on one of the foundations of human life: We all eat.

“This isn’t a specific drug that may be rarely prescribed,” he said. “This is the intervention everyone participates in.”

However, standard nutritional guidelines don’t help everybody to the extent they need to, he added. Food choices are part of a larger tableau of personal health.

“You consider as much as you can about the individual so that you factor into the decision-making that person’s circumstances, their preferences, their socioeconomic status, their access to whatever the intervention is,” Dr. Franks said.

Despite evidence from landmark studies that show lifestyle interventions heavily predicated on diet manipulation reducing the risk of progressing to diabetes, there also has been considerable heterogeneity in responses to those interventions. For some patients, these lifestyle interventions may even be detrimental. At least for glycemic control, more personalized nutritional interventions do better than standard dietary advice, Dr. Franks said.

“We’re really talking about whether or not you can make better choices given the options available,” he said.

Not ready for prime time

Dr. Hall, Integrative Physiology Section Chief at the National Institute of Diabetes and Digestive and Kidney Diseases, will present an opposing viewpoint in the debate. He characterizes precision nutrition as the organizing principle for the future of nutrition science and says now is the time to “separate the promise from the hype.”

Too many questions remain unanswered for precision nutrition to be considered ready for prime time, he contends, although he noted that interest and funding for research in the field have increased. The National Institutes of Health, which published its first strategic plan for nutrition research last year, is investing more than $150 million in a precision nutrition initiative.

Studies conducted prior to this initiative have demonstrated variability in responses to the same diet interventions, including postprandial responses like glucose and triglyceride levels, as well as weight loss.

“Almost every randomized control trial that does any sort of diet intervention, or even drug intervention, results in a huge variability between the participants in terms of outcomes,” Dr. Hall said. “It seems like, with respect to precision nutrition in particular, there are several companies that are capitalizing on the results of early research in the area and maybe hyping them a little bit more than they should be.”

Further study is needed on how much of the observed variability is signal versus random noise, and whether the most important biological variables are being targeted, he said.