Personalised nutrition not yet proven to prevent type 2 diabetes, say researchers
This is the view of researchers from the department of nutrition at the Harvard T. H. Chan School of Public Health, who conducted a review of existing studies on precision nutrition.
The researchers focused on reviewing dietary interventions based on the study of the individual's genome.
They noted that although there are some indication that individuals with different genotypes respond differently to dietary interventions, few independent and reproducible results exist. There is also a lack of causal evidence.
As such, current evidence is "not sufficient to make personalised dietary recommendations for diabetes prevention or management based on genetic information".
Some findings also show that individuals might benefit more from interventions to improve diet quality or physical activity.
As for the commercial use of precision nutrition for disease prevention, the researchers observed that although many companies are marketing personalised nutrition assessment and treatment based on genotype, their ability to improve diet quality and health outcomes "have not been demonstrated".
"Major challenges exist in applying precision nutrition to the prevention and management of T2D, including a lack of robust and reproducible results, the high cost of omics technologies, and methodological issues in study design and high-dimensional data analyses."
The value of personalised nutrition thus depends on whether the additional cost and complexity incurred by new laboratory tests and modification of interventions can be offset by its benefits.
Hence, researchers have urged the public and industry players to "manage unrealistically high expectations" and to "balance the emerging field of precision nutrition with public health nutrition strategies".
Conventional methods
Type 2 diabetes is highly preventable — about nine out of 10 cases could be avoided with the correct lifestyle choices. Conventional intervention methods that alter lifestyle habits remain key in preventing diabetes, the researchers said.
Lifestyle habits, such as the amount of exercise, television-watching, and sleep, as well as socioeconomic factors, including income, education, social networks, and neighbourhood food environment, may "play a more important role than biomarkers in modifying an individual's response to dietary exposure".
Thus, the researchers said conventional methods should receive "equal or even higher priority" in the process of developing evidence-based precision nutrition.
"It is important to ensure that investment in precision nutrition is balanced against the limited resources available for public health nutrition."
Additional research
In their review, the researchers acknowledged that currently, there were no comprehensive attempts to rigorously evaluate the efficacy, cost-effectiveness, and sustainability of personalised nutrition in the prevention and management of type 2 diabetes.
However, the researchers wrote that in order to use precision nutrition to prevent and manage the disease, it is important to address the current challenges by establishing a solid evidence base.
Thus, they proposed the emphasis of more rigorous study design, integration of high-dimensional big data from various sources, development of computational approaches for handling big data, and reduction in the cost of gene analyses.
On the other hand, they also said there was a need for head-to-head comparisons between personalised nutrition interventions and traditional approaches.
Source: Lancet Diabetes Endocrinol 2018
http://dx.doi.org/10.1016/S2213-8587(18)30037-8
"Precision nutrition for prevention and management of type 2 diabetes"
Authors: Dong D Wang, Frank B Hu
