A report by the Nutrition Business Journal (NBJ) identified gut health as a key growth area for personalised nutrition brands in the US in 2023 and, of all available testing methods, microbiome analysis is set to lead the way, with a forecast growth of over 50%.
While the gut microbiome is hugely complex – it both influences and is influenced by a myriad systems in the body – it could be that the personalised nutrition category, through the data it generates, builds the scientific base required to create gut health products that are highly effective, noted the NBJ analysts.
What outcomes should gut health brands tackle?
With research suggesting that the gut microbiome is associated with health benefits from immunity to digestive wellness and even emotional wellbeing via the gut-brain axis, where should a brand start?
Kingdom Supercultures is a New York-headquartered startup that has isolated and characterised tens of thousands of novel, natural microbial strains already found in food, creating what it says is one of the largest biobanks of food-borne microbial diversity in the world.
It then “arranges” natural microbial strains into new communities that offer novel functionalities for the food industry. Its process is free from genetic modification and artificial chemicals, and it works directly with food and drink manufacturers to tailor-make the final ingredients, available as either live cultures or fermentates, which can be added into their consumer-facing products.
Co-founder Ravi Sheth said the company works “from the consumer benefit backwards”, first identifying the benefits that consumers are interested in and then creating the ingredients. Recently, much of its work has focused on immune health (both systemic immunity and skin immune health) as well as the gut-brain axis and how to promote relaxation and emotional wellbeing, Sheth told attendees at the Future Food Tech conference in London.
Digestive health, and the role of fibre and probiotics, is also a hugely popular area for personalised gut health brands, according to Professor Tim Spector, epidemiologist and co-founder of Zoe, a precision nutrition startup. Zoe has developed an at-home test kit that analyses the gut microbiome as well as blood sugar and blood fat responses using the tests featured in PREDICT, the largest in-depth nutrition study in the world.
The popularity of gut health can be seen in the massive increase in products like kefir and kombucha – “unbelievable” compared to just five years ago, Spector said.
From research lab to supermarket shelf
While the science behind personalised microbiome nutrition is strong and, as the science evolves, getting stronger, it presents a conundrum for food manufacturers. How can they map every individual’s personal response to different foods and create mass market products that are highly personalised yet sold to everyone?
"This is where it gets tricky because the microbiome, unlike genetics, is extremely variable between people,” said Spector. “We only share on average about 25% of our gut microbes, and we've all got some unique microbes that are specific to us.”
The solution lies in bringing down the cost of microbiome testing to make it as accessible and affordable as, say, current blood cholesterol tests, he said.
Stratification is the first step towards true personalisation
Spector believes that stratification – rather than truly unique personalisation – will define the category going forward.
Companies, such as Zoe, can analyse an individual’s microbiome, categorise them into groups depending on their main bacteria populations, and then make food and meal suggestions with the aim of inducing better glycaemic response or increasing certain bacterial species.
“The advice is still pretty crude, but every day it's getting better as the databases grow from a tiny size of a few hundred to hundreds of thousands of people. That's where we'll get real precision nutrition in the future,” Spector said.
Smartphone apps could help make the process more seamless by linking food suggestions to e-commerce retailers, delivering products directly to the consumer’s home. Going forward, shoppers could scan bar codes on products in the supermarket to tell them the product’s “gut score”, Spector suggested.
Increasing the range and diversity of products available to buy could also create a level of personalisation. Kingdom Supercultures is helping brands create healthier products that cater to “hyper-specific consumer groups and consumer populations”, Sheth said.
"There's a different dimension to personalisation that we [at Kingdom Supercultures] think a lot about where individual brands can personalise their products to target different consumers,” he added.
Targeting the microbiome in a holistic way
While personalised nutrition is highly targeted, it is important to look at the microbiome as a whole, both speakers said.
Historically, the food and nutrition industries have taken a very targeted approach when developing functional ingredients. High-intensity artificial sweeteners, for instance, were designed with a precise function in mind – stimulating the sweet taste receptors – and ingredient developers did not consider other unintended consequences in the body.
However, research has suggested that artificial sweeteners may transform beneficial bacteria into harmful ones, alter blood-glucose levels, or contribute glucose intolerance.
Similarly, in recent years, many food brands have added inulin, a prebiotic fibre derived from chicory, to make food and drink products gut-friendly. However, research suggests that large amounts of inulin may be harmful for overall gut health because, by only feeding certain microbes, it reduce bacterial diversity.
In its product development process, Kingdom Supercultures tries to avoid this “reductionist” approach, Sheth said. Instead, it tries to determine the impact of ingredients on the full microbiome system, exploring how to “use ingredients to perturb this system, rather than single factors”.
Spector agreed that such reductionism and the search for one magic bullet ingredient to make processed foods healthy – such as inulin – was not likely to succeed.
“You need the complex fibres that are in real food,” he said. “When you give people high-fibre, Mediterranean-style diets, you do get that increase and benefit [for] the gut. [...] Fibre is extremely complex and the microbes [are] specific to each type of fibre, not just soluble and insoluble.”
‘This is not you forever’: Ever-changing microbiome requires regular testing
Another element for the nutrition industry to consider is that the gut microbiome is constantly evolving, and so testing should be done on a regular basis. This means the cost of testing also needs to come down.
"It's not a static thing like genetics, and I think it's really important for people to realise this. This is not you forever. This is something that people have to look at [at] different stages of life," Spector said, adding that an individual could do an annual microbiome test, receiving updated nutrition information each time.
The menopause is an example of a life stage that has a significant impact on the gut microbiome. Disease state – being diagnosed with a disease or starting medication – can also affect gut diversity.
In addition to cost, developing home testing kits that are user-friendly will be instrumental in mainstreaming personalised nutrition, and ensuring people want to do regular testing.
Current kits, which involve consumers sending stool samples to a laboratory, are undoubtedly an obstacle to uptake. And, while one day, in-home “smart toilets” that assess gut health by analysing metabolite content in faecal matter could become widespread, currently only external laboratories have the capacity to offer the scale and volume required to first bring costs down.
