By Dr Dilip Ghosh
Today’s food and nutrition market is considerably different than it was 10 to 15 years ago with consumer demands for healthy foods changing every year, particularly in the last decade. Consumers are increasingly believing that foods with specific functionality can contribute directly to their health. Each individual is different from the next by an average of over 3 million genetic variations in their DNA. This genetic diversity causes many of the interindividual differences in food preferences, nutritional needs, and dietary responses. Personalised medicine has emerged as a novel strategy for treating disease based on race-specific genotyping. In addition, by combining analyses of genetic and environmental factors treatment efficacy is improved by tailoring it specifically to the individual. This approach has proved useful particularly in cancer, where high heterogeneity in tumour phenotypes and microenvironments make ‘one-size-fits-all’ treatments difficult. The success of these personalised medicinal approaches encouraged application to other areas, including both disease prevention and maintenance of good health through nutritional science. Current nutritional guidelines are typically derived from epidemiological and associative studies and resulting large clinical databases but these databases are not country-specific and are not always useful or actionable for individuals.
Where to go from here?
Human desire for individuality is not new. It embedded in all ancient civilisations and traditional healthcare systems such as Traditional Chinese Medicine and the Indian Ayurvedic system. All traditional medical systems are descriptive and phenomenological—they typically diagnoses patients using concepts based on the relationship between signs and symptoms. In the Western-style modern medicine model, the concept of ‘one disease – one target – one size-fits-all,’ is shifting towards more personalisation, including the use of multiple therapeutic agents and the consideration of nutritional, psychological and lifestyle factors when deciding the best course of treatment. This strategic shift in medical practice is being linked with the discipline of systems science—and systems biology in the biomedical domain. The concepts and practices of systems biology align very closely with those of traditional Asian medicine as well as the very idea of ‘health’ as per the current World Health Organization definition. We know individual dietary components can modulate and change gene function. Based on this robust evidence, healthcare professionals are now able to control gene-specific physiological expression with specific dietary intervention. This hypothesis has just become more attainable for more people due to rising prosperity, particularly in emerging markets. Moreover, the tremendous technological advancement reduces the gap in-between desire and reality by reaching more cost effective personalised products and services. The individualism mega-trend represents consumers’ desires to be themselves and be recognised as having personal needs rather than being part of the mass market. Consumers seek products that make them stand out from the crowd and provide them with (or at least reinforce) a sense of personal and social identity.
Burden of excessive commercialisation
Every month, more businesses join in dipping a toe into the personalised nutrition pool by offering a product to practitioners for integrating into their practices and to improve patient health outcome. But more than a decade after the introduction of nutrigenomics science, the commercial growth and success rate are slower than expected. Some of these reasons are scientific in nature, some technical and others related to consumer, market or ethical issues. However, there’s definitely strong hype and a market has grown for promoting different kinds of genetic analyses directly to public.
A market has grown for promoting different kinds of genetic analyses directly to public. Plenty of companies offer genetic testing services for a wide range of predispositions for diseases and disorders via the internet direct to the consumer or via a nonmedical intermediary, such as a pharmacist or alternative health practitioner. The majority of them market tests combined with nutritional advice and, in some cases, with nutritional supplements, and a few companies offer biomarker assessment tests.
Silver lining at the end
Advances in genetic science during the past decade have revolutionised our understanding of the relationship between nutrients and human diseases, particularly in weight management. We now have a detailed understanding of how certain genes control metabolism and body weight. We can understand these relationships down to the level of specific genes. Importantly, we even understand how specific variations in each individual’s genetic code control how they respond to different foods. Depending on individual genetic variations, people respond differently to fats, proteins and carbohydrates in their daily diet.
Several companies have started making the impossible possible by using artificial intelligence to map the structure of specific food components and their interactions in the body as well as releasing disease-beating components from food called bioactive peptides. We are moving towards a very bright future in the personalised nutrition era.