The National Institutes of Health’s (NIH) National Heart, Lung, and Blood Institute (NHLBI); National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); and Office of Disease Prevention (ODP) convened a virtual two-day workshop on “Precision Nutrition: Research Gaps and Opportunities” on January 11–12, 2021. The workshop was open to the public; about 1,800 participants registered, and about 1,350 logged in during the course of the meeting. Forty-seven posters were presented.
The purpose of the workshop was to convene scientists with diverse expertise to explore best approaches to addressing the complex array of factors (e.g., genetics, dietary habits, nutrients, circadian rhythm, psychosocial characteristics, and microbiome) within the framework of precision nutrition, and to identify research gaps and opportunities. A presentation was made on the 2020-2030 Strategic Plan for NIH Nutrition Research, which emphasizes cross cutting and innovative opportunities to advance nutrition research across NIH. Presenters discussed diet-related chronic diseases (e.g., cardiovascular, cognitive decline, diabetes, and cancer) and contributors to interindividual variability (e.g., genetics, sensory and immune system function, social determinants of health, and neuropsychosocial factors). Discussions also included potential roles of artificial intelligence (AI) techniques that could be used to generate algorithms and individualized dietary recommendations. In addition, participants discussed opportunities for research and training of the next generation of precision nutrition scientists.
The NIH Office of Nutrition Research (ONR) presented the NIH Common Fund initiative Nutrition for Precision Health, powered by All of Us. The workshop co‑chairs, who are experts in nutrition research and/or data analysts, moderated the sessions, and several NIH staff served on the organizing committee and participated in the workshop.
The importance of nutrition for good health and disease prevention is well established and global Dietary Guideline recommendations are clearly defined to guide impactful policy. However, the practical questions of what, when, and how to eat to stay healthy and to guide individuals in their personal quest to optimize healthy dietary patterns are much more complex. Many key influencing factors, including individual differences in disease risk, socio-environmental and cultural factors, and biological, physiological, and psychosocial responses to dietary interventions require consideration. Precision nutrition aims to understand these complex interrelationships to optimize metabolic responses to diet, tailor dietary approaches, and ultimately make sustainable and targeted individual dietary recommendations to prevent and treat diseases and improve overall health and wellbeing.
After brief introductions and charge, the workshop focused on the following discussion topics:
Precision nutrition in diet-related chronic diseases
Participants discussed precision nutrition in four major chronic disease areas: 1) cardiovascular disease, 2) cognitive decline and Alzheimer’s disease, 3) type 2 diabetes and impaired glucose regulation, and 4) diet-related cancers. Presenters illustrated the marked interindividual variability in response to dietary modulations designed to impact health and disease. Examples include a) variability in blood pressure changes in response to the Dietary Approaches to Stop Hypertension (DASH) trial, and b) variability in cognition changes in response to omega 3 fatty acid intake in patients with Alzheimer’s who had the ApoE4 allele--such patients need larger doses of omega 3 fatty acids compared to those without ApoE4 allele, suggesting gene-diet interactions. Other examples include variability in weight loss and blood glucose levels in response to different types of interventions involving diverse eating patterns, macronutrient distribution, and order and timing (chronobiology) of meals. Variability in cancer prevention and treatment strategies, metabolite generation, and the microbiome were also discussed. The presentations were followed by panel discussions of research gaps and high-priority opportunities.
Measuring potential contributors to interindividual variability in dietary responses
Participants discussed the factors that contribute to individual variability in response to dietary exposures. These include genetics, age, gender, lifestyle health behaviors (e.g., sleep/physical activity), nutritional status at the start of an intervention, circadian rhythms the immune system, social determinants of health and health disparities, and psychosocial and cultural factors. Other discussions include sensory nutrition, mixed meal challenges, physiological measures and individual responses to alcohol. The presentations were followed by panel discussions on research gaps and opportunities and approaches for measuring contributors to individual variability in response to dietary exposures.
Systems Science, Data Science, and Computational Analytics
Since precision nutrition requires understanding and addressing complex systems, computational approaches, methods, and tools can help to elucidate complex factors and mechanisms. However, these need to be applied with systems science approaches in mind. Otherwise, rather than clarifying the systems involved, computational approaches could lead to inappropriate and misleading findings and conclusions. After a brief introduction to systems science and computational/data analytics, the presenters gave examples of how social network analysis, computational modeling, AI and machine learning (ML) could facilitate precision nutrition. These were followed by presentations on how to interpret and translate findings from such computational approaches and how potential ethical issues should be considered and addressed. A wrap-up panel discussed the tremendous potential that new computational and data analytics have in furthering precision nutrition as long as systems science and appropriate ethical approaches are incorporated.
Workshop Registration Announcement