Change in Weight, BMI, and Body Composition in a Population-Based Intervention Versus Genetic-Based Intervention: The NOW Trial

The Future of Obesity Management through Precision Nutrition: Putting the Individual at the Center

PURPOSE OF REVIEW: The prevalence of obesity continues to rise steadily. While obesity management typically relies on dietary and lifestyle modifications, individual responses to these interventions vary widely. Clinical guidelines for overweight and obesity stress the importance of personalized approaches to care. This review aims to underscore the role of precision nutrition in delivering tailored interventions for obesity management. RECENT FINDINGS: Recent technological strides have expanded our ability to detect obesity-related genetic polymorphisms, with machine learning algorithms proving pivotal in analyzing intricate genomic data. Machine learning algorithms can also predict postprandial glucose, triglyceride, and insulin levels, facilitating customized dietary interventions and ultimately leading to successful weight loss. Additionally, given that adherence to dietary recommendations is one of the key predictors of weight loss success, employing more objective methods for dietary assessment and monitoring can enhance sustained long-term compliance. Biomarkers of food intake hold promise for a more objective dietary assessment. Acknowledging the multifaceted nature of obesity, precision nutrition stands poised to transform obesity management by tailoring dietary interventions to individuals' genetic backgrounds, gut microbiota, metabolic profiles, and behavioral patterns. However, there is insufficient evidence demonstrating the superiority of precision nutrition over traditional dietary recommendations. The integration of precision nutrition into routine clinical practice requires further validation through randomized controlled trials and the accumulation of a larger body of evidence to strengthen its foundation.

Personalized Nutrition: Tailoring Dietary Recommendations through Genetic Insights

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene-diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. Moreover, we discuss practical implementations of PN, including technological advancements in genetic testing that enable real-time dietary customization. Looking forward, this review identifies the robust integration of bioinformatics and genomics as critical for advancing PN. We advocate for multidisciplinary research to overcome current challenges, such as data privacy and ethical concerns associated with genetic testing. The future of PN lies in broader adoption across health and wellness sectors, promising significant advancements in public health and personalized medicine.

Obesity and Nutrigenetics Testing: New Insights

BACKGROUND

Obesity results from interactions between environmental factors, lifestyle, and genetics. In this scenario, nutritional genomics and nutrigenetic tests stand out, with the promise of helping patients avoid or treat obesity. This narrative review investigates whether nutrigenetic tests may help to prevent or treat obesity. Scientific studies in PubMed Science Direct were reviewed, focusing on using nutrigenetic tests in obesity. The work showed that few studies address the use of tools in obesity. However, most of the studies listed reported their beneficial effects in weight loss. Ethical conflicts were also discussed, as in most countries, there are no regulations to standardize these tools, and there needs to be more scientific knowledge for health professionals who interpret them. International Societies, such as the Academy of Nutrition and Dietetics and the Brazilian Association for the Study of Obesity and Metabolic Syndrome, do not recommend nutrigenetic tests to prevent or treat obesity, especially in isolation. Advancing nutrigenetics depends on strengthening three pillars: regulation between countries, scientific evidence with clinical validity, and professional training.

Precision Nutrition to Improve Risk Factors of Obesity and Type 2 Diabetes

PURPOSE OF REVIEW

Existing dietary and lifestyle interventions and recommendations, to improve the risk factors of obesity and type 2 diabetes with the target to mitigate this double global epidemic, have produced inconsistent results due to interpersonal variabilities in response to these conventional approaches, and inaccuracies in dietary assessment methods. Precision nutrition, an emerging strategy, tailors an individual's key characteristics such as diet, phenotype, genotype, metabolic biomarkers, and gut microbiome for personalized dietary recommendations to optimize dietary response and health. Precision nutrition is suggested to be an alternative and potentially more effective strategy to improve dietary intake and prevention of obesity and chronic diseases. The purpose of this narrative review is to synthesize the current research and examine the state of the science regarding the effect of precision nutrition in improving the risk factors of obesity and type 2 diabetes.

RECENT FINDINGS

The results of the research review indicate to a large extent significant evidence supporting the effectiveness of precision nutrition in improving the risk factors of obesity and type 2 diabetes. Deeper insights and further rigorous research into the diet-phenotype-genotype and interactions of other components of precision nutrition may enable this innovative approach to be adapted in health care and public health to the special needs of individuals. Precision nutrition provides the strategy to make individualized dietary recommendations by integrating genetic, phenotypic, nutritional, lifestyle, medical, social, and other pertinent characteristics about individuals, as a means to address the challenges of generalized dietary recommendations. The evidence presented in this review shows that precision nutrition markedly improves risk factors of obesity and type 2 diabetes, particularly behavior change.

Effect of green-lipped mussel (Perna canaliculus) supplementation on faecal microbiota, body composition and iron status markers in overweight and obese postmenopausal women: a randomised, double-blind, placebo-controlled trial

The present study aimed to determine the effect of whole meat GSM powder on gut microbiota abundance, body composition and iron status markers in healthy overweight or obese postmenopausal women. This was a 3-months trial involving forty-nine healthy postmenopausal women with body mass index (BMI) between 25 and 35 kg/m² who were randomly assigned to receive 3 g/d of either GSM powder (n 25) or placebo (n 24). The gut microbe abundance, serum iron status markers and body composition were measured at the baseline and the end of the study. The between-group comparison at the baseline showed a lower abundance of Bacteroides and Clostridium XIVa in the GSM group compared with the placebo (P = 0⋅04). At the baseline, the body fat (BF)% and gynoid fat% were higher in the GSM group compared with the placebo (P < 0⋅05). No significant changes were found in any of the outcome measures, except for ferritin levels that showed a significant reduction over time (time effect P = 0⋅01). Some trend was observed in bacteria including Bacteroides and Bifidobacterium which tended to increase in the GSM group while their abundance decreased or remained at their baseline level in the control group. Supplementation with GSM powder did not result in any significant changes in gut microbe abundance, body composition and iron markers compared with placebo. However, some commensal bacteria such as Bacteroides and Bifidobacteria tended to increase following supplementation with GSM powder. Overall, these findings can expand the knowledge surrounding the effects of whole GSM powder on these outcome measures in healthy postmenopausal women.

Precision Nutrition: Recent Advances in Obesity

"Precision nutrition" is an emerging area of nutrition research that focuses on understanding metabolic variability within and between individuals and helps develop customized dietary plans and interventions to maintain optimal individual health. It encompasses nutritional genomic (gene-nutrient interactions), epigenetic, microbiome, and environmental factors. Obesity is a complex disease that is affected by genetic and environmental factors and thus a relevant target of precision nutrition-based approaches. Recent studies have shown significant associations between obesity phenotypes (body weight, body mass index, waist circumference, and central and regional adiposity) and genetic variants, epigenetic factors (DNA methylation and noncoding RNA), microbial species, and environment (sociodemographics and physical activity). Additionally, studies have also shown that the interactions between genetic variants, microbial metabolites, and epigenetic factors affect energy balance and adiposity. These include variants in FTO, MC4R, PPAR, APOA, and FADS genes, DNA methylation in CpG island regions, and specific miRNAs and microbial species such as Firmicutes, Bacteriodes, Clostridiales, etc. Similarly, studies have shown that microbial metabolites, folate, B-vitamins, and short-chain fatty acids interact with miRNAs to influence obesity phenotypes. With the advent of next-generation sequencing and analytical approaches, the advances in precision nutrition have the potential to lead to new paradigms, which can further lead to interventions or customized treatments specific to individuals or susceptible groups of individuals. This review highlights the recent advances in precision nutrition as applied to obesity and projects the importance of precision nutrition in obesity and weight management.

Implementation of Nutrigenetics and Nutrigenomics Research and Training Activities for Developing Precision Nutrition Strategies in Malaysia

Nutritional epidemiological studies show a triple burden of malnutrition with disparate prevalence across the coexisting ethnicities in Malaysia. To tackle malnutrition and related conditions in Malaysia, research in the new and evolving field of nutrigenetics and nutrigenomics is essential. As part of the Gene-Nutrient Interactions (GeNuIne) Collaboration, the Nutrigenetics and Nutrigenomics Research and Training Unit (N2RTU) aims to solve the malnutrition paradox. This review discusses and presents a conceptual framework that shows the pathway to implementing and strengthening precision nutrition strategies in Malaysia. The framework is divided into: (1) Research and (2) Training and Resource Development. The first arm collects data from genetics, genomics, transcriptomics, metabolomics, gut microbiome, and phenotypic and lifestyle factors to conduct nutrigenetic, nutrigenomic, and nutri-epigenetic studies. The second arm is focused on training and resource development to improve the capacity of the stakeholders (academia, healthcare professionals, policymakers, and the food industry) to utilise the findings generated by research in their respective fields. Finally, the N2RTU framework foresees its applications in artificial intelligence and the implementation of precision nutrition through the action of stakeholders.

A Clustering Approach to Meal-Based Analysis of Dietary Intakes Applied to Population and Individual Data

BACKGROUND

Examination of meal intakes can elucidate the role of individual meals or meal patterns in health not evident by examining nutrient and food intakes. To date, meal-based research has been limited to focus on population rather than individual intakes, without considering portions or nutrient content when characterizing meals.

OBJECTIVES

We aimed to characterize meals commonly consumed, incorporating portions and nutritional content, and to determine the accuracy of nutrient intake estimates using these meals at both population and individual levels.

METHODS

The 2008-2010 Irish National Adult Nutrition Survey (NANS) data were used. A total of 1500 participants, with a mean ± SD age of 44.5 ± 17.0 y and BMI of 27.1 ± 5.0 kg/m2, recorded their intake using a 4-d weighed food diary. Food groups were identified using k-means clustering. Partitioning around the medoids clustering was used to categorize similar meals into groups (generic meals) based on their Nutrient Rich Foods Index (NRF9.3) score and the food groups that they contained. The nutrient content for each generic meal was defined as the mean content of the grouped meals. Seven standard portion sizes were defined for each generic meal. Mean daily nutrient intakes were estimated using the original and the generic data.

RESULTS

The 27,336 meals consumed were aggregated to 63 generic meals. Effect sizes from the comparisons of mean daily nutrient intakes (from the original compared with generic meals) were negligible or small, with P values ranging from <0.001 to 0.941. When participants were classified according to nutrient-based guidelines (high, adequate, or low), the proportion of individuals who were classified into the same category ranged from 55.3% to 91.5%.

CONCLUSIONS

A generic meal-based method can estimate nutrient intakes based on meal rather than food intake at the sample population and individual levels. Future work will focus on incorporating this concept into a meal-based dietary intake assessment tool.

MD, Eckel-Passow J, Acosta A. Precision Medicine for Obesity

Obesity is a multifactorial disease with a variable and underwhelming weight loss response to current treatment approaches. Precision medicine proposes a new paradigm to improve disease classification based on the premise of human heterogeneity, with the ultimate goal of maximizing treatment effectiveness, tolerability, and safety. Recent advances in high-throughput biochemical assays have contributed to the partial characterization of obesity's pathophysiology, as well as to the understanding of the role that intrinsic and environmental factors, and their interaction, play in its development and progression. These data have led to the development of biological markers that either are being or will be incorporated into strategies to develop personalized lines of treatment for obesity. There are currently many ongoing initiatives aimed at this; however, much needs to be resolved before precision obesity medicine becomes common practice. This review aims to provide a perspective on the currently available data of high-throughput technologies to treat obesity.

Recent advances and current controversies in genetic testing for personalized nutrition

PURPOSE OF REVIEW

Considerable interest in personalized nutrition exists among the general public, policymakers, healthcare organizations and the private sector, but there is also skepticism of its utility. The present review aims to provide a summary of current controversies in the field of nutrigenomics, and to highlight recent research on the potential impact of implementing genetic testing for personalized nutrition in practice.

RECENT FINDINGS

Numerous companies already offer genetic testing for personalized nutrition based on research developments in nutritional genomics. However, controversy exists over whethexr genetics contributes to interindividual responses to diet; the utility of single genetic variants versus genetic risk scores; the ability of DNA-based nutritional advice to elicit positive behavior change and health effects; and whether genetic information makes a difference on the type of dietary advice provided. Potential factors contributing to the discrepant viewpoints are discussed.

SUMMARY

Despite the existing controversies, a solid body of evidence demonstrates that genetic testing for personalized nutrition is a powerful tool to guide dietary recommendations to improve health and performance, and to elicit positive behavior change.

Genotype-guided dietary supplementation in precision nutrition

Achieving adequate micronutrient status, while avoiding deficiencies, represents a challenge for people globally. Consequently, many individuals resort to oral nutrient supplementation (ONS) in order to correct suboptimal dietary intakes. Advances in the fields of nutrigenetics and nutritional genomics have identified differences in response to micronutrient supplementation according to genetic makeup, adding dietary supplement use to the clinician's toolkit in the precision nutrition era. This review focuses on published evidence linking genetic variants to the responses associated with some of the most popular dietary supplements. With an increasing number of health professionals becoming involved in the prescription of ONS, identifying and matching individuals to the appropriate dietary supplement according to their genotype is important for achieving optimal health benefits and micronutrient equilibrium, while reducing the adverse events and financial costs often associated with excessive ONS.

Exploring Attitudes, Subjective Norms and Perceived Behavioural Control in a Genetic-Based and a Population-Based Weight Management Intervention: A One-Year Randomized Controlled Trial

BACKGROUND

Several studies demonstrate that the provision of personalized lifestyle advice, based on genetics, can help motivate individuals to engage in greater nutrition and physical activity changes compared to the provision of population-based advice. The theoretical mechanism behind this phenomenon is poorly understood. The objective of this study was to determine the impact of providing genetically tailored and population-based lifestyle advice on key constructs of the Theory of Planned Behaviour (TPB).

MATERIALS AND METHODS

A pragmatic, cluster randomized controlled trial (n = 140) took place at the East Elgin Family Health Team, in Aylmer, Ontario, Canada. Participants were primarily Caucasian females enrolled in a weight management program (BMI ≥ 25.0 kg/m2). Weight management program groups were randomized (1:1) to receive a population-based lifestyle intervention for weight management (Group Lifestyle Balance™ (GLB)) or a lifestyle genomics (LGx)-based lifestyle intervention for weight management (GLB+LGx). Attitudes, subjective norms and perceived behavioural control were measured at baseline, immediately after receiving a report of population-based or genetic-based recommendations and after 3-, 6- and 12-month follow-ups. Linear mixed models were conducted, controlling for measures of actual behavioural control. All analyses were intention-to-treat by originally assigned groups.

RESULTS

Significant changes (p < 0.05) in attitudes, subjective norms, and perceived behavioural control tended to be short-term in the GLB group and long-term for the GLB+LGx group. Short-term and long-term between-group differences in measures of subjective norms were discovered, favouring the GLB+LGx group.

CONCLUSIONS

The TPB can help provide a theoretical explanation for studies demonstrating enhanced behaviour change with genetic-based lifestyle interventions.

CLINICAL TRIAL REGISTRATION

NCT03015012.