The concept of nutrigenomics and the market for personalized nutrition solutions—while still nascent—have the potential to make significant strides in coming years thanks to technological advances, capital investment, and consumer interest and buy-in.

Commercial blood tests, DNA analyses, and health questionnaires tied to real-time feedback have attracted consumers to personal nutrition platforms, especially as reactive healthcare systems often marginalize diet and lifestyle factors in favor of treatment models. 

At the same time, discrete, wearable health-tracking devices have proliferated, offering consumers access to a wealth of  health and wellness data.

“A significant number of consumers in the U.S. are leaning toward personalization in terms of adopting nutrition/supplement plans using tools such as a blood test, DNA test, or questionnaire related to a user’s lifestyle,” said Shivani Singh, project lead of Kline & Company’s Consumer Products Practice. “Moreover, there is a greater emphasis on tracking the effect of personalized diets or nutrition using technology such as wearable devices and mobile apps.”

Traditionally, nutrigenomics was used to assess specific medical conditions, according to Kline’s recently published report, “Personalized Nutrition USA.” Today, it is a rapidly developing field in which specialists can assess how individuals react to different foods and nutritional products, resulting in the ability to tailor and recommend personalized solutions.

A Defining Role
The American Nutrition Association (ANA) defines personalized nutrition as “a field that leverages human individuality to drive nutrition strategies that prevent, manage, and treat disease and optimize health.”

“It is rooted in the concept that one size does not fit all,” said Michael Stroka, CEO of the ANA. “Differences in our genetics, biochemistry, metabolism, and microbiota all contribute to our unique nutritional needs and expressions of health or illness. Many circumstantial factors are at play in our immune responses—nutrition and nutrient status, environmental exposures, stress response, and lifestyle factors.”

Poor nutrition is the leading cause of chronic disease and obesity; and an estimated 60% of Americans suffer from one or more chronic diseases. Making nutrition a cornerstone of health management represents a shift to a new paradigm.

“In personalized nutrition, practitioners look at all the available information about an individual—from genomic reports to food preferences—to design personalized interventions that aim to efficiently improve health and immune status,” said Stroka.

For example, nutrition is crucial for building up well-functioning systems, including the immune system, he noted. “Recent research suggests that there are several ‘immune phenotypes’—patterns or types of immune responses that individuals tend toward,” said Stroka. “By tailoring nutritional approaches to the pattern of response, we have more potential to restore the immune system’s functional capacity so our bodies are more resilient in the face of something like the coronavirus.”

Catalyzing Potential
According to Kline, the current market for personalized nutrition is relatively small; however, it presents a promising scope for future development and exponential growth given the aging population and growing consumer interest in personal ownership of health and wellness.

“The vibrant startup scene and active venture capital investors have led to widespread innovation in food technology, and U.S. consumers are generally eager to use the industry’s new offerings,” said Singh.

Some of the key factors driving the personalized nutrition market include innovation and experimenting by fast-moving consumer goods (FMCG) companies, startups, and the active role of venture capital investors, heightened focus on health and wellness, and a consumer belief in the benefits of nutritional supplements.

Scientific advancements and technological innovation in the marketplace have “catalyzed” the potential for personalized nutrition to become a reality, according to Stroka. “We can gather and review data at home, sometimes continuously, through innovations in glucose monitoring and wearable devices. This can drive behavior change. Knowing how your body responds to a certain type of meal (pizza vs. salad, for example) can drive behavior change.”

In terms of scientific advancement, the development of high-throughput technology allows scientists to process thousands or even millions of samples relatively quickly, he added. “This produces reams of data that can be analyzed in order to discover new biomarkers, gain insight into poorly understood interactions, and ultimately improve our ability to tailor recommendations for individuals and groups of people with similar traits,” said Stroka.

One of the challenges today is that these large datasets need to be stored and analyzed so that meaningful associations can become clear, he continued. “When we are able to map an individual’s status more accurately, we will be able to predict responses to tailored interventions.”

Companies are expanding their capabilities to offer more complex testing with the goal of providing more accurate and personalized recommendations, according to Kline’s report. Capabilities often include combinations of nutrient reports, supplement and meal plans, as well as reports covering fitness, beauty, and aging.

For example, InsideTracker expanded its portfolio last year with an at-home DNA test kit that analyzes DNA and blood together. The testing claims to include 29 wellness traits based on 261 genetic biomarkers in five areas: weight, sleep, food sensitivities, aging, and performance.

According to Kline, “Some of the key indicators that companies have been offering include genetic markers known to have an impact on nutrient metabolism, food intolerances, weight management, eating behaviors, and cardiometabolic health and wellness, along with genetic insights with a focus on inflammation and antioxidant capacity, sleep, and alcohol sensitivity.”

In addition to DNA testing markers, some companies like AncestryDNA, 23andMe, and Vitagene, are also providing ancestry reports.

In May 2020, Pharmavite, the manufacturer of Nature Made supplements, launched its monthly subscription service Nurish. It features data based on individual assessment inputs such as age, diet, lifestyle, fitness, wellness goals, general health, and environmental factors.

In August 2020, Baze innovated by leveraging its team’s mathematical, pharmaceutical, and medical backgrounds. The company, which was recently purchased by Nature’s Way, received a patent for its “feedback loop approach,” allowing the company to continuously assess the consumers’ biological and lifestyle input that can re-analyzed after it is put back in the recommendation engine.

DSM has made personalized nutrition a key pillar of its strategy. In late 2019 it acquired AVA, a Boston, MA-based personalized nutrition platform that provides nutrition and coaching recommendations across a range of health and wellness segments.

Meanwhile, a new generation of smartwatches, introduced in 2019 and 2020, feature increased functionalities, Kline noted. “Some include the ability to monitor blood oxygen level (similar to an oximeter), cardiac performance, skin temperature, and stress levels.”

A considerable percentage of the U.S. population has adopted fitness tracking wearable devices, according to Singh, and the trend is only expected to accelerate in coming years with so much emphasis on healthy living.

Kline also recognized “digital nutraceutical and dietary supplements” as a next-stage in personalized nutrition whereby the effect of specific supplements can be tracked using wearable devices or mobile apps.

For example, the Spanish company Monteloeder has commercialized this combination, focusing on the weight loss market. “Via its mobile app, the firm is able to detect and track the effect of its Metabolaid ingredient on the consumer,” Kline said. “Consumers can track product benefits with the app, which sends notifications to the consumer if the desired weight loss is not achieved; the messages suggest possible reasons such as low physical activity or lack of sleep.”

Looking forward, Singh predicted that gut health will continue to gain traction. “The well-developed science behind gut health is expected to be the key backbone behind the evolution of the personalized nutrition industry,” she said.

Meanwhile, on a fundamental consumer level, an estimated 200 million people avoid allergens or certain ingredients, have a dietary medical need, or follow a special lifestyle diet, according to Sifter SP LLC, which recently launched a new online shopping site called Sifter.shop that identifies products that fit into personalized diets, medical needs, or lifestyles.

According to the company, “Sifter’s science-backed database allows shoppers to filter products by hundreds of different attributes: allergens, medical diets, ingredients, brands and more.”

Sifter was developed by Andrew and Thomas Parkinson, the founders of Peapod, the first online grocer (1989), and ItemMaster, a company dedicated to accurate grocery product detail to help shoppers make more informed buying decisions.

Sifter has over 100 dietary filters, called SiftTags, that are grouped into five categories: 1) Allergens & Concerns: diets that omit specific foods or ingredients, such as gluten or lactose; 2) Health Diets: diets consistent with medical nutrition care practices, such as cardiac health or diabetes; 3) Lifestyle Diets: diets that reflect personal preferences and values, such as keto or vegan; 4) Medications: allows users to identify foods that will not interact with prescription medications; 5) Responsible Practices: products that comply with ethical practices, such as fair trade.

A Market Still Heating Up
Personalized nutrition as it exists today would not be possible without the Human Genome Project, which sequenced the first human genome in the early 2000s for around $300 million, noted Stroka.

“Since then, technologies have been developed that make those types of analyses much faster and cheaper. Now, whole genome sequencing can be done for under $1,000 and partial or specialized genome tests can be done for under $100. With the lowered cost of the technology, companies have sprung up to offer testing to the public.”

The idea that one size does not fit all seems to resonate with the public, he added. “Now that we can make connections between genes, health, and nutrition quickly and affordably, the market has responded. Companies are innovating to meet consumer demands for things like wearable health trackers, customized foods and meals, and personalized supplements. The pandemic has clearly made the personalized nutrition segment hotter and it will continue to grow.”

Scientific understanding is set to continue marching forward as well. For example, the National Institutes of Health (NIH) Precision Nutrition 2020-2030 initiative aims to advance nutrition research over the next 10 years.

“NIH is providing funding to multidisciplinary research projects in order to spur discovery about the effects of our food, timing of eating, and how eating behaviors impact our health,” said Stroka. “The goal of this project, and of much of our work at the ANA, is to reduce the burden of chronic disease through improved delivery of personalized nutrition. The research NIH is funding will translate to better interventions and health outcomes through multidisciplinary and interdisciplinary work.”

NIH is also interested in study design. “Nutrition research has historically looked at the relationship between discrete food components and distinct health outcomes. Doing so means we can’t see many connections between foods, meals, food patterns, and multiple health-related outcomes,” said Stroka. “Additionally, diet is very hard to quantify and control. Interdisciplinary teams can use multiple study designs beyond the randomized controlled trial and network or systems approaches to make personalized nutrition research impactful and meaningful.”

With more attention to fundamental inequities in society, it’s important to note the gap—or chasm—in diversity of study populations.

NIH itself noted that “Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians, and other Pacific Islanders” have been underrepresented historically.

“This is likely an incomplete list,” said Stroka. “Really any non-white race identity is underrepresented. And there are so many other identities and demographic groups such as those below federal poverty level, LGBTQIA individuals, those in rural communities, those with disabilities, as well as younger and older populations.”

In an effort to be more inclusive, the All of Us research program by the NIH is funding research for underrepresented groups. “It will be very important for this research to be equitable and meaningful to the groups and individuals being studied. Biomedical research should be just and be of benefit,” Stroka said.

It’s becoming clearer that research done in predominantly homogenous populations falls short in these areas, he added. “Research diversity matters because the standards that governments set forth for health markers and nutrient intake are based on the “norm.” But the norm is established based on research results from a very homogenous population. Diversifying research populations means that meaningful standards can be designed for communities using that community’s own data and health norms.”

A Pathway Forward
In an effort to shift the health paradigm and empower consumers, healthcare practitioners have a critical role to play.

“The ANA has developed one of the first third-party accredited certifications in nutritional genomics for practitioners,” said Stroka. “This course is designed for nutrition professionals and advanced healthcare practitioners who’d like a deeper understanding of the science and clinical application of nutritional genomics. Nutritional genomics is an important tool that practitioners can utilize when creating personalized nutrition interventions. It’s a growing area of interest for professionals with so much research oriented toward nutritional genomics.”

However, because it is a fairly new discipline, many practitioners don’t have a robust practical education in nutritional genomics.

“One of the key objectives of the course is to provide practitioners with a comprehensive understanding of how to analyze the research,” Stroka explained. “This is such a crucial component for building confidence and staying up-to-date with such a rapidly evolving field. With so much market demand, many individuals get a genetic or genomic report and use what they can find on the Internet to understand their results, but that doesn’t mean they’re getting reliable information. It is important that healthcare practitioners can meet this need for their clients and patients. Furthermore, the certification is a way for the public to know their practitioner has the appropriate knowledge and training.”

The course also focuses on the practice landscape, he added. “In addition to the relationship between personalized nutrition and nutritional genomics, practitioners also need to understand their scope of practice, the legal, social, and ethical obligations, and the benefits vs. limitations of the field. Nutritional genomics isn’t about assessing disease risk or discussing diagnostic genes. It’s about providing patients with personalized, actionable advice to support their health goals and improve their nutritional status.”  

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Sean Moloughney has been the Editor of Nutraceuticals World since 2012. He can be reached at SMoloughney@RodmanMedia.com.