Precision nutrition for optimal health
Personalized nutrition is a growing industry and trend that sits at the intersection of Nutrition, Food, Technology and Health. The premise of Personalized nutrition is that individuals respond differently to the same food based on a number of factors including their environment, their social determinants and their biology to name a few. New technologies combined with an advanced understanding of the complex relationship between food and health has carved an emerging industry that requires the knowledge and expertise of a multiple disciplines. This post provides a detailed overview of what Personalized nutrition is, who is using it, current applications, how the industry has evolved, and where it is heading next.
A brief history on Nutrition as a science
If you have used, or acted on advice such as "Eat your greens" or "An apple a day, keeps the Dr away" or probably the best known.... "Let food be thy medicine", you have a headstart on what Personalized nutrition is all about. At the core it is using food and lifestyle as a way to improve health or achieve a specific health goal. Personalized nutrition is certainly not new, scientific records dating back to 1550 BC in Eber’s papyrus, an Egyptian medical scroll indicating the possibility of the presence of Scurvy otherwise known as Vitamin C deficiency. Further reports were documented by Captain James cook, a scottish surgeon who discovered that sailors with bleeding gums (who had minimal access to fruits and vegetables) at sea, responded well to citrus fruit.
With the advent of World war I & II and famine, food rations became commonplace which resulted in nutritional deficiencies, but also resulted in the creation of a new profession which is that of Dietitians, who were experts in nutritional science. Dietitians were trained to conduct nutritional assessements, make a nutritional diagnosis and subsequently treat medical conditions using their knowledge of food composition. The Dietetics became a profession that transcended acute to community care, food service management and more. These services were eventually reimbursed and professionals managed to develop specializations from pediatrics, to kidney disease, cardiovascular conditions and so much more.
There was only one obviour issue, which was that dietitians were trained to deal with individuals who already had conditions and diseases. This approach, together with similar approaches contributed to the sick-care system we see today.
Fast foward to 2019 and COVID changed the perception of what healthy tryly meant across the globe. Suddenly prevention and optimizing health was a goal everyone wanted to achieve.
This rapid rise in consumer interest in health and wellness coupled with advances in technology have given fuel to the Personalized health industry. Consumers are understanding that the foundation of good health lies in the consumption of a healthy diet and that not everybody responds to food or ingredients in the same way. Consumers are seeking and buying solutions that address their health holistically, meet their dietary preferences, beliefs & values, are effective and transparent, this is Personalized nutrition.
Macro trends driving a monumental shift in health
A move towards prevention and personalised healthcare
Spurred on largely by the COVID pandemic, consumers are increasingly looking towards improving their health using a preventative approach by adopting healthier diets , being more active and mindful of their choices and behaviour on their daily choices and the planet.
A shift towards digital health
Digital transformation has impacted all industries driven by advances in technologies as well as more affordable technologies which take solution out of research labs and universities into the hands of consumers.
An increased concern and awareness of people and planet
Consumers are increasingly concerned about how the choices they make affect the environment and people. Consumers increasingly shop for brands that match their beliefs and values and this has filtered into the foods and supplements they buy.
A rapidly aging population
An aging population is forcing healthcare systems to review and revise how and where healthcare is delivered. This means that healthcare has become more predictive and personalized in order to ensure that healthcare spend is kept low for as long as possible whilst improving healthspan.
This means consumers are increasingly prioritizing their health and looking for ways to address their health concerns and meet their health goals.
New technologies such as AI have resulted in the proliferation of social media platforms
This has meant that information has become more accessible, messages have spread faster and anyone can now be a self-proclaimed nutrition expert. A recent study showed that 87% of Gen Z and millenial Tik Tok users get their nutrition advice from these platforms, and only 2% of nutrition information was actually found to be accurate. This demonstrates the high interest and priority on nutrition topics, yet there is a lack of awareness of credible resources.
Personalized nutrition is not a fad, a dream nor new, it's already happening...
With a fundamental shift towards prevention and health optimization, the trend towards a personalised health approach is already happening across the globe enabled by advances in technology and digital health adoption.
By 2030 every individual will hold their personal and biological data - Mintel
What is Personalized nutrition?
There are a few different definitions of what Personalised nutrition is, this means there is no agreed definition which has been globally accepted.
At Qina we believe that personalised nutrition crosses the spectrum from prevention to disease, and vertically can be delivered at different levels based on the type of information shared by the individual from questionnaires to biometric.
Personalised nutrition fundamentally puts the consumer at the start of a journey to optimal health through actionable, relevant and timely feedback that is based on science-based information and privately, securely and longitudinally shared by the user.
We support the definition of Personalised nutrition recently developed by the Foodvalley community.
‘Personalised nutrition could be a service or a product. It uses individual-specific information, is founded in evidence-based science and has the goal to give consumers control and promote a positive, sustainable dietary behavioural change. This may then result in measurable benefits for personal goals like health improvement and health maintenance, or disease specific benefits.’- Foodvalley 2021 Position paper
Personalised nutrition entails our dietary preferences, our nutritional requirements and health goals based on what we need as well as how we respond to specific dietary patterns, ingredients, foods and supplements. Nutrition should be based on foods that are nutrient dense, are healthy and from a sustainable sources. Nutritional recommendations should be culturally sensitive, relevant and meet the health goals and outcomes that are important to the consumer. Nutritious food should be affordable, accessible and transparent in terms of ingredients and formulation.
The different levels of Personalized nutrition
In our view, personalised health is made up of 5 core pillars which are: nutrition, physical activity, mental health, behaviours and social determinants. These pillars are entirely interlinked and therefore personalised health cannot be achieved if personalised nutrition is not a key component of this framework. Fundamentally, what we eat affects how we feel, live, move and learn and this synergistic relationship is constantly evolving and adapting as we age.
- At lower levels, personalized nutrition can be based on lifestyle, preferences, culture, dietary patterns.
- At the next level, personalized nutrition can be based on biomarkers and pheotypical characteristics (things that are measurable such as blood pressure or cholesterol)
- At the higher level personalized nutrition can be based using omics data (metabolomics, genetics, microbiome)
- At the highest level, the systems approach, Personalized nutrition can be based on combining all the level data below it
How does Personalized nutrition work?
Personalization requires data, this can be from completing a questionnaire at the basic level, to providing a biological sample at the more sophisticated end. The collected data can be enhanced further with wearable, tracker and sensor data. The Personalized nutrition industry has a wide range of solutions that offer personalization in 5 different ways:
- Survey - Asks questions about lifestyle, diet, medication, supplements, symptoms
- DNA - This can be a saliva or blood sample
- Metabolites - This can be a blood, urine, hair, saliva sample
- Microbiome - This is a stool sample
- Healthcare professional who decides on the best way and the priorities
After data has been collected, personal and biological data is matched to food, health and scientific databases to come up with dietary and lifestyle recommendations which the user can track and monitor.
A breakdown of the Personalized nutrition solutions is illustrated below. It is clear that the majority of solutions use a survey-based approach.
What are the benefits of Personalized nutrition?
Personalised nutrition has demonstrated benefits in 3 relevant areas:
- Health outcomes - A personalised approach has led to imporved clinical outcomes such as improved HbA1C, and ApoB and a reduction in BMI
- Nutritional outcomes: A personalized approach has been demonstrated to lead to increased fiber intake, a reduction in consumption of total calories as well as increase in fruit and vegetable intake.
- Behavioural outcomes: A personalized approach leads to better adherence to recommendations, engagement and enjoyment
Consumers are therefore no longer considered average, each individual is considered holistically as a person with their unique biological fingerprint. While we are not currently at the hyper-personalized level. Most solutions are offered on a customized nutrition level where products are matched to the health goal or interest of the individual.
About Mary - An example of Personalized nutrition
What is the difference between Personalized nutrition and Precision nutrition?
The answer depends on who you ask! According to us at Qina, we consider Personalized nutrition to be the overarching terms for diet and lifestyle recommendations based on data which can be personal or biological.
Precision nutrition is considered more accurate, precise and high-tech and usually includes personalization based on data from the omics technologies (genetics, lipidomics, proteomics, microbiome) (Berciano et al., 2022)
You will frequently hear the terms used interchangeably, but essentially it does the same job.
The state of the science of Personalized nutrition
The body of literature is growing rapidly across all applications from using apps, to chatbots and behaviour change techniques.
In 2015 the most quoted study in Personalized nutrition demonstrated that individuals respond differently to the same food and that a machine learning algorithm could predict 2hr- post-prandial responses to food (Zeevi et al 2015)
The body of evidence supporting a personalized approach is still limited but growing. Another large study (Food4me) demonstrated that a personalised nutrition approach was superior than generic dietary advice, but that genetics did not provide superior results (Celis-Morales et al 2017)
In a more recent systematic review of 11 studies, researchers found that dietary changes were superior in individuals who received personalised nutrition advice in comparison to those who received generalized dietary advice. (Jinette et al 2021) resulted in superior dietary
In another recent systematic review by Villinger et al (2019), scientists concluded that digital tools can be effective in modifying behaviour and impacting nutritional outcomes such as BMI, weight and fruit & vegetable intake.
A recently published study conducted by researchers at Zoe on their program found a significant improvement in Triglycerides as well as secondary outcomes which were HbA1C, weight, waist, dietary intake and microbiome diversity (Bermingham et al 2024)
The Personalized nutrition market
The Personalised nutrition is a rapidly growing and is estimated to be worth $16bn by 2025 and $64bn by 2040. However, the Personalised Nutrition industry is highly fragmented and currently made up of mainly small players with no clear leader.
Driven by an increase consumer demand and interest in health and wellbeing, Personalised nutrition has rapidly spread to other verticals such as Consumer health, Fitness, retail, Pharma, Food and digital health.
At present, many solutions are offered in siloes with no interconnectedness meaning that consumers generally need to use 2 or more products to meet their personal health goals with personalised nutritional supplements being clear leaders across segments. However, with over 400K health & nutrition apps in the app stores, it is difficult for consumers to navigate solutions based on their health goals, or know what to trust in terms of the information provided.
At Qina we keep track of new Personalised nutrition startups launches and closures. A map of the current ecosystem players is illustrated below
Types of Personalized nutrition solutions:
At Qina we have defined the different segments in the industry. We have categorized them as
- Smarteating (shopping )
- Diagnostic: Metabolites (microbiome, genetics etc)
- Meal planning & recipes
- Dietary assessment and tracking (image logging, diet and activity tracking)
- Chronic conditions and diseases (Telehealth, Behaviour change), Digital therapeutics)
- Devices
- Prevention & longevity
- Nutritional supplements
- Women's health
Who is using Personalized nutrition now?
According to a recent consumer survey by McKinsey, it is Millenials and Gen-Z who are driving the Personalized wellness market. In fact 17% of this group are already tracking their dietary habits on a daily basis. However more broadly speaking, consumers can be divided in terms of their interest into 3 groups.
Biohackers
These consumers are highly motivated and deeply interested in how their bodies work and how they respond. This group tended to be highly educated, female with high disposable income, but now there is a 50:50 gender split. They are users of any device, wearable or product that can provide data and feedback. They may be interested in Sports, Performance and optimization.
Lifestyle consumers
The consumers are the majority at 70-80% of the market, They are looking for solutions to improve, maintain or prevent. They use food and supplements. They tend to use food to reach their health goals for example improving immune health that is based on health goals but not data. They may follow diet tribes and are interested in imporving their overall health by changing their diet such as imporving their gut health by consuming fiber, consuming functional foods to increase energy.
Individuals living with a condition or disease
These consumers are living with existing conditions and experience symptoms such as migraines. This group is looking towards the latest in science to address their health concerns through diet and lifestyle. They are interested and believe in a food as medicine approach.
Where is the Personalized nutrition industry now?
At present, the market is mostly focused on early adopters whereas we predict that by 2030 we would have reached the early majority owing to better awareness and an understanding of the benefits of a personalised nutrition approach and willingness to pay for personalised products.
Figure: The diffusion of innovation curve
The growth and evolution of the Personalized nutrition market
The Personalized nutrition has grown in leaps and bounds. COVID was the biggest factor thrusting the potential of Personalized nutrition into the limelight. Following the initial explosion, the market challenges have forced stakeholders to look to other ways to continue growing and evolving.
One such development are strategic partnerships between players who share synergies. This has occured across a number of industries as illustrated below. The developments have mostly taken the shape of mergers and aquisitions.
Current challenges in Personalized nutrition
There are many challenges in the industry which is unsurprising considering it is trying to find its way. A short summary is provided below.
Privacy and Ethics concerns
Privacy remains a top concern for consumers as they fear their information will be sold, or shared with rogue players or will affect their insurance premiums and job prospects. Healthcare professionals on the other hand are concerned about the quality of information provided in these products, the risk these solutions pose to their own jobs as well as the relationships they may lose with their clients. Furthermore with the rise of AI and its employment in digital tools especially in health, has got regulators, consumers and experts concerned about the widening of inequality. A practical framework for policymarkers,, developers and industry has recently been published by Qina to overcome this challenge entitled "The Ethics of AI at the intersection of nutrition and behaviour change".
Lack of proof of efficacy
Whilst the effectiveness of personalized nutrition for medical conditions has been demonstrated for years already, the impact of digital solutions is less clear. Many of the current solutions operate in a "black box" meaning that their algorithms for recommendations cannot be scrutinized by experts. This also means that many startups do not invest in research to prove the efficacy of their algorithms, although this is changing slowly.
High Cost
Personalised nutrition solutions are at this point still considered a luxury and not a necessity. Consumers are sensitive to how much money they will spend on their health. Consumer expectations are very high, and considering the current state of the science for many, the lack of deep personalization does not warrant the high price tag.
Lack of regulation
Personalization has created a grey area at the intersection of food, pharma, medical and technology. As a new area, personalized nutrition falls under a number of different regulations, although it is not always clear who the ultimate regulating body is depending on the composition of the solution. At this stage, many companies are positioning themselves in the less regulated "wellness & lifestyle" area, despite crossing over into the medical nutrition field. This will ultimately change as regulators catch up with this growing field.
Lack of support
An increase in consumer demand for solutions that contribute towards their health demonstrates that this is not merely a trend. However consumers have shouted that they need help and support to reach their health goals. This is not surprising considering that your environment contributes greatly to your eating and lifestyle habits. Despite the excitement around the use of technology, research has shown that we are not currently at a stage where digital alone is an option (Rollo et al 2020). However, increased support also means human contact which increases the price point of solutions. This problem has not been solved unless industry and governments can make healthy eating and living easy and affordable.
Social determinants not currently considered
Social determinants contribute to over 40% of our health, this is more than genetics or medical care. How, what and when we eat is largely determined by access to health and food services, what we can afford, our culture, values, cooking facilities and our digital and food literacy. Understanding how consumers live in the real world and the perceptions they hold, is crucial for understanding how to influence behaviour change to improve health.
At present Personalized nutrition is mostly targetted towards those with high disposable inclomes who can afford personalized nutrition solutions. More recently however, developments as part of the "Food as medicine" movement, have meant that that new business models, partnerships and reimbursements resulted in Personalised nutrition becoming more accessible.
In the current inflationary environment, consumers are concerned as food becomes more expensive. By not includig social determinants in AI algorithms and feeding AI systems with data from the healthy and wealthy individuals, we risk perpetuating existing biases and widening the inequality gap.
Lack of education and trust in Personalized nutrition solutions
The lack of trust in digital solutions has many deep roots from a lack of time for training and practice, to a lack of integration of technology in curricula and availability of guidelines. Furthermore healthcare practitioners and consumers are less trusting of solutions that have been developed by industry and have not been validated in the research owing to privacy concerns. The lack of awareness, involvement in the development of new solutions as well as the lack of exposure to new solutions in practice and standardized guidelines are hindering the acceptance and adoption of digital tools.
Behaviour change
Adopting healthy behaviours is notoriously hard. But as humans, our behaviour is hard-wired and imprinted in our brains increasingly influenced by our social networks. Therefore understanding individual behaviour and the factors influencing our behaviour is key to untangling the barriers to potential behaviour change. An understanding of what drives behaviour and the techniques that could support the adoption of healthy behaviours is key, however the design and integration of behaviour change theory and techniques is currently low and more work is required to standardize terminology for data collection and research.
Where is Personalized nutrition headed next?
We have already seen significant shifts across the industry over the last decade from a purely test-kit or questionnaire based approach, to a more holistic and behaviour change approach.
Behaviour change is the gold-standard - Future approaches will know which behaviour change techniques work best for an individual in order to reach a health outcome.
Reimbursement for healthy habits - we envision that Personalized Nutrition solutions will be free or reimbursed for motivated individuals who are willing to share their biometric data with select providers. Consumers will be able to access and receive real-time feedback on what they should do or eat in order to restore balance whether that be for performance, health or biochemical response.
Data-sharing to improve collaboration between food and health - This data will be shared across public and private networks for the benefit of improving public health through dynamic pricing, access to products and services and ultimately the creation of healthy cities. Fresh produce with higher nutritional content will be grown, harvested and delivered in real-time to ensure quality and bioavailability, meaning agriculture, food and health are working closely together. This data-sharing approach will further spur on e-commerce and new research that includes n=1 trials (Krone et al., 2020).
Data collection will be increasingly ongoing, non-invasive and non-intrusive using a variety of sensors such as CGM's, clothing, jewellry, patches, toilets or cutlery. This will mean that unusual patterns or trends can be detected early and it will enhance the possibility of self-tracking and remote monitoring.
Better access to quality information, educational resources and remote services, will lead to consumers knowing which products match their personal preferences, goals and life-stage.
Technology advances exponentially - AI will be integrated into everything, making real-tieme feedback a reality. Consumers will be recommended products based on their taste preferences before they buy them, and it will be possible to know exactly how individual foods, ingredients affect their bodies based on technologies.
Companies who do not prepare for a future of Personalised nutrition risk losing profits, customers and brand positioning. In short, companies risk becoming the next Kodak or Blockbuster story
In summary
Personalized nutrition is a growing industry which has spun out of advances in personalised medicine and a rising consumer demand for personalization across industries. The emerging industry aims to provide solutions that can optimize, manage or treat using a food-first approach which is rooted in the evdience-base. Personalised nutrition can be offered at different levels depending on the budget, health goals and preferences of the individual.
The market is dynamic, thriving and impacting other verticals. The potential applications are huge as are the cost savings. But before that happens, it has many challenges to overcome.
At Qina, we are on a mission to solve the problems of trust, transparency and quality of personalised nutrition solutions.
We believe that the future of food and health is Personalized nutrition
Qina is at the forefront of this monumental shift, by combining technology with our expertise in nutrition, data, research and behaviour change to bridge the gap between now and a hyper-personalised future, where consumers are in control.
We are the first company to track the Personalized nutrition industry with already over 700 companies in our curated database, and a library of expert content and tools, we provide expert insights to help companies understand, navigate and innovate in the industry.
Our vision is to become the trusted hub for data and insights in Personalised nutrition that connects brands and consumers.
For more posts on Personalised Nutrition innovations and science, sign up to Qina.
References
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11. Our findings suggest that higher adherence to the EAT-Lancet diet is associated with lower risks of incident depression, anxiety and their co-occurrence