Expert Interview / Dr. Sujatha Stephen shares her views on precision nutrition.

Precision nutrition, personalized dietary intervention – these are complex terms. Tell us how you explain this to people who ask you about them.

Precision nutrition means looking at all things unique in a person’s biology, for planning their diet strategy. It is an approach to develop targeted and effective diet based on individual needs . Simply put, each and every one of us has a combination of unique biological factors which determine what we should really eat. When we understand this, we can understand what foods to prescribe, and what foods to avoid – for improving our health. We metabolize food differently. We respond to food differently – even in terms of blood sugar, blood pressure, or digestive responses. We absorb nutrients differently and synthesize (immune factors, hormones, etc) differently. These differences determine dietary outcomes in people with and without symptoms/disease.

The bottom line is – the diet should be person-centric, rather than nutrient-centric or goal-centric.

What are the factors that should be considered while formulating a personalized dietary intervention? 

Apart from age, gender, lifestyle and clinical profile, a person’s genetics and gut microbiome composition play important roles in dietary outcomes. Genomics-based findings bring a lot of value while making dietary decisions. Choosing a ‘weight-loss’ diet or ‘high-protein’ diet may not work for someone with underlying issues, which do not even show up in blood tests. They could be struggling to lose weight due to internal factors such as dysbiosis or genetic predisposition. If your goal is to lose weight and keep it off for good, you need to fix the root cause, by feeding on foods that beneficial gut bacteria can feed on, too. Or if you have a gene that makes you a slow producer of an active vitamin, then you need to consume foods rich in that compound.

The good news is that nutrition coaches like myself now have access to getting the tests done and integrating the findings into personal assessments. By doing this, we are making the solutions more sustainable, and health goals more attainable.

The superfood trend caught on very quickly. Would a superfood-rich diet solve most problems, reduce disease?

By definition, superfoods are nutrient-dense and have significant health benefits. But in my opinion, the choice of superfoods should be based on personal needs (as dictated by the body, its genes and gut status). The same superfood can have different effects on different people. Someone could be a slow activator of a vitamin or could be producing lesser amounts of a certain hormone, due to genetic changes or a lack of essential gut bacteria. Foods which would restore balance in these pathways, foods which facilitate those bio-reactions and bio-synthesis – would be superfoods for that person.

You talked about the role of genomics in enhancing dietary management. The gut microbiome is one of the hottest topics in this space. Can you tell us the top 3 scenarios where a microbiome-based test would help? 
  1. Food allergies, sensitivities due to unknown reasons, or in later stages of their life such as adulthood
  2. Endocrine issues such as PCOS
  3. Frequent illness, infection – indicates poor immunity

In conclusion, personalized dietary interventions are a game changer in preventive healthcare, as well as in therapy. However, a few challenges still exist – such as lack of widespread availability of comprehensive tests, reduced awareness among nutrition professionals and lack of training among health practitioners. Experts from both the nutrition and genomics communities should work together to build better tools for precision nutrition.
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