Vydiant

Bench to beside has become a cliché and examples are few and far between. A newly published study on the diet-drug interactions is a notable model of translational research for drug diet interactions (https://lnkd.in/g2ZD9sM). Critical steps in this study included use of high throughout screening, in silico modeling, and in electronic health records. Additional comments and reflections on this study were the subject of AJCN editorial (https://lnkd.in/gjC387U). hashtag #personalizednutrition hashtag #personalizedmedicine hashtag #drugs hashtag #nutrition

Many of us consumers are confused about the conflicting trends in nutritional advice: low fat, high protein, low carbohydrate, vegan, no multivitamins, yes multivitamins, and who knows what to make of ~80,000 dietary supplements (https://tinyurl.com/y2fe5pqu) currently on the U.S. market. This confusion results in part from research strategies and methods that do not account for the complexity of naturally-occurring chemicals in foods, the intricacies of genetic variability..., and the impact of social determinants of health. Although everyone involved in biomedical research is responsible for the current situation, journals have a special responsibility as gatekeepers for approving and disseminating study results. The American Journal of Clinical Nutrition (https://tinyurl.com/y2vvyo4o) is sharpening its focus by introducing 4 new sections: (i) great debates in nutrition to address major controversies, (ii) nutrigenomics and precision nutrition, both systems sciences, to better translate results to individuals, (iii) food systems and the environment to provide evidence to sustain nutrition as the climate changes accelerate, and (iv) women’s nutrition beyond pregnancy and lactation that acknowledges differences in physiology between males and females. The AJCN plans are remarkably similar to the more granular suggestions for propelling the shift from reductionism to systems nutrition published in Genes&Nutrition in 2017 (https://tinyurl.com/y2lepum3). Editors at both journals recognized, as does the constructive criticism of others (https://tinyurl.com/y3ahh72t), that the status quo must change to produce more reliable evidence for individual and public health.

The new meme in nutrition research is the effect of ultra-processed foods (UPF) on health. An excellent review (in https://tinyurl.com/y4xdyj5f) discusses the NOVA categorization of unprocessed, processed culinary ingredients, processed (PF), and UPF (https://tinyurl.com/ycmnr7og). The first randomized control trial (https://tinyurl.com/y4bxyfjn) generated widespread media attention and spirited debates (eg., https://tinyurl.com/y67mtyyn & https://tinyurl.com/y5g4vr7v) focu...sed on extrapolation of results from short term studies to long term health outcomes. Comparing foods based on energy, chemical content, fiber, and meal compositions is difficult because of the complexity and the lack of data on physiological responses, regardless of the amount of processing. Since many in the general public are confused about nutrition recommendations, simplifying messages may be of help: unless the simple message adds to confusion. More rigorous and standard definitions for food and nutrition research and communication are fundamental to the development of healthy, safe, inexpensive, shelf stable foods. A complete food system will be required to meet the nutritional needs of a growing world population, especially as climate changes and chronic diseases continues to increase. #nutrition #personalizednutrition #globalfood

The majority of participants in genome wide association studies are of European genetic ancestry (~86%) with the rest ~10% of Asians, ~2% African-American or Afro-Caribbean, ~1.3% Hispanic/Latino (https://lnkd.in/gbYtTzN). The Population Architecture Genomics and Epidemiology (PAGE) team analyzed ~50,000 non-Europeans for just 26 phenotypes and demonstrated that at least 132 SNPs had differences in effect size across ancestral populations (https://lnkd.in/gAFg8VE). Scaling t...hese numbers to the GWAS catalog suggest a very large number of associations would be affected by ancestry. The effect size of at least some (if not many) variants may also be differentially affected by diet and environment further complicating simplistic use of gene-variant associations. The inescapable conclusions are (i) that single SNP or polygenic risk scores can currently be used for individuals of European ancestry, (ii) ignoring ancestry in direct-to-consumer or clinical decisions may have serious health consequences (example in paper), and (iii) the continued lack of diversity of participants in GWAS (and other genetic studies) exacerbates existing health disparities and prevents equitable development of precision medicine and nutrition. #precisionmedicine #personalizednutrition

Recommending and using micronutrient supplements remains controversial primarily because of the inconsistencies in published data. Since vitamins and minerals are indispensable components of metabolic processes, determining nutrient status and needs are required for improving personal and therefore public health A recent report (https://tinyurl.com/y44d7at6) used NHANES 2009 2012 data provides more evidence that significant proportions of U.S. population in the age groups 2...y 8y and 9y 18y have micronutrient intakes below estimated average requirements (ERA). Vitamins A, D, E, and C, folate, calcium, and magnesium are the most under-consumed micronutrients. Fortification and dietary supplements reduced the percentage of children and teens below the ERA. While the goal that all dietary needs come from whole foods is desirable and laudable, the changing nutrient content in agricultural products, climate change, political instability, and personal and public economic factors make it difficult for ~2 billion individuals to meet their micronutrient needs through food alone.

Artificial intelligence is foundational to precision medicine, personalized nutrition, and public health. USAID & The Rockefeller Foundation published Artificial Intelligence in Global Health: Defining a Collective Path Forward (https://tinyurl.com/y5k52n8a). Many of the opportunities, challenges, and recommendations described for low & middle income countries also apply to the use of these technologies in high income countries.

A chilling (yet fascinating) population clock widget is on the US Census website - only USA and WORLD in separate tabs. @ https://tinyurl.com/y27ppgbj Where will the food come from?

The translation of research findings to healthcare practices depends on rigor and transparency of science. A committee of the US National Academy of Science published a white paper entitled "Reproducibility and Replicability in Science"(https://tinyurl.com/y49zd5z6) that outlines approaches for improving research practices for investigators, institutions, journals, and funders. The committee defined reproducibility to mean computational reproducibilityobtaining consistent ...computational results using the same input data, computational steps, methods, and code, and conditions of analysis and replicability to mean obtaining consistent results across studies aimed at answering the same scientific question, each of which has obtained its own data. The third concept, generalizability, is the extent that results of a study apply in other contexts or populations that differ from the original one. The authors stress the need for training new generations of researchers on computational and statistical practices. A missing discussion was how to conduct, analyze, and report research studies examining inter-individual variability in response to drugs, diets, lifestyle, and environmental conditions.

Our modern food system produces more calories for a higher percentage of the world’s population than at any time in human history. Yet chronic diseases linked to food and lifestyle are at epidemic levels in all economies producing an unsustainable burden on individuals and societies. A science advisory (https://tinyurl.com/y5r4va2q) from the American Heart Association addresses the needs for innovation in creating a sustainable food system. A systems level approach to improvi...ng the nutrient chain would (i) integrate innovation and application from basic sciences, (ii) renovate the manufacture of food products to be healthier while maintaining shelf stability, cost, and broad distribution, (iii) increase the accessibility to fresh and less expensive natural foods, (iv) develop health-enabling policies at the federal, state, and local levels, (v) empower consumers to opt for healthy food and lifestyle choices. No one agency or government can coordinate of dictate these activities, necessitating independent actions within each sector. The AHA advice provides specific recommendations for policy makers, the food and manufacturing sectors, public health agencies and healthcare operations, community, family, and individuals to effect change in the food system

A premise of precision medicine and nutrition is that genetic information can be used to target medicines and foods for individuals to improve health. The common variant-common disease model was the conceptual basis for genome wide association studies that have identified 138,312 variants (of a total of ~320 million in humans) associated one or more complex traits. While the genetic community generally acknowledges that multiple loci contribute to conditions, additive polygen...ic risk scores have not proved useful for determining treatments or nutritional interventions. A new omnigenic model (https://tinyurl.com/yxd2qnlk) posits that a small set of core genes directly affect conditions or traits (albeit with small effect sizes). A larger number of peripheral genes in this model function in cell specific networks that indirectly affect the phenotype. Members of the peripheral gene family could include regulatory molecules that alter the expression of core genes as well as non-core genes. Although controversial (e.g., https://tinyurl.com/y4obpn5d), this model can be tested. Genetic models are important not only to guide research but also the development of diagnostics and treatment options for personalized healthcare. #vydiant #precisionmediciine #nutrition

Developing evidence for precision medicine, personalized nutrition, and individual health maintenance requires new research study designs that go beyond comparing the responses of a treated/intervention group versus a control group. A prime example of one such design was reported in Nature Medicine (https://tinyurl.com/y38gckgu) and based on longitudinal analysis over ~2.8 years of 109 individuals who were deeply phenotyped by measuring clinical (including oral glucose tolera...nce test), transcriptomic, proteomic (with immunome), metabolomic, microbiome, activity, stress, vascular ultrasound, cardiopulmonary exercise, echocardiographic, diet, and whole genome sequencing. Data were analyzed individually and by subgroups by standard methods including correlation network analysis and linear mixed models. Among the many outcomes were the discovery of (i) 67 clinically actionable health issues, (ii) multiple molecular pathways associated with metabolic, cardiovascular, and oncological pathophysiologies, (iii) predictive models for insulin resistance, and (iv) changes in diet and activity for many of individuals who participated in the research. Translating such approaches to health care face the obvious challenge of cost but nevertheless demonstrate the use of biological (i.e., micro) scale big data to individualize health trajectories.

One, one, and zero are the number of times that the words physical environment, nutrition, and food were mentioned in an otherwise excellent Deloitte report 2019 Global health care outlook: shaping the future (https://tinyurl.com/lnoyg28). A key takeaway of the report recognizes the imperative for stakeholders to collaborate around a whole-life approach to funding and delivering health care. Access to affordable foods and environments that promote health need to be included in the health care ecosystem similar to the emerging focus of addressing the social determinants of health (see below). #Vydiant #health #nutrition #personalizedmedicine #personalizednutrition

The contributions of genes and environmental factors to health and disease are difficult to determine with typical biomedical human research studies. Phenotypes, environmental conditions, and genetic makeup are rarely measured in simultaneously, usually differ between studies, or the studies lack sufficient sample size. These limitations hinder the ability to consistently identify factors associated with health and disease processes. Large health insurance data of (i) twin a...nd non-twin siblings and (ii) environmental factors (socioeconomic factors, air quality, and average temperature) mined from public domain data through zip codes were used to estimate the genetic and environmental (respectively) influences to 560 phenotypes. Even with limitations noted by the authors (https://tinyurl.com/y4k9sv7e), this report demonstrated how health (insurance records) and public domain (through zip codes) data can be used to estimate heritability, overall shared environmental conditions, and the three specific factors contributing to disease. See more