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August 7, 2020

Precision Nutrition—the Answer to “What to Eat to Stay Healthy”

Author Affiliations
  • 1National Institutes of Health, Bethesda, Maryland
JAMA. 2020;324(8):735-736. doi:10.1001/jama.2020.13601

The long-recognized centrality and importance of nutrition for good health naturally lead to the practical question of what to eat to stay healthy.

Many studies have revealed profound differences among individuals in disease risk and biological responses to diet, making it challenging to fully answer this question. This necessitates moving beyond a one-size-fits-all dietary prescription for optimal health and disease prevention.

The modern view of food and medicine has led to a substantial shift in nutrition research and practice known as precision nutrition, which has great potential to offer multidimensional and dynamic nutrition recommendations. Like precision medicine, the field of precision nutrition aims to understand the health effects of the complex interplay among genetics, microbiome, antibiotic and probiotic use, metabolism, food environment, and physical activity, as well as economic, social, and other behavioral characteristics. Only with a firm grasp of the contributions and interrelationships among these factors will it be possible to develop targeted nutrition guidance for diverse individuals in a highly diverse world.

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2 Comments for this article
Public Health Nutrition
Dorcas Asianut, Masters in Public Health | Masinde Muliro University of Science and Technology
Thanks for the insight and foreseeing the future of nutrition. As a Kenyan nutritionist am interested in participating in this research though with the current trends and the fast growing technology, am afraid that even my very own people have not reached the level of identifying what to eat with their limited choices based on food security - availability and affordability of the food. My worry is in the future of nation's wealth in terms of nutrition focussing on the poor nutrition status of our children since infancy.
Will Precision Nutrition Address the US Disadvantage in Overeating?
Kevin Fiscella, MD, MPH | University of Rochester Medical Center
Answering the “key question” posed by the authors is insufficient to improve population health, i.e. "What do we eat and how does it affect us?" That question misses the mark relevant to our declining health.

Overeating, and its sequela obesity, is one of the central reasons that the United States has been declining in life expectancy in both relative and absolute terms. The United States practically leads the world in both overeating and obesity.

The central scientific question for NIH is: Why do Americans overeat and what can be done about it? This fundamental question is central
to addressing the decline in American health and to reducing the enormous downstream health care and disability costs resulting from overeating.

Precision nutrition might provide some clues regarding which people in the United States respond more or less to an obesogenic environment or respond more or less to the addictive-like concoctions of sugar, fat, salt and proprietary ingredients that promote impulsive, over-eating.

However, it is implausible that precision nutrition will address the deeper question of why Americans overeat and what can be done about it. Addressing this more fundamental question will require research that examines federal, state and local nutrition policies, marketing, portion size, food content including additives, social norms, and lobbying. Most importantly, research is urgently needed to build an evidence-base to guide action on how to create an environment that promotes healthy eating while discouraging overeating among Americans.