The Road to Precision Nutrition | DPCPSI

According to the Oxford English Dictionary, nutrition is “the action or process of supplying, or of receiving, nourishment or food.” Most of us in the field of nutrition science agree that this very simple definition hardly captures nutrition’s status as a fundamental pillar of health and contributor to a wide range of diseases. We instead recognize the need to pursue a path toward precision nutrition, a holistic approach to develop individualized, actionable dietary recommendations for what, when, why, and how to eat to optimize health and quality of life.

As a longtime student of the significance of nutrition in overall health, I am honored to have been chosen to serve as the Acting Director of the new NIH Office of Nutrition (ONR), which in 2021 moved from NIDDK to the NIH Office of the Director. This move quickly followed the publication of the 2020-2030 Strategic Plan for NIH Nutrition Research – and the recognition that NIH prioritizes innovative, multidisciplinary nutrition research involving many scientific disciplines.

This blog post is the first of many I’ll share as our office and its activities increase. I will continue to update you on ONR’s goals and progress to provide perspectives on our highly collaborative work, as well as to invite new thoughts and actions to achieve our goals.

Our Strategic Plan centered around the goals of precision nutrition charts a path away from the decades-long focus on individual nutrients and food groups, toward looking more holistically, and comprehensively, at the many complex relationships between biological and socioeconomic factors that influence nutrition and health. This approach will help inform the development of recommendations tailored to individuals and public policy geared to the needs of specific populations.

Precision nutrition is truly a new and exciting frontier leading us to new areas of inquiry and novel and innovative scientific pursuits. There is so much we don’t know. For example:

• Nutrition “dark matter” is a group of previously unrecognized biologically active metabolites that affect physiological or pathological pathways in an individual and that individual’s microbiome. Systems biology methods might be able to derive new knowledge about this mysterious matter by exploring distinct data sets to identify new connections and metabolic pathways.
• Dietary habits and eating patterns have been difficult to study accurately because they rely on self-reported food intake, which can be unreliable. Use of wearable technologies and data science approaches could illuminate both individual behaviors and various external exposures, as well as how patterns change over time. This information might be useful to prevent diseases like obesity, cardiovascular diseases, and some types of cancer.
• The therapeutic use of food as medicine is a promising field that might help address nutrition insecurity, which affects 38 million Americans annually. The lack of access to affordable, nutritious food, is strongly associated with multiple chronic health conditions, and linked to social determinants of health.

These are just a few examples of areas ready for research exploration, and there are many more. I invite you to join me as we organize the challenging and incredibly exciting research to inform precision nutrition. Current funding opportunities from across the federal government describe the many areas where we are looking for good ideas. This research will benefit from the input of many partners, including the healthcare and agricultural sectors, retailers and supermarkets, restaurants, food manufacturers, worksites, educational settings, the insurance industry, media, advocacy groups, and the public.

Reflecting the many angles shaping nutrition science, ONR’s work is integrated across scientific disciplines that study nutrition to help improve health. To guide these efforts, we oversee seven implementation working groups (IWGs) of NIH staff and host listening NIH Research on Nutrition Listening Sessions (“NutRitioNaLS”) with members of the nutrition research community and stakeholders to provide input on scientific ideas along with challenges, barriers, and emerging opportunities in nutrition research.

One of the challenges being addressed by ONR’s Nutrition and Health Disparities IWG is nutrition insecurity and diet-related health disparities. In 2021, an estimated 42 million Americans, including 13 million children, lacked adequate access to food. To address this problem, ONR led a trans-federal workshop and request for information to identify research gaps and opportunities to address food insecurity, hunger, and diet-related health disparities. Furthermore, NIH leaders co-authored a JAMA Viewpoint, “Research Opportunities to Address Nutrition Insecurity and Disparities” to raise awareness of NIH’s interest in this space. This month, ONR published a trans-NIH Notice of Special Interest (NOSI): Stimulating Research to Understand and Address Hunger, Food and Nutrition Insecurity that encourages research applications investigating the efficacy of interventions that address nutrition security and the mechanisms of food insecurity on a variety of health outcomes. ONR is also actively engaged in the upcoming White House Conference on Hunger, Nutrition, and Health which is being planned for September 2022 and will address these topics

Finally, as articulated in our Strategic Plan, it’s important that nutrition science addresses the entire human lifespan, including during pregnancy and in the first days after birth. One example of an area of research deserving additional study with new methodologies is that related to human milk. This amazing substance consists of hundreds of components whose composition changes very frequently: even within a single breastfeeding session. ONR has recently hired Dr. Krista Zanetti to lead efforts in this important area.

Because human milk is so important in infant development, and because it is used as a model for infant formula, we need to know much more about the different components in it. I’ll visit this fascinating area of research and its relevance for child health and development in a future blog post.

Until then, thanks for reading, and please subscribe to receive ONR email updates.