Potential Mechanisms of Precision Nutrition-Based Interventions for Managing Obesity

Abstract

Potential Mechanisms of Precision Nutrition-Based Interventions for Managing Obesity Neel H Mehta 1,y, Samantha L Huey 1,2,y, Rebecca Kuriyan 3, Juan Pablo Pe~na-Rosas 4, Julia L Finkelstein 1,2,3, Sangeeta Kashyap 5, Saurabh Mehta 1,2,6,* 1 Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States; 2 Center for Precision Nutrition and Health, Cornell University, Ithaca, NY, United States; 3 Division of Nutrition, St. John’s Research Institute, Bengaluru, Karnataka, India; 4 Global Initiatives, The Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland; 5 Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine New York Presbyterian, New York, NY, United States; 6 Division of Medical Informatics, St. John’s Research Institute, Bengaluru, Karnataka, India A B S T R A C T Precision nutrition (PN) considers multiple individual-level and environmental characteristics or variables to better inform dietary strategies and interventions for optimizing health, including managing obesity and metabolic disorders. Here, we review the evidence on potential mechanisms—including ones to identify individuals most likely to respond—that can be leveraged in the development of PN interventions addressing obesity. We conducted a review of the literature and included laboratory, animal, and human studies evaluating biochemical and genetic data, completed and ongoing clinical trials, and public programs in this review. Our analysis describes the potential mechanisms related to 6 domains including genetic predisposition, circadian rhythms, physical activity and sedentary behavior, metabolomics, the gut microbiome, and behavioral and socioeconomic characteristics, i.e., the factors that can be leveraged to design PN-based interventions to prevent and treat obesity-related outcomes such as weight loss or metabolic health as laid out by the NIH 2030 Strategic Plan for Nutrition Research. For example, single nucleotide polymorphisms can modify responses to certain dietary interventions, and epigenetic modulation of obesity risk via physical activity patterns and macronutrient intake have also been demonstrated. Additionally, we identified limitations including questions of equitable implementation across a limited number of clinical trials. These include the limited ability of current PN interventions to address systemic influences such as supply chains and food distribution, healthcare systems, racial or cultural inequities, and economic disparities, particularly when designing and implementing PN interventions in low- and middle-income communities. PN has the potential to help manage obesity by addressing intra- and inter-individual variation as well as context, as opposed to “one-size fits all” approaches though there is limited clinical trial evidence to date. Keywords: personalized nutrition, overweight, adiposity, prevention, interventions, randomized trials