Challenges and
Opportunities for Precision and
Personalized Nutrition

PROCEEDINGS OF A WORKSHOP

Emily A. Callahan, Rapporteur

Food Forum

Food and Nutrition Board

Health and Medicine Division

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

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This activity was supported by contracts between the National Academy of Sciences and the National Institutes of Health (HHSN263201800029I/HHSN26300023); the U.S. Department of Agriculture (59-8040-0-001 and 123A9420P0008); and the U.S. Food and Drug Administration (75F40120C00192), with additional support from Academy of Nutrition and Dietetics; American Heart Association; American Institute for Cancer Research; American Society for Nutrition; Cargill, Inc.; Coca-Cola Company; Conagra Brands; Center for Science in the Public Interest; Danone North America; General Mills, Inc.; Keurig Dr Pepper; Mars, Inc.; Mondelēz International; Ocean Spray Cranberries, Inc.; and Unilever. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-08735-3
International Standard Book Number-10: 0-309-08735-X
Digital Object Identifier: https://doi.org/10.17226/26299

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Challenges and opportunities for precision and personalized nutrition: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26299.

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PLANNING COMMITTEE FOR A WORKSHOP ON CHALLENGES AND OPPORTUNITIES FOR PRECISION AND PERSONALIZED NUTRITION¹

ERIC A. DECKER (Chair), Professor and Head, Department of Food Science, University of Massachusetts Amherst

CINDY DAVIS, National Program Leader for Human Nutrition, Agricultural Research Service, U.S. Department of Agriculture

KATIE KOECHER, Associate Expert Nutrition Scientist, Bell Institute of Health and Nutrition, General Mills, Inc.

BRUCE Y. LEE, Professor and Executive Director, Public Health, Public Health Computational and Operations Research Center for Advanced Technology in Communications and Health, City University of New York School of Public Health & Health Policy

JOSIEMER MATTEI, Donald and Sue Pritzker Associate Professor of Nutrition, Harvard T.H. Chan School of Public Health

ROBIN McKINNON, Senior Advisor for Nutrition Policy, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration

NICHOLAS J. SCHORK, Deputy Director and Distinguished Professor, Translational Genomics Research Institute

PATRICK J. STOVER, Vice Chancellor and Dean, Agriculture and Life Sciences, Director, Texas A&M University, Texas A&M AgriLife Research

STEVEN ZEISEL, Professor of Nutrition and Pediatrics, University of North Carolina at Chapel Hill and UNC Nutrition Research Institute, Founder and Board Member, SNP Therapeutics

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¹ The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

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FOOD FORUM (AS OF AUGUST 2021)¹

SYLVIA B. ROWE (Chair), SR Strategy, LLC, Washington, DC

ARTI ARORA, The Coca-Cola Company, Atlanta, Georgia

RODOLPHE BARRANOU, North Carolina State University, Raleigh

WENDY BOLAND, Kogod School of Business, American University, Washington, DC

CINDY DAVIS, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

ERIC A. DECKER, University of Massachusetts Amherst

JOY DUBOST, Unilever Research and Development, Englewood Cliffs, New Jersey

DENISE R. EBLEN, Food Safety and Inspection Service, U.S. Department of Agriculture, Washington, DC

NAOMI K. FUKAGAWA, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

CUTBERTO GARZA, Cornell University, Ithaca, New York

STEPHANIE K. GOODWIN, Danone North America, Washington, DC

M. R. C. GREENWOOD, University of California, Davis

MARTIN HAHN, Hogan Lovells, Washington, DC

TERRY T-K HUANG, City University of New York School of Public Health & Health Policy, New York City RENÉE S. JOHNSON, Congressional Research Service, Library of Congress, Washington, DC

SUSANNE I. KETTLER, Mondelēz International, East Hanover, New Jersey CHRISTINA KHOO, Ocean Spray Cranberries, Inc., Lakeville, Massachusetts VIVICA I. KRAAK, Virginia Polytechnic Institute and State University, Blacksburg

CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland

ALICE H. LICHTENSTEIN, Tufts University, Boston, Massachusetts

PETER LURIE, Center for Science in the Public Interest, Washington, DC

DIANE MALUNOWICZ, Keurig Dr Pepper, Dallas, Texas

SUSAN T. MAYNE, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland DEIRDRE McGINLEY-GIESER, American Institute for Cancer Research, Arlington, Virginia

KAREN McINTYRE, Health Canada, Ottawa, Ontario, Canada

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¹ The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.

MEGAN NECHANICKY, General Mills, Golden Valley, Minnesota

RONI NEFF, The Johns Hopkins University, Baltimore, Maryland

SARAH OHLHORST, American Society for Nutrition, Rockville, Maryland

GITA RAMPERSAD, Feeding America, Washington, DC

JILL REEDY, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

KRISTIN REIMERS, Conagra Brands, Omaha, Nebraska

BRIAN RONHOLM, Consumer Reports, Washington, DC

SHARON A. ROSS, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

KELSEY FREEMAN SAELENS, Cargill, Inc., Washington, DC

PAMELA STARKE-REED, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland

ALISON L. STEIBER, Academy of Nutrition and Dietetics, Chicago, Illinois

MARY T. STORY, Duke University, Durham, North Carolina

PATRICK J. STOVER, Texas A&M University, College Station

CHERYL TONER, American Heart Association, Washington, DC

DOROTHEA K. VAFIADIS, National Council on Aging, Arlington, Virginia

Health and Medicine Division Staff

HEATHER DEL VALLE COOK, Director, Food Forum

CYPRESS LYNX, Research Associate

MARIAH BRUNS, Senior Program Assistant (as of January 2022)

ANN L. YAKTINE, Director, Food and Nutrition Board

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings, nor did they see the final draft before its release. The review of this proceedings was overseen by JOHANNA T. DWYER, Tufts Medical Center. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

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Contents

1 INTRODUCTION

2 THE CURRENT EVIDENCE BASE AND LIMITATIONS

Human Variability: A Basis For Precision and Personalized Nutrition

Precision Nutrition at the Intersection of History and Genomics

Integrating Microbiome and Dietary Data

An Engineering Perspective on Opportunities and Obstacles in Precision Nutrition

Psychosocial Influences on Eating Behavior

Integration of Multiple Omics

Panel Discussion

3 INNOVATIVE METHODOLOGIES AND TECHNOLOGIES

Industry Landscape in Personalized Nutrition

The Genetic Scale

The Physiological/Microbiome Scale

The Individual Scale

The Social-Ecologic Scale

Panel Discussion

4 IMPLEMENTATION OF PRECISION AND PERSONALIZED NUTRITION

Will Precision Nutrition Help in Achieving Greater Health Equity?

Challenges to Implementing Precision Nutrition

Regulatory Challenges and Opportunities for Precision Nutrition

Lessons Learned About Commercializing Personalized Nutrition

Communicating the Benefits of Personalized Nutrition Solutions to Consumers

Incorporating Precision Nutrition into Food-Based and Nutrient-Based Guidelines

Panel Discussion

REFERENCES

APPENDIXES

A Workshop Agenda

B Acronyms and Abbreviations

C Biographical Sketches of Workshop Speakers, Moderators, and Planning Committee Members