Human postprandial responses to food and potential for precision nutrition

Authors: BERRY, SARAH - King'S College; VALDES, ANA - University Of Nottingham; DREW, DAVID - Harvard University; ASNICAR, FRANCESCO - University Of Trento, Italy; MAZIDI, MOHSEN - King'S College; WOLF, JONATHAN - Zoe Global Limited; CAPDEVILA, JOAN - Zoe Global Limited; HADJIGEORGIOU, GEORGE - Zoe Global Limited; DAVIES, RICHARD - Zoe Global Limited; AL KHATIB, HAYA - Zoe Global Limited; BONNETT, CHRISTOPHER - Zoe Global Limited; GANESH, SAJAYSURYA - Zoe Global Limited; BAKKER, ELCO - Zoe Global Limited; HART, DEBORAH - King'S College; MANGINO, MASSIMO - King'S College; MERINO, JORDI - Massachusetts General Hospital; LINENBERG, INBAR - Zoe Global Limited; WYATT, PATRICK - Zoe Global Limited; ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; GARDNER, CHRISTOPHER - Stanford University; DALAHANTY, LINDA - Harvard University; CHAN, ANDREW - Harvard University; SEGATA, NICOLA - University Of Trento, Italy; FRANKS, PAUL - King'S College; SPECTOR, TIM - King'S College

Submitted to: Nature Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/11/2020
Publication Date: 6/11/2020
Citation: Berry, S.E., Valdes, A.M., Drew, D.A., Asnicar, F., Mazidi, M., Wolf, J., Capdevila, J., Hadjigeorgiou, G., Davies, R., Al Khatib, H., Bonnett, C., Ganesh, S., Bakker, E., Hart, D., Mangino, M., Merino, J., Linenberg, I., Wyatt, P., Ordovas, J.M., Gardner, C.D., Dalahanty, L.M., Chan, A.T., Segata, N., Franks, P.W., Spector, T.D. 2020. Human postprandial responses to food and potential for precision nutrition. Nature Medicine. 26(6):964-973. https://doi.org/10.1038/s41591-020-0934-0.
DOI: https://doi.org/10.1038/s41591-020-0934-0

Interpretive Summary: Nutritional research, and the corresponding dietary guidelines, focus on populations. However, the high interpersonal variability in response to foods and weight-loss diets demands the development of more personalized approaches. Moreover, whereas fasting blood assays are used in many clinical diagnoses, most people are predominantly in the postprandial state during waking hours, which is more predictive of cardiovascular disease risk than are fasting concentrations. The development and application of new technologies to quantify many postprandial (non-fasting) traits (e.g., triglycerides and glucose responses) accurately and precisely will better prevent the most common diseases. The purpose of this work, conducted by an international team including investigators at the HNRCA in Boston, was to develop a machine-learning model that predicted, at the individual levels, both triglyceride and glucose responses to food intake. Such development was successful, reaching prediction levels of 47% for triglyceride and 77% for glucose responses. These developments will be informative for developing personalized diet strategies.

Technical Abstract: Metabolic responses to food influence risk of cardiometabolic disease, but large-scale high-resolution studies are lacking. We recruited n = 1,002 twins and unrelated healthy adults in the United Kingdom to the PREDICT 1 study and assessed postprandial metabolic responses in a clinical setting and at home. We observed large inter-individual variability (as measured by the population coefficient of variation (s.d./mean, %)) in postprandial responses of blood triglyceride (103%), glucose (68%) and insulin (59%) following identical meals. Person-specific factors, such as gut microbiome, had a greater influence (7.1% of variance) than did meal macronutrients (3.6%) for postprandial lipemia, but not for postprandial glycemia (6.0% and 15.4%, respectively); genetic variants had a modest impact on predictions (9.5% for glucose, 0.8% for triglyceride, 0.2% for C-peptide). Findings were independently validated in a US cohort (n = 100 people). We developed a machine-learning model that predicted both triglyceride (r = 0.47) and glycemic (r = 0.77) responses to food intake. These findings may be informative for developing personalized diet strategies.