Impersonal Nutrition

The continued rise of personalised nutrition, constant glucose monitors (CGM) and the general array of testing options on the market have understandably led to questions.

Why hasn’t ZAAG gone down that route? If performance is the name of the game, what’s holding us back? It’s a fair question, so let’s dive in.

The idea that what’s good for me might not be good for you has been around for decades – and it’s gathering momentum. We can’t all make the same food choices. You and I both eat the same sarnie for lunch. You finish, grinning with glee and pat your belly; I’m locked in the loo for 30 minutes afterwards.

For many, the inclusion of tech into their nutrition has been a beneficial one. It provides insight into an area that’s historically been opaque and inaccessible.

Similarly, sending stool samples and blood tests and pinning a CGM into your arm adds gravity to actions and lifestyle changes. The tech feels new wave. It is. And it will undoubtedly improve dramatically in the coming years.

But that doesn’t detract from the fact that much of the personalisation angle of these options is still in its testing phase. The marketing, however, suggests we’re already at the “proven” point. We’re not. 

Reference Rage

Send off your stool or blood, and you’ll get results back stating whether your gut microbiome or blood sugar management is good or bad. This categorisation usually stems from the individual company’s standardised reference ranges, according to Professor Andy Galpin. This means you’ll likely get different results if you were to send the same test to different companies.

And if the company testing your samples isn’t using internal data, it’ll typically use hospital records, results based on individuals who aren’t exactly at their healthiest.

Then you get into the discrepancies between ethnicity, background, family history, and lifestyle factors. Basically, the reference ranges leave a lot to be desired.

Pure Poop

With regards to faecal testing, we’re just not at the point where we know enough.

 “There’s so much natural variation between individuals, it’s meaningless,” says Lesley Hoyles, a Professor involved in microbiome research. She went on to say: “We don’t know what a healthy microbiome is.”

If that wasn’t enough, Tariq Iqbal, a Consultant Gastroenterologist, said “It’s more complicated than simply saying there are bad and good bacteria in the gut. At the moment, there is no reason to get your microbiome generally tested.”

So, yeah, no need to send your poo in the post at this point.

Sweet F All

With regards to blood sugar monitoring, for individuals without a history/ risk of diabetes or other blood sugar-related ailments, the picture is similarly clear.

“We have no robust evidence to suggest that the rises and falls are signalling anything untoward in the present, or that they have negative consequences in the future,” says Dr Shivani Misra, a Consultant in Metabolic Medicine at the Imperial College London.

Seeing blood glucose ‘spikes’ is not the same as being clinically tested to measure a person’s blood glucose control. Inferring based on data we do not understand, and then making changes to our lives accordingly, is not a good idea.

Dietversity

As so often is the case with many of the new trends in wellbeing, the advice always returns to the tried and tested ways of thriving. The BBC had multiple people review one personalised nutrition service and concluded: “The foods they were advised to eat and avoid were similar, and fitted broadly within generic healthy eating recommendations.”

Further, there’s no way of including foods that people are intolerant to – eating chickpeas might make you feel terrible but they’ll be top of the list on your recommended foods. In that vein, you’d then have to go through the tried and tested process of removing certain foods and adding others from/to your diet to see how they impact your well-being. This is ostensibly the whole idea of it being personalised via tests in the first place…

That said, if it’s promoting people to make healthier choices then that can only be a positive. If it’s done so under the guise of personalisation, there’s an additional charge for a service that essentially nobody’s receiving.

One Size Fits All

There’s an inherent assumption within the modern, mass populace services, there’s an inherent assumption that what they’re saying is an undeniable fact and based on evidence solely related to you. 

Understandably, this heightens the importance of the message. In reality… it’s all a bit smoke and mirrors. Like ZOE’s choice to use a small survey size of 450 people, using data that refers to how they feel, rather than test results.

That isn’t to say that these technologies are useless, nor that we at ZAAG don’t dabble ourselves to get an idea of what’s going on inside. But personalised as a term is doing a lot of heavy lifting for the most popular services. When they’re servicing tens of thousands of you, perhaps more, the idea what you’re getting is tailor-made is exaggerated.

The most interesting way to look at personalised nutrition is to understand the impact a product has on YOUR health metrics, regularly. Not just for a two-week period, or when you can be arsed to poop in a jiffy bag and give it to the postie. 

To suggest that you have a good or bad level of something means that there has to be an accepted “normal” point for any marker. Given that there’s no agreed set standard – like the 2000/2500 calories per day, for example – it’s tough to draw robust conclusions from much of this data that occupies the bleeding edge of nutritional wellness.

In Closing

The area of personalised nutrition right now may look glossy and futuristic, but it’s not yet achieved a scientific consensus. The lack of standards around testing and reference ranges means that what one company tells you will likely differ from another.

It’s mutton dressed as lamb – neither of which would be recommended foods – in terms of personalisation. Under the bonnet of the fancy apps and the tech, the advice remains the same as it always has.