Imagine being able to hit a perfect dietary bullseye—learning exactly what foods you in particular should eat, and in what proportions and at what time of day, both to promote the best health possible and to prevent disease down the line. The approach is called precision nutrition, and researchers are on the case. The National Institutes of Health (NIH) has developed a strategic plan for the next decade that seeks to advance the possibility of pinpointing each person’s unique nutrition prescription for optimal well-being.
It’s a fascinating venture that will no doubt push the boundaries of the nutrition frontier. Scientists will be conducting studies that look at the interplay between a person’s genetics, the makeup of the bacteria that live in the gut (the gut microbiota), metabolism, and other influencers of the way the body handles food. It’s all with a view toward determining such things as whether your blood glucose spikes unusually high when you eat refined grains and edges you closer to being at risk for a cascade of adverse metabolic effects. Or whether you are someone whose blood pressure is not particularly affected by salt (see “Are You Salt Sensitive?”). This has all been studied to some degree, but not with a view toward individualizing people’s diets across the population.
My scientific, public health-promoting mind is all for it—on one hand. It wouldn’t just save lives. It would save health care dollars because serious diseases could be nipped in the bud. On the other hand, we now know enough about nutrition—so much more than when I was raised on whole milk and fatty meats in the 1950s—that if we heeded just that knowledge alone, we’d have a significantly healthier population. Yet most Americans continue to miss the dietary dartboard entirely.
For instance, decades of research have shown that maintaining healthy body weight helps keep heart disease, diabetes, and other life-threatening ills at bay. However, more than four in 10 Americans are obese—not just overweight but obese. Nutrition researchers have also learned that a diet containing plenty of vegetables and fruits is associated with a reduced risk of cancer and other diseases, and with that in mind the USDA recommends four and a half cups of produce daily for someone consuming 2,000 calories a day. But only one in 10 Americans eats enough produce, says the CDC. And so on. Are we really ready for individual prescriptions when we’re not even handling the basics?
None of this speaks to the fact that people often dine together, and that eating is a cultural and social pursuit at least as much as it is a health mandate. How will we broker that once we all learn we should be eating differently from one another?
The NIH says part of its plan is to answer the question “How can we improve the use of food as medicine?” Can you imagine that query being proposed around a brightly patterned tablecloth in Provence while the bouillabaisse is simmering, or during a dinner of rice, miso soup, pickled vegetables, and grilled meat in Tokyo?
All of which is a long way of saying that while precision nutrition is an intriguing and potentially fruitful field of study, we first have to get the basics down and, second, should keep in mind that, as in other cultures, food does some of its best work when regarded simply as food.
