(P10-002-23) Precision Nutrition: Is the Hype is Exceeding the Science and Evidentiary Standards Needed To Inform Public Health Recommendations for Prevention of Chronic Disease?

Objectives: To describe the historical progression of nutrition guidance and provide background on the biological and contextual factors that contribute to variability in the human response to diet; to propose terms to advance the future of precision nutrition decision making; to describe knowledge gaps that must be considered in the future for what precision nutrition is and how its potential can be utilized or maximized.

Methods: This review summarizes the biological premise, and challenges and opportunities in achieving the aspirational goal of deriving food and nutrient-based guidance for chronic disease risk reduction through precision nutrition.

Results: Reducing chronic disease through diet requires greater precision in 1) establishing essential nutrient needs throughout the life-cycle, 2) considering effects of nutrient and other food substances on metabolic, immunological, inflammatory, and other physiological responses supporting healthy aging, and 3) quantifying eating behaviors.

Conclusions: Given the high proportion of the population with chronic disease and its associated physical, mental, and financial sequalae, a need exists to make more specific and actionable recommendations to population subgroups, and improve the food supply, to promote health and reduce the risk of the diet-related chronic diseases. As dietary guidance for populations shifts from preventing deficiency disorders to chronic disease risk reduction, the biology supporting such guidance is more complex due to the multifactorial risk profile of disease and inherent population heterogeneity in the diet-disease relationship. Now is the time to pause –to collect the requisite data –to admit, we know next to nothing about how to implement precision nutrition. We need investment in better methods to assess exposure and how exposures manifest in disease. The first step in precision nutrition is precision dietary assessment; we must know much more than what, but also the context of food behaviors (i.e. context, timing, preferences, culture, agency, access, etc.) if our recommendations are to be actionable and meaningful. Finally, real time monitoring, data science, and integrated efforts across disciplines is the only viable solution.

Funding Sources: This work was not funded by any agency in the public, commercial, or not-for-profit sectors.