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Session: Personalizing Nutrition - Genetics and Dietary Pattern interactions (Poster Theater Flash Session 2)

(PTFS02-04-23) A More Inclusive Approach to Data-Driven Precision Nutrition: Results From the Nationally-Representative ZOE PREDICT-2 Trial

Saturday, July 22, 2023
2:47 PM – 2:51 PM ET
Location:  Fairfax
Disclosure(s):
Kate M. Bermingham, Phd: Zoe Ltd: Employee (Ongoing)
Objectives: Despite prior work exploring the interplay between diet, gut microbial ecology, and host health, attempts to address this relationship at-scale have been hindered by the resource-intensive nature of dietary interventions, a greater appreciation for personalized responses to food, and a lack of diversity in discovery trials. To usher in a more inclusive future for precision nutrition, we conducted an entirely remote multi-omics-guided dietary intervention trial.

Methods: Through extant academic partnerships and social media outreach, we recruited volunteers to consume a series of standardized test meals and log food intake during a 10-day study period, complemented by continuous glucose monitoring, longitudinal biomarker measurements, and contemporaneous smartphone-guided questionnaires on physical activity and sleep. Stool was self-collected at baseline.

Results: We enrolled 975 participants from all 50 U.S. states–35% of whom were non-White (mean age 44 years). Participation and adherence were high (99% enrolled among 987 interested). Confirming findings from the comparatively more controlled PREDICT-1 trial involving in-clinic/at-home testing, we found that host factors such as the gut microbiome had a greater influence on postprandial triglyceridemia than even meal macronutrients (adjusted R2 5.8 vs. 0.9%, p-value < 0.0001), while gut community structure was one of the stronger host-specific determinants of postprandial glucose rise (adjusted R2 2.3%, p-value < 0.0001). Further, despite considerable inter-individual variability in metabolic responses to food, intra-individual repeatability of our remote measurements was reliable (ICCs for postprandial triglyceride rise: 62.9 [95% CI: 54.0-71.8]; glucose: 64.9 [58.8-70.2]; and C-peptide: 52.7 [44.9-60.3]). We found reproducible gut microbial signals corresponding to improved diet, which in turn, were linked to favorable alterations in health-related biomarkers.

Conclusions: In a nationally-representative population, we demonstrate further evidence of the interaction between the gut microbiome, diet, and human health. Taken together, these findings suggest that gut microbial ecology may be coupled to variable host responses to food. Moreover, these findings are testable in rigorous entirely remote multi-omic investigations.

Funding Sources: ZOE Ltd., NIDDK