In the study of nutrition there is a need to validate and assess food intake and its effects on the body. Food intake is largely measured based on self-reported dietary intake questionnaires, which have limitations. The use of biomarkers provides a more accurate measure of nutrition without the bias of self-reported dietary intake. A nutritional biomarker is one that can be measured in biological samples and used as an indicator of nutritional status.
The most commonly used biological samples are blood-borne (plasma, serum and blood cells), excretion products (urine and faeces) or easily obtainable specimens (nails, saliva and hair). Nitrogen in 24h urine is an already substantially validated biomarker of protein intake and there are many more suggested nutritional biomarkers. The different types of biomarkers that are currently used in nutritional studies are:
- Biomarkers of exposure are intended for the assessment of dietary food intake.
- Biomarkers of effect are related to target function or biological response.
- Biomarkers of health and disease state are biomarkers of ultimate goal and indicative of improved health status and/or reduced risk of disease.
Precision Nutrition and Personalised Medicine
Nutrition is currently moving towards the exciting possibility of personalised nutrition, which is an emerging concept termed ‘precision nutrition’. This therapeutic approach takes into account an individual’s genetic and epigenetic information, as well as age, gender and the physiological and pathological status of the individual in both health and disease.
Personalised medicine is an approach where therapies are targeted to an individual patient to achieve the best outcomes in the management of disease or predisposition to disease. This has become possible due to novel approaches and advances, such as in genomic science where whole genome sequencing has led to a better understanding of the role of genetic variants and epigenetic signatures as well as gene expression patterns in the development of varied chronic conditions, and how specific genes may modify therapeutic responses. Personalised medicine has led to the search for genetic and epigenetic biomarkers to predict the risk of developing chronic diseases for an individual and personalising their prevention and treatment.
Integrated Personal Omic Profile (iPOP)
Determining the physiology and health status of an individual by investigating the genome is called an integrated personal omic profile (iPOP). iPOP is a preventive and diagnostic tool that has the potential to follow, and potentially predict, the evolution of health status and aid in assessing disease risk and provide high diagnostic accuracy, monitoring and targeted therapies. One current aim of nutritional scientists is to identify dietary factors that have the potential to modify the iPOP of an individual, as such these factors would allow the establishment of functional nutritional intakes in order to improve the health of the individual.
Identification of Biomarkers in Nutritional Studies
There is great interest in the identification of novel nutritional biomarkers that can be indicative of food intakes, their effects on the body and their relationship with health and disease status. Such biomarkers may have the potential to be used to quantify intake and validate intake questionnaires, analyse physiological or pathological responses to certain food components or diets, identify persons with specific dietary deficiency, provide information on inter-individual variations or help to formulate personalised dietary recommendations to achieve optimal health for particular phenotypes.
Technical advances in DNA and RNA sequencing, microarray technologies, mass spectrometry, nuclear magnetic resonance, single-cell omics and bioinformatics have allowed the simultaneous analysis of multiple parameters. This has provided extraordinary insights in responses of the transcriptome, proteome and metabolome and an in-depth view of the physiology and pathology of an individual. In turn this allows nutritional scientists to explore the relationships between nutrition and health. Thus, omics platforms appear to be most suitable for the discovery and characterisation of new nutritional markers to define the nutritional status of individuals and to identify nutritional bioactive compounds responsible for beneficial health effects.
Precision Nutrition Targeting Obesity
Obesity is a global epidemic, which has a large number of associated health problems, such as cardiovascular diseases (CVD), dyslipidemias, non-alcoholic fatty liver disease (NAFLD), type 2 diabetes mellitus (T2DM) and cancer. The continuing consumption of unhealthy diets, high in calories, fat and sugar, together with a sedentary lifestyle, contributes to the development of obesity and associated complications. Furthermore, the interactions of genetic and epigenetic signatures with environmental factors are now known to play an important role. Thus, precision nutrition may aid in establishing nutritional guidelines for specific subgroups instead of conventional population-based advice.
Nutrition may have an impact on health outcomes by directly affecting the expression of genes that regulate critical metabolic pathways. This highlights the powerful role that the study of nutrigenomics may have, indicating the importance of the role of nutrients and bioactive food compounds in gene expression and on the proteome and the metabolome. Varied dietary factors have been investigated in a number of studies to evaluate their effect on gene expression profiles, and subsequent disease susceptibilities. Investigations have also shown the beneficial effects of nutrients and bioactive food compounds as a result of the regulation of critical gene expressions. Diet and nutrition has also been shown to effect epigenetic signatures, where complex interactions among nutritional factors and DNA methylation, covalent histone modifications and non-coding RNAs, have been implicated in obesity, CVD, dyslipidemia, NAFLD, T2DM and cancer.
Combining the emerging knowledge discovered from different genetic and epigenetic studies has the potential to lead to the development of new therapeutic tools for advancing the prevention and personalised management of chronic diseases associated with obesity through precision nutrition.
The Future of Nutrition
The concept of precision nutrition is to provide accurate nutritional recommendations for an individual to obtain a healthier life-style. An individual’s personal integrative nutritional biomarker profile can be combined with the identification of food ingredients to determine that individual’s precision nutrition. This can potentially be achieved by the use of mobile appliances to identify food ingredients, by utilising wearables to determine physiological information such as glucose levels and specifically designed, user-friendly mobile applications capable of integrating all this information and translating it into usable outcomes in terms of the specific nutritional needs of that individual.
Conclusion
These scientific and nutritional advances are paving the way for the design of innovative strategies for the control of chronic diseases. Precision nutrition has the huge potential to maintain health, as a result of a rigorous nutrigenomic analysis whilst considering the genetic makeup of an individual. There is thus a need for the identification of novel nutritional biomarkers or patterns of biomarkers that link nutrition with health and will lead to further understanding the role of food in health and disease.
References
Catalina Picó et al. (2019) Biomarkers of Nutrition and Health: New Tools for New Approaches. Nutrients 11(5), 1092.
Ramos-Lopez O et al. (2017) Guide for Current Nutrigenetic, Nutrigenomic, and Nutriepigenetic Approaches for Precision Nutrition Involving the Prevention and Management of Chronic Diseases Associated with Obesity. J Nutrigenet Nutrigenomics. 10(1-2):43-62.
