Department of Nutrition, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Department of Nutrition, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Harvard T H Chan School of Public Health, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Lancet Diabetes Endocrinol. 2018 May;6(5):416-426. doi: 10.1016/S2213-8587(18)30037-8. Epub 2018 Feb 9.
Precision nutrition aims to prevent and manage chronic diseases by tailoring dietary interventions or recommendations to one or a combination of an individual's genetic background, metabolic profile, and environmental exposures. Recent advances in genomics, metabolomics, and gut microbiome technologies have offered opportunities as well as challenges in the use of precision nutrition to prevent and manage type 2 diabetes. Nutrigenomics studies have identified genetic variants that influence intake and metabolism of specific nutrients and predict individuals' variability in response to dietary interventions. Metabolomics has revealed metabolomic fingerprints of food and nutrient consumption and uncovered new metabolic pathways that are potentially modified by diet. Dietary interventions have been successful in altering abundance, composition, and activity of gut microbiota that are relevant for food metabolism and glycaemic control. In addition, mobile apps and wearable devices facilitate real-time assessment of dietary intake and provide feedback which can improve glycaemic control and diabetes management. By integrating these technologies with big data analytics, precision nutrition has the potential to provide personalised nutrition guidance for more effective prevention and management of type 2 diabetes. Despite these technological advances, much research is needed before precision nutrition can be widely used in clinical and public health settings. Currently, the field of precision nutrition faces challenges including a lack of robust and reproducible results, the high cost of omics technologies, and methodological issues in study design as well as high-dimensional data analyses and interpretation. Evidence is needed to support the efficacy, cost-effectiveness, and additional benefits of precision nutrition beyond traditional nutrition intervention approaches. Therefore, we should manage unrealistically high expectations and balance the emerging field of precision nutrition with public health nutrition strategies to improve diet quality and prevent type 2 diabetes and its complications.
精准营养旨在通过针对个体的遗传背景、代谢特征和环境暴露等一个或多个因素来调整饮食干预或建议，从而预防和管理慢性疾病。基因组学、代谢组学和肠道微生物组技术的最新进展为预防和管理 2 型糖尿病提供了使用精准营养的机会和挑战。营养基因组学研究已经确定了影响特定营养素摄入和代谢的遗传变异，并预测了个体对饮食干预的反应差异。代谢组学揭示了食物和营养素消耗的代谢指纹图谱，并揭示了新的代谢途径，这些途径可能通过饮食来改变。饮食干预成功地改变了与食物代谢和血糖控制相关的肠道微生物群落的丰度、组成和活性。此外，移动应用程序和可穿戴设备便于实时评估饮食摄入并提供反馈，从而改善血糖控制和糖尿病管理。通过将这些技术与大数据分析相结合，精准营养有可能为 2 型糖尿病的更有效预防和管理提供个性化的营养指导。尽管取得了这些技术进步，但在精准营养能够广泛应用于临床和公共卫生环境之前，还需要进行大量研究。目前，精准营养领域面临着许多挑战，包括缺乏稳健和可重复的结果、组学技术成本高、研究设计中的方法学问题以及高维数据分析和解释等。需要有证据支持精准营养在传统营养干预方法之外的疗效、成本效益和额外益处。因此，我们应该管理不切实际的高期望，并将精准营养这一新兴领域与公共卫生营养策略相平衡，以改善饮食质量，预防 2 型糖尿病及其并发症。
