Metabolic phenotyping - a tool that could help deliver personalised nutrition
The Nutrition Society Paper of the Month for November is from Nutrition Research Reviews and is entitled ‘Metabotyping and its role in nutrition research’ by Lorraine Brennan and Elaine Hillesheim.
Personalised nutrition is at its simplest form the delivery of dietary advice at an individual level. However, individuals respond differently to the same foods and incorporation of these responses into dietary advice is becoming increasingly important. To get a comprehensive understanding of an individual a tool called metabolic phenotyping or metabotyping has emerged. Essentially it is the classification of individuals in subgroups according to their metabolic profile (set of metabolites). Thus, individuals within a metabotype have similar metabolic profiles and those in different metabotypes have different metabolic profiles. Our review examines the use of the metabotype approach within nutrition research with a focus on the potential for delivery of personalised nutrition.
Through examination of the literature we recognised that application of metabotyping in longitudinal studies identified metabotypes associated with cardiometabolic risk factors and diet-related diseases. A noteworthy example emerged from the study of a prospective German cohort where metabotypes were identified using a combination of body mass index (BMI) and 33 metabolites. Adults classified into the high-risk metabotype had the highest prevalence of cardiometabolic diseases at baseline and seven years later. This study together with others highlights the potential of a metabotyping approach for defining at-risk groups which could be targeted for lifestyle interventions to prevent undesirable health outcomes.
Our review also highlights the potential of the metabotype approach to identify differential patterns of response to interventions. Many dietary interventions report a null effect when examining responses at a group level, however, application of metabotyping has identified sub-groups of individuals who respond positively to the interventions. For example, while no metabolic benefits were identified in a study of 72 participants in a weight loss study the application of metabotyping revealed a sub-group with an improved metabolic response. This together with other studies provided evidence that the metabotype approach has the ability to characterise individuals into meaningful subgroups.
Harnessing the metabotype approach for delivery of Personalised Nutrition will be an important area for future development. We highlight work from two studies where a framework was developed to deliver targeted nutrition advice. In one example metabotypes were defined using four commonly measured markers (fasting triacylglycerols, total cholesterol, HDL-cholesterol and plasma glucose) and dietary advice was delivered at a group level. Comparison of the approach with an individualised approach by a dietician revealed excellent agreement (89%). Overall, the approach is scalable and offers potential to deliver advice to individuals who are not high priority dietetic patients or where the access to a dietitian is limited.
In conclusion, metabotypes have been successfully applied to distinguish individuals at metabolic risk of diet-related diseases and identify sub-groups with differential responses to dietary interventions. Strategies to translate this information into dietary advice are warranted. Further research is needed to ensure that we can harness this approach to deliver maximum impact for the field.
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