Since we have roamed the earth as humans gathering food and sustenance has been a focal point of our daily lives. Fast forward to 2019, and many of us live in dense calorie environments, food is usually minutes away and if you have the means, a delivery app away from your front door. We have so much knowledge about food yet the global burden of disease is growing at alarming rates, in developed and developing countries so what is happening? Advances in our understanding of the interplay of our genetics and the gut microbiota are prompting more solutions in the digital therapeutic space that demystifies nutrition at the individual level and some might argue can provide even more information to a person than currently exists in the health care environment. Do we need more individualized information to make healthier food choices? What gets in the way?
A new viewpoint by Dina Hamideh from the Scripps Research Translational Institute in California published in The Lancet addresses the rapidly developing space of digitally supported nutrition. The authors point out the low adherence rates of traditional weight management solutions (below 5%), logging food intake is a crucial strategy for successful weight loss, but we know we are notoriously bad at food recall so many of the studies we rely on have this flaw built into the results. As smartphones are more ubiquitous, we have the opportunity to leverage this technology to provide much richer data sources like geolocation, physical activity, and sleep quality in addition to visual cues like photos of meals to support a clearer nutritional picture and in theory, help us make better food choices and moves us past the limitations of human memory.
The authors suggest the evolution in technology has not yet shown benefit with a standard of evidence- we know we have the ability, but we don’t yet know if it is accurate or if it makes a difference in supporting healthy food choices. The field is making exciting moves- more apps using DNA and microbiome information can further tailor an individual nutrition plan.
My take is we are still developing the science around implications for DNA and the microbiome so the early to market solutions, while exciting is incomplete. They may meet consumer need via marketing and generating curiosity, but more studies need to be conducted to see if they improve health and reduce disease burden.
One thing is also clear, the current state of what is at the fingertips of registered dieticians in health systems needs an upgrade and most of these professionals are working in the complex chronic condition space as part of a health care team- will these digital nutrition supports be able to move the needle on chronic condition management? The clinical value relies on digital therapeutic solutions to augment complex protocols like dietary requirements for chronic kidney disease and from my vantage point the digital tools on the market today serve prevention best, a laudable goal in its own right and their market opportunity is in supporting chronic condition management, a more complex business scenario. Leveraging artificial intelligence (AI) in supporting clinical protocols will also be an essential component of any of these solutions going forward if we are to scale to meet the tremendous need that exists.
Lastly, from a life course perspective, we don’t’ choose our DNA and evidence points to maternal nutrition patterns playing a more significant role in offspring health so investing in improved nutritional habits today will pay off for generations to come. Efforts to promote breastfeeding, the transition to appropriate solid foods are also necessary efforts that tech can support in the future. We are in the midst of exciting scientific discoveries and I will be following with space with great interest.
Thanks for reading – Trina
(Opinions are my own)
Lancet perspective on digital nutrition