Individual variation

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SusanJ
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Personalized Nutrition, it might just explain a lot of what we see...

Postby SusanJ » Fri Nov 20, 2015 11:54 am

We talk a lot about N=1 when it comes to diet. Here's a study that actually tries to figure out why.

Personalized Nutrition by Prediction of Glycemic Responses
http://www.cell.com/cell/fulltext/S0092-8674(15)01481-6

Dietary intake is a central determinant of blood glucose levels, and thus, in order to achieve normal glucose levels it is imperative to make food choices that induce normal postprandial (post-meal) glycemic responses (PPGR; Gallwitz, 2009). Postprandial hyperglycemia is an independent risk factor for the development of TIIDM (American Diabetes Association., 2015a), cardiovascular disease (Gallwitz, 2009), and liver cirrhosis (Nishida et al., 2006) and is associated with obesity (Blaak et al., 2012), and enhanced all-cause mortality in both TIIDM (Cavalot et al., 2011) and cancer (Lamkin et al., 2009).

Despite their importance, no method exists for predicting PPGRs to food. The current practice is to use the meal carbohydrate content (American Diabetes Association, 2015b, Bao et al., 2011), even though it is a poor predictor of the PPGR (Conn and Newburgh, 1936)...

Here, we set out to quantitatively measure individualized PPGRs, characterize their variability across people, and identify factors associated with this variability. To this end, we continuously monitored glucose levels during an entire week in a cohort of 800 healthy and prediabetic individuals and also measured blood parameters, anthropometrics, physical activity, and self-reported lifestyle behaviors, as well as gut microbiota composition and function. Our results demonstrate high interpersonal variability in PPGRs to the same food. We devised a machine learning algorithm that integrates these multi-dimensional data and accurately predicts personalized PPGRs, which we further validated in an independently collected 100-person cohort. Moreover, we show that personally tailored dietary interventions based on these predictions result in significantly improved PPGRs accompanied by consistent alterations to the gut microbiota.


And here we are back at the microbiome...

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Re: Personalized Nutrition, it might just explain a lot of what we see...

Postby Matisse » Fri Nov 20, 2015 1:19 pm

Yes, I totally agree Susan. I thought the same thing when I read this piece this morning.

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Re: Personalized Nutrition, it might just explain a lot of what we see...

Postby circular » Fri Nov 20, 2015 10:01 pm

Nice to see this concept "officially" explored. One criticism of using glycemic index/load is that the GI for a food is determined based on only about 10 person's responses to it. (Not sure if that's changed.)
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Individual variation

Postby Stavia » Sat Nov 21, 2015 1:46 am

http://www.cell.com/abstract/S0092-8674(15)01481-6

"Elevated postprandial blood glucose levels constitute a global epidemic and a major risk factor for prediabetes and type II diabetes, but existing dietary methods for controlling them have limited efficacy. Here, we continuously monitored week-long glucose levels in an 800-person cohort, measured responses to 46,898 meals, and found high variability in the response to identical meals, suggesting that universal dietary recommendations may have limited utility."


This is what my gut feeling is. We are so genetically diverse and the science as yet not well enough understood that I feel it's short sighted to be too proscriptive with rules. This variability is likely to be in lipid response to dietary changes too.
Wide recommendations within parameters yes.
But each of us IMO needs to tweak and test to be sure of the effect of an intervention in ourselves and not to be too quick to extrapolate other's experiences.

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Re: Individual variation

Postby Tincup » Sat Nov 21, 2015 10:02 am

The full paper is here: http://www.cell.com/cell/pdfExtended/S0092-8674%2815%2901481-6

Kraft's work on glucose challenges (100g) with simultaneous insulin measurement would probably give a lot of insight in this variability (been posted on several times here: https://www.apoe4.info/forums/search.php?keywords=kraft+insulin&terms=all&author=&sc=1&sf=all&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search. Basically, Kraft performed something like 14,234 of these over his career. He found that a substantial number of subjects with normal glucose response had abnormal insulin responses. Kraft labeled them "diabetes in-situ." Here it is graphically (thanks Lance): https://twitter.com/tednaiman/status/638513707450920960.
Last edited by Tincup on Sat Nov 21, 2015 10:19 am, edited 1 time in total.
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SusanJ
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Re: Individual variation

Postby SusanJ » Sat Nov 21, 2015 10:11 am

I just combined these two threads since they were about the same study.

George, some of the criticisms of this study are that they didn't look at insulin. The researchers said it would have been extremely difficult to poke people the number of times that they would have needed it to get accurate data.

I am encouraged that researchers are at least trying to look at individual variation...

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Re: Individual variation

Postby Tincup » Sat Nov 21, 2015 10:21 am

SusanJ wrote:George, some of the criticisms of this study are that they didn't look at insulin. The researchers said it would have been extremely difficult to poke people the number of times that they would have needed it to get accurate data.


I'm guessing, that had they done the glucose/insulin challenge once, then sorted on the insulin results, it would have explained a lot...
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Re: Individual variation

Postby Julie G » Sat Nov 21, 2015 10:38 am

Agreed, George. Thanks for sharing Susan (and Stavia!) I love this study as it applies to so much of what we do here. The bottom line: test your own biomarkers rather than overly relying on other people's experiences, blogs, experts, and even peer reviewed research. In the end, the only thing that matters is your n=1. I just wish testing were less expensive :?. I wonder if we could arrange group buys or discounts on common tests? (I'm obviously thinking beyond glucose.)

And, Susan, I love that so much points back to our microbiome. This is definitely something we can exert control over. BTW, I recently started your recommended probiotic- VSL#3. I like it; am tolerating it well (yay!) and feeling really good. Thanks.


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