Optimisation of a metabotype approach to deliver targeted dietary advice

Abstract

Background: Targeted nutrition is defined as dietary advice tailored at a group level. Groups known as metabotypes can be identified based on individual metabolic profiles. Metabotypes have been associated with differential responses to diet, which support their use to deliver dietary advice. We aimed to optimise a metabotype approach to deliver targeted dietary advice by encompassing more specific recommendations on nutrient and food intakes and dietary behaviours.

Methods: Participants (n = 207) were classified into three metabotypes based on four biomarkers (triacylglycerol, total cholesterol, HDL-cholesterol and glucose) and using a k-means cluster model. Participants in metabotype-1 had the highest average HDL-cholesterol, in metabotype-2 the lowest triacylglycerol and total cholesterol, and in metabotype-3 the highest triacylglycerol and total cholesterol. For each participant, dietary advice was assigned using decision trees for both metabotype (group level) and personalised (individual level) approaches. Agreement between methods was compared at the message level and the metabotype approach was optimised to incorporate messages exclusively assigned by the personalised approach and current dietary guidelines. The optimised metabotype approach was subsequently compared with individualised advice manually compiled.

Results: The metabotype approach comprised advice for improving the intake of saturated fat (69% of participants), fibre (66%) and salt (18%), while the personalised approach assigned advice for improving the intake of folate (63%), fibre (63%), saturated fat (61%), calcium (34%), monounsaturated fat (24%) and salt (14%). Following the optimisation of the metabotype approach, the most frequent messages assigned to address intake of key nutrients were to increase the intake of fruit and vegetables, beans and pulses, dark green vegetables, and oily fish, to limit processed meats and high-fat food products and to choose fibre-rich carbohydrates, low-fat dairy and lean meats (60-69%). An average agreement of 82.8% between metabotype and manual approaches was revealed, with excellent agreements in metabotype-1 (94.4%) and metabotype-3 (92.3%).

Conclusions: The optimised metabotype approach proved capable of delivering targeted dietary advice for healthy adults, being highly comparable with individualised advice. The next step is to ascertain whether the optimised metabotype approach is effective in changing diet quality.

Keywords: Biomarkers; Cluster analysis; Metabotypes; Personalised nutrition; Targeted nutrition.

Fig. 1

Flowchart for the assessment and optimisation of the metabotype approach

Fig. 2

Relative frequency of dietary messages assigned according to optimised metabotype approach and individualised manual approach. a Metabotype 1. b Metabotype 2. c Metabotype 3. Blue lines represent the relative frequency of dietary advice assigned using the optimised metabotype approach. Red lines represent the relative frequency of dietary advice assigned using the individualised manual approach. Green numbers represent the range of the relative frequency. Grey numbers represent the dietary messages as follows: 1—Choose fibre-rich carbohydrates, 2—Eat five servings of fruit and vegetables per day, 3—Limit processed meats and high-fat food products, 4—Choose lean meats, 5—Choose low-fat dairy products, 6—Eat oily fish twice a week, 7—Reduce the intake of high-fat foods, 8—Low-fat cooking advice, 9—Limit the intake of foods high in added sugar to once or twice a week, 10—Choose low-salt products, 11—Limit the salt added during cooking and take it off the table, 12—Do not skip breakfast and avoid eating in the night-time, 13—Reduce the size of food servings, 14—Exercise for 30 min per day, 15—Exercise for 60–90 min per day, 16—Aim to keep your healthy body weight, 17—Aim for a gradual weight loss, 18—Limit alcohol intake to one unit per day, 19—Eat more beans and pulses, 20—Eat more dark green vegetables, 21—Eat three servings of dairy products per day, and 22—Have a small daily handful of seeds and nuts