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Review
. 2025 Mar;78(3):263-271.
doi: 10.1016/j.rec.2024.09.003. Epub 2024 Sep 30.

Recent advances in precision nutrition and cardiometabolic diseases

[Article in English, Spanish]
Miguel A Martínez-González  1 , Francisco J Planes  2 , Miguel Ruiz-Canela  3 , Estefanía Toledo  3 , Ramón Estruch  4 , Jordi Salas-Salvadó  5 , Rafael Valdés-Más  6 , Pedro Mena  7 , Olga Castañer  8 , Montse Fitó  9 , Clary Clish  10 , Rikard Landberg  11 , Clemens Wittenbecher  12 , Liming Liang  13 , Marta Guasch-Ferré  14 , Rosa M Lamuela-Raventós  15 , Dong D Wang  16 , Nita Forouhi  17 , Cristina Razquin  3 , Frank B Hu  18
Affiliations
Review

Recent advances in precision nutrition and cardiometabolic diseases

[Article in English, Spanish]
Miguel A Martínez-González et al. Rev Esp Cardiol (Engl Ed). 2025 Mar.

Abstract
in English, Spanish

A growing body of research on nutrition omics has led to recent advances in cardiovascular disease epidemiology and prevention. Within the PREDIMED trial, significant associations between diet-related metabolites and cardiovascular disease were identified, which were subsequently replicated in independent cohorts. Some notable metabolites identified include plasma levels of ceramides, acyl-carnitines, branched-chain amino acids, tryptophan, urea cycle pathways, and the lipidome. These metabolites and their related pathways have been associated with incidence of both cardiovascular disease and type 2 diabetes. Future directions in precision nutrition research include: a) developing more robust multimetabolomic scores to predict long-term risk of cardiovascular disease and mortality; b) incorporating more diverse populations and a broader range of dietary patterns; and c) conducting more translational research to bridge the gap between precision nutrition studies and clinical applications.

Un número creciente de investigaciones sobre las ómicas en nutrición ha dado lugar a recientes avances en la epidemiología y la prevención de las enfermedades cardiovasculares. En el ensayo PREDIMED se identificaron asociaciones significativas entre los metabolitos relacionados con la dieta y las enfermedades cardiovasculares que después se han reproducido en cohortes independientes. Entre los metabolitos identificados destacan las concentraciones plasmáticas de ceramidas, acilcarnitinas, aminoácidos de cadena ramificada, triptófano, vías del ciclo de la urea y el lipidoma. Estos metabolitos y sus vías asociadas se han relacionado con la incidencia tanto de enfermedades cardiovasculares como de diabetes mellitus tipo 2. Algunas líneas futuras de investigación en nutrición de precisión deberían incluir: a) el desarrollo de índices multimetabolómicos más sólidos para predecir el riesgo a largo plazo de enfermedades cardiovasculares y mortalidad; b) la incorporación de poblaciones más diversas y una gama más amplia de patrones dietéticos, y c) la realización de más estudios traslacionales para salvar la brecha entre los estudios de nutrición de precisión y sus aplicaciones clínicas.

Keywords: Cardiopatía isquémica; Cardiovascular disease; Diabetes mellitus tipo 2; Dieta mediterránea; Enfermedad cerebrovascular; Epidemiología de la nutrición; Ischemic heart disease; Mediterranean diet; Metabolomics; Metabolómica; Nutrición de precisión; Nutritional epidemiology; Precision nutrition; Type 2 diabetes.

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Conflict of interest statement

CONFLICTS OF INTEREST

M. Guasch-Ferré acknowledges that The Novo Nordisk Foundation Center for Basic Metabolic Research is supported by an unrestricted grant from the Novo Nordisk Foundation (grant no. NNF18CC0034900). J. Salas-Salvadó expresses appreciation for financial backing from ICREA through the ICREA Academia program. O. Castañer acknowledges ISCIII contracts CP21/00097, PI20/00012, and the CIBER Network of Epidemiology and Public Health (CIBERESP). P. Mena received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (PREDICT-CARE project, grant agreement No 950050). F.J. Planes was supported by the European Union’s Horizon 2020 research and innovation program (STAN-CE4HEALTH, Grant No. 816303). All other authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Central illustration. Several National Institutes of Health-funded substudies nested within the PREDIMED randomized trial were designed to better understand the health benefits of MedDiet interventions on cardiometabolic risk prevention through metabolomics profiling. Case-cohort designs with repeated metabolomic profiling (baseline and after 1 year) allowed testing: a) the effects of baseline metabolites on CVD events; b) the effect of the intervention (MedDiet) on 1-year metabolite changes; c) the effects of changes in metabolites (from baseline to 1-year) on subsequent CVD events (after 1 year); d) the effect modification (potential attenuation) by the MedDiet intervention (interaction) on the associations between plasma metabolites and CVD events. All these tests were also applied to the risk of type 2 diabetes with analogous designs. BCAA, branched-chain amino acids; CVD, cardiovascular disease; MedDiet, Mediterranean diet; PAD, peripheral artery disease; PUFA, polyunsaturated fatty acids.
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