Eran Segal (Solve grantee): Personalised microbiome-based diets for blood glucose regulation

Fascinating TEDx talk here by Eran Segal, who has just received a Ramsay Award grant from Solve ME/CFS.

https://www.youtube.com/watch?v=0z03xkwFbw4

 

The book, which is called 'The Personalized Diet: The revolutionary plan to help you lose weight, prevent disease and feel incredible', is coming out on 26 December.

In Israel, people can get analysed for free as part of the research, if I've understood that correctly:

http://personalnutrition.org/AboutGuests.aspx

One question that I had was whether 1,000 people would be a sufficient sample to come up with a reliable algorithm.

 

I'm skeptical.

 

I don't know how to make a judgement on it. Whether the number is too small or is adequate will depend on all sorts of things (the number of variables being measured, the strength of the underlying correlations, etc.).

The proof will be in the resulting model's predictive power, I suppose.

Haven't had time to search for his scientific publications on this, but that's where we should be looking.

I wonder how this ties in with PWME's various metabolic issues.

 

Well curb your enthusiasm, there. The basic premise – that diet should be personalized – is probably sound, though.

 

He says that average person eats 50 meals a week? That works out to 7 meals a day. He's including snacks I guess, but still.

I don't gain weight easily but if I ate that much I would be overweight.

 

Hi everybody, please try and keep on topic, I've removed some posts. Might be a good idea in future if a technical problem crops up to take it to the Technical Support forum.

(ps, there's a thread in the tech support forum now dealing with the image embedding issue that came up).

 

I see what you did there. Yeah I didn't mean to sound so negative, it's a good thing to explore and work out for sure, I just don't imagine we're quite there yet and that we'll need a much bigger sample before we are.

 

@Jenny TipsforME - We were talking about this a while back. Interesting stuff.

 

I imagine it probably is good enough to make broad suggestions. Probably the algorithms could be refined further with more subjects studied.

 

I think that's what the book is about, @Trish - how to do that.

Here's the blurb from Amazon:

There are certain things we take as universal truths when it comes to dieting and health: kale is good; ice cream is bad.

Until now.

When Dr Segal and Dr Elinav published their ground-breaking research on personalized nutrition, it created a media frenzy. They had proved that individuals react differently to the same foods-a food that might be healthy for one person is unhealthy for another. In one stroke, they made all universal diet programs obsolete.

The Personalised Diet helps readers understand the fascinating science behind their work, gives them the tools to create an individualized diet and lifestyle plan (based on their reactions to favourite foods) and puts them on the path to losing weight, feeling good, and preventing disease by eating in the way that's right for them.​

 

Abstract of a recent paper on which he's co-author (I haven't done a thorough search):

Bread Affects Clinical Parameters and Induces Gut Microbiome-Associated Personal Glycemic Responses.

Korem T1, Zeevi D1, Zmora N2, Weissbrod O1, Bar N1, Lotan-Pompan M1, Avnit-Sagi T1, Kosower N1, Malka G1, Rein M1, Suez J3, Goldberg BZ4, Weinberger A1, Levy AA5, Elinav E6, Segal E7.

Abstract
Bread is consumed daily by billions of people, yet evidence regarding its clinical effects is contradicting. Here, we performed a randomized crossover trial of two 1-week-long dietary interventions comprising consumption of either traditionally made sourdough-leavened whole-grain bread or industrially made white bread.

We found no significant differential effects of bread type on multiple clinical parameters. The gut microbiota composition remained person specific throughout this trial and was generally resilient to the intervention. We demonstrate statistically significant interpersonal variability in the glycemic response to different bread types, suggesting that the lack of phenotypic difference between the bread types stems from a person-specific effect.

We further show that the type of bread that induces the lower glycemic response in each person can be predicted based solely on microbiome data prior to the intervention. Together, we present marked personalization in both bread metabolism and the gut microbiome, suggesting that understanding dietary effects requires integration of person-specific factors.​

Full text: http://www.cell.com/cell-metabolism...m/retrieve/pii/S1550413117302887?showall=true

 

Actually, here's a far more relevant one:

Personalized Nutrition by Prediction of Glycemic Responses

Highlights

• High interpersonal variability in post-meal glucose observed in an 800-person cohort
• Using personal and microbiome features enables accurate glucose response prediction
• Prediction is accurate and superior to common practice in an independent cohort
• Short-term personalized dietary interventions successfully lower post-meal glucose

Summary
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.

We devised a machine-learning algorithm that integrates blood parameters, dietary habits, anthropometrics, physical activity, and gut microbiota measured in this cohort and showed that it accurately predicts personalized postprandial glycemic response to real-life meals. We validated these predictions in an independent 100-person cohort.

Finally, a blinded randomized controlled dietary intervention based on this algorithm resulted in significantly lower postprandial responses and consistent alterations to gut microbiota configuration. Together, our results suggest that personalized diets may successfully modify elevated postprandial blood glucose and its metabolic consequences.​

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

 

Really this is fascinating stuff. I'm interested.

I was testing my blood sugars a while ago, and still have some of the kit. My fasting sugars tend to be high, and I discovered the work of Dr Jason Fung on the benefits of fasting for sugar control. (A T2 diabetic relative came off all her insulin using his methods).

To my surprise fasting really helped my energy levels! Mostly due to a reduced PEM effect.

I now don't eat on Tuesdays (36 hr fast) or during most of Friday (24 hr fast or maybe 36 hr if I feel so inclined). This has REALLY helped my stamina from day to day, and when I stop I get more PEM etc. Apparently there are benefits to fasting for the immune system, so it might not just be about sugars. (However I've also been on ARVs for a year, so perhaps this is a quirk of my history on them.. who knows... )

I suspect if I now also worked out how different foods affect my sugar control that this would also be good. I know I don't react will to very sugary foods, so working out what others might cause a high sugar spike in me, might be good too....

Food for thought indeed.

 

This looks like woo to me so far but I will listen to the talk.

As far as I know all we all need to do is to avoid eating so much that we get fat - and develop insulin resistance. If you have type I diabetes it might be helpful to know which foods spike your sugar I guess but otherwise I doubt it.

I wouldn't want to eat the foods my gut bacteria prefer rather than the ones I prefer.

 

The only consistent factor for my fasting blood sugar being high in the morning (I have diabetes now) is how much I've over-exerted recently.