Research in Personalised Nutrition
Personalised medicine is a rapidly emerging approach that will revolutionise the current medical paradigm. Over the next decade, CNELM is investing in building a research centre with the aim to engage postdoctoral, PhD and MSc researchers focused on developing the theory and practice of evidence-based personalised nutrition. To achieve this, our objective is to build bridges between academic communities: bringing together researchers in computer science and systems biology with practitioners in nutrition and functional medicine.
Personalisation can either mean interventions that are targeted at disease population subgroups, or interventions that are tailored to the individual. The former is sometimes known as stratification and the latter as individualisation. At CNELM, our principal approach is ‘individualised’. Tailoring a nutritional intervention to the individual involves: (1) a detailed evaluation of an individual’s case-history and functional biochemical test results; and (2) using this analysis to design interventions that can vary from individual to individual, even though those individuals may present similarly. Importantly, at CNELM we also recognise the utility of stratification where appropriate; moreover, we are particularly interested in the advantages afforded by blending both approaches.
In either approach, personalised nutrition interventions involve specific diet & lifestyle changes and supplementation recommendations designed to work together synergistically to achieve a positive outcome. Currently, these interventions are designed using Patho-Physiological Reasoning (PPR): this means reasoning about the mechanisms of pathology or disease present in the individual to design a positive intervention. However, PPR plays a more significant role in tailored personalisation, as the clinician is the one performing the PPR. In stratification, this reasoning is performed beforehand by nutritional scientists, and hence can have less flexibility in many instances.
Personalisation should provide demonstrable improvements to healthcare outcomes. Demonstrable improvements require clinical evidence; to this end we use Greenhalgh’s definition of Evidence Based Medicine (EBM) to define our approach:
“[EBM is … ] the use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision-making in the diagnosis, investigation or management of individual patients.”
Our aim is to build predictive models of personalised nutritional interventions by combing the findings of systematic reviews of the biomedical literature with advanced statistical analysis of clinical data. These models, when combined with Randomised Controlled Trials (RCTs), should provide a solid evidence base for personalised nutrition. We call this combined approach Evidence-Based Patho-Physiological Reasoning (EB-PPR).
Undergraduate and Taught Postgraduate Research
Undergraduate and postgraduate students engage in individual and group research projects that systematically review the literature around nutritional interventions and mechanism of disease; some postgraduate projects can also analyse human data relevant to such interventions. We aim to maximise the number of publications emanating from student research to help support this developing field. All projects involving human data are overseen by the CNELM Research Ethics Committee (REC).