Iris de Hoogh, personalised health scientist at the organisation for applied scientific research TNO, discussed the topic in a presentation at the Active Nutrition Summit last week (9 – 11 October).
Personalised process
To develop a personalised health system, Hoogh explained that TNO first obtains information such as body biomarkers and lifestyle data depending on the desired consumer outcome, which are obtained through blood tests, wearables, or behavioural questionnaires.
She said the health benefit of interest must first be identified before the algorithm, whether its sporting or performance goals, as well as any associated barriers and limiting factors.
De Hoogh told attendees in Amsterdam that the measurement points must then be decided on, emphasising the importance of real-time measurement and feedback for more actionable monitoring and personalised interventions.
“At TNO, we do a lot of research in this field using wearables like heart rate monitors and continuous glucose monitoring, which can be used to model trends in glucose profiles in a personalised way. But we know from our own research that the influence of contextual factors on glucose levels, like physical activity and sleep, varies largely between individuals.
“So for one person it may be very important to focus on their sleep to balance glucose levels, whilst for others it may be their physical activity levels,” she explained.
The subsequent user specific information can be then translated into personalised advice, which she said can be knowledge-driven and/or data-driven.
“Whilst data-driven approaches allow for the collection of large datasets, there are downsides as tools like AI can be influenced by bias or confounding. Also, often this amount of data cannot really be interpreted. So, we have an outcome where we don’t really know the mechanism behind it or if we can trust it. It’s really important to validate the solution in a real life setting before marketing,” she stressed.
She added that the type of data used for knowledge-based solutions is also important to consider, only including systematic reviews and meta-analyses of RCTs, as well as existing EFSA health claims which already have a strong science backing.
The personalised intervention
She expressed the importance of personalising subsequent recommendations by personality and preference, with a study concluding that advice was rated higher if it was tailored to the individual’s specific personality using ‘the big five’ personality traits.
“It is also important to consider the behavioural change techniques, such as motivational interviewing which is used by dieticians and goal setting to increase the engagement with the advice given. You can also help them self-monitor their behaviour to see if they’re on track with their goals. Feedback and rewards can be very effective.
“You can also adapt your interventions or how you support them over time. You might want to challenge the individual to set a more ambitious goal but also if it’s not working out, you can help them to set a more realistic one,” she added.
Regarding personalised sports supplementation, Hoogh said potential is still limited due to the research still being in its infancy. Yet, she noted one study investigating factors that may modify the response to supplementation to improve blood alkalosis.
She explained: “From this it became clear that the dose and the timing of the supplementation is an important modifying factor, and that the sodium bicarbonate levels in the blood differ a lot between individuals, as well as the associated gastrointestinal complaints. Also training status, genetics, and type and duration of training play a role in how effective the supplement is.”
Case studies
Hoogh highlighted TNO’s array of partnerships with personalisation companies, spotlighting the app-based sports nutrition company ‘The Athlete’s Foodcoach’ which is currently being used by various sports clubs and amateur athletes.
With continual support from a nutritional coach, she said the service first collects demographic and training information which results in the calculation of a nutritional plan. Finished recipes are then created which can be ordered and delivered to the training grounds.
She explained a further partnership with the food production company ‘IMAGINE’, which combines a personalised advice system with digital food manufacturing technology resulting in 3D printed personalised snacks.
“There are several use bases for this, but one of which is for the military where the aim is to help soldiers increase their performance and endurance. So, this involves a soldier entering their demographic and personal data which is securely held in a portal. The solider then gets some information on their health status as well as some nutritional advice, and the 3D printed snack.
“The soldier can select some main benefit areas to target, which can include endurance, recovery from injury, digestive health, mental health, and immunity. They can also input their training for the day, whether its marching or strength training, so that these nutritional recommendations can be linked to them,” she explained.