Individualizing Nutrition Recommendations: Are You Stepping Up to the Plate?

Individualization - what does it mean?

Individualization has permeated all aspects of our lives, from technology to clothes, television programming to the cars that we drive. Everywhere we turn we have choices to make - size, color, dimensions, features, functions. We have become a society that not only expects but demands to have these choices… with the end result meeting our needs, preferences and lifestyles to a much greater degree than the “one-size-fits-all” philosophy of the past.

In the same way, food choices and nutrition recommendations are becoming more highly individualized to meet specific concerns and needs of consumers. The population-based guidelines of the past are slowly becoming more specific, factoring in one’s gender, age, physical activity level, chronic disease risk, lifestyle, among a multitude of other factors. The end result will be a set of recommendations highly tailored to meet the needs of every individual to optimize their health, prevent disease, and meet any specific personal goals they might have such as physical fitness. Consumers are no longer satisfied with population-wide guidelines. They expect to be treated as unique, special, and different from the crowd… both in products that they purchase and in services they receive.

History of Individualization Movement

The widely accepted foundation of nutrition science has focused on individual nutrients and nutrient adequacy. For years, government recommendations and health professionals have directed the public to choose foods that provide sufficient amounts of known nutrients to help prevent deficiency diseases. In the past, research available at the time lead to recommending the same nutrients, in the same amount, to age-and gender-matched groups. Today, we recognize that traditional nutrients play a much broader role in health. For example, calcium is recognized for its role in lowering blood pressure and in body weight reduction, in addition to well-accepted roles in bone and dental health. Vitamin E has gained visibility as an antioxidant and in possible prevention of age-related neurological degeneration.

Concurrent with this expansion of knowledge about the role of traditional nutrients in health, there is also growing awareness of the role bioactive components in foods play in reducing risks of certain chronic diseases and enhancing overall health. Specific examples include lycopene in tomato products for its role in reducing cancer risk, polyphenols in tea for reducing cancer and heart disease risk, and whey proteins for their immune-enhancing properties and blood pressure-lowering effects.

Patterns of food consumption and food synergy, or the positive interactions of food components, are being recognized as playing a critical role in health. Realizing that there are multiple components in every food is a mind shift from years ago when the emphasis was on identifying specific nutrients and specific foods for their health effects.

What does this new approach mean to the nutrition and health professional?
While such customization of nutrition recommendations has been a goal of the nutrition community for years, there now appears to be a convergence of information from the basic, applied and social sciences providing insight and tools to enhance the products and services offered in this arena. In addition, federal guidelines have started to incorporate such information into population-based recommendations and will continue to do so. The food industry will meet the demand by continuing to develop and market products to meet the needs of diverse segments of the population. As a result, consumers have more choices and nutritionists have increased opportunities to highly customize food choices, thus adding meaningful value to the information exchanged between client and professional.

Suggestions for the Practicing Clinician
Here are some specific suggestions to incorporate a higher level of individualization into recommendations that you provide to your patients and clients:

• Become familiar with the newly released Dietary Reference Intakes (DRIs) from the National Academy of Sciences. These list nutrient recommendations across expanded age groupings and include Upper Levels (UL) to avoid over-consumption of potentially hazardous amounts of nutrients.
• Utilize the Food Guide Pyramid to help the customer visualize food choices within categories of recommended groupings. Take this tool a step further by helping your client differentiate foods within food groups that might be more practical or more healthful choices for their specific needs.
• Use expanded nutrient and bioactive component lists of foods to assist clients in selections appropriate to their lifestyle and genetic patterns as determined by family health histories.
• Make an effort to become familiar with new food products offered in the marketplace that might be a match to the taste and health needs of your clients.
• For one-on-one counseling, query your clients not just on age, weight and nutritional goals but on family history, genetic predisposition to disease, ethnicity, current physical activity levels, lifestyle, environment, and any other factor that might impact their nutritional needs. Remember that although gender, age and disease risk may not vary much from one session to the next, other lifestyle variables such as smoking and activity may… and should be factored into your final recommendations.
• In the public health arena, individualizing nutrition recommendations is also possible. Segment your clients into subgroups that have similar needs, for example by weight status, disease risk, stage of pregnancy, or iron-deficiency anemia, and provide recommendations based on those prioritized needs.
• For any one client, focus on one to two dietary goals at a time. An overweight, sedentary woman at risk for heart disease will need help prioritizing which goals to work on first in order to optimize her health in a realistic fashion.
• Stay abreast of emerging research in the area of health and nutrition. Over the past few years it has become clear that soy and oat products can help lower cholesterol levels, fish rich in omega-3 fatty acids can lower risk of heart disease and stroke, and probiotics may confer intestinal health benefits. Often these effects are well-known and accepted within the health community long before FDA approves labeling of such benefits on the actual food product.
• Remember that while food preferences may not affect actual nutrient needs in major ways, successful dietary guidance must consider the taste and food preferences of the individual, or the nutrients recommended will never be consumed. Thus any dietary plan must factor in an individual’s preferences.

Summary and Call To Action
Individualizing dietary recommendations including specific foods and patterns of food choices to match an individual’s specific health- and disease-related needs is clearly the future of nutrition practice. The emerging explosion of research in this arena cannot be ignored if nutrition professionals are to maintain their positions as credible leaders in the interpretation and application of nutrition science. While the specific elements of application of individualized recommendations and food choices are still unclear at this point, the nutrition community has an unprecedented opportunity to set parameters and provide guidance around this movement. It is within the realm of our collective ability to move beyond population-based guidelines to more finely-tuned dietary recommendations and food choices… and in doing so we help to enhance the nutritional health of the population as a whole.