The food of the future: algorithms define what to eat.

After 20 years of life with Type 2 diabetes, Tom Idema had given up control of his disease. He had tried many diets without success and even considered weight loss surgery. When her employer offered her the chance to try a new diet app that uses artificial intelligence to monitor her blood sugar, she took it.

Mr Idema, 50, submitted a stool sample for sequencing of his microbiome and completed an online questionnaire with his blood sugar level, height, weight and medical conditions. This data was used to create a profile for him, to which he added continuous blood sugar measurements for a few weeks. After that, the app, called DayTwo, rated different foods for their positive or negative effect on Mr. Idema’s blood sugar levels, to help him make better food choices.

After nearly 500 days of using the program, his diabetes is in remission and his blood sugar has dropped to the upper limit of normal. And while DayTwo says the app isn’t aimed at weight loss, it went from 300 to 225 pounds. “I wear pants sizes that I haven’t worn since high school,” said Mr. Idema, a trustee at Central Michigan University in Mount Pleasant, Michigan.

DayTwo is just one of many apps that claim to offer AI power solutions. Instead of a traditional diet, which often has a fixed list of “good” and “bad” foods, these programs work like personal assistants that help someone quickly make healthy food choices. They’re based on research showing that bodies react differently to the same foods, and the healthiest choices are likely to be unique to each individual.

It is not yet clear whether these AI nutritionists are ready for widespread use, and there is very little research available from sources outside of companies selling apps. Users should be wary of overly broad claims that go beyond predicting the effect of foods on blood sugar.

But proponents say blood sugar is just the start and AI programs could target other aspects of metabolic health, such as obesity and heart diseaseand possibly help guide a person’s daily food choices.

How to make (artificially) smart food choices

Application DayTwo uses an algorithm based on research by Eran Elinav and Eran Segal of the Weizmann Institute of Science in Israel.who co-founded the company in 2015. Last year, the company found that when it used its algorithm to match a diet to an individual’s microbiome and metabolism, it was better at controlling blood sugar than the Mediterranean diet. , considered one of the healthiest. in the world.

“Instead of measuring foods by calorie content and trying to come up with a ‘healthy diet,'” Dr Elinav said, “We have to start measuring the individual”.

This technology is relatively new and only concerns blood sugar. Meanwhile, the Mediterranean diet has decades of research behind it and will likely remain the gold standard for healthy eating for years to come. Yet for people like Mr. Idema, an AI like DayTwo’s can make it easier to maintain healthy eating habits.

The Mediterranean diet, which combines carbohydrates with legumes and vegetables, is considered one of the healthiest.File, archive

The app’s machine learning algorithm can identify patterns and learn data with human assistance. Analyze data on the glycemic responses of different individuals to tens of thousands of different foods identify personal characteristics (age, sex, weight, microbiome profile and various metabolic measures) that explain Why does one person’s glucose rise with certain foods while another person does not?. The algorithm uses these observations to predict how a particular food will affect blood sugar and assigns a score to each food.

The system still can’t take into account the chocolate bar someone ate two hours ago, but users can play around with food combinations to change the score for each meal. For instance, the app gave the cheese noodles, one of Mr. Idema’s favourites, a low rating, but was able to improve it by adding protein. That’s because adding protein or healthy fats can dampen the blood sugar spike of a high-carb meal like pasta.

“I thought they were going to say, ‘Oh my God, just eat salads, and you didn’t.'”said Mr. Idema.

DayTwo, which is currently only available to businesses or health plans, not consumers, is one of the few AI-powered apps that recommends healthier meal options. Another company, ZOE, also generates Meal Scores and is available directly to consumers for $59 per month.

ZOE’s algorithm uses additional data, such as blood fat levels, in addition to microbiome and blood sugar tests. Algorithm was able to predict how a person’s blood sugar and fat react to different foods in a large 2020 study led by one of the company’s founders, Dr Tim Spector, professor of genetic epidemiology at King’s College London.

Currently, these algorithms primarily focus on blood sugar, but newer versions will incorporate more personal data and, in theory, recommend diets that lower cholesterol, blood pressure, resting heart rate, or any other measurable clinical indicator.

“Integration of all these different types of data is very powerful, and that’s where machine learning comes in,” said Dr. Michael Snyder, a professor of genetics at Stanford University who helped to establish the healthcare company.

Attention buyer

The field of personalized nutrition is still in its Wild West phase, and experts say it’s important to sidestep the hype. Many companies are willing to assess your microbiome and offer AI-based dietary recommendations and sell you supplements, but few are based on scientifically rigorous testing.. Last year, uBiome, which made one, was even accused of fraud. In general, the broader the health and weight loss claims made by companies, the less reliable the supporting evidence is.

“I think everything is overrated right now, unfortunately,” said Dr. Eric Topol, cardiologist and founder and director of the Scripps Research Translational Institute.

The data used by apps like DayTwo and ZOE also only captures a fraction of the interaction between the gut microbiome, our metabolism, and our diet. Certainly there are many other factors, such as genetics, that affect metabolism and are ignored by current AI programs.

“That doesn’t tell you the whole story, and glucose optimization alone will not create the perfect diet for you.i,” said Dr. Casey Means, co-founder and chief medical officer of a digital health company called Levels. AI apps could trick users into eating foods that are good for preventing blood sugar spikes and diabetes, but may not be healthy in other ways.

For example, when Dr. Topol tested the DayTwo app, his recommendations for controlling your blood sugar, such as eating spinach and raspberries, were high in oxalic acid, which may have caused kidney stones. That’s because the app didn’t take into account your pre-existing risk for the condition.

In addition, restrictive diets are increasingly seen as a bad way to change eating habits and often backfire. But many experts hope that custom AI applications will be easier to track and create better long-term behaviors.

For the moment, these apps could help nutritionists with meal suggestionsbut they won’t replace them, and ZOE and DayTwo have regular virtual checkups with a dietitian or nutritionist built into their programs.

Dr. Topol says larger, longer-term studies that incorporate more layers of data, such as sleep, exercise or stress, into the algorithms could make these programs more accurate and precise for each individual. They could also help people see how short-term responses, such as post-meal glucose spikes, influence long-term health.

What we don’t know is how or if daily improvements translate into long-term health.. Dr. Topol clarified AI diet programs. “Can diabetes be prevented? Can heart disease and other chronic diseases be prevented?

These big studios are coming. The National Institutes of Health’s Nutrition for Precision Health research program launched a multi-year study in January to develop algorithms to predict individual responses to food.

But for Mr. Idema, the effects of personalized diets are already tangible, most recently when his improved blood sugar levels allowed him to enjoy his daughter’s birthday cake. “I had turned the meter off at the time and stayed within range, so my body handled it well”, he claimed. “So now I’m in a better place, and in my opinion, this show has definitely saved my life.”

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