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Weekly UpdatesABSTRACT
Human beings are not created equal, at least not in terms of nutritional needs. Nutritional needs are dictated by a mixture of genetics, epigenetics, personal history and lifestyle. Obvious cases of genetically-based or genetically-predisposed special nutritional needs are well known; insulin-dependent (Type 1) diabetes mellitus and phenylketonuria being good examples. Other special dietary needs are of less clear origin, but disorders such as coeliac disease, irritable bowel disease and lactose intolerance are becoming widely recognised as having strong genetic components. Additionally, there is emerging evidence of individually different responses in fat metabolism in individuals, leading to differences in lipoprotein profiles (HDL and LDL--indicators of heart health) in response to diet. Some lifestyles also give rise to special dietary requirements. This is particularly noted for athletes, who often have very specific nutritional advice. All of these examples are exceptional, relating to specific metabolic disorders or extreme lifestyle needs, with quite specific goals. This paper is concerned with an emerging trend towards personalised nutrition becoming mainstream in affluent society, with a goal of general good health, and the potential for mass customisation to provide personalised nutrition on a wide front.
Keywords: nutrigenomics; nutrigenetics; personalised nutrition; mass customisation; Maslow; individual choice
INTRODUCTION
Personalised nutrition
Personalised nutrition is a response to differences between individuals, and attempts to balance an individual's diet to their specific individual and situational needs. Nutrition today is not just about balance of macro- and micronutrients: a plethora of 'functional' (bioactive) food components are also known to affect health in ways that extend far beyond the simple supply of nutrients, and they can be modifiers of nutrient uptake and usage, thus modifying the effect of nutritional balance as seen by the body's metabolism. Structural forms of food at the macro-, micro- and nano scale are affected by chewing and stomach processing, and can have effects on the availability of nutrients and bioactives. The kinetics of nutrient uptake are just as important as overall absolute uptakes of nutrients. Personalised nutrition attempts to take this into account, to provide optimal customised nutrition for the individual.
In sophisticated markets today, there is increasing acceptance that nutrition has a pro found effect on health and wellness, and as individuals become more aware of their specific nutritional needs, the demand for personalised nutrition is set to increase.
Mass customisation
Mass Customisation, an apparent oxymoron, is defined as 'the ability to satisfy the particular needs and wants of individual customers' (Pine 1998) and relates to systems that have the efficiencies normally associated with mass production but can satisfy personalised requirements. It is an approach to developing individually tailored products from a range of mass-produced precursors that can be assembled and processed in different ways, usually enabled by a computer-based system. The concept of customisation on a mass basis was first raised by Toffler (1980), and the term 'mass customisation' was first coined by Stanley M Davis (1987), although it is often attributed to Joseph Pine, who wrote an early treatise on the subject (Pine 1998).
An important aspect of mass customisation is the involvement of the final customer in the design of the product. Two distinct aspects of design in mass customisation have been described (Boland 2006):
* Mass customisation of sensory performance--for example for appearance (fashion, design, colour), sound (programming on the iPod) or taste and smell of food.
* Mass customisation of functional performance--this can relate to various aspects of performance, for example, speed, power and handling of automobiles, and speed, display size and memory capacity of computers.
Both aspects of mass customisation are important, and true mass-customised products involve the customer in the design of both aspects. In reality, most products focus on one or the other, so that mass-customised fashion articles, or automobiles, tend to focus on the sensory aspect, while other mass-customised products such as computers, focus on functionality.
The power of mass customisation lies in the mathematics of combinations. For N different ingredients, there are [2.sup.N] possible combinations, thus a range of 20 ingredients will give more than a million combinations. Mass customisation offers the possibility of being able to match the varied nutritional requirements of a wide range of individuals for personalised nutrition.
DRIVERS FOR PERSONALISED NUTRITION
Health and nutrigenomics
Consumers are increasingly demanding elements of personalised nutrition for health, wellness and fitness. This is the result of increasing awareness of the effects of diet on health (and appearance). The success of diet clinics attests to this, but this is merely a portent of what is to come. The occurrence of (and attention being paid to) current high levels of obesity in affluent societies is spurring interest in diet at all levels of society, from individual to government.
The conjunction of availability of individual genetic data on a scale never before seen--and rapidly growing as a consequence of the human genome mapping and its outcome--with detailed understanding of nutrition--has led to the field of 'nutrigenomics'. Nutrigenomics is the study of the relationship between a person's genetic makeup and their individual nutritional needs. Some experts distinguish between nutrigenomics--where the study is based on a whole genome and systems biology approach--and nutrigenetics, which involves hypothesis-driven investigation around specific known genetic variations. However, nutrigenomics is the term widely used to cover both aspects of nutritional science, and it is used in that sense here.
Individuals can now obtain information about their own genetic profile, with respect to known genetic polymorphisms related to health and metabolism. In the USA, some companies will provide a mail order analysis of key genetic polymorphisms, together with advice about diet and lifestyle (see Box 1).
Other companies offering genetic testing, generally by mail order, include One Person Genetics, Interleukin Genetics, and Salugen.
While there is wide availability of these tests and accompanying dietary guidelines (largely via the internet), it must be understood that our knowledge of these genetic variations is very much in its infancy and there is a much wider range of genetic variability affecting response to food that is only partially understood, or still to be discovered. Present knowledge is mainly limited to a few single nucleotide polymorphisms (SNPs) that affect specific metabolic pathways. Genetic diversity is much wider than that, encompassing gene duplication, gene insertion, gene deletion and epigenetic effects as well as SNPs (Ordovas 2007). In addition, it is known that, apart from a few simple single-gene effects that are well known, such as lactose intolerance and phenylketonuria, most nutritional effects involve many genes, with often opposing effects for different polymorphisms (Joost et al 2007), so the effect of a single known SNP is only a small part of the puzzle. For that reason nutritionists and medical personnel are urging caution in the use of these genetic testing services (Joost et al 2007). Nevertheless, if the tests are available, people will use them, particularly the 'worried well' segment: early adopters within this segment will be particularly quick to pick up on and use these tests and a significant market will be created for personalised nutrition.
As genetic effects on nutrition are further elucidated and physicians become familiar with the application of nutrigenomics, mainstream acceptance will occur, with the potential for large and widespread demand. This is unlikely to occur until well into the second decade of the 21st century.
Ageing and nutrigenomics
A further important driver for nutrigenomics is an ageing, affluent baby-boom population that is aware of the importance of healthy nutrition to prevent or minimise the adverse effects of ageing. This is played to by popular literature, such as the book, Feed Your Genes Right: Eat to turn off disease-causing genes and slow down ageing (Challem 2005). Although such books may be 'alternative' and as such not authoritative, they have a strong presence with the alternative health population and can create substantial demand.
[FIGURE 1 OMITTED]
i-space
A further driver for personalised nutrition is the increasing awareness of consumers (in a marketing sense) of their individuality. This has been led by Apple with its iPod. The success of individualised products appeals to today's sophisticated consumer, and allows them to feel empowered and distinguished from the crowd.
It is instructive to look at personalisation in the context of Maslow (Maslow 1943; Maslow & Lowery 1998). One version of Maslow's 'hierarchy of needs' pyramid is shown in Figure 1. The principle of the pyramid is that needs must be met on a lower level before needs are addressed at a level above. In affluent society, all of the survival needs are easily met for the majority of the population. It is the 'self-actualisation' drivers in the higher levels that drive the consumer. Personalised nutrition is all about meeting these higher level needs in the context of nutrition.
A further insight into personalised nutrition is that it is a part of the 'experience economy'. This idea, pioneered by Pine and Gilmore (1999), is that affluent customers today will make purchases of goods based not only on the quality of the good, but also on the experience of the purchase. The catch-cry of the seminal book on the experience economy by Pine is 'work is theatre and every business a stage'. It has been said that Starbucks is not about coffee--it is about empowerment. The harried company worker can make several unchallenged executive decisions when ordering a coffee before starting work. A perusal of the cost of a cup of coffee in Figure 2 illustrates this point: while there is a clear difference in price going from a consumer good to a service item (the diner coffee), the Starbucks (or equivalent) is offering an experience, for which the consumer pays another substantial mark-up.
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