The Possibility of a Better Measure for Dietary Disease Risk

Scientists have a pretty good handle on how to predict a person’s risk of diabetes and how to diagnose it. The gold standard is a glucose tolerance test. How does your body handle glucose? But diabetes is just one dimension of dietary disease risk and nutrition scientists are hungry for a better way to predict dietary risk beyond a simple view of glucose tolerance. Understanding dietary risks and advances in precision nutrition require a view of more than just how a person’s body handles glucose. More than the response to a glass of sugar water.

This is why nutrition scientists are excited about the possibilities for a mixed meal tolerance test. New research in Nutrition & Diabetes suggests that such a test might offer an important marker of dietary disease risk. And thus it might open new possibilities for claiming the full potential of precision nutrition.

A Modest, Promising Step

Cassie Mitchell and colleagues analyzed data from a prospective cohort of indigenous American adults for multiple metabolic measures. They looked closely at the value of a mixed meal tolerance test (MMTT). They found that the test of mixed meal tolerance could accurately predict development of type 2 diabetes. Further, they found promise of broader potential:

“MMTTs generate additional and clinically useful data across a range of physiological systems in addition to the risk for type 2 diabetes, including endothelial, renal, and hepatic functioning [3]. Given this, MMTTs are used with increasing frequency in precision nutrition studies. Our data, combined with findings from others, demonstrates that in addition to assessing response to diet interventions, MMTTs also can predict important clinically relevant outcomes.

“Our data indicate that MMTT response. which simulates more “real world” intake can inform health risks beyond the immediate response to dietary interventions.”

A Tool for Precision Nutrition

In a commentary on these findings, Sai Krupa Das, Ted Kyle, and Leah Whigham point to the possibility that a mixed meal tolerance test could become an essential tool for precision nutrition:

“The nutrition field is in urgent need of guidance for an established/standardized methodology for measuring phenotypic flexibility. It is critical that the scientific community works to identify an MMTT that shows diagnostic and prognostic potential. By standardizing, validating, and scaling such a test, we may be able find a new gold standard for identifying biomarkers that (a) illuminate interindividual variability in response to diets and (b) inform precision nutrition approaches that target chronic disease.”

Measuring real responses to real meals (not just sugar water) with rigor might be the step beyond glucose tolerance testing that powers big advances in precision nutrition.

Click here for the Mitchell study and here for the Das commentary. For further perspective on the potential of mixed meal tolerance testing and precision nutrition, click here and here.

The Stairway, painting by George Ault / WikiArt

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August 30, 2024