Personalized Nutrition- Is the Future Here Yet?

By Robert Dunn, Dietetic Intern

Is the secret to a perfect diet hidden in your own body?

Personalized nutrition is a modern approach to nutrition that aims to prescribe specific diets based on biomarkers. Biomarkers are substances that provide information on a person’s condition, and can be used to measure disease risk. By assessing their impact on nutrition, medical professionals may be able to precisely determine the best diet for improving a person’s health.

The role of personalized nutrition is evolving quickly. Many researchers are optimistic that it may provide a breakthrough in the treatment of certain diseases. One of the diseases being closely studied is diabetes, a condition that affects over 29 million people in the United States. Additionally, over 80 million people are estimated to have prediabetes, putting them at risk for developing diabetes later in life. Diet and lifestyle have always been important for diabetes management, and personalized nutrition may soon play a key role in this process.

Researchers in Denmark recently published a study on personalized nutrition in diabetes treatment. Their goal was to determine the most effective weight loss diet for people that were diabetic, pre-diabetic, or neither (healthy group). To do so, they divided patients from prior weight loss studies into those groups based on two biomarkers: fasting insulin and fasting blood glucose. Once the patients were assigned groups, the researchers could then compare weight loss data to determine if any diet had a particularly strong effect on any specific group.

After comparing the data, several trends became clear. Patients in the diabetic group lost more weight on a low-carbohydrate diet that was high in plant-based fats like olive oil. Meanwhile, the healthy group was more successful with a low fat, high-carbohydrate diet. Finally, pre-diabetic patients who followed a diet high in fiber (fruits, vegetables, whole grains) lost more weight than those who followed a control diet. Based on these results, the researchers concluded that biomarkers like fasting blood sugar could be helpful in planning diet interventions for patients with either diabetes or pre-diabetes.

The results of this study seem promising, and may offer insight into weight loss strategies for people with diabetes or pre-diabetes. However, personalized nutrition is an emerging area of research and it is important we don’t make conclusions based on limited evidence. The study’s authors stated that next steps include “research to explore additional biomarkers…which may help to more effectively customize the right diet for specific individuals.”

In the meantime, people with diabetes and pre-diabetes should be encouraged to optimize their nutrition and physical activity. Nutrition counseling with qualified professionals has been shown to improve the health of people with these conditions. Anyone interested nutrition for diabetes management should consider meeting with a Registered Dietitian (RD).  Registered Dietitians are nutrition experts who help people of all backgrounds use diet to meet their medical needs.

To schedule an appointment with an RD from Massachusetts General Hospital, contact the Department of Nutrition and Food Services by calling 617-726-2779.

Content reviewed by Melanie Pearsall, RD, LDN, CDE

GRADE Study at Mass General

Do you have type 2 diabetes?

Have you had it for less than 5 years?

Do you take only metformin for your diabetes?

You may be able to join GRADE, a clinical research study being conducted at Massachusetts General Hospital. GRADE seeks to identify the best combination of commonly used medications to treat type 2 diabetes for long-term health.

Participants receive, at no cost to them:
• Diabetes treatment, tests, medicines and supplies
• $100/year and free parking at Mass General parking garages
• Regular, coordinated care from a diabetes medical team at the Mass General Diabetes Center. Visits are four times a year for four to seven years, depending on date of enrollment.

The diabetes medicines, and medication combinations studied in GRADE are regularly prescribed by doctors, and are approved by the U.S. Food and Drug Administration and the American Diabetes Association to treat type 2 diabetes.

To learn more, call 617-643-7737

GRADE: Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study: A nationwide clinical research study sponsored by the National Institutes of Health.

Guest Post, Heart Health, Nutrition

Spotlight on the Mediterranean Diet

By Emma Louise Toolson
Dietetic Intern

Med Diet Pyramid 2

Earlier this year, the New England Journal of Medicine (NEJM) published a study linking the Mediterranean diet with a reduced risk of cardiovascular disease.  Quite simply, the Mediterranean diet is a way of eating that is based on the traditional foods and cooking styles of countries along the Mediterranean Sea. The general eating pattern while following a Mediterranean diet includes:

  • Several servings of fruits and vegetables daily
  • Focus on healthy fats like olive oil and canola oil
  • Consuming fish and poultry at least two times per week
  • Limiting dairy products, red meat, processed meats and sweets
  • Use of herbs and spices to flavor foods in place of salt
  • Red wine, in moderation (if appropriate)

While the Mediterranean diet is abundant in fruits, vegetables, whole grains and healthy fats, a typical Western diet, in contrast, contains more processed foods, refined carbohydrates and saturated fat. Another key feature of the Mediterranean diet is the inclusion of regular physical activity — the Western diet, meanwhile, tends to be more sedentary.

The NEJM study followed 7447 participants over 6 years. Two groups of participants were randomly assigned to a Mediterranean diet pattern, while a third followed a low-fat diet which acted as a control. The two groups following the Mediterranean eating plan were given either olive oil or mixed nuts to provide the monounsaturated (healthy) fats. Restricting calories was not advised for either group.  The study observed a Mediterranean diet, in which extra-virgin olive oil or nuts were the main source of fat, resulted in a significant reduction in the risk of major cardiovascular events in high-risk individuals. This led researchers to conclude that following a Mediterranean diet may prevent cardiovascular disease, particularly in those that are already at risk.



MGH logo with blue circle

The MGH Diabetes Center has been in the vanguard of research on lifestyle interventions to prevent and treat type 2 diabetes. In studies funded by the National Institutes of Health (NIH) such as the Diabetes Prevention Program and the Look AHEAD study, MGH Diabetes Center dietitians and lifestyle coaches helped people living with type 2 diabetes take control of their health through teaching strategies for managing diet, exercise, and weight.

Now Linda Delahanty RD MS, one of the dietitians who pioneered those national programs, is leading the Improving Diabetes Outcomes through Lifestyle Change (IDOLc) Translation Studyat MGH.  The purpose of the IDOLc study is to look at the effect of a group lifestyle program on weight loss, diabetes control, and quality of life.  We believe it is a great opportunity for anyone with type 2 diabetes to connect with a dietitian experienced in diabetes.  In addition, we hope to find out whether the lifestyle program that worked in the national trial when spread out over the course of many years can provide similar benefits to patients in a shorter time frame.

You may be able to take part if you have type 2 diabetes, are overweight with stable weight for the past 3 months, and are at least 18 years old.  Everyone who participates will have a study visit and a 6-month follow up (both last 2 hours – parking costs will be covered for these visits).  Study volunteers will be randomly assigned (like the flip of a coin) to one of two groups.  One group will receive the usual nutrition and lifestyle care, meeting one-on-one with a dietitian.  The other will participate in the intervention program that focuses on teaching lifestyle skills related to a variety of nutrition, activity and behavioral topics (19 sessions total lasting approximately 1 to 1.5 hours each).  Click here to watch a quick video about the intervention being tested by this study.

Visit the Partners clinical trials website for more information.  You can also call
(617) 724-4981 or e-mail with any questions.

Blood Pressure, Heart Health, Nutrition

Ready . . . Set . . . DASH!

Apples and pears. Photo Credit Zsuzsanna Kilian

It seems every day we’re hearing about some new product that promises to do  amazing things like save you time and/or money on household chores or eliminate fat from certain parts of the body.  Sometimes these gadgets and gizmos work, and sometimes they . . . well . . . don’t. 

 The same is true for a number of popular (some may say “fad”) diet programs on the market:  some are more successful at helping people develop healthy eating habits and maintain a healthy weight than others.  Earlier this year, U. S. News & World Report investigated and ranked 20 popular diet plans based on their effectiveness at promoting weight loss (both short and long term), ease of use, nutritional content and other criteria.  The DASH diet, an eating plan recognized for its effectiveness at lowering high blood pressure, was ranked number one in two categories.

 DASH (which stands for Dietary Approaches to Stop Hypertension) was developed through research by the National Heart, Lung and Blood Institute on the effect of diet on blood pressure.  Study participants following the DASH eating plan—which emphasizes fruits and vegetables, whole grains and low fat dairy, as well lean protein and nuts (which are all naturally low in sodium and saturated fat)—saw a significant decrease in blood pressure and cholesterol.  Not only that, following the DASH diet can help avoid heart attack and stroke and can prevent the development of hypertension among people with normal blood pressure.  Thanks to its proven cardiovascular benefits, the DASH diet has been endorsed by the American Heart Association  

DASH is lower in fat and sodium and higher in several key nutrients believed to help lower blood pressure (including magnesium, calcium and potassium) than a typical American diet.  And, because of its focus on nutrient-rich whole foods (especially fruits, vegetables and whole grains), DASH may also help prevent the development of osteoporosis and some cancers

(Post content reviewed by MGH Nutrition Department. Photo Credit Zsuzsanna Kilian)