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
My Story

My Story: Journey Through Weight Loss Surgery

By Isabel

When I was diagnosed with diabetes in 2010, it was a total shock. Even though diabetes runs in both sides of my family (both my grandmothers had it as well as some aunts and uncles), I never felt I would get diabetes. My primary care provider reassured me that WE would get through this and started me on metformin and I learned how to use a glucometer. At the time I thought I’ll just learn what I need to do. When I got home and started looking through my materials, it hit me hard. I broke down and started to cry. I felt that diabetes was a death sentence. I was also angry because I had been going to Weight Watchers and started losing weight! The diagnosis was devastating, but I said: I. Will. Beat. This.

I continued with Weight Watchers, but started thinking what else could I do to help me lose more weight and control my diabetes. So I thought about gastric bypass surgery. Would it be a good option for me, am I thinking this is an easy way out? So I started doing research about diabetes and weight loss surgery. I attended support groups and talked to people about how they felt after having the surgery. I realized that I was going to be 40 in a few years. I said I wanted to be healthy plus, I wanted to have children and would need to be healthy for them. Because of these reasons I decided to move forward with the surgery. My primary care physician was very supportive of my decision and gave me recommendations for weight loss surgeons at a local hospital.

My surgery went well with no complications, however I started to have doubts during my first month of recovery. You can’t eat anything except liquids, and the protein shakes I was supposed to drink made me feel sick. That, and dealing with the pain, made me feel depressed and defeated. To get through it, I kept reminding myself why I had the surgery to begin with. At my first month follow up I had lost 40 pounds and my A1C had dropped way down. I was able to stop taking metformin and my blood pressure medication. Beyond that, I started feeling better and noticed my clothes feeling looser.

As I continued to lose weight eventually I did plateau, but I was ready for it. I kept up with my healthy eating habits, making adjustments until I reached a weight range I felt comfortable with. I had my surgery in 2012, and I’ve lost a total of 95 pounds. Much of my success comes from the lessons learned from Weight Watchers and the “no guilt” attitude of my support group. I have gained a few pounds above my goal range, but it’s okay – I know I can lose the weight again and what I need to do to get there.

Diabetes was like a hit below the belt, but never once did I say “Why me?!” I know it will always be there, and it may come back down the line. For me, gastric bypass was a tool to use to control my weight and beat diabetes. Since my surgery, I have more confidence, am more accepting of my body, and have more energy. I’ve become an educator and advocate for taking charge of your own health. Gastric bypass was a good fit for me, but it’s not for everyone. If you are considering surgery, I encourage you to educate yourself about the different types of surgery available and talk to people who have done it. Do some research to prepare yourself for what happens afterward, and make sure you surround yourself with a strong support network. Do not let anyone make you feel ashamed for having weight loss surgery. Your health is yours, and in the end it’s about you, not them.

Fitness, Guest Post, My Story

Facing Challenges and Overcoming Fears

 By Monica 

Rock climbing.

As good as we are at watching what we eat, sometimes we do slip and have a  little too much (or a few too many sweet treats).  There is a program where I work that helps employees learn how to eat healthy and exercise to lose weight.  Several people in my department have done it and enjoyed it, but I was always reluctant – I didn’t really like going to the gym.  But, when the new session started a few weeks ago I finally signed up.  I’m so glad I did. 

On the first day, we had an assessment of where we are now so we can track our progress and chose a goal for what we wanted to accomplish.  There are several teams doing this program at once, and each meeting starts with a rally where the program’s leader shares with the groups where each team is as far as weight loss, steps taken, and amount of exercise.  The team with the most improvement for the week gets a trophy.  It keeps you motivated to work hard and win that trophy!  

The most unexpected thing about this program is how much I’m enjoying being there and doing the exercises.  It’s changed how I look at going to the gym.  Before, I’d been afraid of not knowing how to use the equipment properly and too shy to ask for help.  Going through this program has helped me overcome my shyness; now I’m not as scared to ask questions if I don’t know how to use a machine or need help getting started.  I’ve also enjoyed meeting with our nutritionist and learning more about mindful eating and portion size. 

I feel great, my clothes feel looser, and I know I’m getting stronger.  I really recommend finding a program like this.  Being with a group can help keep you motivated, and some of the nutrition information might stick with you to help improve your family’s eating habits.  If you have a gym near you, check out their class schedule.  Many offer things like yoga or Zumba; ask if you can try a class to see if you like it.  And don’t be afraid to ask questions if you need help.

(Photo Credit: Bryan Wintersteen)


Weight Management (Part 2)

Debra Hollon, MS, RD, CDE, LDN
Senior Clinical Nutritionist 

Red apple, tape measure and stethescope. Photo Credit: sanja gjenero

The American Society for Nutrition published a study showing any diet works as long as you stick with it.  That last part is the most important.  Any diet that reduces calories will help you lose weight, but only if you keep it up.  Think about the fad diets out there that are built around eating one particular food exclusively, or cut out an entire food group.  These kinds of diet plans restrict calories, but the variety of foods you can eat is very limited and there’s rarely any plan for long-term commitment.  Considering this, how long can you really stick with it?  

A healthy diet is one that emphasizes fruits and veggies, whole grains and low-fat dairy as well as lean protein like poultry and fish, beans and nuts.  It’s also low in saturated fat, cholesterol and sodium.  Whole grains and vegetables are both good sources of fiber which, in addition to keeping your digestive system healthy, helps fill you up so feel less hungry.  Fish, nuts and seeds are sources of good fats that keep your heart healthy.  

Now, we’ve said that the key to losing weight is reducing your calorie intake.  But it’s not a good idea to do so by skipping meals—especially not breakfast.  Going long periods without eating can actually make you so hungry that you overeat at your next meal.  Instead, plan out small meals throughout the day; it will help control hunger and keep your blood sugar levels steady.  And, breakfast really is the most important meal of the day:  eating a good breakfast keeps you full throughout the morning so you’re less likely to overeat later. 

When you reach your weight loss goals, your next challenge is to maintain it.  For some this can be just as difficult as losing it, but many of the same strategies you used to lose the weight will help you keep it off long-term.  Unfortunately there’s no one-size-fits-all plan for weight loss, but just remember that losing even a few pounds will help with managing your Diabetes.  If you have questions about your weight, talk to your health care provider or a Registered Dietitian. 

Photo Credit: sanja gjenero


Motivating Lifestyle Change

By Sandy O’Keefe
Program Manager, Chronic Disease Education

Rock climbing. Photo Credit: Bryan Wintersteen

Question: How many Diabetes educators does it take to change a light bulb?
Answer: One, but the light bulb really has to want to change.

How many times have you vowed to lose weight or start running only to have it fall to the wayside a few days later? You may blame it on lack of willpower, not having enough time, etc., but it’s time to give yourself a break; it happens to many of us! However, if you fine tune your action plan a bit, you can set yourself up for success.

First you need to figure out what motivates you to make changes in your life. This needs to be a powerful motivator— saying something like “I want to look better” isn’t strong enough to hold your attention. Instead, “I want to lose weight so I can walk my daughter down the aisle at her wedding next May” or “so I can spend time laughing and playing tag with my children outside this summer” are examples of motivators that will help you emotionally stay attached and focused on your goals. Equally important, this motivator must come from you personally.  It’s not enough to say, “I am doing this so my wife stops nagging me to lose weight.” Keep digging inside yourself until you find your own personal motivator, then write it down and keep it somewhere you can read it any time you need to remind yourself why you’re making this change.

In order to be successful at behavior change, the focus should be on immediate attainable goals rather than long term results. For example, when you say that you want to lose weight you are defining what you hope to experience in the future. Weight loss is the outcome you hope to achieve in the long run, but it’s not the goal. Think about the steps you will need to take before you experience the outcome. For example, maybe you need to invest in a pair of sneakers or join a gym. These are things that you can do in the immediate future to get started.

Goals should always be “S.M.A.R.T.” This is an acronym that stands for Specific, Measurable, Actionable, Reasonable and Time-based. A S.M.A.R.T. goal might be, “I will buy a new pair of running sneakers from Sally’s Sneakers on Sunday May 6, 2012.” Consider what might get in the way of this goal and adjust as needed. Again, I suggest writing your goal down and having it in a place where you can see it to remind yourself.

From time to time assess the success you’ve had with each goal. You might say to yourself:  “last week my goal was to buy a pair of sneakers— how successful was I with this goal?” Goals may seem small at first, but each one builds upon the success of the one before it.  As they link together, you’ll start to believe, “hey, maybe I can stick to my plan this time!” 

You may want to ask a friend or family member to be a support person for you to help you stay on track. Having a health coach is also a great way to set a clear S.M.A.R.T action plan. Coaches aid you in identifying those strengths you possess that can help you change your behavior. Once you begin to realize that you really do have the power to change, you will be well on your way to making a behavior change that will help you realize your long-term vision.

Photo Credit: Bryan Wintersteen