by Blake Herzog
Recommendations for the treatment of diseases and disorders don’t come out of thin air; these clinical practice guidelines are arrived at by a committee of experts on the condition under review, which drills down into the scientific evidence supporting proposed interventions until a consensus emerges on the best approach to treating the illness.
These guidelines often don’t take into account how differently people may respond to the same medication, diet or other prescribed action, depending on their genetic makeup, lifestyle or other factors.
The vanguard of medical science is striving to close that gap for patients.
Precision (a.k.a. personalized) medicine
Precision medicine is a term that evolved from personalized medicine because in most cases treatments are being customized to genetic subgroups, rather than to individuals. Treatments are tailored to how patients with certain gene variants do or don’t respond to specific treatments and what lifestyle and environmental factors may be at hand.
Still in its early development, precision medicine is currently most frequently used in oncology, cancer immunotherapy, pharmacogenomics (prescribing drugs based on the patient’s genetic makeup) and treating rare diseases. These have led to revolutionary treatments being found for diseases that used to stump physicians and researchers alike.
The goal is to expand this approach to all areas of healthcare to improve outcomes for everyone, and many higher-end medical practices already offer genetic testing for predictive and clinical purposes. They can also use wearable technology and other patient feedback to provide the kind of monitoring that can identify issues earlier, when treatment is more effective.
Personalized nutrition
This is a more specific application of precision medicine that uses DNA testing, blood markers for glucose and cholesterol and gut microbiome analysis to get a complete picture of how your body digests different kinds of food. More research is needed to determine how effective it really is, but some of the early data is encouraging.
The usual dietary advice of eating more fruits, vegetables, whole grains and lean proteins while reducing sugar, salt and processed foods holds true across populations but factors including genetics, sleeping patterns, timing of meals and physical activity can substantially affect how individuals’ blood responds to glucose and triglycerides, for example.
Registered dieticians or nutritionists work with results from lab tests and information from patients about their diet and lifestyle to craft an individualized dietary plan aiming to prevent or even treat disease. Research and trials are examining whether this method can help treat people with Type 2 diabetes.
The testing and analysis that makes this level of medical treatment possible can be pricey and may not be covered by insurance, so for now it’s most available through practices catering to higher-income clients able to foot the bill and invest the time needed to work with healthcare providers as a team.
