Mariëtte Abrahams, Director of Mariette Abrahams Consulting, has worked in the NHS and was a scientific and medical affairs advisor at Nestle. Here she talks about the key spaces where technology could significantly impact health via nutrition
It’s a fact, and comes as no surprise, that we are at a healthcare crossroads. Globally healthcare bills are soaring, ‘diabesity’ rates are rising, and yet we are living in a technologically advanced age where faster diagnoses and better treatment options are within reach. It is well known that personalised nutrition and healthy lifestyles play a key role in the prevention of chronic diseases, yet we continue to practice within a disease-care climate where treatment is only provided when disease has already presented. There is therefore a great opportunity for digital health brands to ensure that nutrition is incorporated in new products as a platform for personalisation and education.
With nutrition education scantily covered in medical schools, funding for training for Allied healthcare professionals cut and only 9 per cent of GDP spent on healthcare, some serious reshaping and re-thinking will need to be achieved to balance the scales to ensure that public health remains a priority, and that healthy nutrition messages are adopted.
Lifestyle medicine is becoming a more popular approach with new organisations such as the European Lifestyle medicine organization, and the Institute of Functional Medicine’s approaches making big strides to integrate the, dare I say obvious, solutions such as nutrition and lifestyle first. But while good nutrition seems easy to achieve, our obesogenic environment can make those seemingly ‘healthy’ food choices so innocent and rewarding. Recent large consumer studies have demonstrated that personalised nutrition advice whether delivered online or in person, is more effective and leads to better behaviour change than general population based advice. Yet, how can we deliver personalised nutrition when it is not reimbursed or adequately funded? I believe that a number of possibilities exist.
Companies such as Lifesum and Dacadoo focus on your health goals and provide a score as to how you are doing in terms of those goals. This approach takes away the overwhelming nature of food logging, calorie counting and exercise tracking but rather looks at small nudges and positive reinforcement to keep you motivated. Small changes that benefit your health in the longterm and provide an excellent stop-gap for those who know they need to adopt healthier habits but just need to get started.
Our health is influenced by so many factors, and usually nutrition is not the sole culprit as our mood, our stress level or environment all play a role in what we choose to eat on any particular day. With newer approaches that focus on measuring health, rather than the traditional way of measuring disease markers, things are rapidly changing and this presents a new paradigm in promoting health and longevity. Artificial Intelligence and machine learning are useful tools to learn about preferences and behavior in the context of the individual’s lifestyle. For instance platforms such as Nutrino and Suggestic can recommend recipes based on your profile, which includes taste and health goals.
Food is at the crux of our wellbeing. We use it to sustain, to socialise, to heal, to enjoy, but even a simple trip to the supermarket can be stunningly overwhelming. Platforms using big data such Shopwell and Spoonguru have made it easier for consumers to shop for products that match their health goals through barcode scanning technology. If you, like many, know you should be on a salt reduction plan but don’t really know what that means in terms of choosing products, these apps make it easier to understand and incorporate healthy swaps. With further opportunities for linking with instant food delivery and smart home appliances, these approaches provide practical solutions to address behaviour change to deal with chronic diseases.
With 55-98 per cent of the elderly living with co-morbidities, poly-pharmacy is a common problem. Not only from a drug-drug interaction point of view but also from a drug-nutrient interaction point of view. Antibiotics cause changes in the microbiota composition, which can have deleterious effect on longterm health. Statins are known to deplete CoenzymeQ10 stores, yet not all patients are advised to take supplements. Also blood pressure medication can lead to electrolyte imbalances that are not always picked up at standard medical consultations. There are opportunities for digital health brands to tap into this gap, by providing biosensors or tracking devices that can prevent further prescription of drugs for symptoms that can be addressed by nutritional intervention.
Already VR has been seen to have significant potential in surgical education. But the opportunities to tap into nutrition, whether it be for education, cooking, for group sessions, for treatment or for personalised shopping, have not yet been explored or exploited.
From bacteria in our poo, to metabolites in blood, or even the genes we have inherited from our parents, digital health brands need to ensure that we understand the person as a whole, as a system, in order to fine-tune nutrition and health advice. For this we need to track individual response to an intervention whether that comes from following specific dietary changes, to exercise, nutritional supplements or drugs for instance. Consumers want and need feedback, they want to know if something is working or not. Habit is the latest company that provides a solution by tracking metabolites following a challenge test, and providing chef-prepared meals that are best suited to the individual.
We all need to eat, and with the personalised nutrition market estimated to be worth $6 – $18 billion (5€ – 16€ billion), the opportunities are huge. Nutrition is inextricably linked to good health, but it’s time to get truly personal. Any digital health solution needs to ensure that nutrition is a core component, and of course that any product development is conducted in combination with a nutrition expert and research team who can guide on current clinical guidelines, latest research and provide consumer insight to ensure that the advice provided is evidence-based.
There are still plenty of opportunities to provide tailored solutions and with dwindling healthcare expenditure, consumers will continue to search for technologies that can help them cut through the plethora of information online and can guide, reassure and educate.
Recommendations on how we should use AI, genomics and medtech in the NHS – click here for 98 pages to guide us to the future. ‘The greatest challenge is the culture shift in learning and innovation, with a willingness to embrace technology for system-wide improvement. An ambitious drive “towards the NHS becoming the world’s largest learning organisation”’.
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