Here come the artificial intelligence nutritionists

Companies are experimenting with personalized diet apps, saying the future of healthy eating is artificial intelligence. (Photo: NYTimes)
After 20 years of living with Type 2 diabetes, Tom Idema had given up hope of controlling his condition. He had tried many diets that proved unsuccessful and even considered weight-loss surgery. When his employer offered him a chance to try a new dietary app that uses artificial intelligence to control blood sugar, he took it.اضافة اعلان

Idema, 50, sent in a stool sample to get his microbiome sequenced and filled out an online questionnaire with his blood sugar, height, weight and medical conditions. That data was used to create a profile for him, to which he added continued blood sugar measurements for a couple of weeks. After that, the app, called DayTwo, rated different foods according to how good or bad they might be for Idema’s blood sugar, to aid him in making better food choices.

After nearly 500 days using the program, his diabetes is in remission and his blood sugar levels have dropped to the upper end of normal. And even though DayTwo says the app isn’t aimed at weight loss, he has gone from 320 pounds to 229 pounds. “I’m wearing pant sizes I haven’t worn since high school,” said Idema, who is an administrator at Central Michigan University in Mount Pleasant.

DayTwo is just one of a host of apps claiming to offer AI eating solutions. Instead of a traditional diet, which often has a set list of “good” and “bad” foods, these programs are more like personal assistants that help someone quickly make healthy food choices. They are based on research showing that bodies each react differently to the same foods, and the healthiest choices are likely to be unique to each individual.

How to make (artificially) intelligent food choices.

The DayTwo app uses an algorithm based on research by Eran Elinav and Eran Segal of the Weizmann Institute of Science in Israel, who co-founded the company in 2015. Last year, the company found that when they used their algorithm to match a diet to an individual’s microbiome and metabolism, it was better at controlling blood sugar than the Mediterranean diet, considered one of the healthiest in the world.

“Rather than measuring foods by caloric content and trying to come up with a ‘healthy diet,’” said Elinav, “you need to start measuring the individual.”

This technology is relatively new and only relates to blood sugar. The Mediterranean diet, meanwhile, has decades of research behind it and will probably remain the gold standard for healthy eating for years to come. Still, for people such as Idema, AI such as DayTwo’s can make it easier to maintain healthy eating patterns.

The app’s machine-learning algorithm can identify patterns and learn from data with human help. It analyzes data from different individuals’ blood sugar responses to tens of thousands of different meals to identify personal characteristics — age, gender, weight, microbiome profile and various metabolic measurements — that explain why one person’s glucose spikes with certain foods when another person’s doesn’t. The algorithm uses these observations to predict how a particular food will affect one’s blood sugar and assign each meal a score.

DayTwo, currently available only to employers or health plans, not consumers, is one of a handful of AI-based apps recommending healthier meal options. Another company, ZOE, also generates meal scores and is available directly to consumers for $59 per month. ZOE’s algorithm uses additional data, such as blood fat levels, in addition to microbiome and blood sugar tests. The algorithm was able to predict how a person’s blood sugar and fats respond to different foods in a large 2020 study led by one of the company’s founders, Dr. Tim Spector, a professor of genetic epidemiology at King’s College in London.

Buyer, beware.

The field of personalized nutrition is still in its Wild West phase, and experts say it’s important to sort through the hype. Many companies are willing to test your microbiome and offer AI-driven dietary recommendations — as well as sell you supplements — but few are based on scientifically rigorous trials. Last year, uBiome, which made one, was even charged with fraud. In general, the more broad-ranging the health and weight-loss claims the companies make, the less reliable the evidence to support them.

“I think it is all overhyped right now, unfortunately,” said Dr. Eric Topol, a cardiologist and founder and director of the Scripps Research Translational Institute.

The data used by apps such as DayTwo and ZOE also only capture a fraction of the interplay between the gut microbiome, our metabolism and diet. There are certainly a lot more factors, including genetics, that affect metabolism and are ignored by current AI programs.

“It does not tell you the whole story, and just optimizing around glucose is not going to be enough to create the perfect diet for you,” said Dr. Casey Means, co-founder and chief medical officer at a digital health company called Levels. AI apps could nudge users into eating foods that are good for preventing blood sugar spikes and diabetes but may be unhealthy in other ways.

For instance, when Topol tried out the DayTwo app, its recommendations for controlling his blood sugar — such as eating spinach and raspberries — were high in oxalic acid, which could have induced kidney stones. That’s because the app didn’t take into account his preexisting risk for the condition.

Additionally, restrictive diets are increasingly seen as a bad way to change eating habits and often backfire. But many experts hope personalized AI apps will be easier to follow and build better long term behaviors.

For Idema, the effects of personalized diets are already tangible, most recently when his improved blood sugar levels allowed him to enjoy his daughter’s birthday cake. “I had the glucose monitor out at the time, and I stayed well within range, so my body handled it just fine,” he said. “So I’m in such a much, much better place now, and in my mind this program definitely saved my life.”

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