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This article is cross posted on the blogs Freely Magazine, & Ana V’s Tokyo Rewind .
A merciless curiosity to taste mysterious blue muffins led me to volunteer for the world’s largest nutrition study, Predict 2.
One summer night, alone at the gym and trying to ignore the buzzing of Planet Fitness treadmills, I was trying to listen to one of the ultimate foodie podcasts, “Gastropod”, produced by an East coast startup about the science behind food.
The two passionate co-hosts were raving about flavorless, nausea-inducing blue muffins they force-fed themselves as participants of the world’s largest nutrition study. The muffins were made up of different macros, some with more sugar than anyone should eat in a day, some very high in fat, so researchers could have a baseline to measure participant blood sugar responses. Participants ate blue muffins for breakfast for about 8 days, recording blood sugar levels and the amount of daily exercise, took blood samples and stool samples, and followed up with a Quest diagnostics appointment for even more blood samples. Additionally, any food passing through their lips during the 8-day challenge had to be timed, measured, photographed, and recorded in an app. Even the smallest bit of fish oil in a stir fry needs recording. At the end of the study participants received results about how their bodies react to carbohydrates, fats, and proteins and what they should eat more or less of to avoid heightening their risk of obesity, to keep their gut bacteria (microbiome) optimal, and to hopefully maximize their years on earth.
While the results have the potential to be extremely valuable, the hosts of Gastropod emphatically highlighted the rigor of participating in the study, saying it wasn’t for the faint-hearted as excessively weighing their food gave them food anxiety, and they had problems cooking, eating, and living normally throughout the week and a half the study took place.
I jumped off the treadmill and pounded the word “Predict 2 study” into Google.
Predict 2 is currently the world’s largest ongoing nutrition study, run by Stanford University, Massachusetts General Hospital, and Zoe a UK/USA based nutrition technology company. The original “Predict” study collaborated with Zoe, Mass General, and King’s College of London in 2018 with results released in 2019.
The two studies were largely the same, both measuring roughly 1,100 different people for 10-14 days to uncover each individual’s nutritional responses to food.
What are the global consequences for this kind of study and what is it that the King’s College of London and Stanford Medicine are trying to achieve?
The study combines efforts of UK creator Tim Spector and business experts Jonathan Wolf and George Hadjigeorgiou to create individualized nutrition profiles for people around the world. Spector conducted a 25-year study called the UK Twin registry, measuring about 14,000 twins living in similar environments who ate different foods with varying nutritional compositions according to their unique food preferences. Afterward, Spector made a revolutionary finding. He discovered that even identical twins can have individual responses to a food’s nutritional makeup which meant that there is no single “right way to eat” and it is impossible for global nutrition guidelines to be suitable for all kinds of people.
Of global importance, Spector’s findings can contribute to research suggesting that genes are not the biggest predictor of obesity. Anywhere from 40 to 70 percent of a person’s risk for obesity is attributed to genes. The rest results from the person’s unique makeup of their gut microbiome. The gut microbiome was widely studied by the “father of human microbiome research,” Jeff Gordon, a researcher based in St. Louis. Tim Spector felt motivated by Gordon’s research to develop the Predict study based on his work. Spector is so adamant about the importance of the gut microbiome because although humans share about 99% of the same genetic makeup, in contrast, our microbes, even with identical twins, share only about 37% similarity.
If the secret of obesity’s relationship to our gut microbiome versus our genes is uncovered, then global obesity can be managed. It’s important that science works towards understanding which genes indicate higher predispositions for weight gain, and which gut bacteria controls a person’s risk for obesity. Obesity and the concept of overnutrition link to wide reaching societal issues, especially for higher income countries. Food insecurity affects 10 percent of the global population which means about every one in nine, or about 820 million people, are suffering from hunger. Hunger affects those in developing nations in various devastating ways, but it does lower the risk of obesity. In high income countries, hunger can lead to poor quality nutrition and over-nutrition. Overnutrition, simply means we are eating too much food, and remaining under nourished. We remain under nourished through consuming too many of the high calorie, high fat, highly satiable foods more readily available, which in turn raises the risk of obesity. The study of nutrition and the way it reacts with our genes called nutrigenomics, is a relatively new scientific and medical field but the Predict study is so far the largest research study working to peel away more layers of complexity within food and how we react to it.
My own experience
Eventually, the study aims to develop personalized nutrition in an affordable, highly accessible smartphone app. As a participant in the Predict study, I was able to test the app prototype. Through the app, I had the ability to communicate with the research team, follow the directions for the study, log exercise, foods, and the times of day I ate, how much the food weighed, and even post the photos of the food into the app. It was a comprehensive application that I hope is developed for the mass market in the near future.
I confess, the main reason I first joined the Predict 2 study by Zoe was to get to try those mysterious blue muffins. I now miss their oozing artificial glucosity and the subtle oiliness that I scooped out of the aluminum muffin cups. I was greedy for more because it’d be the only food I was allowed to eat for four hours at a time before a fasting period. The study oscillated between fasting and eating periods so that I could accurately measure what a particular food did to my body. Oddly enough I don’t remember the exit of the blue muffins and worry they still might be lost somewhere in my organs or maybe they permanently dyed my insides blue –just like what happens when you drink too much Gatorade.
The researchers advised me to eat as normal as possible and eat what I would on any given day. I ate my favorites such as sweet potatoes, pumpkin, bread, vegetables of all different kinds, peanut butter, dark chocolate, beans, tofu, tsurimi, miso soup, and coffee with soy milk. I tried to test controversial foods such as artificial sugar, diet beverages, cheese, dairy, eggs, and soy. I even went out of my normal diet to see if we could measure what a shake shack burger did to my body. Until that moment, I had never had a Shake Shack burger but this was the time to check what meat would do to me.
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An interesting reaction I had after the study was the intrinsic positive reinforcement I got from taking photos of all my food. It gave me a vantage point to analyze my eating. For me, I realized that my diet was living up to my expectations. It also helped me to find more structure in eating habits. For example, I liked having to fast overnight for about 12 hours because I knew when it was time to eat and when I needed to end eating for the day. I also enjoyed the periods in between meals because I knew what I could and could not have. For example, I could only drink water, black coffee or tea with no added sugar or milk. After four hours, I was free to eat something for only 30 minutes, then back to fasting for two to four hours. It was only after breakfast when I needed to fast for four hours, but other meals needed spacing for at least two hours.
There were difficult moments in the study. One day I had to take three blood samples by myself. I had never pricked my fingers, but they gave me a small kit to stab my finger, blot the blood sheet and were kind enough to include bandaids in the kit. I even had extra blotting paper in case I missed dropping my blood in the right places.
I still feel a little pain at the sides of my middle finger where I had to prick for blood testing. On some days, before eating the muffins, I was required to take a fasting blood glucose blood sample. In the morning, there is minimal circulation in your hands so I ran my hands under warm water and swung them all around. However, I still didn’t bleed enough so I ran my finger under running water only to make a river of thin blood, too diluted with water to use. I started sweating from the pressure to accurately dot a blood spot on the blood absorbent card, and with only a centimeter thick circle to fill with concentrated blood, it was a challenge I had not anticipated. I missed the round circles four times in a row, after squeezing my shaking fingers over the paper. My completely white bathroom temporarily looked like a murder scene.
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While not as challenging, it was interesting to use the blood glucose monitor I inserted into my arm. The number of stares I got when people saw my blood sugar monitor was staggering. For example, I walked into an office once, had a meeting, and then upon exiting the advisor’s eyes darted to my left arm and I could see the curiosity and concern shadow her face. I reminded myself these kinds of experiences are typical for some suffering with Type 2 Diabetes.
I made many other mistakes and it’s a wonder I was not kicked out of the research cohort. Once, I forgot to remove my activity tracker before entering the shower and got it wet, something they emphasized I was not to do. I also continuously forgot a card I needed for every food photo whenever I left my house. I had to improvise with business cards o that the researchers could judge my meal portions. I haphazardly created each meal, keeping a list on my phone of the ingredients, the weight in grams, and then snapped a photo of the finished plate, but several times the researchers asked me to confirm what was in the photo. If I wanted seconds, I had to measure, snap a photo, and document all of this information in my cellphone’s app.
I was rewarded only with the intuitive sensation that I had accomplished the challenge, contributed to nutrition research, and tried the miraculous blue muffins. My data will be available for me in 2020, so until then I have to almost keep guessing what I believe to be healthy for my body by following certain guidelines provided to me from nutrition classes and general buzz I hear from health communities. It would be a lot less convoluted to have an app like the Predict app, to exactly inform me how my particular genomic makeup reacts to an egg versus oatmeal for my breakfast.
If the challenge sounds intimidating, it was. However, I urge the reader not to shy away from applying to join Predict 2. The friendly research team screens you based on your health history only, not on ethnicity, nationality, or any other metric (although at the moment, participants in the United States are the only ones accepted). Equally, as unfortunate, my guess is they want people who have no allergies, are not taking medication, and are both medically and physically healthy people (healthy BMI, weight, not anorexic, bulimic, pregnant, taking steroids, drugs). You are alerted within a few business days whether you are accepted as a participant. And you never know, the study might change your life and the way you eat, helping you become a healthier culinary explorer, fearless, empowered with extra knowledge about your individual body.