Single-Subject Studies in Translational Nutrition Research

Annual Review of Nutrition - Tập 37 Số 1 - Trang 395-422 - 2017
Nicholas J. Schork1,2,3, Laura H. Goetz4,5,2
1Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, La Jolla, California 92037
2J. Craig Venter Institute, La Jolla, California 92037;
3Translational Genomics Research Institute, Phoenix, Arizona 85004
4Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, California 92037
5Department of Surgery, Scripps Clinic Medical Group, La Jolla, California 92037

Tóm tắt

There is a great deal of interest in personalized, individualized, or precision interventions for disease and health-risk mitigation. This is as true of nutrition-based intervention and prevention strategies as it is for pharmacotherapies and pharmaceutical-oriented prevention strategies. Essentially, technological breakthroughs have enabled researchers to probe an individual's unique genetic, biochemical, physiological, behavioral, and exposure profile, allowing them to identify very specific and often nuanced factors that an individual might possess, which may make it more or less likely that he or she responds favorably to a particular intervention (e.g., nutrient supplementation) or disease prevention strategy (e.g., specific diet). However, as compelling and intuitive as personalized nutrition might be in the current era in which data-intensive biomedical characterization of individuals is possible, appropriately and objectively vetting personalized nutrition strategies is not trivial and requires novel study designs and data analytical methods. These designs and methods must consider a very integrated use of the multiple contemporary biomedical assays and technologies that motivate them, which adds to their complexity. Single-subject or N-of-1 trials can be used to assess the utility of personalized interventions and, in addition, can be crafted in such a way as to accommodate the necessarily integrated use of many emerging biomedical technologies and assays. In this review, we consider the motivation, design, and implementation of N-of-1 trials in translational nutrition research that are meant to assess the utility of personalized nutritional strategies. We provide a number of example studies, discuss appropriate analytical methods given the complex data they generate and require, and consider how such studies could leverage integration of various biomarker assays and clinical end points. Importantly, we also consider the development of strategies and algorithms for matching nutritional needs to individual biomedical profiles and the issues surrounding them. Finally, we discuss the limitations of personalized nutrition studies, possible extensions of N-of-1 nutritional intervention studies, and areas of future research.

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Tài liệu tham khảo

10.1093/ajcn/85.2.426

10.3389/fnut.2015.00026

10.4155/bio-2016-0088

10.1016/j.ocl.2016.05.008

10.1161/CIRCGENETICS.112.000010

10.1037/0022-006X.60.2.225

10.1182/blood.V84.11.3613.bloodjournal84113613

10.1016/S0140-6736(10)60961-0

10.1016/j.cll.2006.06.007

10.1017/S0007114515001786

10.1210/jc.2002-021480

10.1038/35052543

10.1056/NEJMoa1103782

10.1038/ncomms6028

10.1371/journal.pone.0087752

10.1016/j.clinthera.2015.12.001

10.1038/nature12480

10.1098/rsta.2016.0153

10.1136/gutjnl-2014-308778

10.1186/gb-2014-15-7-r89

10.1038/nature12820

10.1136/gutjnl-2012-303304

10.1161/HYPERTENSIONAHA.113.03353

10.1200/JCO.2012.43.6691

10.1016/j.jclinepi.2013.04.006

Dugard P, 2011, Single-Case and Small-n Experimental Designs: A Practical Guide to Randomization Tests, 2

10.1016/j.nut.2009.09.001

10.1186/s12966-015-0314-1

10.1089/big.2015.0049

10.1016/S0027-5107(01)00079-3

Fenech M, 2005, Carcinogenesis, 26, 991, 10.1093/carcin/bgi042

10.2337/db16-0291

10.1016/j.cgh.2015.02.044

10.1126/science.aab2319

Garrod AE, 2002, Lancet, 75, 161

10.1001/jama.2012.14641

10.1016/j.cmet.2015.09.005

10.1186/s40168-015-0138-x

10.7326/0003-4819-129-7-199810010-00002

10.1159/000380951

10.1007/s12263-013-0338-6

10.1111/j.1094-7159.2004.04010.x

10.1186/1741-7015-11-164

10.1186/gm46

10.1038/nbt.2424

10.1016/j.jneb.2015.12.009

Hogben L, 1953, Br. J. Prev. Soc. Med., 7, 163

10.1001/jama.295.6.655

10.1161/CIRCGENETICS.113.000106

10.1176/appi.ajp.2009.09060881

10.1002/biot.201400348

10.3945/jn.113.184358

Jones B, 2014, Design and Analysis of Cross-Over Trials, 3, 10.1201/b17537

Kaput J, 2016, Nestle Nutr. Inst. Workshop Ser., 84, 1, 10.1159/000436947

10.1024/0300-9831/a000128

10.1080/02640414.2015.1085589

10.1089/tmj.2013.0282

10.1096/fj.09-148452

10.1214/09-STS290

10.1016/j.nut.2009.05.022

10.3389/fgene.2011.00021

10.2217/17410541.5.5.447

10.1245/s10434-011-1675-6

10.1038/468S2a

10.1186/1472-6963-10-241

10.1093/hmg/ddp476

10.2217/pme.11.7

10.1111/bmsp.12071

10.1001/jama.2008.864

10.1056/NEJMoa1212914

10.1007/s11695-016-2308-8

Macey PM, 2016, F1000Res, 5, 563

10.1016/j.atg.2016.08.001

10.1093/ajcn/81.1.230S

10.1001/jamainternmed.2016.1189

10.1038/nprot.2007.319

10.2337/diacare.22.9.1462

10.1096/fj.15-271833

10.1023/A:1022591007673

10.1023/A:1007529206050

10.1007/s12263-015-0466-2

10.1152/ajpendo.00645.2007

10.1038/447655a

10.1016/j.nutres.2016.10.004

10.1038/nrmicro.2015.10

10.1146/annurev-nutr-071715-050815

10.2196/jmir.1100

10.1046/j.0306-5251.2001.01498.x

10.1001/jama.295.6.629

10.1017/S0007114515005425

10.1016/j.jclinepi.2016.03.023

10.1016/j.jclinepi.2016.03.026

10.1093/jnci/djp037

10.1007/s00394-014-0652-9

10.1038/oby.2008.512

10.3945/ajcn.111.018267

Renfro LA, 2016, Ann. Oncol., 28, 34, 10.1093/annonc/mdw413

10.1007/s00439-012-1221-z

10.1016/0895-4356(90)90139-G

10.1038/35015728

10.1038/520609a

10.1002/humu.20526

10.1007/s11606-010-1352-7

10.1002/0470854596

10.1001/jama.2008.600

10.1016/S1470-2045(14)70381-X

10.1017/S0007114515003049

10.1016/j.gaitpost.2014.03.189

10.2307/2529473

10.1128/mSystems.00098-16

10.3945/jn.110.128371

10.2337/diacare.23.3.295

10.1214/aos/1176349042

10.1176/appi.ajp.159.12.2099

10.1038/nm.2504

10.1198/sbr.2011.10070

10.1038/ejcn.2011.214

10.1007/s12263-010-0192-8

119. Vesnic-Alujevic L, Breitegger M, Guimarães Pereira Ã. 2016. ‘Do-it-yourself’ healthcare? Quality of health and healthcare through wearable sensors.Sci. Eng. Ethics.In press

10.1038/ismej.2010.118

10.1093/ajcn/81.1.243S

10.1016/j.metabol.2015.07.001

10.1016/j.cell.2015.11.001

10.1109/TBME.2014.2309951

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Annual Review of Nutrition

Tập 37 Số 1

395-422

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