Metabolic responses to food influence diabetes risk, but data suitable for determining personalized nutritional advice are lacking. PREDICT 1 (n=1102 twins and unrelated healthy UK/U.S. adults) examined genetic, metabolic, microbiome, and meal composition/context contributions to postprandial metabolic responses in clinic and at home. This 2-week interventional trial included the administration of standardized meals/beverages and monitored of ad libitum food intake. Objective assessments of sleep and physical activity were made. Blood glucose was continuously assessed and triglycerides and C-peptide were measured repeatedly. Large and consistent differences between individuals in blood triglyceride, glucose, and insulin responses to identical meals were observed. Person-specific factors, including variation in the gut microbiome, had a greater influence than meal macronutrients; genetic variants had a modest impact on predictions. Modifiable factors such as meal timing had large effects, highlighting avenues to improve postprandial responses. As predictors of CVD risk, postprandial triglyceride and glucose improved on traditional fasting markers. Machine learning was utilized to derive personalized predictions for both triglyceride (r=0.47) and glycemic (r=0.77) responses.


P.W. Franks: Advisory Panel; Self; Zoe Global Ltd. Consultant; Self; Eli Lilly and Company, Novo Nordisk A/S. Research Support; Self; Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk A/S, Sanofi, Servier. S. Berry: Consultant; Self; Zoe Global. A.M. Valdes: None. D.A. Drew: None. R.J. Davies: Employee; Self; Zoe Global Ltd. J. Merino: None. A.T. Chan: Consultant; Self; Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Pfizer Inc. N. Segata: Consultant; Self; Zoe Global Ltd. T.D. Spector: Stock/Shareholder; Self; Zoe Global Ltd.


Zoe Global Ltd.; UK Wellcome Trust (212904/Z/18/Z); Medical Research Council/British Heart Foundation Ancestry and Biological Informative Markers for Stratification of Hypertension (M016560/1); European Research Council (CoG‐2015_681742_NASCENT to P.W.F.); UK Wellcome Trust; Medical Research Council; European Union; Chronic Disease Research Foundation; Zoe Global Ltd.; National Institute for Health Research-funded BioResource, Clinical Research Facility and Biomedical 511 Research Centre based at Guy’s and St. Thomas’ NHS Foundation Trust in partnership with King’s College London

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