1. health and fitness
2. nutrition

STRATEGIC INFORMATION FOR THE NUTRITION INDUSTRY
Volume XX | No. 4 | APRIL 2015 | Ingredient Innovation | newhope360.com/nbj | $199
The Personalized-Nutrition Boom
Microbiome research, wearable fitness trackers, and at-home DNA tests usher in a new era
by Lisa Marshall
W
hat does the future of person- puts it, “it’s not so simple.” Our resident might consider supplements. Meanwhile,
alized medicine look like? Ask bacteria, bodily fluids, and easily trackable people with certain versions of the ACTN
STRATEGIC INFORMATION FOR THE NUTRITION INDUSTRY
Jeffrey Bland. He’s already living it. biometrics also provide key pieces of the gene respond better to endurance sports,
Over the past year, the nutritional bio- picture needed to accurately customize our while those with others are better suited
chemist and founder of the Personalized path to wellness. And thanks to an infusion for strength training. And where genome
Lifestyle Medicine Institute has had his of investment and an explosion of research, mapping cost $300,000 just five years ago,
consumers can now map their genomes
entire genome sequenced once, his gut those fields are booming, too.
bacteria assessed four times, and his
The ultimate key, says Bland, will be to for $3,000 and get readings of smaller
blood, spit, and urine scrutinized quar- bring all that information together swiftly chunks for just $100.
What’s new: Unlike DTC-predecessors
terly to measure everything from insulin and affordably in a form the average lay(which
have mostly ceased to exist in the
sensitivity and inflammation to food al- person can understand. That day may not
wake
of
the Food and Drug Administration’s
lergies and nutrient absorption. He tracks be so far off.
2013
request
that 23andMe discontinue its
his sleep habits, heart rate, and physical
“We are already starting to see the interPersonal
Genome
Service) most companies
activity via monitors around his wrist and section of genomics, phenotypic markers,
today
route
their
services through practichest. He analyzes and uploads the result- and wearable devices with the power of intioners.
In
2014,
New
Orleans-based startup
ing data points to his personal account on formatics and big data,” says Bland. “We are
the cloud, which he frequently accesses to moving from the age of the average to the GenoVive began offering a gene-based
weight-management system through phyanalyze changes to his diet, supplement age of the individual.”
choices, and exercise habits.
Here’s a look at what’s here, and what’s sicians. Patients have their saliva analyzed
for 17 SNPs related to diet and exercise, and
“I’ve learned a tremendous number of coming:
an algorithm assigns them a daily calorie
things about myself that I’ve already been
count and one of four diets. They can even
able to put into action,” says Bland, one of Gene sequencing
100 participants in the Hundred Person
What it tells us: In recent years, the have their customized meals and suppleWellness Project, a pilot research study field of nutritional genomics has discov- ments delivered to their door daily.
“Those who stick to the closed-loop system
by the Seattle-based Institute for Systems ered hundreds of genes that influence the
Biology (ISB). “It has been extraordinarily way we metabolize nutrients, perceive diet tend to lose more than those who do it
empowering.”
taste, regulate hunger, and respond to ex- on their own,” says founder Vic Castellon,
Bland’s ultra-quantified year has no- ercise. “We have figured out that your diet who lost 85 pounds on the plan. Six-yeardoubt been an expensive one. (ISB report- and genes absolutely interact, helping to old Pathway Genomics offers 12 categories
edly budgeted $10,000 per subject.) And he determine the best nutrients for you,” of genetic tests, via 20,000 practitioners. Its
is quick to acknowledge that he, as a sci- says Michael Nova, M.D., PhD, chief inno- most popular tests, the Healthy Weight DNA
entist, can interpret his data more readily vation officer for San Diego-based genetic Insight test and Pathway Fit test—a favorite
than the average Joe could. But his experi- testing company Pathway Genomics. For among athletes—explore about 80 genes.
ence says a lot about how far the person- instance, the APOA, PPARG and FABP With $14.4 million in revenue in 2013, $80
alized nutrition/wellness movement has genes all influence fat burning and stor- million from investors, and a three-yearcome—and where it’s headed. Twelve years age. Depending on which variants—or growth rate of 2,416 percent, Pathway was
after the completion of the Human Genome single nucleotide polymorphism (SNPs)— recently named No. 173 on Inc. 500’s list of
Project prompted a flurry of direct-to-con- you have, you may be better suited for a fastest-growing private companies.
What’s coming: In September, with
sumer DNA tests and “you have this gene higher-fat or low-fat diet. Some variants
funding
from the IBM Watson Group (a
so you should do this” advice, pioneers in interfere with absorption of vitamins D
business
unit dedicated to developing
the field have come to realize that, as Bland and C or Omega 3s. People with those
CONTINUED ON PAGE 3
nbj 2015
Personalized Nutrition
Strategic Information for the Nutrition Industry
HEAR IT AS IT HAPPENS: @nutritionbizjrl
01
Cheaper tests, wearable tech,
08
13
and advances in nutrition
science have converged to take
personalized nutrition from
industry ideal to consumer
expectation.
Direct marketing puts thousands of MLM distributors face
to face with millions of customers, but that personal contact
won’t necessarily mean success
in personalized medicine.
As research continues to show
how much our wellbeing is
tied to the gut, probiotics and
microbiome products become a
consumer gateway to concepts
of personalized nutrition.
05
Regulatory pushback from
09
As the science of personalized
16
The science is better, but it’s still
FDA has changed the 23andMe
business model—in a way that
could give the company an even
bigger impact.
07
Not all personalized nutrition
tests involve labs and pin pricks.
A new wave of hydration guages
could let beverage companies
build tests directly into their
packaging.
nutrition evolves, business
plans will need to evolve with it.
Insiders and entrepreneurs predict who might succeed in the
personalized nutrition space,
and how they’ll get there
11
Q&A with NBJ co-founder Tom
Aarts, who discusses the pioneers of the personal-nutrition
movement and where they’re
leading the industry.
Editor in Chief
John Bradley
Senior Editor
Rick Polito
Research Analyst
James Johnson
Design
Cindy Zelenak
Subscription Services
Kim Merseli
Exec. Director of Content,
New Hope Natural Media Carlotta Mast
nbj Editorial Advisory Board
Tom Aarts
complicated: Any move toward
personalized nutrition will
have to lean on the practitioner
channel.
NBJ Co-founder & EAB Chairman
18
As it has with nutrition, the
CEO, Vitargo Global Sciences, LLC
personalized healthcare space is
finding that anti-aging products
are not a once-size-fits-all play.
21
As science outruns policy, and
policy outruns legislation, how
can the FDA keep up?
Steve Allen
Retired Nestlé Executive
Anthony Almada
Mark Blumenthal
Founder, American Botanical Council
Bob Burke
Founder, Natural Products Consulting
Greg Horn
CEO, Specialty Nutrition Group
Adam Ismail
Executive Director, GOED
Loren Israelsen
President, UNPA
Larry Kolb
President, TSI Health Sciences
Bernie Landes
President, Nutritional Products Consulting
Janica Lane
Managing Director, Piper Jaffray
Michael McGuffin
President, AHPA
Randi Neiner
Director of Market Research, Shaklee
Ian Newton
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april 2015
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Nutrition Business Journal® (ISSN 1548-6168)
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Personalized Nutrition
Strategic Information for the Nutrition Industry
COVER STORY CONTINUED
LETTER FROM NBJ: IT’S ALL PERSONAL
Almost 10 years ago, while looking for cutting-edge dietary advice for
a story I was working on, I happened upon a man named Laurent Bannock, a British nutritionist and personal trainer who had just set up a
practice in Santa Fe, New Mexico, where I was living. Though I thought
I was just reporting a story and relying on a local source, I was in fact
about to change my entire approach to food. Without having ever really
thought about the term, I was about to dive into the world of personalized nutrition.
Bannock had been a staff trainer at a gym in London, where he became
Princess Diana’s personal trainer. Through that connection, he started
advising several other British celebrities and became a star trainer in
his own right, appearing on TV and in magazines to dispense all sorts of
health advice—right up until the point when he decided that his fame
had outrun his knowledge. So he promptly gave it all up and moved to
the US to obtain a master’s degree and certifications in nutrition and
sport science. He was just re-establishing himself as a practitioner when
I happened into his office.
Bannock’s approach at the time was to zero in on ethnic backgrounds
as a starting point for dietary advice and to supplement that with blood,
urine, and saliva tests to measure lipids, hormones, free radicals, and
the like. He then put me on a customized and very specific diet—game
meats and ancient grains were in, chicken and nightshades were out,
and each day started with a handful of dietary supplements—and offered this bit of explanation: “Food is a pharmaceutical cocktail. You can
find benefits in almost anything, but you have to look at the whole picture. Different [ethnic] groups evolved with certain foods and without
others. There’s just no diet that works for everyone.”
This one very much worked for me. In one month, my cholesterol
dropped 60 points (I had it checked independently), I was sleeping better and my body fat percentage dropped while my weight stayed the
same. I was objectively healthier—because I was eating only for myself.
Bannock was a bit ahead of his time, but not by much. Terms like
“nutrigenomics,” “personalized medicine,” and “personalized nutrition”
are everywhere now. Fast and cheap genetic sequencing, better understandings of the microbiome, and at-home diagnostics are making it
possible for regular consumers to eat and supplement for their specific
needs—and creating new product and service models for manufacturers, retailers, and practitioners.
Inside this issue, NBJ founder Tom Aarts discusses leaders in the field
of personalized medicine and opportunities for practitioners and supplement brands; Larissa Zimberoff looks at 23andMe’s move into targeted drug therapies, and Todd Runestad explores the booming business in
probiotics and microbiome testing.
Will the move to personalization mean a move toward high-margin,
low-volume supplements? Will it strain the practitioner channel? Or
will it just mean better and more efficient use
of the tools we already have?
Those are questions we’re just starting to
explore. But one thing is certain: This is where
everything is headed.
John Bradley
Editor-in-chief, NBJ
@johnwbradley
april 2015
apps using the Watson supercomputer),
Pathway Genomics will roll out the Pathway Panorama mobile app. The app will
tap into genetic information, published
research, medical records, GPS coordinates, info from wearable devices, and
Watson to give users instant answers to
questions like “What should I eat today,
given what I ate yesterday? or “I’m on a
business trip: How far should I run and at
what pace, given the change in altitude?
“It is basically a supercomputer in your
hand that will grab any information you allow it to in order to give you a very personalized answer,” says Nova.
Microbiome Testing
What it tells us: While all humans
have roughly 99.9 percent of their genes in
common, they vary greatly when it comes
to their microbiomes—in what species
they host and in what proportion, says
researcher Rob Knight, PhD. Some organisms, like lactobacillus and bifidobacterium, protect against pathogens, while
others help extract carbohydrates and
amino acids from food, or promote immunity. A diverse microbiome is ideal, but
poor diet, antibiotic use, and even lack of
sleep and exercise can wipe out diversity.
Knight says that for some conditions, like
obesity, the microbiome is better than
DNA for predicting a person’s risk. The
good news: Unlike the genome, the microbiome can be easily changed.
What’s new: These are early days for
testing and even earlier days for acting
on results. Knight’s American Gut Project,
which he recently moved from the University of Colorado-Boulder to the University of
California San Diego, expressly states that
it is a “pure science project, not a fee-for
service business.” For $99, participants get
a kit for collecting and sending back samples and, once the samples are analyzed, a
glimpse at what bacteria they host and how
it compares to others. And every kit means
more data for Knight and his colleagues,
who hope to get a better picture of what a
healthy microbiome looks like, so people
can someday try to emulate or restore it.
San Francisco-based Ubiome.com is taking a more traditional business approach.
Founded in 2012 by Stanford grad Jessica
Richman, the company raised $350,000 in
newhope360.com/nbj | 3
nbj 2015
Personalized Nutrition
10 weeks via Indiegogo.com and another
$6.5 million via traditional tech-startup
investments. Richman concedes that
Ubiome’s microbiome tests—which cost
from $89 to $399—have been more of a
“curiosity” so far. But that will change this
year, as the company moves to offering
actionable science-based advice and collaborates with companies on new microbiome-based products.
What’s coming: In September, Massachusetts-based Seres Health announced
initial results of clinical trials on SER-109,
the first prescription “oral microbiome
therapeutic” for the treatment of chronic
Clostridium Difficile, a form of infectious
diarrhea. A single dose was capable of
restoring diversity to the microbiome.
After eight weeks, 29 of 30 patients were
infection-free. The company has a whole
line of Health Ecobiotics in the pipeline
to address infectious, metabolic, and inflammatory diseases. In 2014 it received
$110 million in investments, including
$65 million from Nestle Health Sciences.
Meanwhile, Ubiome has launched a
crowdfunded dental-health research project, in hopes of developing toothpaste and
mouthwash to restore a healthy oral microbiome. And Richman says that major
CPG companies are interested in developing microbiome-based shampoos and
acne medications. She says she would also
love to work with probiotic companies to
help personalize supplements: “Our goal
is to move very quickly to commercialize
this research.”
Blood Testing
What it tells us: To determine whether
someone needs a supplement, or whether
it’s working, there’s no better test than
blood, says Paul Jacobson, of Thorne Research. Unlike gene tests, which map propensity for disease, blood shows what’s
happening now. “Your blood regenerates
every three to four months,” he says. “Let’s
say you are diagnosed with high cholesterol and you want to get it down. You can
take our products, change the way you eat,
and have your blood tested later to see if
it’s working.”
Blood testing can also assess proteins
associated with liver, lung, brain, and
heart health; immune-cell activity; adrenal
april 2015
Strategic Information for the Nutrition Industry
health; and insulin sensitivity. And the advent of drop-in clinics, home test kits, and
on-line practitioner consultation services
has made it so a costly doctor’s appointment isn’t necessarily required.
What’s new: Since 2014, Thorne has
acquired a majority share of online health
technology company Wellness FX and
waded heavily into the diagnostics business with a new motto “solutions beyond
supplements.” Wellness FX clients drop
by a stand-alone Quest Diagnostics lab
to give blood, and pay $78 to $1,000 for
a blood panel. Options include thyroid,
women’s health (which tests for hormones
related to sleep and mood disturbance),
sports performance, and heart health.
Their results appear in an online dashboard, and they consult with an online
practitioner who, if appropriate, steers
them toward supplements. Other supplement companies are also partnering
with diagnostic companies. Nordic Naturals steers customers to Lipid Technologies’ Holman Omega-3 Blood Spot Test,
an at-home kit which tests for Omega 3
levels, and Pure Encapsulations has collaborated with the Cleveland HeartLab
to align supplements with heart health
biomarker tests.
What’s next: After what Jacobson describes as a “building year” for Wellness FX,
the company is now focusing on partnerships with health clubs, corporate wellness
programs, and academic health research
centers. Thorne recently rolled out a new
line of supplements, LipoCardia, to support
lipid metabolism and heart health, and the
EXOS line of sports nutrition products.
Bland believes that at a time when supplements have gotten a bad rap (sometimes
deservedly), diagnostic testing may be key
for getting individuals the supplements
they truly need and, via follow-up, separating the ones that work from those that
don’t. “Give a supplement to a big group of
people and, on average, it doesn’t do that
much,” Bland says. “But supplements given
to the right person at the right dose at the
right time can have a huge effect.”
Scanners, wearable trackers, and
other gadgets
What they tells us: For the past several
years, MLM company NuSkin has had its
representatives use a “biophotonic scanner”a laser light shined on the palm of the
hand—to measure antioxidant levels in
prospective customers’ skin to assess the
need for certain supplements. The company has scanned 17 million people and
offers a money-back guarantee if no measurable difference is shown in eight weeks.
“It is a cornerstone of our supplement category and a differentiating feature for our
company,” says Joe Chang, the company’s
chief science officer. In 2014 Thorne partnered with Itamar Medical Inc. to market
EndoPAT, a non-invasive fingertip test
that measures blood vessel function. Results can be uploaded to a person’s Wellness FX dashboard and incorporated with
blood tests to help people make health decisions. Then there are wearable trackers,
like those from FitBit, Jawbone, and Apple,
which track activity, heart rate, sleep, etc.
in real time and can nudge users toward
better behaviors.
What’s new: The smart fitness tracker
market is expected to grow from $2 billion
in 2014 to $5.4 billion in 2019, according to a
March report by market-research firm Parks
Associates. Nearly 30 percent of US households already have one. And new wearables
go far beyond counting steps. Spire is a new
clip-on device that measures breathing to
map and analyze the user’s stress patterns
and offers suggestions for chilling out if it
detects things getting too tense. What’s next: Through his role in the
Hundred Person Wellness Project—the
first phase in the Institute of Systems Biology’s sweeping participatory wellness
study—Bland was able to learn, via DNA
testing, that he doesn’t synthesize Vitamin
D well and he’s better suited for strength
training than endurance sports. His blood
tests showed he had relatively high levels of
mercury (likely from his love of seafood)
and has sensitivity to certain food additives. His FitBit tracker nudged him to
move slightly more than he was. Within a
few years, everyone can have this experience. “As we get more information measured non-invasively, get it to the cloud
where it can be stored, develop algorithms
for crunching it, and get it back to the user
on their smartphone to personalize their
unique questions we will have a transfor mative technology,” he says.
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