Discovery-based nutritional systems biology: developing N-of-1 nutrigenomic research

The progress in and success of biomedical research over the past century was built on the foundation outlined in R.A. Fisher's The Design of Experiments (1935), which described the theory and methodological approach to designing research studies. A key tenet of Fisher's treatise, widely adopted by the research community, is randomization, the process of assigning individuals to random groups or treatments. Comparing outcomes or responses between these groups yields “risk factors” called population attributable risks (PAR), which are statistical estimates of the percentage reduction in disease if the risk were avoided or in the case of genetic associations, if the gene variant were not present in the population .High throughput metabolomics, proteomic and genomic technologies provide 21st century data that humans cannot be randomized into groups: individuals are genetically and biochemically distinct. Gene–environment interactions caused by unique dietary and lifestyle factors contribute to heterogeneity in physiologies observed in human studies. The risk factors determined for populations (i.e., PAR) cannot be applied to the individual. Developing individual risk or benefit factors in light of the genetic diversity of human populations, the complexity of foods, culture and lifestyle, and the variety of metabolic processes that lead to health or disease are significant challenges for personalizing dietary advice for healthy or medical treatments for individuals with chronic disease.