Precision nutrition in Asian populations: a Multi-omics review of mechanisms, biomarkers, and implementation pathways

The rapid expansion of omics technologies has created new opportunities to understand inter-individual variations in metabolic responses to diet. Such advances are particularly relevant for Asian populations, which exhibit distinct metabolic characteristics, including increased visceral adiposity, reduced β-cell reserves, and heightened susceptibility to type 2 diabetes at lower BMI levels, compared to Western populations. This review synthesizes the current evidence on metabolomic and genomic biomarkers associated with metabolic health in Asians and outlines the mechanistic pathways through which diet influences these biomarkers. Metabolomic signatures, such as lysophosphatidylcholines, micronutrient-derived metabolites, amino acid profiles, and oxidative stress indicators, have demonstrated strong potential for the early detection of metabolic dysfunction. In addition, carbohydrate-related markers of glycemic excursions, microbiome-derived metabolites, and diet-responsive fatty acid profiles may help capture the heterogeneity in postprandial regulation and diet responsiveness. Genetic variants enriched in Asian populations, including TMEM182- and NPC1L1-related polymorphisms, further modulate lipid metabolism, adipogenesis, and glycemic regulation. We also highlighted β-cell and nutrient-handling loci (e.g. KCNQ1, TCF7L2, SLC30A8, FUT2/6, BCMO1, and FADS1/2) as mechanistic anchors for biologically stratified dietary personalization. We discuss nutrient-metabolite interactions - particularly those involving dietary fibre and legumes - within culturally patterned Asian diets and highlight culturally consistent dietary strategies supported by multi-omics evidence. Finally, we propose a translational framework for implementing precision nutrition in Asia, emphasizing analytical standardization, clinician training, digital health integration, and equity considerations. Together, these insights underscore the potential of multi-omics approaches to inform individualized dietary recommendations and improve metabolic health across diverse Asian populations.