Precision nutrition testing is the future of personalized care: evidence and coverage policies for equitable access

The one-size-fits-all approach to dietary and metabolic interventions often fails to improve population health outcomes. This problem has been made more urgent by the rise of GLP-1 receptor agonist medications for obesity, which are high-cost but have variable patient outcomes. Precision nutrition (PN) testing has the potential to address this gap by using biomarkers, such as genetics and metabolic profiles, to predict individual responses to foods and drug therapies. Although some PN tests are on the market, most are not FDA-approved or covered by insurers, requiring out-of-pocket payment and creating access disparities. In this Commentary, we draw on experience from precision medicine to argue that payers, developers, regulators, and professional societies must begin building the evidence and coverage infrastructure for PN testing now. Payer coverage will require demonstrated clinical utility and defined clinical pathways that guide who should be tested and how results should change care. The policy question is not whether current tests should be covered; they should not be broadly covered without evidence, but whether the health system is preparing for equitable implementation once validated tests emerge. Building evidence and coverage infrastructure proactively will help ensure that future PN testing innovations improve population health equitably rather than widen existing disparities.