How precision medicine will transform the future of metabolic healthcare

Combining biometric tracking, wearables, and the world of "omics" will someday guide lifestyle choices and treatments uniquely suited to you.

WRITTEN BY

Jessie Sebor

REVIEWED BY

Josh Clemente

UPDATED: 03 Oct 2024

PUBLISHED: 02 Oct 2024

🕗 12 MIN READ

When it comes to the state of our health, we’re living in an age of extreme contradiction. America’s healthcare system is considered one of the best in the world, yet we have some of the world’s worst health outcomes and highest rates of avoidable deaths compared to other high-income countries. 

Consider this: Heart disease is the single biggest killer in the United States. At the same time, nearly half of all heart attacks are silent, meaning that people may not know in the moment that they’re having one. However, our heart muscle tissue releases proteins into the bloodstream long before the attack occurs. What if we could measure these proteins, see them rising, and and intervene before a heart attack causes irreversible damage?

This is the potential of personalized medicine, which emphasizes real-time data collection across a broad range of biomarkers. As the saying goes, “If you can measure something, then you can manage it.” Medical professionals can use this information to create precise and dynamic patient recommendations to improve and optimize their health. 

The problem is complex, but one thing is sure: Preventable disease and poor metabolic health create a dangerous burden. Almost nine out of 10 Americans are metabolically unwell, a designation that significantly increases the risk of developing heart disease, diabetes, stroke, and other diseases. These three largely avoidable chronic conditions alone are responsible for more than $600 billion in annual healthcare costs—plus the immeasurable cost of our health and well-being. 

Instead of focusing so much of our resources on treatment, it’s time to harness the burgeoning science that can detect metabolic dysfunction in its earliest stages and stop disease from happening in the first place.

Read on for a deeper look at what’s in store for the future of metabolic healthcare.

What is personalized medicine?

Personalized medicine (also known as precision or individualized medicine) uses personalized data to inform care. This data can include information about a person’s genome, microbiome, metabolic system, and more, along with traditional clinical metrics (like weight and blood pressure), lifestyle (diet and exercise), and environmental details (where you live and who you live with). 

This kind of measurement and its intelligent analysis enables a precise, tailored plan for one individual’s preventive care and treatment. Rather than doling out the generic recommendations commonplace in modern healthcare, medical providers can fine-tune guidance to benefit a particular person’s current and changing health needs.

To understand how personalized medicine has the potential to pave a new way forward, contrast how this forward-thinking approach diverges from traditional healthcare: 

• Proactive vs. reactive: Typically, people wait to seek medical care after symptoms crop up. (According to the CDC, about three-quarters of U.S. adults had a routine check-up in the past year.) Personalized medicine flips this script by using predictive biomarkers to prevent diseases before they occur. For example, about 25% of people with prediabetes develop full-blown diabetes within five years without intervention. What’s worse, more than 80 percent of people with this condition don’t know they have it. Research into personalized medicine shows that by measuring how your body turns food into energy (often called metabolite patterns), a doctor could anticipate the risk of Type 2 diabetes more than a decade before it starts. Empowering people to be proactive could mean a slight shift, like losing a few pounds, staves off diabetes for a lifetime. 
• Dynamic vs. static: Most Americans have no idea what their blood pressure, cholesterol levels, and other vitals are until they step into a doctor’s office for testing. And that only gives a snapshot of health at one particular point in time. Personalized medicine prefers continuous monitoring (like glucose monitors, fitness trackers, and biometric sensors) to provide a more accurate understanding of a person’s current state and what might be affecting their body. Think of it like this: Traditional check-ups are like taking a single photo each year, while personalized medicine gives you a live video feed of your health. Continuous measurement allows you to see how your body responds to different foods, exercises, and medications in real time, so you can make adjustments that keep you healthier and prevent problems before they start.
• Personalized vs. generalized: Traditional medicine offers a wide-net approach to care. For example, the National Library of Medicine sets 4,000 milligrams of acetaminophen (two over-the-counter 500mg pills four times a day) as the maximum daily dose for adults. Your doctor might give you the go-ahead to take this much when you’re in pain—but depending on your genetic code, height, and weight, this could cause liver injury. Personalized medicine considers all of this to create targeted solutions that work on an individual level. Instead of general recommendations, you’ll get an exact dosage that is right for you. 

What data can be measured and give us insights?

The power of personalized medicine hinges on the ability to measure critical data points (biomarkers) about your body. Our bodies have thousands of biomarkers, including proteins, genes, metabolites, RNA, and cell counts.

When you go for an annual check-up today, your healthcare provider will collect a handful of biomarkers like your heart rate and blood pressure. They may also order a comprehensive metabolic panel (CMP) that looks at 14 substances in your blood, including glucose, calcium, electrolytes, and creatine. However, this “comprehensive” test provides a narrow look at your body at this point in time. We know, for example, that our electrolyte levels shift based on how much water we drink, if we’ve recently exercised, any medications we take, and more. Plus, the CMP is only a small piece of your health puzzle.

Personalized medicine examines a broader range of biomarkers and measures these markers more regularly or even continuously. We can then evaluate the effects of stimuli on them—everything from caffeine intake to time spent at a desk—and examine their interplay. This creates a more in-depth and individualistic understanding of what’s going on in your body.

We already see this emerging in wearable devices like smartwatches, shirts, rings, and even earrings that measure body temperature, heart rate, blood oxygen levels, respiratory rate, and more. Continuous glucose monitors are another early-stage precision medicine tool. With real-time blood-sugar data, these devices empower you to see how choices in things like diet, alcohol intake, physical activity, and sleep can change your glucose levels. Once you establish a baseline of data, you can discover whether your body responds to deep breathing exercises to ward off stress or if eating fewer processed foods can help you avoid an afternoon slump. Over time, this knowledge can help you make smarter decisions about your health that can help prevent disease.

Other powerful metabolic biomarkers that we can and should measure today (not continuously but with blood testing) include:

• Insulin (a hormone that helps turn what we eat into energy and indicates metabolic health)
• ApoB (a better cholesterol marker for cardiovascular risk than typical measurements)
• Cortisol (a hormone that is part of the stress response)
• Lactate (an organic molecule that spikes during workouts when your cells need to make energy without oxygen)
• Troponin (a protein complex tied to cardiac events)

For every additional biomarker we track, a clearer and more exact picture of our health can emerge as our understanding of how everything in our body interacts expands exponentially. This multidirectional, high-definition view can help us zero in on how to live our healthiest lives.

What are omics, and what do they have to do with personalized medicine?

The discovery and assessment of biomarkers are directly tied to the study of omics. This field of science studies large sets of biological molecules, including genes, proteins, and metabolites, to understand how they work together. In biology, the word “omics” refers to the total makeup of a cell. The different fields it includes—like genomics, proteomics, metabolomics—all use this suffix. 

Here’s a look at the different areas of omics and how each may elevate healthcare.

Genomics

Genomics focuses on the structure and function of a person’s complete set of DNA or genome. In the last few decades, genomic scientists have developed a deeper understanding of human diversity and disease generation. They’ve discovered that our DNA can be used to measure risk, and, in turn, we can be proactive about our health. 

For example, the gene APOE e4 is linked to late-onset Alzheimer’s disease, HLA-B27 is connected to arthritis, and Type 2 diabetes is related to variants in KLF14, KCNQ1, GRB10, TCF7L2, THADA, and PEG3. These conditions are known as “multifactorial” disorders, meaning both genes and lifestyle play a role in risk. So, if you discover you’re at high risk for arthritis, you might prioritize adding omega-3 fatty acids to your diet, which has been shown to help prevent the onset of the disease.

Epigenomics

While genomics looks at the sequence of genes, epigenomics examines how their activity can change. Environmental exposures—stress, aging, diet, substance abuse, and more—can chemically modify DNA and make specific genes less active. Epigenomics examines what happens when these changes occur and how the changes can predict different health conditions. 

Epigenomics could potentially help prevent, treat, and even reverse diseases like cancer, autoimmune diseases, and metabolic disorders. Drugs, including DNA methyltransferase (DNMT) inhibitors and histone deacetylase (HDAC) inhibitors, may be able to correct gene changes at a cellular level, stopping a disease in its tracks. 

Recent research has shown epigenomics can play a role in identifying and treating Type 2 diabetes, osteoporosis, obesity, and more, allowing for timely interventions to reduce risk, add medication when appropriate, and promote smart lifestyle choices. 

Transcriptomics

The study of gene expression, transcriptomics, examines how genes are expressed in our cells by examining RNA (ribonucleic acid). RNA is a molecule in cells that reads the instructions from DNA and carries them to the part of the cell that makes proteins.

Our genetics can predispose us to a disorder, but through transcriptomics, we can learn how this gene variation manifests into the disease itself. Also, different people with the same gene can see that gene expressed differently. For example, scientists have found that the same 320 genes act differently in people with severe non-alcoholic fatty liver disease (NAFLD) compared to people without it. 

Transcriptomics allows for more tailored treatment plans. For example, if transcriptomics reveals that someone with NAFLD has increased activity in genes responsible for fatty acid synthesis, a doctor might prescribe medications or dietary changes aimed explicitly at reducing fatty acid production in the liver, thereby addressing the root cause of that individual’s disease.

Proteomics

Proteomics studies how protein works in our body. Scientists have created a working version of the human proteome, the group of proteins found in healthy tissue. They use this baseline to compare with the proteins in tissue of people with different conditions to find links between protein changes and specific diseases. 

While this area of study is still in its early stages, researchers have found protein biomarkers could flag diseases very early on. In the future, it’s possible that protein in tissue could be measured frequently or continuously to keep you healthy. For example, if you find that eating specific foods elevates levels of certain proteins linked to inflammation, you might adjust your diet to reduce those foods and lower inflammation, leading to better health outcomes.

Metabolomics

The process of metabolism turns food into energy. When this occurs, the body produces small molecules called metabolites. Metabolomics analyzes these metabolites. The hope of this developing technology is that a person’s metabolite readout will deliver a clear and detailed picture of their current metabolic health to help develop a personalized plan to ward off illness or treat disease. In one study, metabolite patterns were found to detect Type 2 diabetes more than 10 years before the onset of the disease. 

Metabolomics may also provide a clear window into exactly how someone’s body reacts to a medication and whether the drug is working well or creating adverse issues, like hormonal imbalance or oxidative stress. In that case, you could talk to your doctor about managing your dose or switching medications.

Metabolomics is a powerful tool, even if you’re healthy. For instance, if analysis reveals you metabolize carbohydrates very quickly, leading to rapid spikes and drops in blood sugar levels, you could change your diet to include more protein and healthy fats, and small amounts of fiber-rich carbs, all of which promotes a smaller glucose response and, in turn, reduces the risk of various diseases.

Gut microbiome

Our gut microbiome, the community of microorganisms that help us to turn food into energy, is directly linked to metabolic health. While these microorganisms live in our digestive tracts, their impact goes far beyond our digestive tract. Our gut microbiome plays a role in regulating our immune, nervous, and endocrine systems. An imbalance of “good” and “bad” bacteria in the gut has been linked to anxiety, depression, cancer, asthma, allergies, and more.

The good news is that the microbiome can be healed through probiotics, prebiotics, and fecal transplants. Multi-omics can provide a tailored approach through the emerging field of precision probiotics to deliver the exact forms of gut microbiota a person needs to improve their digestion and health.

Nutrigenomics

Nutrition guidelines are full of blanket statements like, “Eat more vegetables and less fried food.” While this might be sound advice, it ignores our individual nutritional needs. Finding the proper diet for you often takes trial and error, and that takes time and money. Nutrigenomics takes out the guesswork by examining your genes, metabolic health, environment, and lifestyle to determine your unique dietary requirements.

The study of nutrigenomics may explain why a diet that works for your best friend doesn’t work for you. For example, for people with a specific variation of the gene PPARA, a diet higher in polyunsaturated fatty acids (found in fatty fish, nuts, and seeds) may lower triglyceride levels. However, people with specific variants of the APOA5 gene may see the opposite effect—their triglycerides rise when they eat this kind of fat. 

AI’s critical role in precision medicine

Taken alone, one area of omics, like sequencing your genome, may give you a window into your risks for inherited diseases and a roadmap for health that reaches far beyond traditional medicine. And when several different omics come together, the possibilities are endless. This is called a multi-omics approach: Personalized medicine takes information from all possible areas—transcriptomics, pharmacogenomics, epigenomics, and more—to get a data-driven, incredibly in-depth view into your body. 

When you think of all of the data and possible data combinations this could involve, the numbers become staggering. No one patient or doctor could make sense of how all of this works together with a simple analysis. That’s where artificial intelligence (AI) comes in. 

AI can take on loads of data, often measured in the millions of gigabytes and beyond. It uses algorithms and models to process these enormous levels of data. Once this kind of analysis is available, the AI will benefit from a large data set—the kind that continuous monitoring of multiple molecules could provide. And the real-time nature of these measurements also gives the AI more analytical context for what’s happening simultaneously (i.e., food, exercise, sleep, etc.).

Right now, your doctor can make suggestions based on a meager amount of information—primarily point-in-time measurements—and the limited processing power of the human brain. In the future, they could use AI tools to take all of that continuous biometric data into account instantly. The result? Hyper-specific, real-time recommendations around lifestyle choices, optimized diets, and medical protocols tailored specifically to you.

The future of metabolic healthcare

As technology advances and the study of omics grows, we may unlock a healthier future. As we closely monitor hundreds or even thousands of molecules in our body, we may be able to make lifestyle changes that alter our health course, allowing us to bypass disease before it has a chance to even take seed.

This is only the beginning of the possibilities that biomarker tracking, wearable technology, and AI-powered multi-omics could bring. Though this won’t happen overnight, as databases grow and platforms integrate these various omics, we can obtain an eye-opening view of our health and, in turn, take control of it.

Take control of your metabolic health

Levels help you see how food and lifestyle affect your health through macro tracking, habit building, and customized insights and advice. Levels members can also incorporate biomarker data like real-time glucose and metabolic blood testing for an even more personalized experience.  Click here to get started with Levels.