ABSTRACT
This chapter discusses personalized nutrition and the practical implementation of nutritional advice for cancer prevention, treatment, and relapse prevention. Traditionally, nutritional advice has been provided on the basis of average dietary requirements or desired goals in a population rather than on a personalized basis. Precision nutrition uses genomics to identify a subset of individuals in a population with special nutritional needs different from the general population. While primarily based on genetic variation, a great deal of research is progressing on the use of metabolic pathways, microbiome, and phenotype to improve the accuracy of personalized nutrition advice. While our current knowledge on the impact of nutrition in prevention, treatment, and survivorship is considered in detail in separate chapters, this chapter will set out the principles of personalized nutrition and differentiate it from precision nutrition. Precision oncology and precision medicine are being applied to patient care, and some large research efforts are aimed at utilizing advanced technologies and artificial intelligence to attempt to develop the field of precision nutrition. From nutrigenomics to deep phenotyping, many factors may interact to influence oncogenesis, tumor progression, choices of effective treatment options, drug tolerance, remission, and relapse. At the same time, there are also more general nutritional and physiological principles which apply to all individuals at some level with regard to macronutrients and energy balance. Precision nutrition can point to specific examples where genomics has guided individuals to different nutritional or supplement recommendations than the general population. Despite these few clear examples which are discussed such as variations in choline requirements, it is important to put the science of precision nutrition into proper perspective for the vast majority of individuals dealing with cancer. Physiological characteristics, hormonal principles, and individual food preferences also guide personalized nutrition advice. There is still much more to learn in the science of precision nutrition before it will be possible to practically apply all of the personal attributes of patients into a comprehensive nutrition program that can enhance the results of the rapidly progressing field of precision oncology. Therefore, this chapter will detail the practical tools and dietary recommendations that are available now to personalize nutritional recommendations in order to optimize immune function, maintain muscle and lean body mass, and provide essential micronutrients for optimum health. Implementation of these guidelines will hopefully result in better outcomes for all those individuals whose lives intersect with cancer whether in the setting of prevention, treatment, or relapse prevention.
