Who Will Respond to Treatment? A Diet Example

Will this person (or I) respond well to the treatment? This is perhaps one of the most asked questions by all healthcare providers. What if our bodies themselves could supply the answer to that question? We think they can, and it all boils down to the proteins that make you, you.

One notable treatment example is diet. There seem to be more diet strategies than stars in the sky. Some diet plans do work for some, but not for everyone. The trick is finding the right plan for the right person. It turns out that proteomics (a comprehensive look at your proteins) potentially can help.

Valsesia et al. set out to use several methods (including proteomics) to determine what factors could identify a person who would not respond to a diet even before the person began it (Valsesia et al., 2020). In their study, a group of overweight people were identified with similar features (similar body composition, being non-diabetic, etc.) and placed on a low-calorie diet for eight weeks. Those that lost more than 8% of their body weight were placed on a maintenance diet for 26 weeks. For the proteomic analysis, blood samples were collected at the start of the study, after the diet and after the maintenance diet. Even though people did lose weight, not all reaped the benefits of the diet and the data hint at why.

One key benefit to losing weight is improved control of blood sugar (glycemic control). The team noted “responders” as having improved glycemic control and “non-responders” as not having improved glycemic control. At the end of the study, the responders lost more weight than the non-responders.

So, what was going on with the responders to allow them to reap the desired benefits of the diet? The team learned through their analysis that responders typically had more visceral fat (fat stored around organs) than non-responders. They also lost quite a bit of that visceral fat compared to the non-responders. At the proteomic level, responders had a higher level of Apolipoprotein E (ApoE) – a protein with roles in fat accumulation, insulin resistance and onset of metabolic syndrome (factors that increase risk of stroke, type 2 diabetes or heart disease)- compared to non-responders, which dropped during the diet. ApoE levels did not really change for non-responders. During the low-calorie diet phase of the study, 106 proteins and 22 biological pathways involved in the immune system, insulin signaling, clotting mechanism and how fats were processed further separated responders from non-responders.

With the proteomic analysis and other analyses completed, the team constructed predictive models that could determine if a person would see all the benefits of a low caloric diet before the person even started. In their assessment, they concluded that their model could show if a person would reap the full benefit (including glycemic control) of the low-calorie diet better than just a clinical assessment of the individual.

It is amazing what our bodies can tell us: We only need to listen. It may soon be possible to know what treatments (or diets) could be best for an individual to realize the full benefits.



Valsesia, A., Chakrabarti, A., Hager, J., Langin, D., Saris, W. H. M., Astrup, A., . . . Masoodi, M. (2020). Integrative phenotyping of glycemic responders upon clinical weight loss using multi-omics. Sci Rep, 10(1), 9236. doi:10.1038/s41598-020-65936-8

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