High-income countries are experiencing an obesity epidemic that follows a socioeconomic gradient, affecting groups of lower socioeconomic status disproportionately. Recent clinical findings have suggested new perspectives for the prevention and treatment of obesity, using personalized dietary approaches. Precision nutrition (PN), also called personalized nutrition, has been developed to deliver more preventive and practical dietary advice than ‘one-size-fits-all’ guidelines. With interventions becoming increasingly plausible at a large scale thanks to artificial intelligence and smartphone applications, some have begun to view PN as a novel way to deliver the right dietary intervention to the right population. We argue that large-scale PN, if taken alone, might be of limited interest from a public health perspective. Building on Geoffrey Rose’s theory regarding the differences in individual and population causes of disease, we show that large-scale PN can only address some individual causes of obesity (causes of cases). This individual-centred approach is likely to have a small impact on the distribution of obesity at a population level because it ignores the population causes of obesity (causes of incidence). The latter are embedded in the populations’ social, cultural, economic and political contexts that make environments obesogenic. Additionally, the most socially privileged groups in the population are the most likely to respond to large-scale PN interventions. This could have the undesirable effect of widening social inequalities in obesity. We caution public health actors that interventions based only on large-scale PN are unlikely, despite current expectations, to improve dietary intake or reduce obesity at a population level.

中文翻译：

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精准营养：大肆宣传还是希望通过公共卫生干预措施来减少肥胖？

高收入国家正经历着一种随社会经济梯度变化的肥胖病流行，这对社会经济地位较低的群体造成了不成比例的影响。最近的临床发现提出了使用个性化饮食方法预防和治疗肥胖症的新观点。精确营养（PN）也被称为个性化营养，其开发目的是提供比“千篇一律”指南更多的预防性和实用性饮食建议。得益于人工智能和智能手机的应用，随着干预措施在大范围内变得越来越合理，一些人已开始将PN视为一种将正确的饮食干预措施提供给合适的人群的新颖方法。我们认为，从公共卫生的角度来看，大规模的PN，如果单独使用，可能会受到关注。基于杰弗里·罗斯（Geoffrey Rose）关于个体和人群疾病原因差异的理论，我们表明大规模PN仅能解决肥胖的某些个体原因（病例原因）。这种以个人为中心的方法可能会忽略人口中肥胖的分布，因为它忽略了肥胖的人口原因（发病原因）。后者嵌入使环境变得肥胖的人口的社会，文化，经济和政治环境中。此外，人口中社会地位最高的群体最有可能对大规模的PN干预措施做出反应。这可能具有扩大肥胖中社会不平等的不良影响。我们提醒公共卫生参与者，仅基于大规模PN的干预措施不太可能，