Abstract
This Nevin S. Scrimshaw Prize Lecture presented in Paris on August 28, 2025, chronicles the scientific journey from Dr. Scrimshaw's vision of “Nutrition for All” to the emerging paradigm of “Precision Nutrition for Everyone,” with a focus on Asian metabolic health. The central research question—“Why don't Western nutrition guidelines work optimally for Asian people?”—arose from clinical observations of Korean patients showing suboptimal metabolic outcomes despite adherence to conventional dietary recommendations. By 2024, nearly 1 in 3 Korean adults had metabolic disease, with particularly alarming trends among Millennials and Generation Z developing risk factors at earlier ages and lower BMIs than Western populations. Through 3 distinct research phases spanning 2017-2029, this work demonstrates that population specific precision nutrition requires integration of genomics, metabolomics, and culturally relevant dietary interventions. Phase I (2017-2020) identified obesity-inflammation biomarkers including NK cell activity and lipid mediators (lysoPE/lysoPC) in metabolically unhealthy obese individuals. Phase II (2019-2024) developed predictive models combining Genetic Risk Score and Oxidative Stress Score, achieving 75.1% accuracy for obesity prediction. Korean-specific genetic variants (TMEM182 rs141764639, NPC1L1 rs217434, LP-PLA2 Val279Phe) were identified as strong metabolic disease predictors absent from Western genome-wide studies. Phase III (2024-2029) translated omics findings into actionable dietary recommendations, establishing a fiber threshold of ≥17.28 g/day for maintaining healthy metabolic profiles and demonstrating metabolic benefits of legume-based rice substitution through randomized controlled trials. This journey underscores that precision nutrition must democratize health equity by recognizing genetic diversity as signal rather than noise, ensuring that molecular discoveries translate into accessible public health interventions for all populations.
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