I think this critique conflates a valid critique of tech solutionism, individualisation, and heathcare privatisation with misplaced criticism of traditional methods, and scientific advances. Just because ZOE stinks of the optimisation mindset that's common with alot of healthcare fads and is a private service, doesnt mean that the fundamental science is wrong. It also doesnt mean that you shouldnt be avoiding ultra-processed food and and eating more traditionally fermented foods. Neither does it mean that you should be putting all the responisibility on yourself for eating within an industrialised food system. But concluding from 'No matter how much effort we expend, not everything is potentially within our control" that it's not worth taking action is a false dichotomy that will only serve to reproduce the existing industrial food system that we are suffering the consequences of.
If you want to preserve the NHS in the long term, we need to respect the medical impacts of food. Illness caused by obesity and overweight currently costs the NHS £54bn a year and this is set to rise, unless we change food systems. Ignoring this link will only make it easier for advocates of the privatisation to win the argument. Is individualising the solution the answer? No, clearly not. But that's no reason to conclude "microbial diversity be damned" in my view.
'If nutrition really is as important as the gut-health gurus claim, it needs to become something other than a niche hobby for the middle classes'!!!!! Exactly.
Could have written this article about female hormonal health (a really similar issue.)
I genuinely think that these movements are great and important because what we eat really can help improve such specificities in our health, but the forces of power should be doing something about it, not solely us. The knowledge alone without the means to improve is as you said, just inducing anxiety which is fucked. Let's all stop putting ALL of the responsibility on ourselves for societal issues.
I’m a public health nutrition specialist - decided early on that I didn’t want to give 1:1 nutrition advice to people because food issues are rarely about food. I am interested in how this tech can be used to support people in a world where our food choices aren’t really our own. I know that is a comment to be hated for but we are clearly struggling to eat in a way that support mind and body.
The EU include personalised nutrition in their Food 2030 framework. I did write to Zoe to ask if the app has potential at the public health level but it was just an email and didn’t get a response.
As a brown woman I struggle with white men telling me that how I’ve been eating/what I eat/everything I know about food is wrong and I should listen to them….I think that’s also a thing that needs to be considered each time there is a ‘food revolution’. Then again I’m sure I’m not their target audience anyway.
"bespoke services like ZOE are not a scalable solution but a form of private healthcare which will further entrench existing inequalities."
James' fundamental thesis here seems to be that Zoe's pricing (£299 + subscription) will remain that way. Let's challenge that notion:
Ever wonder about memory chips in your computers or phones? In 1985, they used to cost $113K per GB of capacity. Today? $2.1 per GB - nearly 54,000 times cheaper than 40 years ago. (source: our world in data). Some forecasts estimate it to go to 10 cents per GB in the next 7 years (another 21x fall)
Gene sequencing - cost $100 million per genome in 2001. Today? $900 per genome. (source: US national institute of health). Nearly 111K times cheaper. And that price is predicted to go down, too. It's made gene sequencing to test for diseases much more accessible than ever before. Even the NHS has a genomic medicine programme now!
James presumes (and I can't imagine how wrong this presumption is) that a product like Zoe will be priced the same over years. Almost always never the case. Someone will see if Zoe is successful, clone it, sell it for a pittance. And then, it ceases to be more widely available, than just "a niche hobby for the middle classes. " If it works, it might even be available on the NHS! (IF it works)
If you've been around for 30-35 years now, think - how expensive was the first PC you or your family purchased? And what would be the average price and feature set for a computer you may purchase today? Articles like James' would have valid criticisms - but by anchoring to price, his entire thesis rests on very shaky foundations.
Disclaimer: I don't use Zoe. I've read about it, and eh, it could be interesting (or not). But I do know a bit about pricing from my work. I wish people do think of what happens over time when writing articles about price.
Disclaimer: I use Zoe. I no longer log things, but I appreciate the things I have learned about my body and various health benefits.
But my main point is that having a NON-medicalised diet is the exception, not the rule. Chinese and Indian diets, to name but two are inherently medicalised. And this makes them no less delicious.
Not quite sure I understand the author's argument here - he experienced health problems as a result of too much lager drinking, it was a scary experience that he was worried would last forever, he'd prefer to never think about it again as it was so unpleasant, and so... we should all be suspicious of companies like ZOE who are trying to make us think about our gut health? Because also Zoe makes eating less fun, makes us too preoccupied with monitoring our own health, and because it's expensive?
Firstly, I agree with 'Andy's' comment below that just because Zoe is expensive now (in its infancy) doesn't mean it will remain so.
Secondly, I am signed up to Zoe, but really you can take or leave / pick and choose what it's offering you. You don't even have to go through the programme - just reading some of the articles or listening to the podcasts are interesting and informative (and free). So I disagree with the comment: 'The sheer specificity of it, the level of self-surveillance, management and monitoring that it demands, the expectation that we should achieve such a heightened level of expertise regarding our own bodies – none of this strikes me as realistic or desirable.' This hasn't been my experience at all - if you want to get more deeply involved then you can, or as I say, just pick and choose, and what you'll likely come away with is the simple (and surely positive) guidance to eat a wide variety of plants, plenty of fibre, less meat, and ideally avoid Ultra processed foods / eat as many whole foods as you can. The fermented foods are good if you can make a regular thing of it, but no worries if not!
On the idea that Zoe has made 'even the most mundane consumer choices suddenly more fraught and high-stakes' - if anything, it's made choosing what I eat on a daily basis feel a lot simpler and more reassuring. As above - whole foods, plant variety, fibre, less meat etc. None of that feels particularly fraught and high-stakes? And re all those 'neurotic questions' - they're normally really about debunking a lot of food myths. Are nuts bad for you? No... Can bread be healthy? Yes... Is coffee healthy? Yes you just probably shouldn't have loads of really milky coffees in one day... Can alcohol be healthy? Obviously it's not great but some better than others but don't worry TOO much about it (unless you're drinking enough lager to lacerate your stomach lining). Basically a lot of reassuring common sense!
As someone who has always struggled with their weight - and has suffered from heartburn and digestive issues for most of their adult life, taking the approach promoted by Zoe has completely changed both my body and my health in the past year, and I still love food - cooking, eating out, sweet things, alcohol... (as I imagine do most people reading this column, which is why it's a shame that the article seems to be promoting an 'it's better to bury your head in the sand on diet' approach). But what got me interested in nutrition in the first place was Bee Wilson's excellent book 'The Way We Eat Now' - published in 2019 and promoting many similar ideas to Zoe. I highly recommend!
In a world of massively rising cases of obesity and - connected to this - diabetes, heart disease, and preventable cancers, and a lack of regulation from our governments in the face of cynical, powerful food manufacturing companies, surely a company like Zoe can be no bad thing, even if they're occasionally a bit annoying?!
The tone of this article is excessively neurotic, and says more about the author’s apparently highly strung general state of mind than it does about Zoe.
“...even the most mundane consumer choices suddenly become more fraught and high-stakes...” it really shouldn’t feel that way. For most people the advice boils down to: eat whole foods when you can, especially vegetables, nuts and pulses; be mindful of the risks associated with HPFs and try not to snack late at night. If this guidance feels too overwhelming to contemplate then maybe the author has other stuff going on that needs to be addressed?
Well said. I've seen plenty of my clients' Zoe results and even as a nutrition pro I struggle to translate them into everyday 'doable' advice for people. In fact I dread being asked to. Fine to make generalised improvements to diet and lifestyle – people can hugely benefit from the stuff we all already know, like eating plenty of veg, getting some fresh air every day and going to bed earlier – but this level of minutiae is baffling and unnecessary.
The big impact stuff in public health programmes by WHO etc have always been simple information campaigns. Not fancy costly things. Im not sure why zoe or any other app provider think they can suddenly provide basic Public Health strategies that we couldnt before hand.
Theres plenty of things Public Health Experts know write about actually backed by data (unlike zoe). It's just there's simply no political will when the food/supermarket lobbies have all the influence. Why anyone would think that the use of an app will change anything in the current environment I dont know. Its not only lacking any peer reviewd data on improved clinical outcomes, you cant use it to magically change any of the societal inequalities and lack of agency people face.
Having tried Zoe out of curiosity, I can tell you it doesnt give you anything reading free articles, or a decent book on the subject can.
There maybe data that suggests people "feel "more positive about their wellbeing after using Zoe, but there's no clinical data to show it actually has any discernible impact on health outcome (yet anyway)..
From a biomedical background I can't tell you how dismayed and astonished i was to find the report you get has no science based on mechanisms or aetiological data points. They merely group AI generated sets of correlated data points with no aetiological or diagnostic under pining or insight .
It may bamboozle people with no understanding of the science. They may feel more informed. But there's no actionable data with a proven impact on outcomes as some of the other comments from nutritionists indicate
Feels like just the next snake oil for people with money to feed their anxiety or curiosity.And there are already plenty of cases of people worrying about their Zoe scores in a way many would have obsessed over calories previously.
Long term maybe Zoe data will show useful clinical measurable benefits. They cant say it does right now. And in the meantime they're getting people to pay to have data extracted for them by what i found to be aggressively corporate model with a brazenly private/profit agenda.
There's nothing wrong with taking some agency over your nutritional choices (as much as you can based on income and a food system geared to maximise profit over public health). But zoe has no proven impact. The one Israeli study I read about a personalised approach (not zoe) basically concluded being given a diet sheet had similar results on blood sugar control. That sll Ive found. So do yourself a favour and get a decent book on the subject. £300 up front with £60 a month ongoing costs is a not just a waste of money it feels like snake oil to unsuspecting punters that takes advantage of their anxieties (or misunderstanding of what it can offer)
It’s not true that the available clinical data shows that ZOE works. There is no available clinical data, only something on PREDICT, which is not identical.
I think this critique conflates a valid critique of tech solutionism, individualisation, and heathcare privatisation with misplaced criticism of traditional methods, and scientific advances. Just because ZOE stinks of the optimisation mindset that's common with alot of healthcare fads and is a private service, doesnt mean that the fundamental science is wrong. It also doesnt mean that you shouldnt be avoiding ultra-processed food and and eating more traditionally fermented foods. Neither does it mean that you should be putting all the responisibility on yourself for eating within an industrialised food system. But concluding from 'No matter how much effort we expend, not everything is potentially within our control" that it's not worth taking action is a false dichotomy that will only serve to reproduce the existing industrial food system that we are suffering the consequences of.
If you want to preserve the NHS in the long term, we need to respect the medical impacts of food. Illness caused by obesity and overweight currently costs the NHS £54bn a year and this is set to rise, unless we change food systems. Ignoring this link will only make it easier for advocates of the privatisation to win the argument. Is individualising the solution the answer? No, clearly not. But that's no reason to conclude "microbial diversity be damned" in my view.
'If nutrition really is as important as the gut-health gurus claim, it needs to become something other than a niche hobby for the middle classes'!!!!! Exactly.
Could have written this article about female hormonal health (a really similar issue.)
I genuinely think that these movements are great and important because what we eat really can help improve such specificities in our health, but the forces of power should be doing something about it, not solely us. The knowledge alone without the means to improve is as you said, just inducing anxiety which is fucked. Let's all stop putting ALL of the responsibility on ourselves for societal issues.
Loved this.
I’m a public health nutrition specialist - decided early on that I didn’t want to give 1:1 nutrition advice to people because food issues are rarely about food. I am interested in how this tech can be used to support people in a world where our food choices aren’t really our own. I know that is a comment to be hated for but we are clearly struggling to eat in a way that support mind and body.
The EU include personalised nutrition in their Food 2030 framework. I did write to Zoe to ask if the app has potential at the public health level but it was just an email and didn’t get a response.
As a brown woman I struggle with white men telling me that how I’ve been eating/what I eat/everything I know about food is wrong and I should listen to them….I think that’s also a thing that needs to be considered each time there is a ‘food revolution’. Then again I’m sure I’m not their target audience anyway.
"bespoke services like ZOE are not a scalable solution but a form of private healthcare which will further entrench existing inequalities."
James' fundamental thesis here seems to be that Zoe's pricing (£299 + subscription) will remain that way. Let's challenge that notion:
Ever wonder about memory chips in your computers or phones? In 1985, they used to cost $113K per GB of capacity. Today? $2.1 per GB - nearly 54,000 times cheaper than 40 years ago. (source: our world in data). Some forecasts estimate it to go to 10 cents per GB in the next 7 years (another 21x fall)
Gene sequencing - cost $100 million per genome in 2001. Today? $900 per genome. (source: US national institute of health). Nearly 111K times cheaper. And that price is predicted to go down, too. It's made gene sequencing to test for diseases much more accessible than ever before. Even the NHS has a genomic medicine programme now!
James presumes (and I can't imagine how wrong this presumption is) that a product like Zoe will be priced the same over years. Almost always never the case. Someone will see if Zoe is successful, clone it, sell it for a pittance. And then, it ceases to be more widely available, than just "a niche hobby for the middle classes. " If it works, it might even be available on the NHS! (IF it works)
If you've been around for 30-35 years now, think - how expensive was the first PC you or your family purchased? And what would be the average price and feature set for a computer you may purchase today? Articles like James' would have valid criticisms - but by anchoring to price, his entire thesis rests on very shaky foundations.
Disclaimer: I don't use Zoe. I've read about it, and eh, it could be interesting (or not). But I do know a bit about pricing from my work. I wish people do think of what happens over time when writing articles about price.
Disclaimer: I use Zoe. I no longer log things, but I appreciate the things I have learned about my body and various health benefits.
But my main point is that having a NON-medicalised diet is the exception, not the rule. Chinese and Indian diets, to name but two are inherently medicalised. And this makes them no less delicious.
Not quite sure I understand the author's argument here - he experienced health problems as a result of too much lager drinking, it was a scary experience that he was worried would last forever, he'd prefer to never think about it again as it was so unpleasant, and so... we should all be suspicious of companies like ZOE who are trying to make us think about our gut health? Because also Zoe makes eating less fun, makes us too preoccupied with monitoring our own health, and because it's expensive?
Firstly, I agree with 'Andy's' comment below that just because Zoe is expensive now (in its infancy) doesn't mean it will remain so.
Secondly, I am signed up to Zoe, but really you can take or leave / pick and choose what it's offering you. You don't even have to go through the programme - just reading some of the articles or listening to the podcasts are interesting and informative (and free). So I disagree with the comment: 'The sheer specificity of it, the level of self-surveillance, management and monitoring that it demands, the expectation that we should achieve such a heightened level of expertise regarding our own bodies – none of this strikes me as realistic or desirable.' This hasn't been my experience at all - if you want to get more deeply involved then you can, or as I say, just pick and choose, and what you'll likely come away with is the simple (and surely positive) guidance to eat a wide variety of plants, plenty of fibre, less meat, and ideally avoid Ultra processed foods / eat as many whole foods as you can. The fermented foods are good if you can make a regular thing of it, but no worries if not!
On the idea that Zoe has made 'even the most mundane consumer choices suddenly more fraught and high-stakes' - if anything, it's made choosing what I eat on a daily basis feel a lot simpler and more reassuring. As above - whole foods, plant variety, fibre, less meat etc. None of that feels particularly fraught and high-stakes? And re all those 'neurotic questions' - they're normally really about debunking a lot of food myths. Are nuts bad for you? No... Can bread be healthy? Yes... Is coffee healthy? Yes you just probably shouldn't have loads of really milky coffees in one day... Can alcohol be healthy? Obviously it's not great but some better than others but don't worry TOO much about it (unless you're drinking enough lager to lacerate your stomach lining). Basically a lot of reassuring common sense!
As someone who has always struggled with their weight - and has suffered from heartburn and digestive issues for most of their adult life, taking the approach promoted by Zoe has completely changed both my body and my health in the past year, and I still love food - cooking, eating out, sweet things, alcohol... (as I imagine do most people reading this column, which is why it's a shame that the article seems to be promoting an 'it's better to bury your head in the sand on diet' approach). But what got me interested in nutrition in the first place was Bee Wilson's excellent book 'The Way We Eat Now' - published in 2019 and promoting many similar ideas to Zoe. I highly recommend!
In a world of massively rising cases of obesity and - connected to this - diabetes, heart disease, and preventable cancers, and a lack of regulation from our governments in the face of cynical, powerful food manufacturing companies, surely a company like Zoe can be no bad thing, even if they're occasionally a bit annoying?!
The tone of this article is excessively neurotic, and says more about the author’s apparently highly strung general state of mind than it does about Zoe.
“...even the most mundane consumer choices suddenly become more fraught and high-stakes...” it really shouldn’t feel that way. For most people the advice boils down to: eat whole foods when you can, especially vegetables, nuts and pulses; be mindful of the risks associated with HPFs and try not to snack late at night. If this guidance feels too overwhelming to contemplate then maybe the author has other stuff going on that needs to be addressed?
Well said. I've seen plenty of my clients' Zoe results and even as a nutrition pro I struggle to translate them into everyday 'doable' advice for people. In fact I dread being asked to. Fine to make generalised improvements to diet and lifestyle – people can hugely benefit from the stuff we all already know, like eating plenty of veg, getting some fresh air every day and going to bed earlier – but this level of minutiae is baffling and unnecessary.
The big impact stuff in public health programmes by WHO etc have always been simple information campaigns. Not fancy costly things. Im not sure why zoe or any other app provider think they can suddenly provide basic Public Health strategies that we couldnt before hand.
Theres plenty of things Public Health Experts know write about actually backed by data (unlike zoe). It's just there's simply no political will when the food/supermarket lobbies have all the influence. Why anyone would think that the use of an app will change anything in the current environment I dont know. Its not only lacking any peer reviewd data on improved clinical outcomes, you cant use it to magically change any of the societal inequalities and lack of agency people face.
Having tried Zoe out of curiosity, I can tell you it doesnt give you anything reading free articles, or a decent book on the subject can.
There maybe data that suggests people "feel "more positive about their wellbeing after using Zoe, but there's no clinical data to show it actually has any discernible impact on health outcome (yet anyway)..
From a biomedical background I can't tell you how dismayed and astonished i was to find the report you get has no science based on mechanisms or aetiological data points. They merely group AI generated sets of correlated data points with no aetiological or diagnostic under pining or insight .
It may bamboozle people with no understanding of the science. They may feel more informed. But there's no actionable data with a proven impact on outcomes as some of the other comments from nutritionists indicate
Feels like just the next snake oil for people with money to feed their anxiety or curiosity.And there are already plenty of cases of people worrying about their Zoe scores in a way many would have obsessed over calories previously.
Long term maybe Zoe data will show useful clinical measurable benefits. They cant say it does right now. And in the meantime they're getting people to pay to have data extracted for them by what i found to be aggressively corporate model with a brazenly private/profit agenda.
There's nothing wrong with taking some agency over your nutritional choices (as much as you can based on income and a food system geared to maximise profit over public health). But zoe has no proven impact. The one Israeli study I read about a personalised approach (not zoe) basically concluded being given a diet sheet had similar results on blood sugar control. That sll Ive found. So do yourself a favour and get a decent book on the subject. £300 up front with £60 a month ongoing costs is a not just a waste of money it feels like snake oil to unsuspecting punters that takes advantage of their anxieties (or misunderstanding of what it can offer)
It’s not true that the available clinical data shows that ZOE works. There is no available clinical data, only something on PREDICT, which is not identical.