Determinants of Heterogeneous Treatment Effects in Precision Cardiometabolic Medicine

Precision nutrition and metabolic medicine sit at the forefront of a paradigm shift in cardiometabolic care. Pharmacological, dietary, and lifestyle interventions consistently improve metabolic, cardiovascular, and renal outcomes, yet their effects vary profoundly between individuals. GLP-1 receptor agonists can produce weight reductions ranging from minimal to over 25% of baseline, while responses to dietary patterns such as low carbohydrate or Mediterranean diets differ sharply even among clinically similar participants. This response heterogeneity is not statistical noise; it reflects meaningful biological, metabolic, and behavioral variation, shaped by determinants such as genetic profile, insulin resistance subtype, gut microbiome composition, inflammatory pathways, and sex specific hormonal influences. Systematic integration of these factors into clinical decision making remains limited, leaving a critical gap at the intersection of precision nutrition and metabolic medicine.This Research Topic aims to elucidate the determinants of heterogeneous treatment effects across nutritional, pharmacological, and lifestyle interventions to advance precision cardiometabolic care. It seeks to identify the biological, metabolic, and environmental modifiers that influence who benefits most, or least, from a given therapy. The Topic will bridge evidence from clinical nutrition, systems biology, and epidemiology with analytical approaches such as causal inference and machine learning to define individualizable response phenotypes, building a mechanistic understanding of how treatment outcomes can be tailored to specific patient profiles and driving the transition from average effect recommendations to personalized clinical strategies.This Research Topic welcomes studies on interventions, dietary, pharmacological, or combined, that modulate metabolic health; studies limited to population average effects fall outside scope.We invite articles addressing, but not limited to, the following themes:• Heterogeneous treatment effects of pharmacological, dietary, and lifestyle interventions in cardiometabolic disease• Nutritional precision medicine: diet gene, diet microbiome, and diet phenotype interactions• Mechanistic determinants of variability in weight loss, glycemic control, lipid metabolism, and organ specific outcomes• Integrative multi omics and systems biology approaches to metabolic and nutritional response heterogeneity• Methodological innovation for individualized effect estimation and causal inference in nutritional and metabolic research• Translating heterogeneous treatment effect findings into precision nutrition guidelines and stratified therapy frameworks• Cross population generalizability and health equity in precision metabolic and nutritional medicine Topic editors: Filippos Anagnostakis, Ilias Papadimopoulos, Jong-Sang Kim Source: https://www.frontiersin.org/research-topics/83485/determinants-of-heterogeneous-treatment-effects-in-precision-cardiometabolic-medicine