ZOE Personalized Nutrition Review: Pros, Cons, and How It Works

What Is ZOE?

ZOE is a company that analyzes your gut microbiome, blood fat, and blood sugar responses to help manage your weight and optimize your long-term health.

The company was born out of a desire to unlock the power of science for everybody and give everyone the ability to understand their body’s unique biology.

ZOE combines clinical studies with machine-learning technology (AI), microbiome sequencing, and scientific collaboration to help with this goal.

This program can be used for weight loss, but it is also for people who want to learn more about optimizing their health.

How It Works

ZOE uses your blood sugar response, fat response, and gut microbiome makeup to guide food choices that reduce dietary inflammation, work with your metabolism, and improve your gut health.

By choosing ZOE, you can also opt in to be a part of their ongoing clinical studies.

If you consent to be in the trial and are eligible, you will receive a continuous glucose monitor (CGM). If not, the ZOE app will have alternative instructions for some days during the testing period.

ZOE is not for people who are underweight, currently pregnant, or have a chronic gut disease.

ZOE is only available on iOS (Apple) systems, but they are working to be available on Android.

Once you’ve purchased your ZOE kit, you receive a CGM, a gut health testing kit, a food scale, and three sets of test muffins.

Over 14 days, you will eat clinically tested muffins, send in blood fat and gut health tests samples, experiment with foods to learn how they affect your blood sugar, and learn about metabolism in short lessons.

After your initial 14 days, you will continue to learn information about nutrition and metabolism until you get your laboratory results and insights.

The insights will review your blood sugar response, blood fat response, and the composition of your gut bacteria.

You will learn about ZOE’s food scores, which are tailored to guide you in your food choices towards foods that work with your gut and metabolism.

Finally, after you receive your insights, you can use the ZOE Insights app for four months to get more information about foods that work with your body, receive a 4-week personalized eating plan, and get immediate feedback on the meals you eat.

When signing up for your test kit, can also purchase access to additional coaching to provide accountability and give guidance for your meal choices.

My Experience with ZOE

I got the opportunity to try the ZOE test process myself, so I want to share my experience.

The ordering process was pretty simple. I had to be eligible for and consent to join ZOE’s ongoing clinical trials to use a continuous glucose monitor during my ZOE test.

The box with all of my testing supplies came in about two days after I made my order.

The kit contained a Libre Freestyle 14-day continuous glucose monitor (CGM), a gut health testing kit, a food scale, and three sets of test muffins.

To go along with the items in the test kit, I was required to download the free ZOE Test app onto my phone. From there, I used the test app to scan a code on my box to “activate” my ZOE experience.

It gave clear instructions on what to do with my items, such as freeze my test muffins and select a date to start my 14-day testing period.

Most days had a short, 2 to 3-minute long lesson about the ZOE method and nutrition from then on. I was surprised at how informative these lessons were and appreciated them focusing on metabolic processes instead of weight loss.

There were also daily tasks to complete during the 14-day test period. Tasks were rated to be from very easy to medium in difficulty.

Day 1

On my first day, I had to set up my CGM.

The ZOE Test app had instructions on placing the CGM and setting up your readings on the corresponding CGM app. I used the LibreLink app with a login provided by ZOE.

Placing a CGM on my arm for the first time was a bit intimidating, but it went well, and my arm was only a little bit sore.

Day 2

On the second day, I did my gut health test and was able to send it off quickly. I also prepared for my first day of muffins.

Day 3

This day was a bit rough. The day was very time-consuming because I had to eat two sets of muffins and perform a blood test at specific times.

The first pair of test muffins had the nutritional equivalent to an average muffin and were followed by a 4-hour fast.

The second pair of muffins, the metabolic challenge muffins, were standardized muffins meant to be high in calories, sugar, and fat. After eating those muffins, I had to fast for another 2 hours.

The muffins didn’t taste bad, but it got tiring having the same thing for breakfast and lunch.

That day I also had to do my blood sample, which was somewhat difficult because it took a while for me to get enough blood for the sample.

By the end of the testing, I felt “the crash” and had to lay down and eat something to feel better. The process felt like an all-day affair despite the reported task time of 50 minutes.

Day 4

I was grateful to be on my last day of muffins, which was another pair of standard muffins for breakfast.

After that, I could log my own meals and check my blood sugar in response to the meals.

All of my foods had to be carefully measured or weighed before eating, which was a new experience for me.

Days 5–7

These days were very simple. I had short lessons daily and was given a grocery list of options for the food experiments on the following days.

During these days, it was highly encouraged by the app to check my blood sugar with meals, which was indeed a fun experience.

Days 8–13

These days were about showing principles that could optimize your blood sugar response – eating high carb foods alone, eating high protein and fat-containing foods, the impact of sequencing protein and fats before carbohydrates, exercising after a meal, and so on.

These days were optional but very informative for daily eating.

The standardized foods experiments got a bit tiring because they were repetitious and somewhat bland.

For example, my standardized foods were things like plain bagels, plain yogurt, and three tablespoons of peanut butter for several days.

Days 12 and 13 were dedicated to flattening my blood sugar curve using the principles covered in previous days.

These days were pretty easy as I logged my own food and exercise and checked my blood sugars.

Day 14

The last day was bittersweet. It was the end of my 14-day CGM, and I was happy to be done with testing foods and having to wait for a certain number of hours before eating foods.

On the other hand, I had become used to the CGM and enjoyed seeing how my blood sugar reacted to certain foods.

I now know that chips of any sort cause my blood sugar to spike, even more than eating plain bread or dried fruit!

Testing Results

About six weeks after sending in your gut and blood samples, ZOE emails you an Insights report detailing your dietary inflammation profile and logged meal results, as well as a gut health report.

You are given scores for each of your results, calculated by comparing your data to other ZOE test users in their clinical studies.

The Insights report gives you a score for your blood sugar control, blood fat control, and food scores based on your biology.

The Gut Health report informs you of the diversity in your gut microbiome, the ratio of good to bad bacteria in the gut, the relative abundance of 15 beneficial and 15 harmful bacteria present in your sample, and the presence of a beneficial parasite (Blastocystis).

Both reports tie into the ZOE Insights app, which you can use to guide your dietary choices through their food scores.

ZOE food scores are based on a combination of predicted blood sugar response, blood fat response, and gut health impact and range from 0–100 (100 being an excellent food).

My Results

I wasn’t too surprised at what I saw when I got my results, but the reports were interesting.

The ZOE report stated that my blood sugar control was excellent, even compared to people my age. This aligned with the readings I’d gotten while wearing the CGM, which were usually in a low to normal range.

My blood fat control was good and similar to other people of my age and sex. I’ve had other family members struggle with managing their blood fats, so I was happy to know that I didn’t have that problem.

My overall gut health score wasn’t the best, but I also expected that. I’d been having some out-of-the-ordinary poops that week, and I had a feeling that my gut health score would reflect that.

Overall, my gut bacteria diversity was average, and some of my “bad” bacteria were higher than average.

One thing that was fascinating about my gut health results was that I had a significantly higher relative abundance of Prevotella copri (nicknamed Peter) in my gut compared to others (25.612% vs. 3.929%).

This bacteria strain is associated with higher insulin sensitivity and a non-Westernized diet. Considering how my blood sugars were frequently hovering around the 70s, I think the bacteria were doing their job in helping control my blood sugars. (1, 2)

My test results also showed that many strains of good and bad bacteria weren’t present in my gut.

In my results, I also got some food scores from the foods I had eaten. The foods that gave me the lowest scores were typically either high-carb or primarily simple carbs low in fiber.

One area the ZOE program focuses on is blood glucose control, so it made sense that foods that may spike blood sugar are naturally rated lower.

From this experience, I want to continue focusing on eating foods that are good for my gut to have good bacteria diversity and a healthy gut microbiome.

Evaluation of ZOE Test

Research and clinical study are central to the protocol behind ZOE.

Scientists from Massachusetts General Hospital, the Harvard T.H. Chan School of Public Health, Stanford Medicine, and King’s College London collaborate on ZOE’s PREDICT studies.

Research suggests that our postprandial (post-meal) blood sugar and blood fat responses may impact the development of metabolic diseases.

Postprandial hyperglycemia or spikes in blood sugar may increase the risk of oxidative stress and disease development. (3)

Having elevated triglycerides after meals is also a risk factor for cardiovascular disease. (4)

Research is unclear whether a diet that causes a low glycemic response can improve weight loss compared to a diet with high glycemic index foods. (5)

In the PREDICT 1 (personalized responses to dietary composition) study published in 2020, researchers used standardized muffins (the muffins used in ZOE) to measure triglyceride, blood sugar, and insulin responses. (6)

From those responses and machine learning, the ZOE team determined that metabolic responses differ from person to person, even between twins.

They also learned that for each person, post-meal responses are consistent enough that one can predict metabolic responses to other foods.

The ability of ZOE to promote weight loss was not considered in this app due to the study being focused on metabolic responses.

The researchers behind ZOE recently finished the PREDICT 2 study in March 2020, consisting of 1,200 volunteers across the United States.

At the time of writing, the results from the PREDICT 2 study have not yet been published.

Their research continues with the PREDICT 3.1 study, the clinical study I participated in while trying out ZOE. The study covers the first seven days of the ZOE experience and test muffins.

These studies have helped design and validate the ZOE at-home test kits, and inform the food scores used in the ZOE Insights app.

Sustainability

ZOE is easy to follow. The ZOE apps give well-detailed information and daily reminders to keep you on track.

The day full of test muffins is a bit time-consuming and may not be easy to do on a workday, so some schedule adjustments may be needed.

ZOE recommends that people measure and weigh all of the foods they eat to improve the accuracy of their food scoring, which can be cumbersome.

As a person who doesn’t weigh food, this was a step that took extra time and effort to incorporate into the program.

This step may not be sustainable for people if they intend on using the ZOE Insights app for the entire four months to get feedback on their meals.

The ZOE app does not eliminate any food groups during its testing process or when giving nutrition recommendations.

There are specific foods that should be eaten during the testing process, but you do have the freedom to choose other foods for non-test meals.

When using the ZOE Insights app, they will note foods that should be enjoyed freely, in moderation, or only once in a while.

While following the ZOE nutrition recommendations, your goal is to create meals that will give you a food score of 75 or higher.

This can be achieved by different food combinations, so you don’t have to feel limited in your food choices.

Accountability

ZOE offers two levels of accountability after you’ve completed your testing and received your reports.

Purchasing the ZOE test kit gives you access to the ZOE Insights app for four months.

The app allows you to log your food, get feedback on your meals, and learn what foods may benefit your body the most.

After receiving your ZOE test kit results, the standard plan gives you access to six hours of one-to-one support and guidance from a ZOE health coach.

Coaches are available through video chats and text communication through the ZOE Insights app.

These coaches have a minimum of a bachelor’s degree in nutrition science and give guidance to help you eat according to your ZOE results.

However, they are only available for general wellness and cannot address medical conditions that affect your intake, allergies, food intolerances, or medication interactions.

If you would like more extended support and nutrition guidance from ZOE, you can choose a subscription plan to extend your coaching with a ZOE coach when purchasing your test kit.

Value for the Price

The ZOE at-home test kit contains the gut microbiome test, blood sugar, and fat test, test results and insights, access to the ZOE Insights app for four months, a 4-week personalized plan to help you “eat for your body,” and 6 hours of one-to-one guidance from a ZOE health coach.

The ZOE test kit is $294 and can be paid in 6 monthly installments of $49 per month.

When purchasing your test kit, you can add a program membership for continued support from a ZOE health coach. This subscription starts when you receive your test kit results, and it is automatically renewed based on the length of your subscription selection.

The longer you remain on the program, the cheaper the monthly cost will be:

• 1 month: $59/month
• 4 months: $39/month
• 12 months: $29/month

All ZOE sales are final and may not be canceled unless the order has not been prepared yet, which is a window of 24–48 hours after order completion.

It is well priced for providing laboratory testing and results, a 4-week personalized plan, and short-term access to an app that can provide feedback on your foods.

The additional coaching is reasonably priced, especially if you sign up for a year-long subscription.

It is more costly than some other diet programs that offer monthly coaching, but the coaching offered through ZOE is based on your individual testing results and metabolic responses. This adds extra value to ZOE’s coaching program.

Safety

The ZOE program appears to be overall safe and clinically tested.

The metabolic test muffins contain high amounts of carbohydrates, which can result in postprandial reactive hypoglycemia, or a sugar crash. (7)

Symptoms of a sugar crash may include hunger, anxiety, headaches, fatigue, discomfort, dizziness, shakiness, excessive sweating, and irritability.

The greatest risks come from having to do at-home gut testing and blood tests. Because you are handling blood and poop, it is imperative to follow precautions for cleanliness and the handling of these samples.

After placement of a CGM, potential side effects include local redness, local infection, inflammation, pain, bruising, itching, scarring, bleeding at the insertion site, skin discoloration, hematoma, and irritation secondary to the adhesive. (8)

Individuals may experience some finger pain after doing a finger prick for the blood sample. (9)

The ZOE test muffins are dairy-free and do not contain gluten, though they are not certified gluten-free. They contain egg ingredients (egg whites), and the muffins have been produced in a facility that handles major allergens.

How ZOE Compares to Alternatives

Personalized nutrition based on lab results is becoming increasingly popular.

ZOE is unique because it is a nutrition personalization service that considers blood sugar, blood fat response, and gut health for optimal health.

The lab testing and standardized protocols give added value to recommendations.

After receiving your results, the continued support and health coaching are also good features offered by ZOE.

ZOE’s blood glucose monitoring is only for a short period of time (14 days), and the rest of the ZOE program depends on algorithms that try to align with your body’s metabolism.

A few companies offer long-term monitoring of glucose through the use of CGMs.

Signos and NutriSense are two of these companies.

In addition to a CGM, NutriSense also includes counseling from a registered dietitian, who may provide more tailored nutrition recommendations.

If you’re only looking to focus on gut health, Ombre not only tests your gut microbiome, they provide individualized probiotic supplements to support your gut health.

Thorne is another brand that offers gut health testing as one of its products.

Brands like Viome focus on both gut microbiome and gene expression to evaluate your health.

Even if you don’t use a program like ZOE, there are ways that you can improve your gut health and eat foods that support a healthy metabolism.

Eating foods containing probiotics and prebiotics support a diverse and healthy gut microbiome.

There are many ways to eat healthy to support healthy blood fat and blood sugar responses.

Eating patterns such as the Mediterranean Diet, DASH Diet, or even having a plant-based diet can support your overall health.

Frequently Asked Questions

The Bottom Line

ZOE is a company that uses your individual gut, blood fat, and blood sugar responses to help you understand your metabolism for managing your weight and long-term health.

While some parts of ZOE may be time-intensive and repetitive, the insights you get from the testing and education makes this product worth it.

ZOE is not just for people interested in a new way of approaching weight loss, but it’s for anyone who wants to learn more about the science of how their body works.

According to the eligibility criteria for ZOE, this program is not for people with existing chronic gastrointestinal conditions such as ulcerative colitis, Crohn’s disease, or celiac disease.

If you have any health concerns that may require a particular diet, I recommend speaking to a doctor before implementing any ZOE recommendations.