Savor Health is dedicated to helping cancer patients and their loved ones by offering virtual, expert nutritional guidance on demand. We chatted with founder and CEO Susan Bratton to find out more.
The core of the business is an AI-based expert system that combines proprietary intake, clinical decision support, and matching algorithms, with a proprietary database of more than 52,000 unique, evidence-based nutrition interventions.
This powers a virtual nutrition assistant named Ina® (an acronym of Intelligent Nutrition Assistant). Ina® and the expert platform are designed to replicate the knowledge, logic, and thinking of an oncology-credentialed dietitian. This helps to bridge the access gap created by a shortage of dietitians, which has resulted in 80% of patients never even seeing one.
What we’re doing is using AI machine learning and expert knowledge to deliver a “dietitian in your pocket” to people when they’re having symptom-related issues during their cancer treatment.
It’s highly personalized and the interventions are based on both clinical and contextual variables. It’s also based on where the patient is at in their treatment journey.
A patient could query Ina® and ask for an easy-to-prepare recipe that won't irritate mouth sores, or for a list of foods that won’t exacerbate diarrhea. The beauty of the platform is that we start out with a profile that the patient provides to us, then we base our personalized interventional guidance on this.
This is nutrition as symptom management, so we’re addressing symptoms of cancer with nutrition as an interventional lever. There’s a growing body of evidence that shows this can improve survival, reduce symptom burden, and prevent costly ER visits and inpatient admissions.
I lost a friend to glioblastoma (an aggressive brain tumor) in 2009. I quit my job in 2010 to start the company, and then my dad was diagnosed with terminal cancer. I spent six months with him – he is still alive.
I started officially working on Savor Health in 2011. I wrote a business plan and hired people in 2012. We built our website and our algorithms. Then, in 2013, we launched the first direct-to-consumer, medically tailored meal delivery service for cancer patients.
We essentially began life in the meal delivery business. What we found was that our lifetime value was topping out at five weeks. When we looked at why that was, we found it wasn't the cost or quality, it was psychology.
Almost all of our patients said that meal delivery to them signified a loss of independence and control. What they wanted was to be empowered with information and resources that could give them back that control, allowing them to remain independent, and to do something that could have an impact on their outcome.
When everything in our cancer patients’ world is spinning out of control, one of the few things they can control is what they eat. And that's an empowering feeling when you just feel so lost.
We took the next 18 months to expand the algorithms and build the database that collectively became our AI-based expert platform, which was launched in August 2019.
Cancer in itself, and certain tumors, are highly metabolic. They’re fast-growing, and what that means is the energy expenditure within the body will cause weight loss.
We always think about cancer patients as having lost a lot of weight. This is one way that cancer causes nutritional issues, such as malnutrition. Interestingly, nine out of 10 non-terminal cancer patients have addressable nutritional issues before they even start treatment.
When they do start treatment, inevitably they develop treatment-related symptoms. I think it’s fair to say that all cancer patients experience side effects of their cancer and its treatment.
Then there are treatment-related issues. With chemotherapy, platinum-based therapies can cause changes in taste; specifically, often food tastes like aluminum. To mitigate this, patients can eat with plastic cutlery rather than metal cutlery.
Other chemotherapies cause a complete lack of taste or make food taste like sandpaper. Patients can develop mouth sores, and sores up and down the GI tract, which cause diarrhea. Immunotherapy, radiation, and surgery all have their own set of cancer nutrition or symptom-related issues.
Research shows two things: firstly there is a correlation between being overweight and obese and developing certain cancers. Inflammation is also considered a risk factor.
Additionally, research shows a correlation between high levels of consumption of red and processed meats and an increased risk of developing colorectal cancer. Excess alcohol consumption is shown to increase the risk of cancers of the throat, the colon, and the GI tract.
I think as time goes on we're going to find out more about why certain foods and certain conditions are related to the development of cancer. I think technology can have an incredible impact on understanding nutrition's role in the development, progression, treatment, and hopefully, the prevention of recurring cancer.
Our business model has been B2B and we’ve focused primarily on pharmaceutical companies offering it to their patients for free alongside their drugs to improve adherence, reduce dose reductions and treatment suspension, and extend survival.
Now we’re focusing on healthcare insurance companies. Oncologists are a logical place to go but the problem is, from an economic perspective, it's like going directly to the consumer.
The cost to acquire a customer is significant, whereas, with aggregators such as pharmaceutical and health insurance companies, and patient advocacy groups, the cost per new user is less.
There’s no “typical” nutrition plan for cancer patients, and that is the value of our platform. Every person has their own set of medical conditions, issues, and medications, as well as context such as what they actually like to eat.
That said, there are certain fundamental “truths” that form the foundation of a healthy diet and then from there we customize according to each patient’s unique clinical and contextual parameters.
As an example, the principles of the Mediterranean diet, which include consuming fruits and vegetables, whole grains, legumes, lean protein, and even a little bit of red wine, is considered healthy – resulting in healthy caloric intake, low inflammation, and high nutrient value.
These principles can be applied to the dietary patterns within a specific culture, such as what would be considered the typical Japanese or Chinese diet.
The end goal is to have low inflammation. From this point, we’ll personalize the diet to address patient-specific symptoms or caloric needs. We look at underlying medical conditions such as kidney disease and diabetes.
We also look at the medications and ensure we don't have any food/drug interactions, or any sort of contra-indications. Very importantly, we look at intent – what do they want to eat right now?
Our goal is to help patients survive cancer and minimize the severity of their symptoms. We need to find both clinically and contextually appropriate solutions for them to meet their unique needs.
Many variables impact the development of cancer. I do think diet and nutrition contribute. We’ve completely polluted our food supply – we eat highly processed foods which result in obesity.
So excess calories is one reason. In addition, the quality of the calories we take in has deteriorated with the emergence of processed foods that are inflammatory and low in nutrient value.
People do not exercise enough and stress levels are high. Pesticides are also huge contributors. We do need more information but primarily obesity, excess alcohol, lack of exercise, stress, and exposure to environmental carcinogens all contribute to the development of cancer.
Our proof-of-concept disease state was cancer, but we have built – and will soon launch – nutrition-as-intervention and support for other diseases, including diabetes and heart disease. I believe that evidence-based nutrition should be a standard of care that's incorporated into the treatment guidelines for all diseases, beginning in oncology.
We can build the evidence that will enable us as a society to ultimately use nutrition as an interventional lever. There's a lot that has to happen but we are laying out the scientific research roadmap so we can get from here to there. Hopefully, we can help people do better with whatever medical condition they have.