Decoding #healthtech
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23 December 2022
ZOE
© ZOE

Let food be thy medicine: charting the success of nutrition startup ZOE

The nutrition and health startup is riding high following a record-breaking Crowdcube campaign, a funding round valuing the company at more than £200M, and a current waitlist of 250,000. Max Lunn hears a different side of the story from cofounder George Hadjigeorgiou, however, whose main interest is to make people feel alive.

ZOE is on a roll. The nutrition startup, founded out of London and Boston by a team including the Kings College London epidemiologist Tim Spector, first made a name for itself during the pandemic when its self-reporting Covid app went viral. Due to its exponential uptake, reaching 1M+ downloads in just a few days, the app was able to track virus symptoms more accurately than the NHS; a remarkable example of a community coalescing around a common cause. The app provided early clues into how the virus operated, crucial for updating global healthcare guidance in the early chaos of the pandemic.

Now, in a difficult funding environment, ZOE has raised £25M from institutional investors, an equity investment that reportedly values the company at £209M. Given its community focus, ZOE also decided to bring individuals into its investor journey by means of a Crowdcube. Speaking to cofounder George Hadjigeorgiou earlier this week after the campagin closed with over £7M raised – 773% of their original target –  he tells me the 13K+ investors have made this the third-most participated in Crowdcube ever, behind fintech titans Monzo and Moneybox. The campaign was also significant as it included the most female investors to participate in a crowdfund campaign to date.

Since the pandemic, ZOE has turned its attention back to its original mission: using self-reporting tech to deliver highly personalised nutrition insights to users. Using data at a scale not previously realised in nutrition, their central belief is that we all react differently to the same foods – meaning only data can give us the key to unlock our heath. Zoe’s product is an at-home test kit which measures your gut microbiome, blood sugar and fat levels through a stool sample, glucose monitor and pinprick test respectively. Customers then get personalised insights, and access to the app to help build a nutrition plan.

Unusually, ZOE has its origins in twins – tens of thousands of them. Twins were Spector’s chosen field of study, where he first realised how differently identically people could react to certain goods. Human beings, genetically speaking, are unusually similar, sharing 99.7 per cent of genetic variation.

However – this level of similarity doesn’t extend to our gut: we have just 25 per cent of our gut microbiome in common with one another. Spector’s research has shown that even identical twins — who share genes and upbringing, nature and nurture — often have completely different reactions to the same food. In his latest book, Food for Life: The New Science of Eating Well, Spector writes, ‘we are all unique. No perfect diet or correct way to eat will work for everyone.’ ZOE’s quest to give personalised insights is therefore a response to these findings.

Along with Spector, the other ZOE cofounders are data science leader Jonathan Wolf and entrepreneur George Hadjigeorgiou. Hadjigeorgiou tells me the work ZOE did in the pandemic typifies their community-centric approach more broadly: galvanising huge numbers of people to come together for a common health goal. Hadjigeorgiou explains that ZOE’s mantra is ‘food is medicine’ and by approaching it more purposively, the results can be transformational. Hadjigeorgiou’s own experience with ZOE tallies with what many others have found: it works. He tells me he that following the testing, insights and nutrition plan he significantly lowered his cholesterol and lost weight.

So what does ZOE’s product actually consist of? It starts with an at-home test kit, where you monitor your blood sugar, fat levels and microbiome. The data is then fed into an algorithm based on ZOE’s PREDICT research that takes into account your test results and questionnaire answers, and calculates how well you respond to fats and carbohydrates, as well as the impact food will have on your gut health. You then receive a detailed report comparing your results to thousands of other people, which uses machine-learning to generate your personal ZOE scores for each and every food in their database. This finally results in a personalised nutrition program built around your gut health and metabolism.

I ask Hadjigeorgiou why ZOE was able to find such spectacular success in the nutrition space. It all has to do with the poor quality of studies and connected lack of investment he points out, saying that typically nutrition studies of this type had only involved tens of participants and nutrition was a broadly underfunded area. Aside from making use of the Twins Study, ZOE’s PREDICT 1 and PREDICT 2 Studies are what laid the groundwork to develop the algorithm which succinctly coordinates each user’s nutrition program. These two studies involved 2,306 participants, and ZOE now claims to have fifty thousand members contributing to the advancement of their science.

Hadjigeorgiou makes clear him and his cofounders did this ‘the hard way’ – by investing heavily early on, and using the science as a starting point to build a product from – not the other way round. These values seems to characterise the cofounders: George tells me his intent when founding ZOE was to do something with impact. Recounting a Greek holiday he took with now cofounder – then friend and colleague –  Jonathan Wolf in 2016, after they had both exited their previous businesses where the seed of an idea took hold, Hadjigeorgiou then fills me in on the name:

ZOE means life – reflective of this vision of a world we have where people are not just alive – barely alive – ticking along, but one where they live life – they live life every second, every day of the week.

Given their own emphasis on impact and community, it’s fitting to question what concrete steps ZOE is taking to create a company that engages widely and accessibly. ZOE isn’t cheap: you can expect to spend £570 for the test kit and 12 months of further support. This isn’t wildly out of kilter with similar products, and given their waitlist totals 250,000 it won’t affect profitability.

Hadjigeorgiou stresses two core facets of ZOE’s community engagement: the science sharing and the podcast. ZOE ensures that it publicly releases its key breakthroughs, which are published in peer-reviewed journals. Here’s one example from Nature. The ZOE podcast is also huge, topping various nutrition and health podcast charts on Spotify and Apple for its reach. ZOE is also currently conducting the largest ever study into intermittent fasting – the ‘Big IF Study – the results of which will be made public.

Although I’m keen to ask how ZOE is innovating, Hadjigeorgiou starts by emphasising that the product is working well: users everywhere are becoming healthier. A recent survey found an 84% success rate, defined by feeling healthier overall with standout symptoms including more energy and less bloating.

Inevitably, interoperability is on the horizon: integrating the data collection with smartwatches and other hardware would create less faff than having a glucose monitor in your arm for 14 days. Hadjigeorgiou also gestures to a future where ZOE is offered to citizens by public health organisations as a kind of preventative prescription – stopping obesity and heart disease in their tracks – but is keen to point out this won’t happen for decades.

But it’s hyper-personalisation ZOE is focusing in on the short-term. Condition-focused plans are in the pipeline are, so users can input if they are going through menopause or have high blood pressure. There will be a much greater understanding of lifestyle and an attempt to understand personal relationships with food to offer realistic plans. ZOE wants to instantly tell you exactly what you eat when you walk into a Pret for lunch – ‘like having Tim Spector in your pocket’, Hadjigeorgiou says.

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