In 2009, I told a Harvard business professor that the Paleo diet was going to become a massive consumer trend. She saw no evidence of that. I left Kansas City for Los Angeles to start the Paleo Foundation and certify foods anyway. The Paleo Foundation became the world's leading certification body for Paleo, Keto, and Grain-Free products.
Before that wave crested, I called keto. Before keto peaked, I was already talking about the microbiome. Before the microbiome became a consumer buzzword, I was telling people that prebiotics would end up on the front of mainstream beverage cans.
In 2020, I told Fred Hart, the founder of Interact, one of the most respected brand and packaging design agencies in the CPG space, that Pepsi would put prebiotics on their cans. He thought I was nuts.
In 2026, Pepsi did exactly that.
When I messaged Fred about it, his reply was: "Well if it isn't the oracle herself! Too bad we don't have a recording of that call. And now you need to put out a 2030 trends prediction piece."
So here it is. But fair warning: my predictions tend to land on a timeline longer than the one I give them. I was four years too early on paleo. Four years too early on keto. At least fifteen years too early on microbiome medicine, since it still hasn't hit as it should and as it will. I have always been wrong about when. To date, I have never been wrong about what.
Microbial metallomics will blow the lid off everything
This is the one I'm most certain about and the one with the longest fuse. The emerging field of microbial metallomics is revealing that heavy metals don't just poison you directly. They reshape your gut microbiome by selecting for metal-resistant, virulence-enabled pathobionts while suppressing beneficial commensals. The damage from heavy metal contamination is worse and more systemic than current toxicology models suggest.
When the microbial metallomics framework gains traction, every conversation about food safety, agricultural practices, supplementation, and chronic disease will shift. The question will move from "are these levels safe for humans?" to "what are these levels doing to the microbial ecosystem that humans depend on?" That question has a much scarier answer.
This is why I built HMTc. The certification infrastructure needs to exist before the demand wave hits. And it's why I built the Microbiome Signatures Database: because the condition-specific patterns need to be formalized before we can understand what metallomics means for each disease.
The sugar scapegoat will fall
This is a twenty-year prediction and it will be controversial.
I think we will eventually look back and realize that sugar was scapegoated. Not that sugar is harmless, but that the obesity epidemic traces back to something more fundamental: specific agricultural practices and contamination driving metabolic changes that hit everyone across all demographics. Down to lab rats on highly controlled diets. Down to our pets. When every species in proximity to the modern food system is getting fatter, the explanation cannot be that they all lack willpower or eat too much sugar. Something systemic is happening and I think metallomics is the lens that will eventually reveal what it is.
I made this argument in 2019 in a research paper that included Stephan Guyenet's data showing sugar and carbohydrate intake declining while obesity continued to rise. The paper argued that fiber deficiency, driven by agricultural and food processing decisions, was the more fundamental issue.
I don't expect this to be a popular position. It won't be popular for a long time. But the data will accumulate and at some point the narrative will shift.
Nickel will become the metal everyone finally pays attention to
The World Health Organization's top priority pathogens, the ones they are most worried about in terms of antibiotic resistance, are all nickel-dependent for their virulence factors. That fact alone should have changed how we think about nickel contamination in the food supply, in the soil, and in clinical contexts. It hasn't yet. It will.
I've been researching nickel's role in microbial pathogenesis for years, particularly in the context of endometriosis. Nickel is an essential cofactor for bacterial ureases, [NiFe]-hydrogenases, Ni-superoxide dismutases, and Ni-glyoxalases, all of which enable pathogens to survive immune attack and colonize inflamed tissue. The host doesn't need nickel for any of these functions. That asymmetry is a therapeutic lever that nobody is pulling yet.
In the coming years, I expect people to start waking up to nickel contamination in soil and diet as a driver of pathogenic selection. This will connect to the broader microbial metallomics framework and it will change how we think about everything from brassica vegetables to municipal water treatment.
Heavy metal profiling will differentiate dementia subtypes
Right now, Alzheimer's, Parkinson's, Lewy body disease, and other neurodegenerative conditions are differentiated primarily by clinical presentation and, in some cases, by imaging or biomarkers that arrive late in the disease course. I see a future where heavy metal profiling becomes a diagnostic tool capable of distinguishing between these conditions earlier and more precisely.
The Parkinson's work I published in the Microbiome Medicine Journal demonstrated that iron dyshomeostasis, neuromelanin composition, and microbial metal handling all converge in ways that are specific to PD pathology. Different dementias have different metallomic signatures. Once we formalize those signatures, heavy metal testing becomes a diagnostic instrument, not just a toxicology screen.
I expect metabolomics to increase substantially as a diagnostic tool within ten years, and heavy metal speciation to become part of the standard workup for neurodegenerative disease within twenty.
Phage cocktails will answer antibiotic resistance
Bacteriophage therapy is not new. It's been used in Eastern Europe for decades. What's new is that Western medicine is running out of options. Antibiotic resistance is accelerating and the pipeline for new antibiotics is nearly dry.
Phage cocktails, tailored combinations of bacteriophages that target specific bacterial species without harming commensals, will become a standard therapeutic tool within the next fifteen years. The specificity of phages is their advantage: instead of carpet-bombing the microbiome with broad-spectrum antibiotics, phage therapy can surgically remove a pathogen while leaving the rest of the ecosystem intact.
This aligns directly with the microbiome signatures approach. If you know which taxa are elevated in a given condition, you can design phage cocktails that target exactly those organisms. The Microbiome Signatures Database is, among other things, a targeting guide for future phage therapy.
Drug repurposing will reshape cancer treatment
The drug repurposing movement is gaining traction but it's fixated on the wrong drugs. Everyone is talking about fenbendazole and ivermectin. Those are fine starting points but they're not the endgame.
I see itraconazole and clotrimazole as far more promising candidates with much easier access. The mechanisms are better understood: hedgehog pathway inhibition and cholesterol transport disruption, both of which have well-characterized roles in tumor biology. I expect terms like "hedgehog pathway inhibitor" and "cholesterol transport inhibitor" to become much more widely spoken in the drug repurposing community within five years.
More broadly, I think the future of drug repurposing involves understanding inter-kingdom relationships in disease. We are going to spend more time looking at how fungi and bacteria interact, how targeting one organism changes the behavior of another, and how the ecological dynamics of the microbiome can be leveraged for therapeutic effect rather than bluntly suppressed.
The Akkermansia rush will produce ugly surprises
Right now everyone is scrambling to sell an Akkermansia muciniphila probiotic. This makes me very nervous. Akkermansia is a mucin-degrading bacterium. In some contexts, it appears protective. In other contexts, mucin degradation is the last thing you want. The idea that there is a universally beneficial probiotic is the same intellectual error that led me to refuse to build a "microbiome-approved" food certification in 2020.
There is no such thing as a universally good anything for the microbiome. What helps one condition can harm another. The Akkermansia rush is going to produce some ugly surprises, and when it does, the companies that were careful about context-specific claims will be the ones still standing.
A lot of the advice given by doctors regarding supplements, prebiotics, and probiotics is going to change in the coming years. The era of blanket recommendations is ending. The era of condition-specific, microbiome-signature-informed interventions is beginning.
Inter-kingdom targeting will change how we treat disease
I wrote about this in my paper on Candida albicans and P. gingivalis. The current approach to infectious disease focuses on the primary causal pathogen. But in many conditions, the pathogen that causes the most damage is not the one that initiated the infection. It's the one that was enabled by the conditions the first pathogen created.
In the future, we're going to develop therapies that target the inter-kingdom relationships between bacteria and fungi, between commensals and pathobionts, between the organisms that create the ecological conditions and the ones that exploit them. This is a fundamental shift from "kill the pathogen" to "reshape the ecology."
Nutritional immunity factors, the host's ability to sequester metals like iron, zinc, and nickel away from pathogens, will become more relevant as diagnostic and therapeutic tools than many of the older methodologies currently in use.
Human-grade pet food will go mainstream
The pet food industry is undergoing the same transformation that human food went through fifteen years ago. Pet owners are reading labels, questioning sourcing, and rejecting products with vague claims. There will be a "Poppi" of pet foods: brands selling human-grade, certified-clean pet food, and the old guard will start to fizzle.
I expect human-grade pet food certified by organizations like ours for heavy metals to move from specialty to mainstream by 2030. The demographic pressure is clear: millennials and Gen Z treat pets as family and will pay for the same standards they demand for their own food.
Anti-aging is the next frontier after microbiome medicine
Microbiome medicine hasn't fully arrived yet. When it does, the next wave will be anti-aging. Not the cosmetic kind. The kind that asks whether the aging process itself can be slowed or modified by interventions targeting the microbiome, the metallome, and the interconnected systems that degrade over time. The tools being built now for microbiome signatures and microbial metallomics will become the foundation of longevity science.
Smart everything for passive biomonitoring
Smart toilets that analyze biological samples. Smart mattresses that gather health data while you sleep. Passive, continuous biomonitoring that doesn't require a clinic visit, a blood draw, or a conscious decision to be tested. The sensors will get cheaper, the AI will get better at interpreting the data, and within fifteen years, the bathroom and the bedroom will be generating more diagnostic information than the annual physical.
3D printing meets AI meets mobile robotics
This is the furthest from my core work but closest to my heart. In 2017, I started watching Chinese universities build small autonomous robots capable of 3D printing in the field. The prototypes were no larger than a foot and a half. I bought over 200 domains at the intersection of 3D printing, AI, and mobile robotics, including Swovee.com and Rovalizer.com. The concept I developed, the SWOVEE Rovalizer, is an AI-powered 3D printing robot that goes to a site, scans the landscape, and prints on location, eliminating the need for massive mobile warehouses and prefabrication facilities.
I got Midjourney to render my first visualization of it in 2023. The tech isn't there yet. But it's getting there faster than most people realize. When autonomous mobile robotics, large-format 3D printing, and on-site AI processing converge, the construction and logistics industries will be unrecognizable.
Alongside that, I see the need for large-scale charging infrastructure for mobile robotics. Not just Tesla Superchargers for cars but charging stations designed for autonomous robots: different form factors, different power requirements, different geographic distribution. Someone will build the "gas station" network for robots. I bought the domains.
Human connection becomes more valuable, not less
In a world where AI can generate content, synthesize research, design products, and even predict trends, the things that AI cannot replicate become more valuable. Human experience. Physical presence. Emotional labor. The ability to say "I took care of 92 cats in a sanctuary in Cyprus" or "I did a DIY fecal transplant in 2012 because no doctor would help me" or "I know what it's like to deal with death and trauma on a daily basis in a rescue operation."
I'm bullish on apps and platforms that bring people together in person. I purchased fiestafriday.org for this reason. I think Meetup.com is going to have its heyday. The pendulum is swinging back from digital isolation toward physical community, and the platforms that facilitate that will thrive.
This is also why I'm telling my story now. I've never been one for personal branding. But right now I'm bullish on getting myself out there as an individual, telling people what I've done, because the human experiences I've accumulated are things a robot cannot claim. That's a competitive advantage that only appreciates over time.
The pattern
I'm always too early. Four years too early for paleo. Four years too early for keto. Fifteen years too early for microbiome medicine. The 3D printing robot is probably twenty years from being real. The sugar scapegoat thesis might take just as long.
But I have never been wrong about direction. Not once. And everything on this list is moving in the direction I've described. The only question is how fast.
If your organization needs to know what's coming and you'd rather hear it from someone with a documented track record than someone with a trend report, you know where to find me.
