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Ulusoy-Gezer HG, Rakıcıoğlu N. The Future of Obesity Management through Precision Nutrition: Putting the Individual at the Center. Curr Nutr Rep 2024; 13:455-477. [PMID: 38806863 PMCID: PMC11327204 DOI: 10.1007/s13668-024-00550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF REVIEW: The prevalence of obesity continues to rise steadily. While obesity management typically relies on dietary and lifestyle modifications, individual responses to these interventions vary widely. Clinical guidelines for overweight and obesity stress the importance of personalized approaches to care. This review aims to underscore the role of precision nutrition in delivering tailored interventions for obesity management. RECENT FINDINGS: Recent technological strides have expanded our ability to detect obesity-related genetic polymorphisms, with machine learning algorithms proving pivotal in analyzing intricate genomic data. Machine learning algorithms can also predict postprandial glucose, triglyceride, and insulin levels, facilitating customized dietary interventions and ultimately leading to successful weight loss. Additionally, given that adherence to dietary recommendations is one of the key predictors of weight loss success, employing more objective methods for dietary assessment and monitoring can enhance sustained long-term compliance. Biomarkers of food intake hold promise for a more objective dietary assessment. Acknowledging the multifaceted nature of obesity, precision nutrition stands poised to transform obesity management by tailoring dietary interventions to individuals' genetic backgrounds, gut microbiota, metabolic profiles, and behavioral patterns. However, there is insufficient evidence demonstrating the superiority of precision nutrition over traditional dietary recommendations. The integration of precision nutrition into routine clinical practice requires further validation through randomized controlled trials and the accumulation of a larger body of evidence to strengthen its foundation.
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Affiliation(s)
- Hande Gül Ulusoy-Gezer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sıhhiye, Ankara, Türkiye
| | - Neslişah Rakıcıoğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sıhhiye, Ankara, Türkiye.
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Taylor CA, Madril P, Weiss R, Thomson CA, Dunton GF, Jospe MR, Richardson KM, Bedrick EJ, Schembre SM. Identifying the Leading Sources of Saturated Fat and Added Sugar in U.S. Adults. Nutrients 2024; 16:2474. [PMID: 39125354 PMCID: PMC11314151 DOI: 10.3390/nu16152474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/20/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
The 2020-2025 Dietary Guidelines for Americans recommend limiting intakes of saturated fat and added sugars (SF/AS) to <10% total energy. Data-driven approaches to identify sources of SF/AS are needed to meet these goals. We propose using a population-based approach to identify the leading food and beverage sources of SF/AS consumed by US adults. Foods and beverages reported as consumed were assessed from two, 24 h dietary recalls (24HRDR) from 36,378 adults aged 19 years and older from the 2005-2018 National Health and Nutrition Examination Survey. Intakes of SF/AS were aggregated across both 24HRDR to identify What We Eat in America food categories accounting for ≥90% of SF/AS, respectively, by the total population and within population subgroups. Data were weighted to estimate a nationally representative sample. Ninety-five discrete food categories accounted for ≥90% of the total SF/AS intakes for >88% of the representative sample of U.S. adults. The top sources of SF were cheese, pizza, ice cream, and eggs. The leading sources of AS were soft drinks, tea, fruit drinks, and cakes and pies. This analysis reflects a parsimonious approach to reliably identify foods and beverages that contribute to SF/AS intakes in U.S. adults.
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Affiliation(s)
| | - Peter Madril
- School of Health and Rehabilitative Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Rick Weiss
- Viocare, Inc., Princeton, NJ 08542, USA;
| | - Cynthia A. Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90039, USA;
| | - Michelle R. Jospe
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA;
| | - Kelli M. Richardson
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ 85721, USA;
| | - Edward J. Bedrick
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Susan M. Schembre
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA;
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Bermingham KM, Linenberg I, Polidori L, Asnicar F, Arrè A, Wolf J, Badri F, Bernard H, Capdevila J, Bulsiewicz WJ, Gardner CD, Ordovas JM, Davies R, Hadjigeorgiou G, Hall WL, Delahanty LM, Valdes AM, Segata N, Spector TD, Berry SE. Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial. Nat Med 2024; 30:1888-1897. [PMID: 38714898 PMCID: PMC11271409 DOI: 10.1038/s41591-024-02951-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/26/2024] [Indexed: 05/15/2024]
Abstract
Large variability exists in people's responses to foods. However, the efficacy of personalized dietary advice for health remains understudied. We compared a personalized dietary program (PDP) versus general advice (control) on cardiometabolic health using a randomized clinical trial. The PDP used food characteristics, individual postprandial glucose and triglyceride (TG) responses to foods, microbiomes and health history, to produce personalized food scores in an 18-week app-based program. The control group received standard care dietary advice (US Department of Agriculture Guidelines for Americans, 2020-2025) using online resources, check-ins, video lessons and a leaflet. Primary outcomes were serum low-density lipoprotein cholesterol and TG concentrations at baseline and at 18 weeks. Participants (n = 347), aged 41-70 years and generally representative of the average US population, were randomized to the PDP (n = 177) or control (n = 170). Intention-to-treat analysis (n = 347) between groups showed significant reduction in TGs (mean difference = -0.13 mmol l-1; log-transformed 95% confidence interval = -0.07 to -0.01, P = 0.016). Changes in low-density lipoprotein cholesterol were not significant. There were improvements in secondary outcomes, including body weight, waist circumference, HbA1c, diet quality and microbiome (beta-diversity) (P < 0.05), particularly in highly adherent PDP participants. However, blood pressure, insulin, glucose, C-peptide, apolipoprotein A1 and B, and postprandial TGs did not differ between groups. No serious intervention-related adverse events were reported. Following a personalized diet led to some improvements in cardiometabolic health compared to standard dietary advice. ClinicalTrials.gov registration: NCT05273268 .
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Affiliation(s)
- Kate M Bermingham
- Department of Nutritional Sciences, King's College London, London, UK
- Zoe Ltd, London, UK
| | - Inbar Linenberg
- Department of Nutritional Sciences, King's College London, London, UK
- Zoe Ltd, London, UK
| | | | - Francesco Asnicar
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | | | | | | | | | | | | | | | - Jose M Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
- IMDEA Food Institute, Campus of International Excellence, Universidad Autónoma de Madrid, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- Universidad Camilo José Cela, Madrid, Spain
| | | | | | - Wendy L Hall
- Department of Nutritional Sciences, King's College London, London, UK
| | - Linda M Delahanty
- Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ana M Valdes
- School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham National Institute for Health and Care Research Biomedical Research Centre, Nottingham, UK
| | - Nicola Segata
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Tim D Spector
- Department of Nutritional Sciences, King's College London, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, London, UK.
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Antwi J. Precision Nutrition to Improve Risk Factors of Obesity and Type 2 Diabetes. Curr Nutr Rep 2023; 12:679-694. [PMID: 37610590 PMCID: PMC10766837 DOI: 10.1007/s13668-023-00491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE OF REVIEW Existing dietary and lifestyle interventions and recommendations, to improve the risk factors of obesity and type 2 diabetes with the target to mitigate this double global epidemic, have produced inconsistent results due to interpersonal variabilities in response to these conventional approaches, and inaccuracies in dietary assessment methods. Precision nutrition, an emerging strategy, tailors an individual's key characteristics such as diet, phenotype, genotype, metabolic biomarkers, and gut microbiome for personalized dietary recommendations to optimize dietary response and health. Precision nutrition is suggested to be an alternative and potentially more effective strategy to improve dietary intake and prevention of obesity and chronic diseases. The purpose of this narrative review is to synthesize the current research and examine the state of the science regarding the effect of precision nutrition in improving the risk factors of obesity and type 2 diabetes. RECENT FINDINGS The results of the research review indicate to a large extent significant evidence supporting the effectiveness of precision nutrition in improving the risk factors of obesity and type 2 diabetes. Deeper insights and further rigorous research into the diet-phenotype-genotype and interactions of other components of precision nutrition may enable this innovative approach to be adapted in health care and public health to the special needs of individuals. Precision nutrition provides the strategy to make individualized dietary recommendations by integrating genetic, phenotypic, nutritional, lifestyle, medical, social, and other pertinent characteristics about individuals, as a means to address the challenges of generalized dietary recommendations. The evidence presented in this review shows that precision nutrition markedly improves risk factors of obesity and type 2 diabetes, particularly behavior change.
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Affiliation(s)
- Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, USA.
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Höchsmann C, Yang S, Ordovás JM, Dorling JL, Champagne CM, Apolzan JW, Greenway FL, Cardel MI, Foster GD, Martin CK. The Personalized Nutrition Study (POINTS): evaluation of a genetically informed weight loss approach, a Randomized Clinical Trial. Nat Commun 2023; 14:6321. [PMID: 37813841 PMCID: PMC10562431 DOI: 10.1038/s41467-023-41969-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023] Open
Abstract
Weight loss (WL) differences between isocaloric high-carbohydrate and high-fat diets are generally small; however, individual WL varies within diet groups. Genotype patterns may modify diet effects, with carbohydrate-responsive genotypes losing more weight on high-carbohydrate diets (and vice versa for fat-responsive genotypes). We investigated whether 12-week WL (kg, primary outcome) differs between genotype-concordant and genotype-discordant diets. In this 12-week single-center WL trial, 145 participants with overweight/obesity were identified a priori as fat-responders or carbohydrate-responders based on their combined genotypes at ten genetic variants and randomized to a high-fat (n = 73) or high-carbohydrate diet (n = 72), yielding 4 groups: (1) fat-responders receiving high-fat diet, (2) fat-responders receiving high-carbohydrate diet, (3) carbohydrate-responders receiving high-fat diet, (4) carbohydrate-responders receiving high-carbohydrate diet. Dietitians delivered the WL intervention via 12 weekly diet-specific small group sessions. Outcome assessors were blind to diet assignment and genotype patterns. We included 122 participants (54.4 [SD:13.2] years, BMI 34.9 [SD:5.1] kg/m2, 84% women) in the analyses. Twelve-week WL did not differ between the genotype-concordant (-5.3 kg [SD:1.0]) and genotype-discordant diets (-4.8 kg [SD:1.1]; adjusted difference: -0.6 kg [95% CI: -2.1,0.9], p = 0.50). With the current ability to genotype participants as fat- or carbohydrate-responders, evidence does not support greater WL on genotype-concordant diets. ClinicalTrials identifier: NCT04145466.
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Affiliation(s)
- Christoph Höchsmann
- Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Shengping Yang
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - James L Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life of Sciences, University of Glasgow, Glasgow, UK
| | | | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Michelle I Cardel
- WW International, Inc., New York, NY, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Gary D Foster
- WW International, Inc., New York, NY, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Wan CS, Cheng H, Musgrave-Takeda M, Liu MG, Tobiano G, McMahon J, McInnes E. Barriers and facilitators to implementing pressure injury prevention and management guidelines in acute care: A mixed-methods systematic review. Int J Nurs Stud 2023; 145:104557. [PMID: 37453248 DOI: 10.1016/j.ijnurstu.2023.104557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Evidence-based pressure injury prevention and management is a global health service priority. Low uptake of pressure injury guidelines leads to compromised patient outcomes. Understanding clinicians' and patients' views on the barriers and facilitators to implementing guidelines and mapping the identified barriers and facilitators to the Theoretical Domains Framework and behaviour change techniques will inform an end-user and theoretically informed intervention to improve guideline uptake in the acute care setting. OBJECTIVES To synthesise quantitative and qualitative evidence on i) hospital clinicians' and inpatients' perceptions and experiences of evidence-based pressure injury practices and ii) barriers and facilitators to implementing guidelines. DESIGN A convergent integrated mixed-methods systematic review was conducted using the JBI approach. DATA SOURCE English language peer-reviewed studies published from 2009 to August 2022 were identified from MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane Central Library. REVIEW METHODS Included studies reported: i) acute care hospital clinicians' and patients' perceptions and experiences of evidence-based pressure injury practices and ii) barriers and facilitators to implementing guidelines. The Mixed Methods Appraisal Tool was used for critical appraisal. Quantitative data was transformed into qualitised data, then thematically synthesised with qualitative data, comparing clinicians' and patients' views. Barriers and facilitators associated with each main theme were mapped to the Theoretical Domains Framework and allocated to relevant behaviour change techniques. RESULTS Fifty-five out of 14,488 studies of variable quality (29 quantitative, 22 qualitative, 4 mixed-methods) met the inclusion criteria. Four main themes represent factors thought to influence the implementation of evidence-based guidelines: 1) nurse-led multidisciplinary care, 2) patient participation in care, 3) practicability of implementation and 4) attitudes towards pressure injury prevention and management. Most barriers identified by clinicians were related to the third theme, whilst for patients, there were multiple barriers under theme 2. Barriers were mainly mapped to the Knowledge domain and Environmental Context and Resources domain and were matched to the behaviour change techniques of "instruction on how to perform a behaviour" and "restructuring the physical environment". Most facilitators mentioned by clinicians and patients were related to themes 1 and 2, respectively, and mapped to the Environmental Context and Resources domain. All patient-related attitudes in theme 4 were facilitators. CONCLUSIONS These review findings highlight the most influential factors related to implementing evidence-based pressure injury care from clinicians' and patients' views and mapping these factors to the Theoretical Domains Framework and behaviour change techniques has contributed to developing a stakeholder-tailored implementation intervention in acute care settings. PROSPERO REGISTRATION CRD42021250885.
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Affiliation(s)
- Ching Shan Wan
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia; National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Heilok Cheng
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mika Musgrave-Takeda
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mark Guosheng Liu
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Georgia Tobiano
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Gold Coast University Hospital, Gold Coast Health Nursing and Midwifery Education and Research Unit, Queensland, Australia
| | - Jake McMahon
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Elizabeth McInnes
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia; National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Englert I, Egert S, Hoffmann L, Kohlenberg-Müller K. Concept of an Intervention for Sustainable Weight Loss in Postmenopausal Women with Overweight-Secondary Analysis of a Randomized Dietary Intervention Study. Nutrients 2023; 15:3250. [PMID: 37513668 PMCID: PMC10383994 DOI: 10.3390/nu15143250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION The approach of an individual diet has great potential for sustainable weight reduction. Social support, participation and empowerment are also key factors for high motivation and compliance. So, the impact of an individual diet in combination with group sessions on weight loss in postmenopausal women with overweight was investigated. METHODS In this reanalysis of a controlled intervention study, postmenopausal women (n = 54; BMI 30.9 ± 3.4 kg/m2; 59 ± 7 years) were recruited receiving an energy restricted diet for 12 weeks, followed by a six-month follow-up phase. The women received 51 individual meal plans based on their habits and were trained in four group sessions. RESULTS Forty-six women completed the intervention phase, and 29 completed the follow-up. Average weight loss was -5.8 ± 3.0 kg (p < 0.001) after 12 weeks and was still significant at follow-up (-4.9 ± 5.4 kg, p < 0.001). Also, decreases in fat-free mass (-1.1 ± 1.2 kg, p < 0.001) and resting energy expenditure (-1096 ± 439 kJ/24 h, p < 0.001) were observed. CONCLUSIONS The individual nutrition approach with a focus on nutritype in combination with group sessions was effective for long-lasting weight loss in postmenopausal women. An important factor is close individual and group support.
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Affiliation(s)
- Isabell Englert
- Department of Nutritional, Food and Consumer Sciences, University of Applied Sciences, 36037 Fulda, Germany
| | - Sarah Egert
- Department of Nutrition and Food Science, Nutritional Physiology, University of Bonn, 53113 Bonn, Germany
| | - Laura Hoffmann
- Department of Nutritional, Food and Consumer Sciences, University of Applied Sciences, 36037 Fulda, Germany
| | - Kathrin Kohlenberg-Müller
- Department of Nutritional, Food and Consumer Sciences, University of Applied Sciences, 36037 Fulda, Germany
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Konic Ristic A, Ryan S, Attjioui M, O'Connell S, Gibney ER. Effects of an Extract of the Brown Seaweed Ascophylum nodosum on Postprandial Glycaemic Control in Healthy Subjects: A Randomized Controlled Study. Mar Drugs 2023; 21:337. [PMID: 37367662 DOI: 10.3390/md21060337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
The effects of the consumption of an extract of the brown seaweed Ascophyllum nodosum (BSW) on postprandial glucose and insulin responses to white bread were investigated in an acute, randomized, double-blind, three-arm, crossover, controlled trial in healthy, normoglycemic subjects. Sixteen subjects were administered either control white bread (50 g total digestible carbohydrates) or white bread with 500 mg or 1000 mg of BSW extract. Biochemical parameters were measured in venous blood over 3 h. Significant inter-individual variation in the glycaemic response to white bread was observed. Analysis of the responses of all subjects to either 500 mg or 1000 mg of BSW extract versus control revealed no significant effects of treatments. The variation in response to the control was used to classify individuals into glycaemic responders and non-responders. In the sub-cohort of 10 subjects with peak glucose levels after white bread above 1 mmol/L, we observed a significant decrease in maximum levels of plasma glucose after the intervention meal with 1000 mg of extract compared with the control. No adverse effects were reported. Further work is warranted to define all factors that determine "responders" to the effects of brown seaweed extracts and identify the cohort that would benefit the most from their consumption.
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Affiliation(s)
- Aleksandra Konic Ristic
- UCD School of Agriculture and Food Science, University College Dublin, D04V1W8 Belfiled, Dublin, Ireland
- UCD Institute of Food and Health, University College Dublin, D04V1W8 Belfield, Dublin, Ireland
| | | | | | - Shane O'Connell
- Marigot Ltd., P43NN62 Carrigaline, Ireland
- Shannon Applied Biotechnology Centre, Munster Technological University-Kerry, V92CX88 Tralee, Ireland
| | - Eileen R Gibney
- UCD School of Agriculture and Food Science, University College Dublin, D04V1W8 Belfiled, Dublin, Ireland
- UCD Institute of Food and Health, University College Dublin, D04V1W8 Belfield, Dublin, Ireland
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Livingstone KM, Rawstorn JC, Partridge SR, Godrich SL, McNaughton SA, Hendrie GA, Blekkenhorst LC, Maddison R, Zhang Y, Barnett S, Mathers JC, Packard M, Alston L. Digital behaviour change interventions to increase vegetable intake in adults: a systematic review. Int J Behav Nutr Phys Act 2023; 20:36. [PMID: 36973716 PMCID: PMC10042405 DOI: 10.1186/s12966-023-01439-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Digital interventions may help address low vegetable intake in adults, however there is limited understanding of the features that make them effective. We systematically reviewed digital interventions to increase vegetable intake to 1) describe the effectiveness of the interventions; 2) examine links between effectiveness and use of co-design, personalisation, behavioural theories, and/or a policy framework; and 3) identify other features that contribute to effectiveness. METHODS A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Library, INFORMIT, IEEE Xplore and Clinical Trial Registries, published between January 2000 and August 2022. Digital interventions to increase vegetable intake were included, with effective interventions identified based on statistically significant improvement in vegetable intake. To identify policy-action gaps, studies were mapped across the three domains of the NOURISHING framework (i.e., behaviour change communication, food environment, and food system). Risk of bias was assessed using Cochrane tools for randomized, cluster randomized and non-randomized trials. RESULTS Of the 1,347 records identified, 30 studies were included. Risk of bias was high or serious in most studies (n = 25/30; 83%). Approximately one quarter of the included interventions (n = 8) were effective at improving vegetable intake. While the features of effective and ineffective interventions were similar, embedding of behaviour change theories (89% vs 61%) and inclusion of stakeholders in the design of the intervention (50% vs 38%) were more common among effective interventions. Only one (ineffective) intervention used true co-design. Although fewer effective interventions included personalisation (67% vs 81%), the degree of personalisation varied considerably between studies. All interventions mapped across the NOURISHING framework behaviour change communication domain, with one ineffective intervention also mapping across the food environment domain. CONCLUSION Few digital interventions identified in this review were effective for increasing vegetable intake. Embedding behaviour change theories and involving stakeholders in intervention design may increase the likelihood of success. The under-utilisation of comprehensive co-design methods presents an opportunity to ensure that personalisation approaches better meet the needs of target populations. Moreover, future digital interventions should address both behaviour change and food environment influences on vegetable intake.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, VIC, 3125, Melbourne, Australia.
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Jonathan C Rawstorn
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Stephanie R Partridge
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephanie L Godrich
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Bunbury, WA, 6230, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Gilly A Hendrie
- Human Health Program, Health & Biosecurity, CSIRO, Adelaide, SA, 5000, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Yuxin Zhang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Scott Barnett
- Applied Artificial Intelligence Institute (A²I²), Deakin University, Geelong, Australia
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE2 4HH, UK
| | - Maria Packard
- The National Heart Foundation of Australia, Melbourne, VIC, 3000, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Warrnambool, Australia
- The Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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Wilson D, Driller M, Johnston B, Gill N. Healthy Nutrition, Physical Activity, and Sleep Hygiene to Promote Cardiometabolic Health of Airline Pilots: A Narrative Review. J Lifestyle Med 2023; 13:1-15. [PMID: 37250274 PMCID: PMC10210965 DOI: 10.15280/jlm.2023.13.1.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/17/2022] [Accepted: 12/21/2022] [Indexed: 05/31/2023] Open
Abstract
Background Airline pilots experience unique occupational demands that may contribute to adverse physical and psychological health outcomes. Epidemiological reports have shown a substantial prevalence of cardiometabolic health risk factors including excessive body weight, elevated blood pressure, poor lifestyle behaviors, and psychological fatigue. Achieving health guidelines for lifestyle behavior nutrition, physical activity, and sleep are protective factors against the development of noncommunicable diseases and may mitigate the unfavorable occupational demands of airline pilots. This narrative review examines occupational characteristics for sleep, nutrition, and physical activity and outlines evidence-based strategies to inform health behavior interventions to mitigate cardiometabolic health risk factors among airline pilots. Methods Literature sources published between 1990 and 2022 were identified through electronic searches in PubMed, MEDLINE (via OvidSP), PsychINFO, Web of Science, and Google Scholar databases, and a review of official reports and documents from regulatory authorities pertaining to aviation medicine and public health was conducted. The literature search strategy comprised key search terms relating to airline pilots, health behaviors, and cardiometabolic health. The inclusion criteria for literature sources were peer-reviewed human studies, meta-analyses, systematic reviews, and reports or documents published by regulatory bodies. Results The results of the review show occupational factors influencing nutrition, sleep, and physical activity behaviors and delineate evident occupational disruptions to these lifestyle behaviors. Evidence from clinical trials demonstrates the efficacy of nutrition, sleep, and physical activity interventions for enhancing the cardiometabolic health of airline pilots. Conclusion This narrative review suggests that implementing evidence-based interventions focused on nutrition, physical activity, and sleep could help mitigate cardiometabolic health risk factors among airline pilots, who are particularly susceptible to adverse health outcomes due to unique occupational demands.
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Affiliation(s)
- Daniel Wilson
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand
- Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga, New Zealand
| | - Matthew Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Ben Johnston
- Aviation and Occupational Health Unit, Air New Zealand, Auckland, New Zealand
| | - Nicholas Gill
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand
- New Zealand Rugby, Wellington, New Zealand
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11
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Jaskulski S, Nuszbaum C, Michels KB. Components, prospects and challenges of personalized prevention. Front Public Health 2023; 11:1075076. [PMID: 36875367 PMCID: PMC9978387 DOI: 10.3389/fpubh.2023.1075076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 02/18/2023] Open
Abstract
Effective preventive strategies are urgently needed to address the rising burden of non-communicable diseases such as cardiovascular disease and cancer. To date, most prevention efforts to reduce disease incidence have primarily targeted populations using "one size fits all" public health recommendations and strategies. However, the risk for complex heterogeneous diseases is based on a multitude of clinical, genetic, and environmental factors, which translate into individual sets of component causes for every person. Recent advances in genetics and multi-omics enable the use of new technologies to stratify disease risks at an individual level fostering personalized prevention. In this article, we review the main components of personalized prevention, provide examples, and discuss both emerging opportunities and remaining challenges for its implementation. We encourage physicians, health policy makers, and public health professionals to consider and apply the key elements and examples of personalized prevention laid out in this article while overcoming challenges and potential barriers to their implementation.
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Affiliation(s)
- Stefanie Jaskulski
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Competence Network Preventive Medicine Baden-Württemberg, Competence Area of Personalized Prevention, Freiburg, Germany
| | - Cosima Nuszbaum
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Competence Network Preventive Medicine Baden-Württemberg, Competence Area of Personalized Prevention, Freiburg, Germany
| | - Karin B Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Competence Network Preventive Medicine Baden-Württemberg, Competence Area of Personalized Prevention, Freiburg, Germany.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
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12
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Worthington A, Gillies N, Roy R, Braakhuis A. Development of eHealth-Based Behavior Change Support for Young Adults Using the Nine Principles Framework. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:38-47. [PMID: 36372660 DOI: 10.1016/j.jneb.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Implementing behavior strategies into nutrition research requires consideration. The Nine Principles framework was used to develop an eHealth behavior change support (BCS) program to enhance young adults' adherence to (1) eating healthily and (2) recording dietary intake when participating in a randomized control trial. The Theory of Planned Behavior and qualitative focus group data informed a 10-week pilot of the BCS delivered on Facebook and texts. The BCS appeared to support optimal dietary recording and maintained dietary behaviors, suggesting using a framework underpinned by theory and user-centered design may be a promising avenue to enhance adherence in randomized control trials.
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Affiliation(s)
- Anna Worthington
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand.
| | - Nicola Gillies
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Rajshri Roy
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
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13
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Grasso AC, Olthof MR, Reinders I, Wijnhoven HAH, Visser M, Brouwer IA. Effect of personalized dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults: results from the PROMISS trial. Eur J Nutr 2022; 61:4015-4026. [PMID: 35788775 PMCID: PMC9596580 DOI: 10.1007/s00394-022-02896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/21/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Diet modelling studies suggest that increasing protein intake with no consideration for sustainability results in a higher environmental impact on the diet. To better understand the impact in real life, the aim of this study was to assess the effect of dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults. METHODS Food consumption and environmental impact were analyzed among 124 Dutch older adults with lower habitual protein intake (< 1.0 g/kg adjusted body weight/day) participating in the six-month PROMISS trial. Dietary intake data from three 24-h dietary recalls, aided by food diaries, and results from life cycle assessments were used to examine the differences in changes in food consumption and environmental impact between those who received dietary advice to isocalorically increase protein intake to ≥ 1.2 g/kg aBW/d (Protein + ; n = 84) and those who did not receive dietary advice (Control; n = 40). RESULTS Compared to the Control, Protein + increased protein intake from animal-based food products (11.0 g protein/d, 95% CI 6.6-15.4, p < 0.001), plant-based food products (2.1 g protein/d, 95% CI 0.2-4.0, p = 0.031) and protein-enriched food products provided during the trial (18 g protein/d, 95% CI 14.5-21.6, p < 0.001) at the 6-month follow-up. Diet-associated greenhouse gas emissions increased by 16% (p < 0.001), land use by 19% (p < 0.001), terrestrial acidification by 20% (p = 0.01), and marine eutrophication by 16% (p = 0.035) in Protein + compared to the Control. CONCLUSION This study found that dietary advice increased protein intake, favoring animal-based protein, and increased the environmental impact of the diet in older adults. TRIAL REGISTRATION ClinicalTrials.gov. NCT03712306. October 2018.
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Affiliation(s)
- Alessandra C Grasso
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ilse Reinders
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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14
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Determinants of consumer acceptance and use of personalized dietary advice: A systematic review. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Shyam S, Lee KX, Tan ASW, Khoo TA, Harikrishnan S, Lalani SA, Ramadas A. Effect of Personalized Nutrition on Dietary, Physical Activity, and Health Outcomes: A Systematic Review of Randomized Trials. Nutrients 2022; 14:4104. [PMID: 36235756 PMCID: PMC9570623 DOI: 10.3390/nu14194104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/18/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Personalized nutrition is an approach that tailors nutrition advice to individuals based on an individual's genetic information. Despite interest among scholars, the impact of this approach on lifestyle habits and health has not been adequately explored. Hence, a systematic review of randomized trials reporting on the effects of personalized nutrition on dietary, physical activity, and health outcomes was conducted. A systematic search of seven electronic databases and a manual search resulted in identifying nine relevant trials. Cochrane's Risk of Bias was used to determine the trials' methodological quality. Although the trials were of moderate to high quality, the findings did not show consistent benefits of personalized nutrition in improving dietary, behavioral, or health outcomes. There was also a lack of evidence from regions other than North America and Europe or among individuals with diseases, affecting the generalizability of the results. Furthermore, the complex relationship between genes, interventions, and outcomes may also have contributed to the scarcity of positive findings. We have suggested several areas for improvement for future trials regarding personalized nutrition.
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Affiliation(s)
- Sangeetha Shyam
- Centre for Translational Research, IMU Institute for Research and Development (IRDI), International Medical University (IMU), Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain
- Pere Virgili Health Research Institute (IISPV), Sant Joan University Hospital in Reus, 43204 Reus, Spain
- Consorcio CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Ke Xin Lee
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
| | - Angeline Shu Wei Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
| | - Tien An Khoo
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
| | | | - Shehzeen Alnoor Lalani
- Dalhousie Medicine DMNS, Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4R2, Canada
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
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16
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Yeşilyurt N, Yılmaz B, Ağagündüz D, Capasso R. Microbiome-based personalized nutrition as a result of the 4.0 technological revolution: A mini literature review. Process Biochem 2022. [DOI: 10.1016/j.procbio.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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17
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O'Connor A, Feeney EL, Bhargava N, Noronha N, Gibney ER. Determination of factors associated with serum cholesterol response to dairy fat consumption in overweight adults: Secondary analysis from an RCT. Front Nutr 2022; 9:945723. [PMID: 35990333 PMCID: PMC9382121 DOI: 10.3389/fnut.2022.945723] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Elevated intakes of saturated fatty acids (SFA) can adversely affect serum cholesterol levels. Dairy fat contains ~60% SFA, prompting healthy eating guidelines to recommend low-fat dairy. Physiological, and environmental factors influence inter-individual variance in response to food consumption. Evidence exploring the dairy matrix has differing effects of dairy fat consumption on serum cholesterol levels when consumed in the form of cheese. The extent of this variability and determinants of response to dairy fat are currently unknown. The objective of this study was to determine factors associated with lipid metabolism response to a dairy fat intervention, with a focus on serum cholesterol. A 6-week randomized parallel intervention trial was carried out in healthy volunteers (≥50 years, BMI ≥25 kg/m2). Participants (n = 104) consumed ~40 g dairy fat daily in addition to their usual diet, in 1 of 3 forms: butter, cheese, or reduced-fat cheese and butter. For this analysis, “response” was based on the percentage (%) change in serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) from pre- to post-intervention. Participants were divided into tertiles for each lipid response. The upper and lower tertiles were used to categorize participants as “responders” and “non-responders.” For TC and LDL-c, response was classified as a decrease, whereas “response” was defined as an increase for HDL-c. Clinical response was also considered, by calculating pre- and post-intervention prevalence of those meeting target levels of cholesterol recommendations. Participants demonstrating the largest % decrease (Tertile 1; “responders”) in TC had significantly higher levels of TC and HDL-c, at baseline, and lower levels of triglycerides (TAGs) compared to those in tertile 3 (i.e., TC non-responders). Those with the largest % decrease in LDL-c (Tertile 1: LDL-c responders) had higher baseline levels of LDL-c and lower levels of TAGs. Multiple regression analysis revealed that the % change in TC and LDL-c was associated with baseline TC, TAG, body weight and high-sensitivity C-reactive protein (hsCRP; P < 0.05). Previous work has demonstrated the dairy food matrix affects lipid response to dairy consumption. This study suggests that phenotypic differences may also influence response to dairy fat in overweight individuals.
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Affiliation(s)
- Aileen O'Connor
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland.,Food for Health Ireland, Dublin, Ireland
| | - Emma L Feeney
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland.,Food for Health Ireland, Dublin, Ireland
| | - Nupur Bhargava
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland.,Food for Health Ireland, Dublin, Ireland
| | - Nessa Noronha
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland.,Food for Health Ireland, Dublin, Ireland
| | - Eileen R Gibney
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland.,Food for Health Ireland, Dublin, Ireland
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18
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Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers. Nutrients 2022; 14:nu14142801. [PMID: 35889758 PMCID: PMC9318739 DOI: 10.3390/nu14142801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 02/05/2023] Open
Abstract
This study explored how South African food labels could be improved, to enhance customer evaluation of the overall healthiness of packaged food. Focus was given to the comparison of front-of-pack (FOP) nutrition labels as a quick assessment tool. The exploratory sequential mixed-methods design used qualitative interviews (n = 49) to gain insight into labeling challenges and select FOP nutrition labels for consumer testing. Consumers (n = 1261) randomly assessed two out of six possible FOP nutrition labels relative to a ‘no-label’ control in one of 12 online surveys, applied to a fictitious cereal product. A mixed-model analysis of variance was used to compare the differences in health ratings for the different FOP nutrition labels. The interviews revealed three themes for label improvement, that are presented over three time horizons. In terms of helping consumers identify less healthy products, the effect sizes were most prominent for health warnings (p < 0.01) and low health star ratings (p < 0.01). The findings of this research not only clarify whether FOP nutrition labeling formats used in other regions such as Europe, South America and Australia could be useful in the South African context, but they can assist policymakers and decision-makers in selecting an effective FOP label.
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19
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Faessen JPM, Lucassen DA, Buso MEC, Camps G, Feskens EJM, Brouwer-Brolsma EM. Eating for 2: A Systematic Review of Dutch App Stores for Apps Promoting a Healthy Diet during Pregnancy. Curr Dev Nutr 2022; 6:nzac087. [PMID: 35711572 PMCID: PMC9197571 DOI: 10.1093/cdn/nzac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
A healthy diet during pregnancy has been associated with beneficial child and maternal health outcomes but is challenging to achieve. Recent technological advances offer new opportunities to support pregnant women in their food choices-for instance, via apps. This is already reflected by a wide availability of pregnancy-related apps, but health care professionals feel unsure about their potential. Therefore, the Dutch Google Play Store and Apple App Store were reviewed to identify existing apps on diet and pregnancy. App quality was assessed using the 1) Mobile App Rating Scale (MARS; i.e., assessing functionality, aesthetics, engagement, information quality), 2) Dutch dietary guidelines for pregnant women, and 3) App Behavior Change Scale (ABACUS). Fifty-seven unique apps were identified with an average star rating of 4.2 ± 0.6 and MARS quality score of 3.2 ± 0.3, indicating a moderate quality. Most apps scored best in terms of functionality and aesthetics (4.0 ± 0.4 and 3.3 ± 0.6), but lowest in terms of engagement (2.5 ± 0.6). Regarding nutrition information provision, most apps were incomplete or deviated from the Dutch guidelines. Folic acid supplementation (91%), hygiene (81%), caffeine (79%), and alcohol (77%) were the most commonly addressed nutrition aspects, whereas licorice (11%), iodine (19%), and soy (18%) were only addressed in a few apps. Moreover, a median of 2 out of 21 ABACUS behavior change items were identified per app, which were predominantly related to the category "knowledge and information." Thus, despite the abundance of apps supporting a healthy diet during pregnancy in the Dutch app stores, there is an urgent need for apps with complete and scientifically sound dietary information that is supported by effective behavior change techniques.
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Affiliation(s)
- Janine P M Faessen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Desiree A Lucassen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
- Systematic Change Group, Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Marion E C Buso
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
- OnePlanet Research Center, Plus Ultra II, Wageningen, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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20
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de Hoogh IM, van der Kamp JW, Wopereis S. The potential of personalized nutrition for improving wholegrain consumption. J Cereal Sci 2022. [DOI: 10.1016/j.jcs.2022.103505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Zenun Franco R, Fallaize R, Weech M, Hwang F, Lovegrove JA. Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial. J Med Internet Res 2022; 24:e29088. [PMID: 35468093 PMCID: PMC9154737 DOI: 10.2196/29088] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/12/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background Evidence suggests that eating behaviors and adherence to dietary guidelines can be improved using nutrition-related apps. Apps delivering personalized nutrition (PN) advice to users can provide individual support at scale with relatively low cost. Objective This study aims to investigate the effectiveness of a mobile web app (eNutri) that delivers automated PN advice for improving diet quality, relative to general population food-based dietary guidelines. Methods Nondiseased UK adults (aged >18 years) were randomized to PN advice or control advice (population-based healthy eating guidelines) in a 12-week controlled, parallel, single-blinded dietary intervention, which was delivered on the web. Dietary intake was assessed using the eNutri Food Frequency Questionnaire (FFQ). An 11-item US modified Alternative Healthy Eating Index (m-AHEI), which aligned with UK dietary and nutritional recommendations, was used to derive the automated PN advice. The primary outcome was a change in diet quality (m-AHEI) at 12 weeks. Participant surveys evaluated the PN report (week 12) and longer-term impact of the PN advice (mean 5.9, SD 0.65 months, after completion of the study). Results Following the baseline FFQ, 210 participants completed at least 1 additional FFQ, and 23 outliers were excluded for unfeasible dietary intakes. The mean interval between FFQs was 10.8 weeks. A total of 96 participants were included in the PN group (mean age 43.5, SD 15.9 years; mean BMI 24.8, SD 4.4 kg/m2) and 91 in the control group (mean age 42.8, SD 14.0 years; mean BMI 24.2, SD 4.4 kg/m2). Compared with that in the control group, the overall m-AHEI score increased by 3.5 out of 100 (95% CI 1.19-5.78) in the PN group, which was equivalent to an increase of 6.1% (P=.003). Specifically, the m-AHEI components nuts and legumes and red and processed meat showed significant improvements in the PN group (P=.04). At follow-up, 64% (27/42) of PN participants agreed that, compared with baseline, they were still following some (any) of the advice received and 31% (13/42) were still motivated to improve their diet. Conclusions These findings suggest that the eNutri app is an effective web-based tool for the automated delivery of PN advice. Furthermore, eNutri was demonstrated to improve short-term diet quality and increase engagement in healthy eating behaviors in UK adults, as compared with population-based healthy eating guidelines. This work represents an important landmark in the field of automatically delivered web-based personalized dietary interventions. Trial Registration ClinicalTrials.gov NCT03250858; https://clinicaltrials.gov/ct2/show/NCT03250858
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Affiliation(s)
- Rodrigo Zenun Franco
- Biomedical Engineering, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Faustina Hwang
- Biomedical Engineering, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
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22
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Martinon P, Saliasi I, Bourgeois D, Smentek C, Dussart C, Fraticelli L, Carrouel F. Nutrition-Related Mobile Apps in the French App Stores: Assessment of Functionality and Quality. JMIR Mhealth Uhealth 2022; 10:e35879. [PMID: 35285817 PMCID: PMC8961341 DOI: 10.2196/35879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/01/2022] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The global burden of disease attributes 20% of deaths to poor nutrition. Although hundreds of nutrition-related mobile apps have been created, and these have been downloaded by millions of users, the effectiveness of these technologies on the adoption of healthy eating has had mixed. OBJECTIVE The aim of this study was to review which nutrition-related mobile apps are currently available on the French market and assess their quality. METHODS We screened apps on the Google Play Store and the French Apple App Store, from March 10 to 17, 2021, to identify those related to nutritional health. A shortlist of 15 apps was identified, and each was assessed using the French version of the Mobile App Rating Scale: 8 dietitians and nutritionists assessed 7 apps, and the remaining apps were randomly allocated to ensure 4 assessments per app. Intraclass correlation was used to evaluate interrater agreement. Means and standard deviations of scores for each section and each item were calculated. RESULTS The top scores for overall quality were obtained by Yazio - Régime et Calories (mean 3.84, SD 0.32), FeelEat (mean 3.71, SD 0.47), and Bonne App (mean 3.65, SD 0.09). Engagement scores ranged from a mean of 1.95 (SD 0.5) for iEatBetter: Journal alimentaire to a mean of 3.85 (SD 0.44) for FeelEat. Functionality scores ranged from a mean of 2.25 (SD 0.54) for Naor to a mean of 4.25 (SD 0.46) for Yazio. Aesthetics scores ranged from a mean of 2.17 (SD 0.34) for Naor to a mean of 3.88 (SD 0.47) for Yazio. Information scores ranged from a mean of 2.38 (SD 0.60) for iEatBetter to a mean of 3.73 (SD 0.29) for Yazio. Subjective quality scores ranged from a mean of 1.13 (SD 0.25) for iEatBetter to a mean of 2.28 (SD 0.88) for Compteur de calories FatSecret. Specificity scores ranged from a mean of 1.38 (SD 0.64) for iEatBetter to a mean of 3.50 (SD 0.91) for FeelEat. The app-specific score was always lower than the subjective quality score, which was always lower than the quality score, which was lower than the rating from the iOS or Android app stores. CONCLUSIONS Although prevention and information messages in apps regarding nutritional habits are not scientifically verified before marketing, we found that app quality was good. Subjective quality and specificity were associated with lower ratings. Further investigations are needed to assess whether information from these apps is consistent with recommendations and to determine the long-term impacts of these apps on users.
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Affiliation(s)
- Prescilla Martinon
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Ina Saliasi
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Denis Bourgeois
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Colette Smentek
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Claude Dussart
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Laurie Fraticelli
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
| | - Florence Carrouel
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
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de Hoogh IM, Reinders MJ, Doets EL, Hoevenaars FPM, Top JL. Design issues in personalized nutrition advice systems (Preprint). J Med Internet Res 2022; 25:e37667. [PMID: 36989039 PMCID: PMC10131983 DOI: 10.2196/37667] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
The current health status of the general public can substantially benefit from a healthy diet. Using a personalized approach to initiate healthy dietary behavior seems to be a promising strategy, as individuals differ in terms of health status, subsequent dietary needs, and their desired behavior change support. However, providing personalized advice to a wide audience over a long period is very labor-intensive. This bottleneck can possibly be overcome by digitalizing the process of creating and providing personalized advice. An increasing number of personalized advice systems for different purposes is becoming available in the market, ranging from systems providing advice about just a single parameter to very complex systems that include many variables characterizing each individual situation. Scientific background is often lacking in these systems. In designing a personalized nutrition advice system, many design questions need to be answered, ranging from the required input parameters and accurate measurement methods (sense), type of modeling techniques to be used (reason), and modality in which the personalized advice is provided (act). We have addressed these topics in this viewpoint paper, and we have demonstrated the feasibility of setting up an infrastructure for providing personalized dietary advice based on the experience of 2 practical applications in a real-life setting.
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Affiliation(s)
- Iris M de Hoogh
- Research Group Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
- Department of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Machiel J Reinders
- Wageningen Economic Research, Wageningen University & Research, Den Haag, Netherlands
| | - Esmée L Doets
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Femke P M Hoevenaars
- Research Group Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Jan L Top
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
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Boedt T, Steenackers N, Verbeke J, Vermeulen A, De Backer C, Yiga P, Matthys C. A Mixed-Method Approach to Develop and Validate an Integrated Food Literacy Tool for Personalized Food Literacy Guidance. Front Nutr 2022; 8:760493. [PMID: 35127779 PMCID: PMC8814651 DOI: 10.3389/fnut.2021.760493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundFood literacy refers to all practicalities associated with healthy eating. Current food literacy tools are limited in practical use in clinical practice. Therefore, an integrated food literacy tool (IFLT) to assess food literacy and to personalize food literacy guidance was developed and validated.MethodsFollowing an iterative process, a food literacy framework was developed and food literacy goals were defined. A corresponding food literacy screener (FLS) to assess food literacy was developed along with an algorithm to provide personalized food literacy guidance based on the food literacy assessment. Content validation of the FLS was assessed by a panel of experts, measuring item and scale content validity index (I/S-CVI) and by the target population in semi structured interviews with 15 adults of reproductive age. Subsequently, an online cross-sectional survey was conducted among 114 adults of reproductive age to evaluate the validity of the FLS. Construct validity was examined against both the validated healthy eating and weight self-efficacy scale and against a food frequency questionnaire assessing healthy eating self-efficacy (HESE) and diet quality, respectively. Reliability was assessed with a two-week test-retest. Pearson correlation tests were conducted.ResultsAn IFLT consisting of a FLS and corresponding algorithm to personalize food literacy guidance by prioritizing food literacy goals was developed. The IFLT includes 24 food literacy goals, addressed by 17 FLS items. Every item received a weighting factor based on theory and expert opinion to prioritize food literacy goals according to personal needs. Content validity revealed that the FLS was rated relevant by experts (S-CVI = 0.93) and well-understood by the target population. The FLS has a good construct validity as it was positively correlated with diet quality (r = 0.536, p < 0.001) and with HESE (r = 0.685, p < 0.001). It also showed a good test-retest reliability (r = 0.721, p < 0.001).ConclusionThe newly developed IFLT is a practically applicable, context specific theory-and expert-based dual purpose tool to assess food literacy and to personalize food literacy guidance by prioritizing individuals' food literacy goals to their needs.
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Affiliation(s)
- Tessy Boedt
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Nele Steenackers
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Joke Verbeke
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Astrid Vermeulen
- Laboratory of Molecular Bacteriology, Department of Microbiology, Immunology and Transplanation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Charlotte De Backer
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Yiga
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Food Technology, Kyambogo University, Kampala, Uganda
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: Christophe Matthys
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Bianchi CM, Mariotti F, Reulet E, Le Goff G, Lluch A, Verger EO, Huneau JF, Gurviez P. Perceptions of Tailored Dietary Advice to Improve the Nutrient Adequacy of the Diet in French Pregnant Women. Nutrients 2021; 14:nu14010085. [PMID: 35010960 PMCID: PMC8747067 DOI: 10.3390/nu14010085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Abstract
Tailored dietary counseling could be specifically efficient during pregnancy, a period accompanied by a rise in nutrition awareness, but little is known about the expectations of pregnant women in this regard. We studied these expectations regarding tailored dietary advice in French women during their pregnancy, as well as their motivations and the perceived barriers and enablers. In French pregnant women, we evaluated the perceptions of tailored dietary advice provided by stepwise dietary counseling based on three types of dietary changes, consisting of: (1) a modification of the amounts consumed, (2) substitutions within the food subgroups, and (3) substitutions between food subgroups. A sequential explanatory mixed-method approach was designed. Using qualitative data from a focus group study (n = 40), we intended to explore in depth the women’s expectations regarding dietary advice and adherence to a tailored approach. These were combined with quantitative and qualitative data from a 6-week online longitudinal study (n = 115), using questionnaires designed to assess the modifications of dietary habits during pregnancy and to evaluate each type of dietary change. Both studies confirmed that most women in our samples did indeed intend to institute changes regarding healthier dietary practices during pregnancy. The principal motivation behind changes to their habits was to ensure the health and well-being of both their babies and themselves. The proposal of dietary advice that is tailored to both the current diet and the specific needs of pregnant women, but that is also positive and credible, was perceived as enabling implementing healthier dietary practices during pregnancy. Regarding the implementation of the dietary changes proposed, the enablers and barriers identified differed between modifications of the amounts consumed and substitutions. The women displayed interest in all types of dietary changes. This gave relevance to combining different types of changes in order to propose dietary counseling during pregnancy. Tailored dietary counseling was identified by French pregnant women in our samples as enabling them to adopt a healthier diet. However, perceived barriers might limit the implementation of dietary changes, especially when they involved marked modifications to their usual diet.
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Affiliation(s)
- Clélia M. Bianchi
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, 75005 Paris, France; (C.M.B.); (E.R.); (J.-F.H.)
| | - François Mariotti
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, 75005 Paris, France; (C.M.B.); (E.R.); (J.-F.H.)
- Correspondence:
| | - Elodie Reulet
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, 75005 Paris, France; (C.M.B.); (E.R.); (J.-F.H.)
| | - Gaëlle Le Goff
- AgroParisTech, INRAE, UMR SayFood, Université Paris-Saclay, 91700 Massy, France; (G.L.G.); (P.G.)
| | - Anne Lluch
- Alimentation Science Department, Danone Nutricia Research, Centre Daniel Carasso, RD 128, 91737 Palaiseau, France;
| | - Eric O. Verger
- MoISA, University Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, 34394 Montpellier, France;
| | - Jean-François Huneau
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, 75005 Paris, France; (C.M.B.); (E.R.); (J.-F.H.)
| | - Patricia Gurviez
- AgroParisTech, INRAE, UMR SayFood, Université Paris-Saclay, 91700 Massy, France; (G.L.G.); (P.G.)
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King A, Saifi S, Smith J, Pilic L, Graham CAM, Da Silva Anastacio V, Glaister M, Mavrommatis Y. Does personalised nutrition advice based on apolipoprotein E and methylenetetrahydrofolate reductase genotype affect dietary behaviour? Nutr Health 2021; 28:467-476. [PMID: 34817242 PMCID: PMC9379385 DOI: 10.1177/02601060211032882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Dietary intake is linked to numerous modifiable risk factors of
cardiovascular disease. Current dietary recommendations in the UK to reduce the risk of
cardiovascular disease are not being met. A genotype-based personalised approach to
dietary recommendations may motivate individuals to make positive changes in their dietary
behaviour. Aim: To determine the effect of a personalised nutrition
intervention, based on apolipoprotein E (ApoE, rs7412; rs429358) and
methylenetetrahydrofolate reductase (MTHFR, rs1801133) genotype, on
reported dietary intake of saturated fat and folate in participants informed of a risk
genotype compared to those informed of non-risk genotype. Methods: Baseline
data (n = 99) were collected to determine genotype (non-risk vs risk),
dietary intake and cardiovascular risk (Q-Risk®2 cardiovascular risk calculator).
Participants were provided with personalised nutrition advice via email based on their
ApoE and MTHFR genotype and reported intake of folate
and saturated fat. After 10 days, dietary intake data were reported for a second time.
Results: Personalised nutrition advice led to favourable dietary changes,
irrespective of genotype, in participants who were not meeting dietary recommendations at
baseline for saturated fat (p < 0.001) and folate
(p = 0.002). Only participants who were informed of a risk
ApoE genotype met saturated fat recommendations following personalised
nutrition advice. Conclusion: Incorporation of genotype-based personalised
nutrition advice in a diet behaviour intervention may elicit favourable changes in dietary
behaviour in participants informed of a risk genotype. Participants informed of a non-risk
genotype also respond to personalised nutrition advice favourably but to a lesser
extent.
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Affiliation(s)
- Alexandra King
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
| | - Shaghayegh Saifi
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
| | - Jenna Smith
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
| | - Leta Pilic
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
| | - Catherine A-M Graham
- Faculty of Health and Life Sciences, Department of Sport, Health and Social Work, Oxford Brookes Centre for Nutrition and Health, 98464Oxford Brookes University, UK
| | | | - Mark Glaister
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
| | - Yiannis Mavrommatis
- Faculty of Sport, Allied Health and Performance Science, 62693St Mary's University Twickenham, UK
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Verain MCD, Bouwman EP, Galama J, Reinders MJ. Healthy eating strategies: Individually different or context-dependent? Appetite 2021; 168:105759. [PMID: 34662601 DOI: 10.1016/j.appet.2021.105759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/30/2021] [Accepted: 10/13/2021] [Indexed: 11/02/2022]
Abstract
Individuals can apply different healthy eating strategies to help them make healthy eating choices. Previous research showed that individuals differ in their preferred strategy, but also that a mix of strategies is often applied by a single person across contexts. The current research investigated the extent to which differences within an individual across contexts (i.e., meal moments, social environment and physical environment) predicted openness to healthy eating strategies in addition to personal predictors that differ between individuals (i.e., intrinsic motivation, self-efficacy, physical opportunity and social opportunity). A representative sample of the Dutch adult population was recruited (N = 892). The within-individual (contextual) predictors were measured nine times just before a meal moment over a period of three weeks, by means of a smartphone application. The between-individual (personal) predictors were administered with a baseline questionnaire. Exploratory factor analysis distinguished three healthy eating strategies: Increasing healthy foods, Limiting unhealthy foods and consuming Light products. A random intercept model, in which within-individual predictors and between-individual predictors were entered successively, showed that context matters for openness to all three strategies, but is most important for increasing healthy foods and least important for light products. Individuals are most open to increase healthy foods at dinner as compared to breakfast, whereas the opposite is true for limiting unhealthy foods and consuming light products. Eating at home is beneficial for openness to all three strategies and eating with others positively influences openness to increase healthy foods but has no effect on the other strategies. Insights gained from this research increase our understanding of an individual's openness to apply healthy eating strategies.
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Affiliation(s)
- Muriel C D Verain
- Wageningen University & Research, Wageningen Economic Research, the Netherlands.
| | - Emily P Bouwman
- Wageningen University & Research, Wageningen Economic Research, the Netherlands
| | - Joris Galama
- Wageningen University & Research, Wageningen Economic Research, the Netherlands
| | - Machiel J Reinders
- Wageningen University & Research, Wageningen Economic Research, the Netherlands
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"My Patients Asked Me If I Owned a Fruit Stand in Town or Something." Barriers and Facilitators of Personalized Dietary Advice Implemented in a Primary Care Setting. J Pers Med 2021; 11:jpm11080747. [PMID: 34442392 PMCID: PMC8399817 DOI: 10.3390/jpm11080747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/16/2022] Open
Abstract
Primary care is especially well positioned to address prevention of non-communicable diseases. However, implementation of health promotion activities such as personalized dietary advice is challenging. The study aim was to understand barriers and facilitators of the personalized dietary advice component of a lifestyle intervention in primary care, as perceived by health center professionals and program participants. Thirteen focus groups were conducted with 49 professionals and 47 participants. Audio recordings were transcribed. Professional group text was coded using the Consolidated Framework for Implementation Research (CFIR). Participant group text was coded via an inductive approach with thematic analysis. Across most CFIR domains, both barriers and facilitators were equally present, except for ‘characteristics of individuals’, which were primarily facilitators. Intervention characteristics was the most important domain, with barriers in design and packaging (e.g., the ICT tool) and complexity. Facilitators included high evidence strength and quality, adaptability, and relative advantage. Participants described the importance of more personalized advice, the value of follow-up with feedback, and the need to see outcomes. Both professionals and patients stated that primary care was the place for personalized dietary advice intervention, but that lack of time, workload, and training were barriers to effective implementation. Implementation strategies targeting these modifiable barriers could potentially increase intervention adoption and intervention effectiveness.
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29
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van der Haar S, Hoevenaars FPM, van den Brink WJ, van den Broek T, Timmer M, Boorsma A, Doets EL. Exploring the Potential of Personalized Dietary Advice for Health Improvement in Motivated Individuals With Premetabolic Syndrome: Pretest-Posttest Study. JMIR Form Res 2021; 5:e25043. [PMID: 34185002 PMCID: PMC8277310 DOI: 10.2196/25043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/11/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background Dietary quality plays an essential role in the prevention and management of metabolic syndrome (MetS). Objective The aim of this pilot study is to organize personalized dietary advice in a real-life setting and to explore the effects on dietary intake, metabolic health, and perceived health. Methods We followed a one-group pretest-posttest design and included 37 individuals at risk of MetS, who indicated motivation to change dietary behavior. For a period of 16 weeks, participants received personalized advice (t=0 and t=8) and feedback (t=0, t=4, t=8, t=12 and t=16) on dietary quality and metabolic health (ie, waist circumference, BMI, blood pressure, lipid profile, fasting glucose levels, and C-peptide). Personalized advice was generated in a two-stage process. In stage 1, an automated algorithm generated advice per food group, integrating data on individual dietary quality (Dutch Healthy Diet Index; total score 8-80) and metabolic health parameters. Stage 2 included a telephone consultation with a trained dietitian to define a personal dietary behavior change strategy and to discuss individual preferences. Dietary quality and metabolic health markers were assessed at t=0, t=8, and t=16. Self-perceived health was evaluated on 7-point Likert scales at t=0 and t=16. Results At the end of the study period, dietary quality was significantly improved compared with the baseline (Dutch Healthy Diet Index +4.3; P<.001). In addition, lipid profile (triglycerides, P=.02; total cholesterol, P=.01; high-density lipoprotein, P<.001; and low-density lipoprotein, P<.001), BMI (P<.001), waist circumference (P=.01), and C-peptide (P=.01) were all significantly improved, whereas plasma glucose increased by 0.23 nmol/L (P=.04). In line with these results, self-perceived health scores were higher at t=16 weeks than at baseline (+0.67; P=.005). Conclusions This exploratory study showed that personalized dietary advice resulted in positive effects on dietary behavior, metabolic health, and self-perceived health in motivated pre-MetS adults. The study was performed in a do-it-yourself setting, highlighting the potential of at-home health improvement through dietary changes. Trial Registration ClinicalTrials.gov NCT04595669; https://clinicaltrials.gov/ct2/show/NCT04595669
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Affiliation(s)
- Sandra van der Haar
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - Femke P M Hoevenaars
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Willem J van den Brink
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Tim van den Broek
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Mariëlle Timmer
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
| | - André Boorsma
- Microbiology & Systems Biology Department, TNO, Netherlands Organization for Applied Scientific Research, Zeist, Netherlands
| | - Esmée L Doets
- Wageningen Food & Biobased Research, Wageningen University & Research, Wageningen, Netherlands
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Livingstone KM, Celis-Morales C, Navas-Carretero S, San-Cristobal R, Forster H, Woolhead C, O'Donovan CB, Moschonis G, Manios Y, Traczyk I, Gundersen TE, Drevon CA, Marsaux CFM, Fallaize R, Macready AL, Daniel H, Saris WHM, Lovegrove JA, Gibney M, Gibney ER, Walsh M, Brennan L, Martinez JA, Mathers JC. Personalised nutrition advice reduces intake of discretionary foods and beverages: findings from the Food4Me randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:70. [PMID: 34092234 PMCID: PMC8183081 DOI: 10.1186/s12966-021-01136-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of personalised nutrition advice on discretionary foods intake is unknown. To date, two national classifications for discretionary foods have been derived. This study examined changes in intake of discretionary foods and beverages following a personalised nutrition intervention using these two classifications. METHODS Participants were recruited into a 6-month RCT across seven European countries (Food4Me) and were randomised to receive generalised dietary advice (control) or one of three levels of personalised nutrition advice (based on diet [L1], phenotype [L2] and genotype [L3]). Dietary intake was derived from an FFQ. An analysis of covariance was used to determine intervention effects at month 6 between personalised nutrition (overall and by levels) and control on i) percentage energy from discretionary items and ii) percentage contribution of total fat, SFA, total sugars and salt to discretionary intake, defined by Food Standards Scotland (FSS) and Australian Dietary Guidelines (ADG) classifications. RESULTS Of the 1607 adults at baseline, n = 1270 (57% female) completed the intervention. Percentage sugars from FSS discretionary items was lower in personalised nutrition vs control (19.0 ± 0.37 vs 21.1 ± 0.65; P = 0.005). Percentage energy (31.2 ± 0.59 vs 32.7 ± 0.59; P = 0.031), percentage total fat (31.5 ± 0.37 vs 33.3 ± 0.65; P = 0.021), SFA (36.0 ± 0.43 vs 37.8 ± 0.75; P = 0.034) and sugars (31.7 ± 0.44 vs 34.7 ± 0.78; P < 0.001) from ADG discretionary items were lower in personalised nutrition vs control. There were greater reductions in ADG percentage energy and percentage total fat, SFA and salt for those randomised to L3 vs L2. CONCLUSIONS Compared with generalised dietary advice, personalised nutrition advice achieved greater reductions in discretionary foods intake when the classification included all foods high in fat, added sugars and salt. Future personalised nutrition approaches may be used to target intake of discretionary foods. TRIAL REGISTRATION Clinicaltrials.gov NCT01530139 . Registered 9 February 2012.
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Affiliation(s)
- Katherine M Livingstone
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, VIC, Australia
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Research Unit on Education, Physical Activity and Health (GEEAFyS), Universidad Católica del Maule, Talca, Chile
- Centre of Research in Exercise Physiology (CIFE), Universidad Mayor, Santiago, Chile
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - Hannah Forster
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, 3086, VIC, Australia
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | | | - Christian A Drevon
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rosalind Fallaize
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Anna L Macready
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, München, Germany
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julie A Lovegrove
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Marianne Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, William Leech Building, Newcastle upon Tyne, NE2 4HH, UK.
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Lopez-Maldonado A, Pastoriza S, Rufián-Henares JÁ. Assessing the antioxidant and metabolic effect of an alpha-lipoic acid and acetyl-L-carnitine nutraceutical. Curr Res Food Sci 2021; 4:336-344. [PMID: 34124692 PMCID: PMC8173094 DOI: 10.1016/j.crfs.2021.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 05/17/2021] [Indexed: 12/16/2022] Open
Abstract
Personalized nutrition (PN) is seen as a potentially effective and affordable strategy for the prevention of non-communicable diseases (NCDs). In this study we aimed to evaluate the antioxidant and metabolic effect of a dietary supplement based on alpha-lipoic acid (ALA) and acetyl-L-carnitine (ALC) in order to include this product in a novel PN service. The antioxidant properties of the commercial nutraceutical were investigated at physiological conditions (through in vitro digestion) and at mitochondrial conditions. The metabolic activity was assessed in a human pilot study using a Gas Chromatography-Mass Spectrometry (GC-MS) methodology in dried urine samples. The nutraceutical exerted an elevated antiradical activity and reducing capacity, especially at mitochondrial conditions, after in vitro digestion. This increase in mitochondrial activity was also evidenced in vivo by a significant increase in the urinary phosphate concentration (p = 0.004). As pro-oxidant effect was reached with the concentration of 4 capsules, 2 capsules at the same time could be a reasonable dose. No adverse effects were recorded in vivo with this dose. Thus, although its metabolic effect was not so conclusive, ALA + ALC combination might be beneficial as a dietary supplement for the prevention of the oxidative stress and an interesting dietary supplement to consider in large scale studies. The nutritional supplement showed a high in vitro antioxidant-reducing capacity. The antioxidant capacity increase after digestion in contrast to other antioxidants. A pro-oxidant effect was reached with the concentration of 4 capsules. 2 capsules at the same time are safe in humans and may exert some metabolic changes.
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Affiliation(s)
- Alicia Lopez-Maldonado
- Departamento de Nutrición y Bromatología, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, 18012, Granada, Spain
| | - Silvia Pastoriza
- Departamento de Nutrición y Bromatología, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, 18012, Granada, Spain
| | - José Ángel Rufián-Henares
- Departamento de Nutrición y Bromatología, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, 18012, Granada, Spain
- Corresponding author. Departamento de Nutrición y Bromatología, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071, Granada, Spain.
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de Hoogh IM, Winters BL, Nieman KM, Bijlsma S, Krone T, van den Broek TJ, Anderson BD, Caspers MPM, Anthony JC, Wopereis S. A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study. Nutrients 2021; 13:1763. [PMID: 34067248 PMCID: PMC8224682 DOI: 10.3390/nu13061763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Personalized nutrition may be more effective in changing lifestyle behaviors compared to population-based guidelines. This single-arm exploratory study evaluated the impact of a 10-week personalized systems nutrition (PSN) program on lifestyle behavior and health outcomes. Healthy men and women (n = 82) completed the trial. Individuals were grouped into seven diet types, for which phenotypic, genotypic and behavioral data were used to generate personalized recommendations. Behavior change guidance was also provided. The intervention reduced the intake of calories (-256.2 kcal; p < 0.0001), carbohydrates (-22.1 g; p < 0.0039), sugar (-13.0 g; p < 0.0001), total fat (-17.3 g; p < 0.0001), saturated fat (-5.9 g; p = 0.0003) and PUFA (-2.5 g; p = 0.0065). Additionally, BMI (-0.6 kg/m2; p < 0.0001), body fat (-1.2%; p = 0.0192) and hip circumference (-5.8 cm; p < 0.0001) were decreased after the intervention. In the subgroup with the lowest phenotypic flexibility, a measure of the body's ability to adapt to environmental stressors, LDL (-0.44 mmol/L; p = 0.002) and total cholesterol (-0.49 mmol/L; p < 0.0001) were reduced after the intervention. This study shows that a PSN program in a workforce improves lifestyle habits and reduces body weight, BMI and other health-related outcomes. Health improvement was most pronounced in the compromised phenotypic flexibility subgroup, which indicates that a PSN program may be effective in targeting behavior change in health-compromised target groups.
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Affiliation(s)
- Iris M. de Hoogh
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | | | | | - Sabina Bijlsma
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Tanja Krone
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Tim J. van den Broek
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | | | - Martien P. M. Caspers
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Joshua C. Anthony
- Habit, Oakland, CA 94607, USA;
- Campbell Soup Company, Camden, NJ 08103, USA
| | - Suzan Wopereis
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
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Kirk D, Catal C, Tekinerdogan B. Precision nutrition: A systematic literature review. Comput Biol Med 2021; 133:104365. [PMID: 33866251 DOI: 10.1016/j.compbiomed.2021.104365] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/04/2021] [Accepted: 03/28/2021] [Indexed: 12/12/2022]
Abstract
Precision Nutrition research aims to use personal information about individuals or groups of individuals to deliver nutritional advice that, theoretically, would be more suitable than generic advice. Machine learning, a subbranch of Artificial Intelligence, has promise to aid in the development of predictive models that are suitable for Precision Nutrition. As such, recent research has applied machine learning algorithms, tools, and techniques in precision nutrition for different purposes. However, a systematic overview of the state-of-the-art on the use of machine learning in Precision Nutrition is lacking. Therefore, we carried out a Systematic Literature Review (SLR) to provide an overview of where and how machine learning has been used in Precision Nutrition from various aspects, what such machine learning models use as input features, what the availability status of the data used in the literature is, and how the models are evaluated. Nine research questions were defined in this study. We retrieved 4930 papers from electronic databases and 60 primary studies were selected to respond to the research questions. All of the selected primary studies were also briefly discussed in this article. Our results show that fifteen problems spread across seven domains of nutrition and health are present. Four machine learning tasks are seen in the form of regression, classification, recommendation and clustering, with most of these utilizing a supervised approach. In total, 30 algorithms were used, with 19 appearing more than once. Models were through the use of four groups of approaches and 23 evaluation metrics. Personalized approaches are promising to reduce the burden of these current problems in nutrition research, and the current review shows Machine Learning can be incorporated into Precision Nutrition research with high performance. Precision Nutrition researchers should consider incorporating Machine Learning into their methods to facilitate the integration of many complex features, allowing for the development of high-performance Precision Nutrition approaches.
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Affiliation(s)
- Daniel Kirk
- Information Technology Group, Wageningen University and Research, Wageningen, the Netherlands.
| | - Cagatay Catal
- Department of Computer Science and Engineering, Qatar University, Doha, Qatar.
| | - Bedir Tekinerdogan
- Information Technology Group, Wageningen University and Research, Wageningen, the Netherlands.
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Shannon OM, Lee V, Bundy R, Gillings R, Jennings A, Stephan B, Hornberger M, Balanos G, Paddick SM, Hanson S, Hardeman W, Holmes R, Garner N, Aldred S, Siervo M, Mathers JC, Minihane AM. Feasibility and acceptability of a multi-domain intervention to increase Mediterranean diet adherence and physical activity in older UK adults at risk of dementia: protocol for the MedEx-UK randomised controlled trial. BMJ Open 2021; 11:e042823. [PMID: 33550254 PMCID: PMC7925921 DOI: 10.1136/bmjopen-2020-042823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/20/2020] [Accepted: 01/21/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Dementia prevalence continues to increase, and effective interventions are needed to prevent, delay or slow its progression. Higher adherence to the Mediterranean diet (MedDiet) and increased physical activity (PA) have been proposed as strategies to facilitate healthy brain ageing and reduce dementia risk. However, to date, there have been no dementia prevention trials in the UK focussed on combined dietary and PA interventions. This study aims to: (1) assess feasibility and acceptability of a theory-underpinned digital and group-based intervention for dementia risk reduction in an 'at risk' UK cohort; (2) evaluate behaviour change responses to the intervention; and, (3) provide information on cognitive, neurological, vascular and physiological outcomes to inform the design of a follow-on, full-scale efficacy trial. METHODS One hundred and eight participants aged 55 to 74 years with a QRISK2 score of ≥10% will be recruited to take part in this 24-week multi-site study. Participants will be randomised into three parallel arms: (1) Control; (2) MedDiet; and, (3) MedDiet+PA. The study will evaluate a personalised website, group session and food delivery intervention to increase MedDiet adherence and PA in older adults at risk of dementia. Diet and PA will be monitored prior to, during and following the intervention. Feasibility, acceptability and hypothesised mediators will be assessed in addition to measures of cognitive function, brain structure/perfusion (MRI), vascular function and metabolic markers (blood, urine and faecal) prior to, and following, the intervention. DISCUSSION This trial will provide insights into the feasibility, acceptability and mechanism of effect of a multi-domain intervention focussed on the MedDiet alone and PA for dementia risk reduction in an 'at risk' UK cohort. ETHICS AND DISSEMINATION The study has received NHS REC and HRA approval (18/NI/0191). Findings will be disseminated via conference presentations, public lectures, and peer-reviewed publications. TRIAL REGISTRATION DETAILS ClinicalTrials.gov NCT03673722.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Vivian Lee
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Rafe Bundy
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Rachel Gillings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Amy Jennings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Blossom Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
| | | | - George Balanos
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Stella Maria Paddick
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle, UK
| | - Sarah Hanson
- School of Health Sciences, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Wendy Hardeman
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich, UK
| | - Rebecca Holmes
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nikki Garner
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Mario Siervo
- School of Life Sciences, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anne Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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Hendrie GA, Lyle G, Mauch CE, Haddad J, Golley RK. Understanding the Variation within a Dietary Guideline Index Score to Identify the Priority Food Group Targets for Improving Diet Quality across Population Subgroups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E378. [PMID: 33418998 PMCID: PMC7825319 DOI: 10.3390/ijerph18020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/18/2022]
Abstract
Globally, population dietary intakes fall below the guideline recommendations and large-scale interventions have had modest success in improving diet quality. To inform the development of more targeted approaches, this study analysed the variations in self-reported data from an online survey of Australian adults collected between 2015 and 2020, to identify common combinations of low scoring components within a dietary guideline index. A low score was defined as meeting less than half the guideline recommendations (a score <50 out of 100). Among 230,575 adults, a single component analysis showed that 79.5% had a low score for discretionary choices, 72.2% for healthy fats and 70.8% for dairy. The combinations approach showed 83.0% of individuals had two to five low scoring components, with men, younger adults aged 18-30 years and individuals with obesity (BMI ≥ 30) more likely to have five or more. The most common dietary pattern combination included low scores for discretionary choices, dairy and healthy fats. There was a considerable but systematic variation in the low scoring components within the dietary patterns, suggesting that interventions with the flexibility to address particular combinations of key food groups across subgroups could be an effective and resource efficient way to improve diet quality in the population.
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Affiliation(s)
- Gilly A. Hendrie
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Greg Lyle
- School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia;
| | - Chelsea E. Mauch
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Joyce Haddad
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
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Abstract
Introduction The health industry has experienced great innovation and will continue to do so in the coming years. The term innovation comes from "outside to inside" driven by the need for knowledge and research to truly translate into effective improvements (hence the sequence from Research and Development to Innovation: R+D+I); but it also comes from "bottom up" as a drive of the health organization (based, as few others, on knowledge as a fundamental asset) to give way to their creativity and their ability to find new solutions to old and new problems. The current health system must advance in the development of a more global and integrated philosophy of care, which allows dealing with the consequences of aging and the increase in chronic diseases and dependence, which represent an increase in the demand for care. In the medium-long term, a care logic based on individual characteristics from the molecular perspective should be promoted, which is known as 5P medicine (personalized, preventive, predictive, participatory and population), also called personalized medicine, a paradigm that has already initiated its entry, slow and uneven, in health systems. And it must also adapt to a society with more informed and participatory people in the management of their own health, which increasingly use technologies whose development speed grows exponentially. Taking into account these characteristics and objectives, in this article we seek to define the fundamental features of the intersection between innovation and clinical nutrition.
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Hillesheim E, Ryan MF, Gibney E, Roche HM, Brennan L. Optimisation of a metabotype approach to deliver targeted dietary advice. Nutr Metab (Lond) 2020; 17:82. [PMID: 33005208 PMCID: PMC7523294 DOI: 10.1186/s12986-020-00499-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Targeted nutrition is defined as dietary advice tailored at a group level. Groups known as metabotypes can be identified based on individual metabolic profiles. Metabotypes have been associated with differential responses to diet, which support their use to deliver dietary advice. We aimed to optimise a metabotype approach to deliver targeted dietary advice by encompassing more specific recommendations on nutrient and food intakes and dietary behaviours. METHODS Participants (n = 207) were classified into three metabotypes based on four biomarkers (triacylglycerol, total cholesterol, HDL-cholesterol and glucose) and using a k-means cluster model. Participants in metabotype-1 had the highest average HDL-cholesterol, in metabotype-2 the lowest triacylglycerol and total cholesterol, and in metabotype-3 the highest triacylglycerol and total cholesterol. For each participant, dietary advice was assigned using decision trees for both metabotype (group level) and personalised (individual level) approaches. Agreement between methods was compared at the message level and the metabotype approach was optimised to incorporate messages exclusively assigned by the personalised approach and current dietary guidelines. The optimised metabotype approach was subsequently compared with individualised advice manually compiled. RESULTS The metabotype approach comprised advice for improving the intake of saturated fat (69% of participants), fibre (66%) and salt (18%), while the personalised approach assigned advice for improving the intake of folate (63%), fibre (63%), saturated fat (61%), calcium (34%), monounsaturated fat (24%) and salt (14%). Following the optimisation of the metabotype approach, the most frequent messages assigned to address intake of key nutrients were to increase the intake of fruit and vegetables, beans and pulses, dark green vegetables, and oily fish, to limit processed meats and high-fat food products and to choose fibre-rich carbohydrates, low-fat dairy and lean meats (60-69%). An average agreement of 82.8% between metabotype and manual approaches was revealed, with excellent agreements in metabotype-1 (94.4%) and metabotype-3 (92.3%). CONCLUSIONS The optimised metabotype approach proved capable of delivering targeted dietary advice for healthy adults, being highly comparable with individualised advice. The next step is to ascertain whether the optimised metabotype approach is effective in changing diet quality.
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Affiliation(s)
- Elaine Hillesheim
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Dublin 4, Belfield Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Dublin 4, Belfield Ireland
| | - Miriam F. Ryan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Dublin 4, Belfield Ireland
| | - Eileen Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Dublin 4, Belfield Ireland
| | - Helen M. Roche
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Dublin 4, Belfield Ireland
- Nutrigenomics Research Group, School of Public Health, Physiotherapy and Sports Science & Diabetes Complications Research Centre, UCD, Dublin 4, Belfield Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Dublin 4, Belfield Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Dublin 4, Belfield Ireland
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Norman CD, Haresign H, Forer B, Mehling C, Krajnak J, Bloomberg H, Howe A, Legare J. Engagement, Innovation, and Impact in a Dietitian Contact Centre: The EatRight Ontario Experience. CAN J DIET PRACT RES 2020; 81:106-111. [PMID: 32072819 DOI: 10.3148/cjdpr-2020-002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: EatRight Ontario (ERO), a multi-modal dietitian service (phone, email, web), provided the public and health intermediaries with healthy eating advice, professional support, and health promotion tools from 2007 to 2018. An evaluation of ERO was conducted to assess the impact of the model on knowledge, attitudes, and behaviour for consumers, utilization, and support levels and satisfaction provided to health intermediaries. Methods: Consumer clients were sent a survey 1-4 weeks after using the ERO service to capture self-reported dietary changes, intentions, nutritional knowledge, and satisfaction. Health intermediaries were recruited through an electronic ERO newsletter and asked about how ERO supported their practice. Results: Of the 867 consumer respondents, 92% had either made a change or indicated that information from ERO confirmed their present behaviour, and 96% indicated they would recommend the services to others. Of the 337 health intermediaries who responded 71% indicated that ERO provided services they could not deliver. Conclusions: ERO's multi-modal dietitian contact centre provides a model for implementing successful remote service access for consumers and professionals to support healthy eating across diverse demographics and geographies, including those in geographically underserved areas.
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Affiliation(s)
- Cameron D Norman
- Jeanne Legare & Associates, Vancouver, BC.,Cense Ltd., Toronto, ON.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | | | - Barry Forer
- Jeanne Legare & Associates, Vancouver, BC.,School of Population & Public Health, University of British Columbia, Vancouver, BC
| | | | - Judith Krajnak
- Jeanne Legare & Associates, Vancouver, BC.,Primary Health Care Evaluation, Alberta Health Services, Edmonton, AB
| | | | - Adam Howe
- Jeanne Legare & Associates, Vancouver, BC.,Department of Sociology, University of British Columbia, Vancouver, BC
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Wickramasinghe K, Mathers JC, Wopereis S, Marsman DS, Griffiths JC. From lifespan to healthspan: the role of nutrition in healthy ageing. J Nutr Sci 2020; 9:e33. [PMID: 33101660 PMCID: PMC7550962 DOI: 10.1017/jns.2020.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
Across the globe, there has been a marked increase in longevity, but significant inequalities remain. These are exacerbated by inadequate access to proper nutrition and health care services and to reliable information to make the decisions related to nutrition and health care. Many in economically developing as well as developed societies are plagued with the double-burden of energy excess and undernutrition. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity, increased medical costs and reduced quality of life. While adequate nutrition is fundamental to good health at all stages of the life course, the impact of diet on prolonging good quality of life during ageing remains unclear. For progress to continue, there is need for new and/or innovative approaches to promoting health as individuals age, as well as qualitative and quantitative biomarkers and other accepted tools that can measure improvements in physiological integrity throughout life. A framework for progress has been proposed by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health. Here, we focused on the impact of nutrition within this framework, which takes a broad, person-centred emphasis on healthy ageing, stressing the need to better understand each individual's intrinsic capacity, their functional abilities at various life stages, and the impact of their mental, and physical health, as well as the environments they inhabit.
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Affiliation(s)
- Kremlin Wickramasinghe
- WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation
| | - John C. Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon TyneNE2 4HH, UK
| | - Suzan Wopereis
- Research Group Microbiology and Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), Zeist, NL-3704 HE, The Netherlands
| | | | - James C. Griffiths
- International and Scientific Affairs, Council for Responsible Nutrition-International, Washington, DC20036, USA
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40
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Dimitratos SM, German JB, Schaefer SE. Wearable Technology to Quantify the Nutritional Intake of Adults: Validation Study. JMIR Mhealth Uhealth 2020; 8:e16405. [PMID: 32706729 PMCID: PMC7407252 DOI: 10.2196/16405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/13/2020] [Accepted: 04/10/2020] [Indexed: 01/20/2023] Open
Abstract
Background Wearable and mobile sensor technologies can be useful tools in precision nutrition research and practice, but few are reliable for obtaining accurate and precise measurements of diet and nutrition. Objective This study aimed to assess the ability of wearable technology to monitor the nutritional intake of adult participants. This paper describes the development of a reference method to validate the wristband’s estimation of daily nutritional intake of 25 free-living study participants and to evaluate the accuracy (kcal/day) and practical utility of the technology. Methods Participants were asked to use a nutrition tracking wristband and an accompanying mobile app consistently for two 14-day test periods. A reference method was developed to validate the estimation of daily nutritional intake of participants by the wristband. The research team collaborated with a university dining facility to prepare and serve calibrated study meals and record the energy and macronutrient intake of each participant. A continuous glucose monitoring system was used to measure adherence with dietary reporting protocols, but these findings are not reported. Bland-Altman tests were used to compare the reference and test method outputs (kcal/day). Results A total of 304 input cases were collected of daily dietary intake of participants (kcal/day) measured by both reference and test methods. The Bland-Altman analysis had a mean bias of −105 kcal/day (SD 660), with 95% limits of agreement between −1400 and 1189. The regression equation of the plot was Y=−0.3401X+1963, which was significant (P<.001), indicating a tendency for the wristband to overestimate for lower calorie intake and underestimate for higher intake. Researchers observed transient signal loss from the sensor technology of the wristband to be a major source of error in computing dietary intake among participants. Conclusions This study documents high variability in the accuracy and utility of a wristband sensor to track nutritional intake, highlighting the need for reliable, effective measurement tools to facilitate accurate, precision-based technologies for personal dietary guidance and intervention.
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Affiliation(s)
- Sarah M Dimitratos
- Foods for Health Institute, University of California, Davis, CA, United States
| | - J Bruce German
- Foods for Health Institute, University of California, Davis, CA, United States
| | - Sara E Schaefer
- Foods for Health Institute, University of California, Davis, CA, United States
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Characteristics of participants who benefit most from personalised nutrition: findings from the pan-European Food4Me randomised controlled trial. Br J Nutr 2020; 123:1396-1405. [PMID: 32234083 DOI: 10.1017/s0007114520000653] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Little is known about who would benefit from Internet-based personalised nutrition (PN) interventions. This study aimed to evaluate the characteristics of participants who achieved greatest improvements (i.e. benefit) in diet, adiposity and biomarkers following an Internet-based PN intervention. Adults (n 1607) from seven European countries were recruited into a 6-month, randomised controlled trial (Food4Me) and randomised to receive conventional dietary advice (control) or PN advice. Information on dietary intake, adiposity, physical activity (PA), blood biomarkers and participant characteristics was collected at baseline and month 6. Benefit from the intervention was defined as ≥5 % change in the primary outcome (Healthy Eating Index) and secondary outcomes (waist circumference and BMI, PA, sedentary time and plasma concentrations of cholesterol, carotenoids and omega-3 index) at month 6. For our primary outcome, benefit from the intervention was greater in older participants, women and participants with lower HEI scores at baseline. Benefit was greater for individuals reporting greater self-efficacy for 'sticking to healthful foods' and who 'felt weird if [they] didn't eat healthily'. Participants benefited more if they reported wanting to improve their health and well-being. The characteristics of individuals benefiting did not differ by other demographic, health-related, anthropometric or genotypic characteristics. Findings were similar for secondary outcomes. These findings have implications for the design of more effective future PN intervention studies and for tailored nutritional advice in public health and clinical settings.
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Reinders MJ, Bouwman EP, van den Puttelaar J, Verain MCD. Consumer acceptance of personalised nutrition: The role of ambivalent feelings and eating context. PLoS One 2020; 15:e0231342. [PMID: 32282841 PMCID: PMC7153894 DOI: 10.1371/journal.pone.0231342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/22/2020] [Indexed: 01/09/2023] Open
Abstract
Providing dietary suggestions based on an individual's nutritional needs may contribute to the prevention of non-communicable dietary related diseases. Consumer acceptance is crucial for the success of these personalised nutrition services. The current study aims to build on previous studies by exploring whether ambivalent feelings and contextual factors could help to further explain consumers' usage intentions regarding personalised nutrition services. An online administered survey was conducted in December 2016 with a final sample of 797 participants in the Netherlands. Different models were tested and compared by means of structural equation modelling. The final model indicated that the result of weighing personalisation benefits and privacy risks (called the risk-benefit calculus) is positively related to the intention to use personalised nutrition advice, suggesting a more positive intention when more benefits than risks are perceived. Additionally, the model suggests that more ambivalent feelings are related to a lower intention to use personalised nutrition advice. Finally, we found that the more the eating context is perceived as a barrier to use personalised nutrition advice, the more ambivalent feelings are perceived. In conclusion, the current study suggests the additional value of ambivalent feelings as an affective construct, and eating context as a possible barrier in predicting consumers' intention to use personalised nutrition advice. This implies that personalised nutrition services may need to address affective concerns and consider an individual's eating context.
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Affiliation(s)
- Machiel J. Reinders
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Emily P. Bouwman
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Jos van den Puttelaar
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Muriel C. D. Verain
- Wageningen Economic Research, Wageningen University & Research, Wageningen, The Netherlands
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Lau Y, Chee DGH, Chow XP, Cheng LJ, Wong SN. Personalised eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials. Prev Med 2020; 132:106001. [PMID: 31991155 DOI: 10.1016/j.ypmed.2020.106001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/26/2019] [Accepted: 01/24/2020] [Indexed: 01/04/2023]
Abstract
Given that many existing electronic health (eHealth) interventions with a general approach have limited effects, a personalised approach is necessary. We aimed to evaluate the effectiveness of personalised eHealth interventions in reducing body weight and identify the effective key features of such interventions. We searched seven databases for randomised controlled trials (RCTs) from inception until September 6, 2018. Of the 26,733 records identified, 15 RCTs were included. Meta-analysis revealed a significant reduction (-2.77 kg, 95% confidence interval - 3.54 to -2.00 kg) in the personalised eHealth intervention group compared with that in the control group (Z = -7.04, p < .001). The duration of the interventions ranged from 14 weeks and three trials had follow-up assessments at 6 and 12 months. Our subgroup analyses highlighted several crucial design elements of future personalised eHealth interventions by utilising a combination of tailored content and customised feedback with human feedback, usage of theoretical basis, short message service, device, reminder, self-monitoring, goal setting and synchronous communication for 12 to 14 weeks. Egger's regression asymmetry test suggested no evidence of publication bias (p = .458). Using meta-regression we found evidence that a statistically significant impact of age and year of publication on the effectiveness of intervention. The overall evidence grade of outcomes ranged from very low to low, hence future trials should use well-designed RCTs.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Xue Ping Chow
- Nursing Division, Singapore General Hospital, SingHealth, Singapore.
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Suei Nee Wong
- National University of Singapore Libraries, National University of Singapore, Singapore.
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Kaufman-Shriqui V, Salem H, Boaz M, Birk R. Knowledge and Attitudes Towards Nutrigenetics: Findings from the 2018 Unified Forces Preventive Nutrition Conference (UFPN). Nutrients 2020; 12:nu12020335. [PMID: 32012749 PMCID: PMC7071140 DOI: 10.3390/nu12020335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Nutrigenetics indicates that individual genetic variability results in altered health outcomes necessitating personalized nutrition adaptation. Registered dietitians are recognized as the clinical nutrition experts, but their knowledge and attitudes regarding nutrigenetics has not been delineated. Methods: This cross sectional online survey was conducted in a convenience sample of 169 national nutrition conference attendees. The survey queried demographics, knowledge, and attitudes towards nutrigenetics and information on training in nutrigenetics. Results: The majority of participants were registered dietitians and female, 45% of whom held advanced degrees. Personalized nutrition was perceived by 93.5% of participants as highly important or important; however, 94% of respondents indicated they are not sufficiently knowledgeable in personalized nutrition and only 9.5% had received training in nutrigenetics. The mean nutrigenetics knowledge score was 6.89 ± 1.67 (out of a possible 12). A multivariate regression model of knowledge score identified education as the only independent predictor of this outcome. Conclusion: Personalized nutrition is a rapidly developing field that incorporates genetic data into clinical practice. Dietitians recognize the importance of advanced studies to acquire knowledge in nutrigenetics. Only by acquiring the necessary knowledge can dietitians accurately translate this nutrigenetics into clinical practice.
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Affiliation(s)
| | | | | | - Ruth Birk
- Correspondence: ; Tel.: +972-3-976-5704; Fax: +972-3-542-3553
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What information do consumers want about the greenhouse gas emissions of their diets? Proc Nutr Soc 2020. [DOI: 10.1017/s0029665120007296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Computer-based tailored dietary counselling improves the nutrient adequacy of the diet of French pregnant women: a randomised controlled trial. Br J Nutr 2019; 123:220-231. [PMID: 31625483 DOI: 10.1017/s0007114519002617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
During pregnancy, mothers-to-be should adapt their diet to meet increases in nutrient requirements. Pregnant women appear to be keener to adopt healthier diets, but are not always successful. The objective of the present study was to determine whether a guided, stepwise and tailored dietary counselling programme, designed using an optimisation algorithm, could improve the nutrient adequacy of the diet of pregnant women, beyond generic guidelines. Pregnant women (n 80) who attended Notre-Dame-de-Bon-Secours Maternity Clinic were randomly allocated to the control or intervention arm. Dietary data were obtained twice from an online 3-d dietary record. The nutrient adequacy of the diet was calculated using the PANDiet score, a 100-point diet quality index adapted to the specific nutrient requirements for pregnancy. Women were supplied with generic dietary guidelines in a reference booklet. In the intervention arm, they also received nine sets of tailored dietary advice identified by an optimisation algorithm as best improving their PANDiet score. Pregnant women (n 78) completed the 12-week dietary follow-up. Initial PANDiet scores were similar in the control and intervention arms (60·4 (sd 7·3) v. 60·3 (sd 7·3), P = 0·92). The PANDiet score increased in the intervention arm (+3·6 (sd 9·3), P = 0·02) but not in the control arm (-0·3 (sd 7·3), P = 0·77), and these changes differed between arms (P = 0·04). In the intervention arm, there were improvements in the probabilities of adequacy for α-linolenic acid, thiamin, folate and cholesterol intakes (P < 0·05). Tailored dietary counselling using a computer-based algorithm is more effective than generic dietary counselling alone in improving the nutrient adequacy of the diet of French women in mid-pregnancy.
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Celis-Morales C, Livingstone KM, Petermann-Rocha F, Navas-Carretero S, San-Cristobal R, O'Donovan CB, Moschonis G, Manios Y, Traczyk I, Drevon CA, Daniel H, Marsaux CFM, Saris WHM, Fallaize R, Macready AL, Lovegrove JA, Gibney M, Gibney ER, Walsh M, Brennan L, Martinez JA, Mathers JC. Frequent Nutritional Feedback, Personalized Advice, and Behavioral Changes: Findings from the European Food4Me Internet-Based RCT. Am J Prev Med 2019; 57:209-219. [PMID: 31248745 DOI: 10.1016/j.amepre.2019.03.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study tested the hypothesis that providing personalized nutritional advice and feedback more frequently would promote larger, more appropriate, and sustained changes in dietary behavior as well as greater reduction in adiposity. STUDY DESIGN A 6-month RCT (Food4Me) was conducted in seven European countries between 2012 and 2013. SETTING/PARTICIPANTS A total of 1,125 participants were randomized to Lower- (n=562) or Higher- (n=563) Frequency Feedback groups. INTERVENTION Participants in the Lower-Frequency group received personalized nutritional advice at baseline and at Months 3 and 6 of the intervention, whereas the Higher-Frequency group received personalized nutritional advice at baseline and at Months 1, 2, 3 and 6. MAIN OUTCOME MEASURES The primary outcomes were change in dietary intake (at food and nutrient levels) and obesity-related traits (body weight, BMI, and waist circumference). Participants completed an online Food Frequency Questionnaire to estimate usual dietary intake at baseline and at Months 3 and 6 of the intervention. Overall diet quality was evaluated using the 2010 Healthy Eating Index. Obesity-related traits were self-measured and reported by participants via the Internet. Statistical analyses were performed during the first quarter of 2018. RESULTS At 3 months, participants in the Lower- and Higher-Frequency Feedback groups showed improvements in Healthy Eating Index score; this improvement was larger in the Higher-Frequency group than the Lower-Frequency group (Δ=1.84 points, 95% CI=0.79, 2.89, p=0.0001). Similarly, there were greater improvements for the Higher- versus Lower-Frequency group for body weight (Δ= -0.73 kg, 95% CI= -1.07, -0.38, p<0.0001), BMI (Δ= -0.24 kg/m2, 95% CI= -0.36, -0.13, p<0.0001), and waist circumference (Δ= -1.20 cm, 95% CI= -2.36, -0.04, p=0.039). However, only body weight and BMI remained significant at 6 months. CONCLUSIONS At 3 months, higher-frequency feedback produced larger improvements in overall diet quality as well as in body weight and waist circumference than lower-frequency feedback. However, only body weight and BMI remained significant at 6 months. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01530139.
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Affiliation(s)
- Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Exercise Physiology Research Centre (CIFE), Universidad Mayor, Santiago, Chile; BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Fanny Petermann-Rocha
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
| | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - Clare B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hannelore Daniel
- Molecular Nutrition Unit, Department Food and Nutrition, Technische Universität München, Munich, Germany
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rosalind Fallaize
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom; Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Marianne Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain; Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Gan J, Siegel JB, German JB. Molecular annotation of food - towards personalized diet and precision health. Trends Food Sci Technol 2019; 91:675-680. [PMID: 33299266 DOI: 10.1016/j.tifs.2019.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Personalized diet requires matching human genotypic and phenotypic features to foods that increase the chance of achieving a desired physiological health outcome. New insights and technologies will help to decipher the intricacies of diet-health relationships and create opportunities for breakthroughs in dietary interventions for personal health management. Scope and Approach This article describes the scientific progress towards personalized diet and points out the need for integrating high-quality data on food. A framework for molecular annotation of food is presented, focusing on what aspects should be measured and how these measures relate to health. Strategies of applying trending technologies to improve personalized diet and health are discussed, highlighting challenges and opportunities for transforming data into insights and actions. Key Findings and Conclusions The goal of personalized diet is to enable individuals and caregivers to make informed dietary decisions for targeted health management. Achieving this goal requires a better understanding of how molecular properties of food influence individual eating behavior and health outcomes. Annotating food at a molecular level encompasses characterizing its chemical composition and modifications, physicochemical structure, and biological properties. Features of molecular properties in the food annotation framework are applicable to varied conditions and processes from raw materials to meals. Applications of trending technologies, such as omics techniques, wearable biosensors, and artificial intelligence, will support data collection, data analytics, and personalized dietary actions for targeted health management.
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Affiliation(s)
- Junai Gan
- Department of Food Science and Technology, University of California, Davis, CA, United States
| | - Justin B Siegel
- Department of Chemistry, University of California, Davis, CA, United States
- Department of Biochemistry and Molecular Medicine, University of California, Davis, CA, United States
- Genome Center, University of California, Davis, CA, United States
| | - J Bruce German
- Department of Food Science and Technology, University of California, Davis, CA, United States
- Foods for Health Institute, University of California, Davis, CA, United States
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Verma M, Hontecillas R, Tubau-Juni N, Abedi V, Bassaganya-Riera J. Challenges in Personalized Nutrition and Health. Front Nutr 2018; 5:117. [PMID: 30555829 PMCID: PMC6281760 DOI: 10.3389/fnut.2018.00117] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 11/14/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Meghna Verma
- Nutritional Immunology and Molecular Medicine Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA, United States.,Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Blacksburg, VA, United States
| | - Raquel Hontecillas
- Nutritional Immunology and Molecular Medicine Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA, United States
| | - Nuria Tubau-Juni
- Nutritional Immunology and Molecular Medicine Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA, United States
| | - Vida Abedi
- Nutritional Immunology and Molecular Medicine Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA, United States.,Department of Biomedical and Translational Informatics, Geisinger Health System, Danville, PA, United States
| | - Josep Bassaganya-Riera
- Nutritional Immunology and Molecular Medicine Laboratory, Biocomplexity Institute of Virginia Tech, Blacksburg, VA, United States
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Seyedhamzeh S, Bagheri M, Keshtkar AA, Qorbani M, Viera AJ. Physical activity equivalent labeling vs. calorie labeling: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2018; 15:88. [PMID: 30217210 PMCID: PMC6137736 DOI: 10.1186/s12966-018-0720-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many countries are trying to identify strategies to control obesity. Nutrition labeling is a policy that could lead to healthy food choices by providing information to consumers. Calorie labeling, for example, could lead to consumers choosing lower calorie foods. However, its effectiveness has been limited. Recently, physical activity equivalent labeling (i.e., displaying calories in terms of estimated amount of physical activity to burn calories) has been proposed as an alternative to the calorie-only label. The aim of this review was to identify and evaluate the published literature comparing effects on health behavior between physical activity equivalent labeling and calorie-only labeling. METHOD We searched the following databases: Pubmed/medline, Scopus, Web of science, Agris, Cochrane library, Google Scholar. We also searched along with reference lists of included articles. Articles that were published between 1 January 2000 and 31 October 2016 were eligible for inclusion provided they reported on studies that examined the effects of both types of labeling and included at least one outcome of interest. Mean and standard deviations of the included results were combined using a fixed-effect model. The difference in calories purchased between people exposed to physical activity labeling and calorie-only labeling was calculated as weighted mean difference by using a fixed-effect model. RESULT The difference of calories ordered between physical activity label and calorie label groups was not statistically significant (SMD: -0.03; 95% CI: -0.13, 0.07). The difference of calories ordered between physical activity label and calorie label according to real vs unreal (e.g. web-based) condition was 65 Kcal fewer in real-world settings. CONCLUSION Physical activity calorie equivalent labeling in minutes does not significantly reduce calories ordered compared to calorie-only labeling.
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Affiliation(s)
- Shirin Seyedhamzeh
- Food and Nutrition Policy, Department of Community Nutrition, School of Nutritional sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. .,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,, No 44, Hojjat-dost Alley, Naderi Street, Keshavarz Boulevard, Tehran, 1416-643931, Iran.
| | - Minoo Bagheri
- PhD student in Nutrition, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Keshtkar
- MD, MPH, PhD of Epidemiology, Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- PhD of Epidemiology, Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Anthony J Viera
- MD, MPH, Professor and Chair, Department of Community and Family Medicine, Duke University, Durham, NC, USA
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