Increasing dietary fibre intake in healthy adults using personalised dietary advice compared with general advice: a single-blind randomised controlled trial

Iris Rijnaarts, Nicole M de Roos, Taojun Wang, Erwin G Zoetendal, Jan Top, Marielle Timmer, Emily P Bouwman, Koen Hogenelst, Ben Witteman, Nicole de Wit, Iris Rijnaarts, Nicole M de Roos, Taojun Wang, Erwin G Zoetendal, Jan Top, Marielle Timmer, Emily P Bouwman, Koen Hogenelst, Ben Witteman, Nicole de Wit

Abstract

Objective: A high-fibre diet is associated with a lower risk for diseases. However, few adults meet the dietary fibre recommendation. Therefore, the effects and acceptance of an algorithm-generated personalised dietary advice (PDA) compared with general advice (GA) on fibre intake were investigated.

Design: A 6-week, single-blind randomised controlled trial with a 3-month follow-up.

Setting: PDA was based on habitual intake and provided fibre-rich alternatives using a website; GA contained brochures. Dietary intake was assessed at baseline, week 1, week 6 and 3-month follow-up. Both groups evaluated their advice at week 6. All participants had access to PDA from week 7 until 3-month follow-up.

Participants: Two groups of healthy adults: PDA (n 34) and GA (n 47). For 3-month follow-up analysis, participants were re-divided into visitors (n 52) and non-visitors (n 26) of the PDA.

Results: At week 6, energy intake remained stable in both groups, but fibre intake per 1000 kcal increased non-significantly in both groups (PDA = Δ0·5 ± 2·8; GA = Δ0·8 ± 3·1, P = 0·128). Importantly, a significantly higher percentage of PDA participants adhered to the recommendation compared with week 1 (PDA = 21 % increase; GA = 4 % increase, P ≤ 0·001). PDA participants evaluated the advice significantly better compared with GA participants. At 3-month follow-up, fibre intake increased compared with baseline (visitors = Δ2·2 ± 2·6, P < 0·001; non-visitors = Δ1·5 ± 1·9, P = 0·001), but was insignificantly different between groups. Visitors had a decrease and non-visitors had an increase in energy intake (visitors =Δ - 132 ± 525; non-visitors = Δ109 ± 507, P = 0·055).

Conclusions: The algorithm-generated PDA was well accepted and stimulated adherence to the recommendations more than GA, indicating to be a suitable and cost-efficient method for improving dietary fibre intake in healthy adults.

Trial registration: ClinicalTrials.gov NCT03848546.

Keywords: Advice; Dietary fibre; Evaluation; Personalised; Tailored.

Figures

Fig. 1
Fig. 1
Overview of the study design. Questionnaires are performed online or via mobile application. General advice consisted of two flyers of the Netherlands Nutrition Center and the Dutch Digestive Foundation, and a website containing general information. The intervention group also received this information and their personal advice
Fig. 2
Fig. 2
Study recruitment and flow chart
Fig. 3
Fig. 3
(A) Dietary fibre intake (per 1000 kcal) did not change during the 6-week intervention. Data are based on 24-h recall recalls. Error bars represent standard errors. , general advice (GA) (n 47); , personalised dietary advice (PDA) (n 34). (B) Adherence to the fibre recommendation during the 6-week intervention is higher in the intervention group. Recommendation according the Dutch Health Council of 14 g of fibre/1000 kcal. , Week 1; , week 6. * indicates significant differences within the group
Fig. 4
Fig. 4
Answers to ‘did you manage to eat more fibre today’ did not differ between groups. Daily assessed using smartphone-based ecological momentary assessment (EMA). Answers were rated on a visual analogue scale rating from 0 ‘not at all’ to 100 ‘yes, very much’. , GA; , personalised dietary advice (PDA)
Fig. 5
Fig. 5
(A) Both groups increased dietary fibre intake at 3-month follow-up compared with baseline. (B) Visitors decreased their energy intake, non-visitors increased their energy intake (NS). Visitors are participants in the intervention group, and control participants who visited the personalised dietary advice (PDA) after the intervention, non-visitors are participants who never visited the PDA website. * Significant difference within the group. Error bars represent the standard errors. Data are based on the FFQ. , Non-visitors (n 26); , visitors (n 52)
Fig. 6
Fig. 6
Intervention group rated the advice significantly better than the general advice (GA) group. The questionnaire was performed after the 6-week intervention. Statements were rated on a seven-point Likert scale. Error bars represent the standard deviation. , Personalised dietary advice (PDA) (n34); , GA (n 47)

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Source: PubMed

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