Exploring the Potential of Personalized Dietary Advice for Health Improvement in Motivated Individuals With Premetabolic Syndrome: Pretest-Posttest Study

Sandra van der Haar, Femke P M Hoevenaars, Willem J van den Brink, Tim van den Broek, Mariëlle Timmer, André Boorsma, Esmée L Doets, Sandra van der Haar, Femke P M Hoevenaars, Willem J van den Brink, Tim van den Broek, Mariëlle Timmer, André Boorsma, Esmée L Doets

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://ichgcp.net/clinical-trials-registry/NCT04595669.

Keywords: diet; dietary advice; dietary behavior; dietary feedback; digital health; metabolic; metabolic health; metabolic syndrome; personalized nutrition.

Conflict of interest statement

Conflicts of Interest: None declared.

©Sandra van der Haar, Femke P M Hoevenaars, Willem J van den Brink, Tim van den Broek, Mariëlle Timmer, André Boorsma, Esmée L Doets. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.06.2021.

Figures

Figure 1
Figure 1
Flowchart of recruitment and screening procedure. HDL: high-density lipoprotein.
Figure 2
Figure 2
Association between the Δ dietary scores and Δ health scores calculated between week 0 and week 16 of the study.

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