Effect of personalized nutrition on health-related behavior change: evidence from the Food4Me randomized controlled trial

Authors: CELIS-MORALES, CARLOS - Newcastle University; LIVINGSTONE, KATHERINE - Newcastle University; O'DONOVAN, CLARE - University College Dublin; WOOLHEAD, CLARA - University College Dublin; FORSTER, HANNAH - University College Dublin; WALSH, MARIANNE - University College Dublin; MARSAUX, CYRIL - Maastricht University; MACREADY, ANNA - University Of Reading; FALLAIZE, ROSALIND - University Of Reading; TSIRIGOTI, LYDIA - Harokopio University Of Athens; LAMBRINOU, CHRISTINA - Harokopio University Of Athens; EFSTATHOPOULOU, EIRINI - Harokopio University Of Athens; MOSCHONIS, GEORGE - Harokopio University Of Athens; NAVAS-CARRETERO, SANTIAGO - University Of Navarra; CAN-CRISTOBAL, RODRIGO - University Of Navarra; KOLOSSA, SYLVIA - Technische Universitat Munchen; HALLMANN, JACQUELINE - Technische Universitat Munchen; GODLEWSKA, MAGDALENA - Instytut Zywnosci Zywienia; SURWILLA, AGNIESZKA - Instytut Zywnosci Zywienia; TRACZYK, IWONA - Instytut Zywnosci Zywienia; DREVON, CHRISTIAN - University Of Oslo; BOUWMAN, JILDAU - Tno Quality Of Life; GRIMALDI, KEITH - Eurogenetica Ltd; Parnell, Laurence; MANIOS, YANNIS - Harokopio University Of Athens; DANIEL, HANNELORE - Technische Universitat Munchen; MARTINEZ, J ALFREDO - University Of Navarra; LOVEGROVE, JULIE - University Of Reading; GIBNEY, EILEEN - University College Dublin; BRENNAN, LORRAINE - University College Dublin; SARIS, WIM - Maastricht University; GIBNEY, MIKE - University College Dublin; MATHERS, JOHN - Newcastle University

Submitted to: International Journal of Epidemiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/7/2016
Publication Date: 8/14/2016
Citation: Celis-Morales, C., Livingstone, K.M., O'Donovan, C.B., Woolhead, C., Forster, H., Walsh, M.C., Marsaux, C.F., Macready, A.L., Fallaize, R., Tsirigoti, L., Lambrinou, C.P., Efstathopoulou, E., Moschonis, G., Navas-Carretero, S., Can-Cristobal, R., Kolossa, S., Hallmann, J., Godlewska, M., Surwilla, A., Traczyk, I., Drevon, C.A., Bouwman, J., Grimaldi, K., Parnell, L.D., Manios, Y., Daniel, H., Martinez, J., Lovegrove, J.A., Gibney, E.R., Brennan, L., Saris, W.H., Gibney, M., Mathers, J.C. 2016. Effect of personalized nutrition on health-related behavior change: evidence from the Food4Me randomized controlled trial. International Journal of Epidemiology. doi: 10.1093/ije/dyw186.

Interpretive Summary: Each one of us is genetically different and some of those genetic differences define the way we respond to the environment, including the foods we eat. The Food4Me study (comprised primarily of top European-based nutrition scientists) sought to test if information on five specific genes would improve a person’s diet and health. The six month test involved 1,269 volunteers enrolled via the internet who lived in one of seven European countries. After six months, results showed persons receiving any personal dietary advice improved their diet in many different ways compared to those persons in the control group, who received typical general dietary advice. No evidence was found to indicate that adding health, lifestyle or genetic information for just five genes improved the benefits of personalizing the dietary advice. Thus, dietary advice designed for the individual is just as effective as that same advice combined with a very limited amount of genetic information.

Technical Abstract: Background - Optimal nutritional choices are linked with better health but most current interventions to improve diet have limited effect. We tested the hypothesis that providing personalized nutrition (PN) advice based on collected information on individual diet and lifestyle, phenotype or genotype would produce larger, more appropriate, and sustained changes in dietary behavior. Methods - Adults from 7 European countries were recruited to an internet-delivered intervention (Food4Me) and randomized to i) conventional dietary advice (control) or to PN advice based on: ii) individual baseline diet; iii) individual baseline diet plus phenotype (anthropometry and blood-based biomarkers); or iv) individual baseline diet plus phenotype plus genotype (5 diet-responsive genetic variants). Outcomes were dietary intake, anthropometry and blood-based biomarkers measured at baseline and after 3 and 6 months intervention. Findings - At baseline, mean age of participants was 39.8 years (range 18 – 79), 59% of participants were female and mean BMI was 25.5. From a cohort of 1607 enrolled subjects, 1269 completed the study. Following a 6 months intervention, participants randomized to PN consumed significantly less energy, red meat, salt, and saturated fat, increased folate intake and had higher Healthy Eating Index score than those randomized to the control arm. There was no evidence that including phenotypic and genotypic information enhanced the effectiveness of the PN advice. Interpretation - Among European adults from 7 countries, PN advice via internet-delivered intervention produced larger and more appropriate changes in dietary behavior than a conventional approach. Inclusion of personalized phenotypic- or genotypic-based advice did not enhance the effectiveness of the intervention.