@Article{info:doi/10.2196/29088,
author="Zenun Franco, Rodrigo
and Fallaize, Rosalind
and Weech, Michelle
and Hwang, Faustina
and Lovegrove, Julie A",
title="Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial",
journal="J Med Internet Res",
year="2022",
month="Apr",
day="25",
volume="24",
number="4",
pages="e29088",
keywords="personalized nutrition; web-based; nutrition app; app; dietary intervention; eNutri; precision nutrition; mHealth; healthy eating index; diet quality scores; FFQ; food frequency questionnaire; EatWellUK",
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 ",
issn="1438-8871",
doi="10.2196/29088",
url="https://www.jmir.org/2022/4/e29088",
url="https://doi.org/10.2196/29088",
url="http://www.ncbi.nlm.nih.gov/pubmed/35468093"
}