JMIR Publications

ABSTRACT

Background:

A digital-first strategy is increasingly implemented in the field of nutrition to relieve participant burden, speed up recruitment rates, collect real-world data and increase the diversity of the study population. However, fully remote studies lack face-to-face interaction, which could impact motivation, particularly in delivering personalized nutritional advice. Additionally, self-reported data may vary in standardization and completeness.

Objective:

We set out to gain insight in participant experience, capability of participants to perform do-it-yourself anthropometric measurements and to test the effectiveness of personalized nutritional interventions via a real-life remote randomized controlled trial.

Methods:

The study was a randomized controlled trial with three arms, including a control group that received generic advice (n=43), a personalized intervention group that received personalized advice only (n=40) and a personalized intervention plus group that received personalized advice plus personalized food boxes (n=39). A total of 180 adult persons who were overweight or obese and motivated to lose weight were included. The intervention lasted six weeks and data on anthropometry, nutritional habits and study experience was collected. The study was fully digital and all data was collected by the participants themselves.

Results:

Participants receiving personalized, but not generic nutritional advice, significantly lost body weight (-1.0kg, p<0.01). Participants receiving personalized food boxes in addition to the personalized nutritional advice lost significantly more body weight compared to the other two groups (-2.5kg, p<0.01), and decreased in hip circumference as well (-2.9cm, p<0.05). The majority of the participants reported to be able to perform anthropometric measurements easily (84%) and fill in the questionnaires (92%) from home. Personalized advice was not easier or more enjoyable to implement compared to generic nutritional advice. Provision of personalized food boxes did increase ease (p<0.001) and pleasure (p<0.01) to implement the personalized nutritional advice. All participants, independent of the intervention arm, reduced the intake of unhealthy food groups such as ready-made meals (-53.4%), sauces & gravy (-46.3% g), sweet snacks (-24.8%) and savoury snacks (-21.1%).

Conclusions:

Providing nutritional advice to overweight and obese adults who are motivated to lose weight resulted in a reduction of unhealthy eating habits. Personalized nutritional advice is more effective in promoting weight loss than generic nutritional advice, even when provided fully digitally. Provision of personalized food boxes helps to translate the advice into an actual diet, resulting in more weight loss and decreased hip circumference. The majority of the participants reported that they could independently perform anthropometric measurements from home themselves. We conclude that it is feasible to perform such nutritional intervention studies fully online, resulting in measurable anthropometric effects. Clinical Trial: ClinicalTrials.gov NCT06547983