In a recent study in Nature Medicine, researchers compared the effectiveness of personalized dietary programs (PDPs) and general advice on cardiometabolic health.
Study: Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial. Image credit: Inside Creative House / Shutterstock.com
The role of diet in disease risk
Diet and lifestyle-related interventions are effective non-drug approaches that can reduce the risk of many chronic diseases. Although many studies emphasize the importance of a proper diet, a significant increase in diet-related illnesses has been observed and is believed to be due to poor adherence to dietary guidelines. .
In fact, one recent study found that less than 1% of the UK population adhered to all dietary recommendations, with similarly low levels of adherence reported in the US. Multiple factors contribute to variation in health responses to foods. Therefore, an effective personalized nutrition program based on lifestyle and phenotypic biological factors may increase compliance with dietary guidelines.
Previously conducted randomized controlled trials (RCTs) to evaluate the effectiveness of individualized nutrition programs have shown overall positive results. Benefits associated with this approach include improvements in blood parameters, glycemic index, dietary habits, intestinal health, physical activity, and anthropometric measurements. Nevertheless, additional research is needed to determine the effectiveness of PDP on adherence to recommendations and health outcomes.
About research
The ZOE Measuring Efficacy Through Outcomes of Diet (METHOD) study found that dietary customization, which includes multiple factors that contribute to inter- and intra-individual variation in nutritional responses to diet, increases adherence to recommendations and improves health outcomes. It was hypothesized that. The ZOE METHOD study was an 18-week RCT with a parallel design that compared the efficacy of PDP with standard dietary advice in a U.S. adult population.
Standard of care dietary advice was taken from the U.S. Dietary Guidelines for Americans 2020-2025, whereas the PDP dietary guidelines were based on the ZOE 2022 algorithm. PDP recommendations were based on personal health history, gut microbiota composition, and glucose and postprandial triglyceride (TG) levels. Dietary and lifestyle recommendations for PDP were delivered remotely through a telephone application called ZOE.
The current study recruited male and female participants between the ages of 40 and 70. All participants were from the United States, reported fruit and vegetable intake of less than 450 grams per day, and had waist circumference measurements greater than the ethnicity- and gender-specific 25th percentile. Selected participants were randomly assigned to one of two treatment groups.
research result
A total of 177 and 170 participants were assigned to the PDP and control groups, respectively. The PDP intervention resulted in greater health improvements than following U.S. standard-of-care dietary guidance, as demonstrated by significant reductions in body weight, TG levels, waist circumference, and hemoglobin A1c (HbA1c) in the PDP group. However, no changes in low-density lipoprotein cholesterol (LDL-C) levels were observed in the PDP group.
Greater variation in nutrient intake and individual foods was associated with PDP compared to the control group. Compared to controls, an improved and maintained gut microbial composition was observed in the PDP group, and these microbiome changes were more predictive of weight loss and hip circumference reduction than the control diet.
Study participants in the PDP group also showed favorable emotions regarding hunger, mood, and energy. Compared with standard dietary advice, customized dietary advice was more effective in reducing central obesity and TG levels in a healthy population.
After 18 weeks of dietary intervention, overall LDL-C levels were similar in both groups, but a significant reduction was observed in healthy participants who adhered to PDP guidelines. When participants were further stratified according to their baseline level of unhealthiness, reductions in LDL-C levels were observed in all adherence groups.
Consistent with previous studies, in the present study we observed that TG levels were sensitive to nutritional interventions. Importantly, LDL-C levels do not change with weight loss induced by dietary changes.
Additionally, the current study reported greater improvements in weight and waist circumference for participants in the PDP group than for participants who followed the general guidance.
conclusion
The potential benefits of PDP replace standard dietary advice, as individuals with the poorest diets were found to experience the greatest benefit from personalized nutritional interventions. Interestingly, in the current study, no significant health benefits were observed for participants who typically led healthy lifestyles from baseline.
Research results show that individualized nutritional programs are highly beneficial in improving cardiometabolic health.
Reference magazines:
Birmingham, K. M., Linenberg, I., Polidori, L., et al. (2024) Effects of a personalized nutrition program on cardiometabolic health: a randomized controlled trial. Natural Medicine 1-10. doi:10.1038/s41591-024-02951-6
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