Internet-Based Nutritional Guidance Encourages Healthier Eating

Chronic health con­di­tions have rapidly increased over the past 30 years, with one of the pre­dom­i­nant fac­tors being diet. Western diets char­ac­ter­ized by a high con­sump­tion of refined sugar, trans fats, and processed foods are asso­ci­ated with increased health risks. The Mediterranean diet (MedDiet), char­ac­ter­ized by high con­sump­tion of veg­eta­bles, fruit, olive oil, nuts, seeds, fish and poul­try, has been exten­sively stud­ied for its large range of ben­e­fits to health and reduced risk of dis­ease.

While a MedDiet is well rec­og­nized as one of the most healthy dietary pat­terns, nutri­tional guid­ance gen­er­ally rec­om­mends a ​“one size fits all” approach, which hasn’t had a great impact on the grow­ing rates of obe­sity and type 2 dia­betes. Personalized dietary inter­ven­tions that take indi­vid­ual ele­ments into con­sid­er­a­tion such as cur­rent diet, phe­no­type, and geno­type, have been shown to be more effec­tive in chang­ing dietary behav­iors.

While face-to-face inter­ven­tions are effec­tive, Internet-based inter­ven­tions are scal­able and more cost effec­tive. Until now, there have been no stud­ies eval­u­at­ing whether an Internet-based dietary inter­ven­tion can help peo­ple achieve a greater adher­ence to the MedDiet pat­tern.

In a new study, pub­lished in the American Journal of Clinical Nutrition, researchers have dis­cov­ered that per­son­al­ized Internet-based inter­ven­tions, could be a solu­tion to engag­ing peo­ple in health­ier eat­ing behav­iors.

The Food4Me PoP 6‑month, 4‑arm, ran­dom­ized trial with 1,270 par­tic­i­pants, aimed to improve dietary intake of food groups and nutri­ents in line with the MedDiet pat­tern, and used an Internet-based lifestyle inter­ven­tion to com­pare the out­comes of per­son­al­ized dietary and phys­i­cal activ­ity advice with gen­er­al­ized diet and lifestyle guid­ance. Participants were given access to a range of online infor­ma­tion, along with access to dieti­tians, nutri­tion­ist and researchers via email.

The two pri­mary out­comes, mea­sured via MedDiet score and var­i­ous anthro­po­met­ric mea­sures, were whether more per­son­al­ized dietary advice moti­vated peo­ple to choose a health­ier diet com­pared to con­ven­tional dietary guide­lines; and whether pro­vid­ing highly per­son­al­ized geno­type and phe­no­type dietary infor­ma­tion fur­ther moti­vated peo­ple to sus­tain those healthy changes.

At the end of the 6‑month inter­ven­tion, the par­tic­i­pants assigned to per­son­al­ized dietary advice had a higher adher­ence to the MedDiet com­pared to con­trols. And for those that received diet, phe­no­type and geno­type advice, healthy dietary adher­ence was even higher. Since the trial was run in sev­eral European coun­tries, fur­ther data analy­sis revealed that par­tic­i­pants in non-Mediterranean coun­tries (United Kingdom, Ireland, Netherlands, Germany, and Poland) had higher adher­ence than those in Mediterranean regions (Greece and Spain).

The authors con­cluded that per­son­al­ized nutri­tion advice is a more effec­tive method for improv­ing adher­ence to a MedDiet than gen­eral dietary guid­ance. Being that a MedDiet has been shown to reduce car­dio­vas­cu­lar risk, can­cer inci­dence, and over­all mor­tal­ity, the fact that an Internet-based inter­ven­tion edu­ca­tion and guid­ance could be imple­mented on a wide scale deserves fur­ther inves­ti­ga­tion for pub­lic health pro­grams that may pro­vide great health ben­e­fits and reduced dis­ease risk for wider pop­u­la­tions.

• American Journal of Clinical Nutrition