Personalized nutrition programs work better than general advice for better heart health

Recently Nature Medicine study, researchers compare the effectiveness of personalized diet programs (PDP) with general advice on cardio-metabolic health.

Study: Effects of a personalized nutrition program on cardiometabolic health: A randomized controlled trial. Image Credit: Inside Creative House / Shutterstock.com

Role of diet in disease risk

Diet and lifestyle interventions are effective non-pharmacological approaches that can reduce the risks of many chronic diseases. Although many studies have emphasized the importance of an adequate diet, a significant increase in diet-related diseases has been observed and attributed to poor adherence to dietary guidelines.

In fact, one recent study showed that less than 1% of the UK population adheres to all dietary recommendations, and similarly poor adherence is reported in the United States. Multiple factors influence the variation in health responses to food; therefore, effective personalized nutrition programs based on lifestyle and phenotypic biological factors may increase dietary guideline compliance rates.

Previous randomized controlled trials (RCTs) conducted to evaluate the effectiveness of personalized nutrition programs have shown an overall positive outcome. Some benefits of this approach include improved blood parameters, glycemic index, dietary habits, gut health, physical activity, and anthropometric measurements. However, further studies are needed to determine the effectiveness of PDP on adherence to recommendations and health outcomes.

About the study

The ZOE Measuring Efficacy Through Dietary Outcomes (METHOD) ZOE study hypothesized that tailoring a diet that incorporates multiple factors that contribute to inter- and intra-variability in nutritional responses to a diet will increase adherence to recommendations and improve health outcomes . The METHOD ZOE study, which involved an eight-week parallel RCT design, compared the efficacy of PDP with standard-of-care dietary advice in the US adult population.

Standard-of-care dietary advice was derived from the United States Dietary Guidelines for Americans 2020-2025, whereas the PDP dietary guidelines were based on the ZOE 2022 algorithm. PDP recommendations were based on an individual’s health history, gut microbiome composition, and post-prandial glucose and triglyceride levels. prandial (TG). The diet and lifestyle recommendations for PDP were delivered remotely via a phone application called ZOE.

The current study recruited male and female participants aged between 40 and 70 years. All participants lived in the US, reported fruit and vegetable intake below 450 grams per day, and waist circumference measurements were higher than ethnicity and sex-specific 25^th percentile values. The selected participants were randomly assigned to one of the two treatment groups.

Results of the study

A total of 177 and 170 participants for PDP and control groups, respectively. The PDP intervention provided more significant health improvements than adherence to US standard care dietary advice, as demonstrated by greater reductions in weight, TG levels, waist circumference, and hemoglobin A1c (HbA1c) in the PDP group. However, no change in low-density lipoprotein cholesterol (LDL-C) levels was observed in the PDP group.

Individual food and nutrient intakes varied more with PDP compared to the control group. An improved and sustained gut microbial composition was observed in the PDP group compared to the control, and these microbiome changes were more predictive of weight loss and reduction in hip circumference than the control diet.

Study participants in the PDP group also showed favorable feelings of hunger, mood and energy. Compared with standard dietary advice, tailored dietary advice was more effective in reducing central sensitivity and TG levels in healthy populations.

Although overall LDL-C levels were similar in both groups after eighteen weeks of dietary intervention, a significant reduction was noted in healthy participants who adhered to PDP guidelines. When participants were further stratified by unhealthy levels at baseline, reduced LDL-C levels were observed across all adherence groups.

Consistent with previous studies, the current study observed that TG levels were sensitive to nutritional interventions. Significantly, LDL-C levels do not change with weight loss due to dietary modification.

In addition, the current study reported a greater improvement in body weight and waist circumference in participants of the PDP group than those who followed a general guideline.

Conclusions

The potential advantage of PDP replaces standard dietary advice, as individuals with the poorest diets were found to benefit the most from a personalized nutritional intervention. Interestingly, the current study did not observe any significant health benefits in participants who generally followed a healthy lifestyle from baseline.

The results of the study show that a personalized nutrition program is very beneficial in improving cardio-metabolic health.