title: Effect of an Internet-based, personalized nutrition randomized trial on dietary changes associated with the Mediterranean diet: the Food4Me Study.
abstract: BACKGROUND
  Little is known about the efficacy of personalized nutrition (PN) interventions for improving consumption of a Mediterranean diet (MedDiet).
  
  
  OBJECTIVE
  The objective was to evaluate the effect of a PN intervention on dietary changes associated with the MedDiet.
  
  
  METHODS
  Participants (n = 1607) were recruited into a 6-mo, Internet-based, PN randomized controlled trial (Food4Me) designed to evaluate the effect of PN on dietary change. Participants were randomly assigned to receive conventional dietary advice [control; level 0 (L0)] or PN advice on the basis of current diet [level 1 (L1)], diet and phenotype [level 2 (L2)], or diet, phenotype, and genotype [level 3 (L3)]. Dietary intakes from food-frequency questionnaires at baseline and at 6 mo were converted to a MedDiet score. Linear regression compared participant characteristics between high (>5) and low (≤5) MedDiet scores. Differences in MedDiet scores between treatment arms at month 6 were evaluated by using contrast analyses.
  
  
  RESULTS
  At baseline, high MedDiet scorers had a 0.5 lower body mass index (in kg/m(2); P = 0.007) and a 0.03 higher physical activity level (P = 0.003) than did low scorers. MedDiet scores at month 6 were greater in individuals randomly assigned to receive PN (L1, L2, and L3) than in controls (PN compared with controls: 5.20 ± 0.05 and 5.48 ± 0.07, respectively; P = 0.002). There was no significant difference in MedDiet scores at month 6 between PN advice on the basis of L1 compared with L2 and L3. However, differences in MedDiet scores at month 6 were greater in L3 than in L2 (L3 compared with L2: 5.63 ± 0.10 and 5.38 ± 0.10, respectively; P = 0.029).
  
  
  CONCLUSIONS
  Higher MedDiet scores at baseline were associated with healthier lifestyles and lower adiposity. After the intervention, MedDiet scores were greater in individuals randomly assigned to receive PN than in controls, with the addition of DNA-based dietary advice resulting in the largest differences in MedDiet scores. Although differences were significant, their clinical relevance is modest. This trial was registered at clinicaltrials.gov as NCT01530139.
authors.affiliation: Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom;
authors.forename: Katherine M
authors.identifier: http://orcid.org/0000-0002-9682-7541
authors.initials: KM
authors.lastname: Livingstone
authors.affiliation: Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom;
authors.forename: Carlos
authors.identifier: http://orcid.org/0000-0003-2612-3917
authors.initials: C
authors.lastname: Celis-Morales
authors.affiliation: Center for Nutrition Research, University of Navarra, Pamplona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;
authors.forename: Santiago
authors.initials: S
authors.lastname: Navas-Carretero
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;
authors.forename: Rodrigo
authors.initials: R
authors.lastname: San-Cristobal
authors.affiliation: Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom;
authors.forename: Anna L
authors.initials: AL
authors.lastname: Macready
authors.affiliation: Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom;
authors.forename: Rosalind
authors.initials: R
authors.lastname: Fallaize
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Hannah
authors.initials: H
authors.lastname: Forster
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Clara
authors.initials: C
authors.lastname: Woolhead
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Clare B
authors.initials: CB
authors.lastname: O'Donovan
authors.affiliation: Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, Netherlands;
authors.forename: Cyril Fm
authors.initials: CF
authors.lastname: Marsaux
authors.affiliation: Research Center of Nutrition and Food Sciences (ZIEL), Biochemistry Unit, Technical University of Munich, Munich, Germany;
authors.forename: Silvia
authors.initials: S
authors.lastname: Kolossa
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;
authors.forename: Lydia
authors.initials: L
authors.lastname: Tsirigoti
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;
authors.forename: Christina P
authors.initials: CP
authors.lastname: Lambrinou
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;
authors.forename: George
authors.initials: G
authors.lastname: Moschonis
authors.affiliation: National Food and Nutrition Institute, Poland; and.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Godlewska
authors.affiliation: National Food and Nutrition Institute, Poland; and.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Surwiłło
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Drevon
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.affiliation: National Food and Nutrition Institute, Poland; and.
authors.forename: Iwona
authors.initials: I
authors.lastname: Traczyk
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Eileen R
authors.initials: ER
authors.lastname: Gibney
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Lorraine
authors.initials: L
authors.lastname: Brennan
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom;
authors.forename: Julie A
authors.initials: JA
authors.lastname: Lovegrove
authors.affiliation: Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht, Netherlands;
authors.forename: Wim H
authors.initials: WH
authors.lastname: Saris
authors.affiliation: Research Center of Nutrition and Food Sciences (ZIEL), Biochemistry Unit, Technical University of Munich, Munich, Germany;
authors.forename: Hannelore
authors.initials: H
authors.lastname: Daniel
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Republic of Ireland;
authors.forename: Mike
authors.initials: M
authors.lastname: Gibney
authors.affiliation: CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain;
authors.forename: J Alfredo
authors.initials: JA
authors.lastname: Martinez
authors.affiliation: Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom; john.mathers@newcastle.ac.uk.
authors.forename: John C
authors.identifier: http://orcid.org/0000-0003-3406-3002
authors.initials: JC
authors.lastname: Mathers
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003376:Counseling; D004034:Diet Surveys; D038441:Diet, Mediterranean; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000235:genetics / Q000517:prevention & control; D010353:Patient Education as Topic; D010641:Phenotype; D057285:Precision Medicine
keywords: European adults; Food4Me; Internet-based; Mediterranean diet; personalized nutrition