title: A Dietary Feedback System for the Delivery of Consistent Personalized Dietary Advice in the Web-Based Multicenter Food4Me Study.
abstract: Despite numerous healthy eating campaigns, the prevalence of diets high in saturated fatty acids, sugar, and salt and low in fiber, fruit, and vegetables remains high. With more people than ever accessing the Internet, Web-based dietary assessment instruments have the potential to promote healthier dietary behaviors via personalized dietary advice.
  
  
  
  The objectives of this study were to develop a dietary feedback system for the delivery of consistent personalized dietary advice in a multicenter study and to examine the impact of automating the advice system.
  
  
  
  The development of the dietary feedback system included 4 components: (1) designing a system for categorizing nutritional intakes; (2) creating a method for prioritizing 3 nutrient-related goals for subsequent targeted dietary advice; (3) constructing decision tree algorithms linking data on nutritional intake to feedback messages; and (4) developing personal feedback reports. The system was used manually by researchers to provide personalized nutrition advice based on dietary assessment to 369 participants during the Food4Me randomized controlled trial, with an automated version developed on completion of the study.
  
  
  
  Saturated fatty acid, salt, and dietary fiber were most frequently selected as nutrient-related goals across the 7 centers. Average agreement between the manual and automated systems, in selecting 3 nutrient-related goals for personalized dietary advice across the centers, was highest for nutrient-related goals 1 and 2 and lower for goal 3, averaging at 92%, 87%, and 63%, respectively. Complete agreement between the 2 systems for feedback advice message selection averaged at 87% across the centers.
  
  
  
  The dietary feedback system was used to deliver personalized dietary advice within a multi-country study. Overall, there was good agreement between the manual and automated feedback systems, giving promise to the use of automated systems for personalizing dietary advice.
  
  
  
  Clinicaltrials.gov NCT01530139; https://clinicaltrials.gov/ct2/show/NCT01530139 (Archived by WebCite at http://www.webcitation.org/6ht5Dgj8I).
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Hannah
authors.identifier: 0000-0001-5944-8027
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authors.lastname: Forster
authors.forename: Marianne C
authors.identifier: 0000-0002-6651-2434
authors.initials: MC
authors.lastname: Walsh
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authors.identifier: 0000-0003-3367-6173
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authors.identifier: 0000-0003-3734-6489
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authors.identifier: 0000-0003-0368-9336
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authors.lastname: Macready
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authors.identifier: 0000-0002-4725-6359
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authors.forename: Santiago
authors.identifier: 0000-0002-5163-2230
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authors.lastname: Navas-Carretero
authors.forename: Rodrigo
authors.identifier: 0000-0001-8054-6553
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authors.lastname: San-Cristobal
authors.forename: Silvia
authors.identifier: 0000-0002-8360-797X
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authors.lastname: Hartwig
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authors.lastname: Tsirigoti
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authors.identifier: 0000-0001-8065-989X
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authors.lastname: Lambrinou
authors.forename: Magdalena
authors.identifier: 0000-0002-1891-7859
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authors.lastname: Godlewska
authors.forename: Agnieszka
authors.identifier: 0000-0003-2189-9249
authors.initials: A
authors.lastname: Surwiłło
authors.forename: Ingrid Merethe Fange
authors.initials: IM
authors.lastname: Gjelstad
authors.forename: Christian A
authors.identifier: 0000-0002-7216-2784
authors.initials: CA
authors.lastname: Drevon
authors.forename: Yannis
authors.identifier: 0000-0001-6486-114X
authors.initials: Y
authors.lastname: Manios
authors.forename: Iwona
authors.identifier: 0000-0002-0483-7778
authors.initials: I
authors.lastname: Traczyk
authors.forename: J Alfredo
authors.identifier: 0000-0001-5218-6941
authors.initials: JA
authors.lastname: Martinez
authors.forename: Wim H M
authors.identifier: 0000-0003-0985-0047
authors.initials: WH
authors.lastname: Saris
authors.forename: Hannelore
authors.identifier: 0000-0003-3937-9719
authors.initials: H
authors.lastname: Daniel
authors.forename: Julie A
authors.identifier: 0000-0001-7633-9455
authors.initials: JA
authors.lastname: Lovegrove
authors.forename: John C
authors.identifier: 0000-0003-3406-3002
authors.initials: JC
authors.lastname: Mathers
authors.forename: Michael J
authors.identifier: 0000-0001-5250-361X
authors.initials: MJ
authors.lastname: Gibney
authors.forename: Eileen R
authors.identifier: 0000-0001-9465-052X
authors.initials: ER
authors.lastname: Gibney
authors.forename: Lorraine
authors.identifier: 0000-0002-7711-7499
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mesh_terms: D000328:Adult; D000465:Algorithms; D001331:Automation; D003663:Decision Trees; D004032:Diet; D004041:Dietary Fats; D004043:Dietary Fiber; D005246:Feedback; D005260:Female; D005638:Fruit; D006266:Health Education; D006293:Health Promotion / Q000379:methods; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D017673:Sodium Chloride, Dietary; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D017673:Sodium Chloride, Dietary
keywords: Food4Me; Web-based dietary assessment tool; dietary decision trees; dietary feedback; human nutrition; personalized nutrition