title: Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial.
abstract: Optimal nutritional choices are linked with better health, but many current interventions to improve diet have limited effect. We tested the hypothesis that providing personalized nutrition (PN) advice based on information on individual diet and lifestyle, phenotype and/or genotype would promote larger, more appropriate, and sustained changes in dietary behaviour.
  
  
  
  : Adults from seven European countries were recruited to an internet-delivered intervention (Food4Me) and randomized to: (i) conventional dietary advice (control) or to PN advice based on: (ii) individual baseline diet; (iii) individual baseline diet plus phenotype (anthropometry and blood biomarkers); or (iv) individual baseline diet plus phenotype plus genotype (five diet-responsive genetic variants). Outcomes were dietary intake, anthropometry and blood biomarkers measured at baseline and after 3 and 6 months' intervention.
  
  
  
  At baseline, mean age of participants was 39.8 years (range 18-79), 59% of participants were female and mean body mass index (BMI) was 25.5 kg/m 2 . From the enrolled participants, 1269 completed the study. Following a 6-month intervention, participants randomized to PN consumed less red meat [-5.48 g, (95% confidence interval:-10.8,-0.09), P  = 0.046], salt [-0.65 g, (-1.1,-0.25), P  = 0.002] and saturated fat [-1.14 % of energy, (-1.6,-0.67), P  < 0.0001], increased folate [29.6 µg, (0.21,59.0), P  = 0.048] intake and had higher Healthy Eating Index scores [1.27, (0.30, 2.25), P  = 0.010) than those randomized to the control arm. There was no evidence that including phenotypic and phenotypic plus genotypic information enhanced the effectiveness of the PN advice.
  
  
  
  Among European adults, PN advice via internet-delivered intervention produced larger and more appropriate changes in dietary behaviour than a conventional approach.
authors.affiliation: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Carlos
authors.initials: C
authors.lastname: Celis-Morales
authors.affiliation: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Livingstone
authors.affiliation: Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Cyril Fm
authors.initials: CF
authors.lastname: Marsaux
authors.affiliation: Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK.
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, UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Fallaize
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Clare B
authors.initials: CB
authors.lastname: O'Donovan
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Clara
authors.initials: C
authors.lastname: Woolhead
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Hannah
authors.initials: H
authors.lastname: Forster
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Department of Nutrition and Physiology, University of Navarra, Navarra, and 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: Department of Nutrition and Physiology, University of Navarra, Navarra, and 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: 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: Christina
authors.initials: C
authors.lastname: Mavrogianni
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Moschonis
authors.affiliation: ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Kolossa
authors.affiliation: ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hallmann
authors.affiliation: National Food & Nutrition Institute (IZZ), Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Godlewska
authors.affiliation: National Food & Nutrition Institute (IZZ), Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Surwillo
authors.affiliation: National Food & Nutrition Institute (IZZ), Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Traczyk
authors.affiliation: 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: TNO, Microbiology and Systems Biology Group, Zeist, The Netherlands.
authors.forename: Jildau
authors.initials: J
authors.lastname: Bouwman
authors.affiliation: TNO, Microbiology and Systems Biology Group, Zeist, The Netherlands.
authors.forename: Ben
authors.initials: B
authors.lastname: van Ommen
authors.affiliation: Eurogenetica Ltd, Burnham-on-Sea, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Grimaldi
authors.affiliation: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.|Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Parnell
authors.affiliation: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.|Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK.
authors.forename: John Ns
authors.initials: JN
authors.lastname: Matthews
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.affiliation: ZIEL Research Center of Nutrition and Food Sciences, Munich Technical University, Munich, Germany.
authors.forename: Hannelore
authors.initials: H
authors.lastname: Daniel
authors.affiliation: Department of Nutrition and Physiology, University of Navarra, Navarra, and 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: Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Lovegrove
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Eileen R
authors.initials: ER
authors.lastname: Gibney
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Brennan
authors.affiliation: Department of Human Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Wim Hm
authors.initials: WH
authors.lastname: Saris
authors.affiliation: UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
authors.forename: Mike
authors.initials: M
authors.lastname: Gibney
authors.affiliation: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: John C
authors.initials: JC
authors.lastname: Mathers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004032:Diet; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D010641:Phenotype; D057285:Precision Medicine; D055815:Young Adult
keywords: Personalized nutrition; diet; genotype; internet-based; metabolic health; obesity; phenotype; randomized controlled trial