Frequent nutritional feedback, personalized advice, and behavioral changes: findings from the European Food4Me internet-based RCT

Celis-Morales, C. et al. (2019) Frequent nutritional feedback, personalized advice, and behavioral changes: findings from the European Food4Me internet-based RCT. American Journal of Preventive Medicine, 57, pp. 209-219. (doi: 10.1016/j.amepre.2019.03.024) (PMID:31248745)

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Abstract

Introduction: This study tested the hypothesis that providing personalized nutritional advice and feedback more frequently would promote larger, more appropriate, and sustained changes in dietary behavior as well as greater reduction in adiposity. Study design: A 6-month RCT (Food4Me) was conducted in seven European countries between 2012 and 2013. Setting/participants: A total of 1,125 participants were randomized to Lower- (n=562) or Higher- (n=563) Frequency Feedback groups. Intervention: Participants in the Lower-Frequency group received personalized nutritional advice at baseline and at Months 3 and 6 of the intervention, whereas the Higher-Frequency group received personalized nutritional advice at baseline and at Months 1, 2, 3 and 6. Main outcome measures: The primary outcomes were change in dietary intake (at food and nutrient levels) and obesity-related traits (body weight, BMI, and waist circumference). Participants completed an online Food Frequency Questionnaire to estimate usual dietary intake at baseline and at Months 3 and 6 of the intervention. Overall diet quality was evaluated using the 2010 Healthy Eating Index. Obesity-related traits were self-measured and reported by participants via the Internet. Statistical analyses were performed during the first quarter of 2018. Results: At 3 months, participants in the Lower- and Higher-Frequency Feedback groups showed improvements in Healthy Eating Index score; this improvement was larger in the Higher-Frequency group than the Lower-Frequency group (Δ=1.84 points, 95% CI=0.79, 2.89, p=0.0001). Similarly, there were greater improvements for the Higher- versus Lower-Frequency group for body weight (Δ= −0.73 kg, 95% CI= −1.07, −0.38, p<0.0001), BMI (Δ= −0.24 kg/m2, 95% CI= −0.36, −0.13, p<0.0001), and waist circumference (Δ= −1.20 cm, 95% CI= −2.36, −0.04, p=0.039). However, only body weight and BMI remained significant at 6 months. Conclusions: At 3 months, higher-frequency feedback produced larger improvements in overall diet quality as well as in body weight and waist circumference than lower-frequency feedback. However, only body weight and BMI remained significant at 6 months.

Item Type:Articles
Additional Information:This work was supported by the European Commission under the Food, Agriculture, Fisheries and Biotechnology Theme of the 7th Framework Programme for Research and Technological Development (265494).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Celis, Dr Carlos and Petermann, Mrs Fanny
Authors: Celis-Morales, C., Livingstone, K. M., Petermann-Rocha, F., Navas-Carretero, S., San-Cristobal, R., O'Donovan, C. B., Moschonis, G., Manios, Y., Traczyk, I., Drevon, C. A., Daniel, H., Marsaux, C. F.M., Saris, W. H.M., Fallaize, R., Macready, A. L., Lovegrove, J. A., Gibney, M., Gibney, E. R., Walsh, M., Brennan, L., Martinez, J. A., and Mathers, J. C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:American Journal of Preventive Medicine
Publisher:Elsevier
ISSN:0749-3797
ISSN (Online):1873-2607
Published Online:25 June 2019
Copyright Holders:Copyright © 2019 American Journal of Preventive Medicine
First Published:First published in American Journal of Preventive Medicine 57:209-219
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
265494