Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial

Rodrigo Zenun Franco, Rosalind Fallaize, Michelle Weech, Faustina Hwang, Julie A Lovegrove

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Background: Evidence suggests eating behaviours and adherence to dietary guidelines can be improved using nutrition-related apps. Apps delivering personalised nutrition (PN) advice to users can provide individual support at-scale with relatively low-cost.
Objective: To investigate the effectiveness of a mobile web application (eNutri) that delivers automated PN advice in improving diet quality, relative to general population food-based dietary guidelines.
Methods: Non-diseased UK adults (aged >18 years) were randomised to (i) PN advice or (ii) control advice (population-based healthy eating guidelines) in a 12-week controlled, parallel, single-blinded, dietary intervention, which was delivered online. Dietary intake was assessed using the eNutri Food Frequency Questionnaire (FFQ). An 11-item modified US Alternative Healthy Eating Index (m-AHEI) aligned with UK dietary and nutritional recommendations was used to derive the automated PN advice. The primary outcome was change in diet quality (m-AHEI) at 12 weeks. Participant surveys evaluated the PN report (week 12) and longer-term impact of the PN advice (mean 5.9 months after completion of the study).
Results: Following the baseline FFQ, 210 participants completed at least one additional FFQ, and n=23 outliers were excluded for unfeasible dietary intakes. The mean interval between FFQs was 10.8 weeks. 96 participants were included in the PN group (43.5 (SD 15.9) years; BMI 24.8 (4.4) kg/m2) and 91 in the control (42.8 (14.0) years; BMI 24.2 (4.4) kg/m2). Compared with the control group, the overall m-AHEI score increased by 3.5 out of 100 (CI 95%: 1.19-5.78) in the PN group, equivalent to an increase of 6.1% (P = .003). Specifically, the m-AHEI components ‘nuts and legumes’ and ‘red and processed meat’ showed significant improvements in the PN group (P’s = 0.04). At follow-up, 64% of PN participants agreed that, compared with baseline, they were still following some (‘any’) of the advice received and 31% were still motivated to improve their diet.
Conclusions: These findings suggest that the eNutri app is an effective online tool for the automated delivery of PN advice. Furthermore, eNutri was demonstrated to improve short-term diet quality and increase engagement in healthy eating behaviours in UK adults, as compared with population-based healthy eating guidelines. This work represents an important landmark in the field of automatically delivered online personalised dietary interventions.
Original languageEnglish
Article numbere29088
JournalJournal of Medical Internet Research
Issue number4
Publication statusPublished - 25 Apr 2022


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