The effectiveness of web-based versus face-to-face personalised nutrition in Kuwait (The EatWellQ8 study)

Abstract/Summary

Background: Personalised nutrition (PN) aims to improve dietary intake and the health of individuals and to minimise the risk of chronic disease. Aims: To develop and validate a web-based food frequency questionnaire (FFQ) suitable for Kuwait. This was incorporated into a PN app (eNutri), to investigate the efficacy of web-based PN compared to identical face-to-face PN and online population advice (EatWellQ8 study). A UK version of the eNutri app was previously used to assess the diet of UK adults (EatWellUK study) and baseline dietary data from these studies were compared. Methods: Free-living adults were recruited from Kuwait for validation of the EatwellQ8 FFQ (n=99) which was compared with a 4 day-weighed food record (WFR) and a paper-form FFQ (PFFQ). To assess the effectiveness of delivering online PN advice using the eNutri app in Kuwait, participants (n=320) were randomised to web-based PN, face-to-face PN or generalised advice control groups for 12-weeks. Diet quality was assessed using a modified Alternative Healthy Eating Index (m-AHEI) at 0 and 12 weeks. Effects on the m-AHEI components, foods and nutrients were analysed using generalised linear models (GLM), as were comparisons between baseline data from the EatWellQ8 and EatWellUK studies. Results: The EatWellQ8 FFQ was reproducible and had moderate agreement with the PFFQ and a 4-day WFR for measuring energy and nutrient intakes. After 12 weeks of the EatWellQ8 study (n=100), m-AHEI scores increased significantly in both PN intervention groups (face-to-face PN 19%, web-based 12%) compared to controls (4%) (P<0.01). BMI (-0.5 kg/m2) reductions were only significant in the face-to-face PN (P<0.01). Compared to baseline data from EatWellQ8 (n=208), EatWellUK (n=309) participants’ overall m-AHEI score was significantly higher (P<0.01). Conclusion: Kuwaiti diets were less healthy than the UK. PN is more effective at improving dietary change than population-based advice in Kuwait. Future work should focus on delivery of PN advice in larger, longer-term trials including more heterogenous populations.