In public health initiatives, generic nutrition advice (GNA) from national guidelines has a limited effect on food-intake improvement. Personalized nutrition advice (PNA) may enable dietary behavior change. A monocentric, randomized, parallel, controlled clinical trial was performed in males (n = 55) and females (n = 100) aged 25 to 70 years. Participants were allocated to control, GNA or PNA groups. The PNA group consisted of automatically generated dietary advice based on personal metabolic health parameters, dietary intake, anthropometric and hemodynamic measures, gender and age. Participants who received PNA (n = 51) improved their nutritional intake status for fruits P (p < 0.0001), whole grains (p = 0.008), unsalted nuts (p < 0.0001), fish (p = 0.0003), sugar-sweetened beverages (p = 0.005), added salt (p = 0.003) and less unhealthy choices (p = 0.002), whereas no improvements were observed in the control and GNA group. PNA participants were encouraged to set a goal for one or multiple food categories. Goal-setting led to greater improvement of food categories within the PNA group including; unsalted nuts (p < 0.0001), fruits (p = 0.0001), whole grains (p = 0.005), fish (p = 0.0001), dairy (p = 0.007), vegetables (p = 0.01) and unhealthy choices (p = 0.02). In a healthy population, participants receiving PNA changed their food-intake behavior more favorably than participants receiving GNA or no advice. When personal goals were set, nutritional behavior was more prone to change.

The current health status of the general public can substantially benefit from a healthy diet. Using a personalized approach to initiate healthy dietary behavior seems to be a promising strategy, as individuals differ in terms of health status, subsequent dietary needs, and their desired behavior change support. However, providing personalized advice to a wide audience over a long period is very labor-intensive. This bottleneck can possibly be overcome by digitalizing the process of creating and providing personalized advice. An increasing number of personalized advice systems for different purposes is becoming available in the market, ranging from systems providing advice about just a single parameter to very complex systems that include many variables characterizing each individual situation. Scientific background is often lacking in these systems. In designing a personalized nutrition advice system, many design questions need to be answered, ranging from the required input parameters and accurate measurement methods (sense), type of modeling techniques to be used (reason), and modality in which the personalized advice is provided (act). We have addressed these topics in this viewpoint paper, and we have demonstrated the feasibility of setting up an infrastructure for providing personalized dietary advice based on the experience of 2 practical applications in a real-life setting.

Background: Dietary quality plays an essential role in the prevention and management of metabolic syndrome (MetS). Objective: The aim of this pilot study is to organize personalized dietary advice in a real-life setting and to explore the effects on dietary intake, metabolic health, and perceived health. Methods: We followed a one-group pretest-posttest design and included 37 individuals at risk of MetS, who indicated motivation to change dietary behavior. For a period of 16 weeks, participants received personalized advice (t=0 and t=8) and feedback (t=0, t=4, t=8, t=12 and t=16) on dietary quality and metabolic health (ie, waist circumference, BMI, blood pressure, lipid profile, fasting glucose levels, and C-peptide). Personalized advice was generated in a two-stage process. In stage 1, an automated algorithm generated advice per food group, integrating data on individual dietary quality (Dutch Healthy Diet Index; total score 8-80) and metabolic health parameters. Stage 2 included a telephone consultation with a trained dietitian to define a personal dietary behavior change strategy and to discuss individual preferences. Dietary quality and metabolic health markers were assessed at t=0, t=8, and t=16. Self-perceived health was evaluated on 7-point Likert scales at t=0 and t=16. Results: At the end of the study period, dietary quality was significantly improved compared with the baseline (Dutch Healthy Diet Index +4.3; P<.001). In addition, lipid profile (triglycerides, P=.02; total cholesterol, P=.01; high-density lipoprotein, P<.001; and low-density lipoprotein, P<.001), BMI (P<.001), waist circumference (P=.01), and C-peptide (P=.01) were all significantly improved, whereas plasma glucose increased by 0.23 nmol/L (P=.04). In line with these results, self-perceived health scores were higher at t=16 weeks than at baseline (+0.67; P=.005). Conclusions: This exploratory study showed that personalized dietary advice resulted in positive effects on dietary behavior, metabolic health, and self-perceived health in motivated pre-MetS adults. The study was performed in a do-it-yourself setting, highlighting the potential of at-home health improvement through dietary changes. Trial Registration: ClinicalTrials.gov NCT04595669; https://clinicaltrials.gov/ct2/show/NCT04595669

Health claims on foods are a way of informing consumers about the health benefits of a food product. Traditionally, these claims are based on scientific evaluation of markers originating from a pharmacological view on health. About a decade ago, the definition of health has been rephrased to ‘the ability to adapt’ that opened up the possibility for a next generation of health claims based on a new way of quantifying health by evaluating resilience. Here, we would like to introduce an opportunity for future scientific substantiation of health claims on food products by using whole-grain wheat as an example. Characterization of the individual whole wheat grain food product or whole wheat flour would probably be considered as sufficiently characterized by the European Food Safety Authority, while the food category whole grain is not specific enough. Meta-analysis provides the scientific evidence that long-term whole-grain wheat consumption is beneficial for health, although results from single ‘gold standard’ efficacy studies are not always straight forward based on classic measurement methods. Future studies may want to underpin the scientific argumentation that long-term whole grain wheat consumption improves resilience, by evaluating the disruption and rate of a selected panel of blood markers in response to a standardized oral protein glucose lipid tolerance test and aggregated into biomarkers with substantiated physiological benefits, to make a next-generation health claim for whole-grain wheat achievable in the near future.

Introduction: As a basis for performance optimal nutritional balance is key to keep the body functioning at homeostatic capacity. When environmental circumstances become challenging such as in a cold environment extraordinary performance is requested specifically for physiological (i.e., vascular response, diet induced thermogenesis, immune response), and cognitive mechanisms (i.e., cognitive function, psychological and cognitive wellbeing) of the human body. In this review we describe which nutritional strategies could enhance military performance in the cold by mitigation of CWIs.Methods: We will first describe how exposure to cold affects the physiological or cognitive mechanisms itself and then we will explain how nutrition can be used to optimize these affected mechanisms. We will discuss long-term nutritional solutions preventing shortfalls and potential direct quick fixes for physiological and cognitive mechanisms.Results: For optimal functioning of the immune system and infection prevention, absence of micronutrient deficiencies is key and should be pursued amongst military personnel. For the effectivity of PUFA’s, Echinacea purpurea and probiotics in immune functioning, more research is needed in the CWO context. A multitude of micronutrients (i.e., nitrate, L-citrulline, L-arginine) appears to be able to enhance vasodilation, perhaps partially offsetting the detrimental effect of cold on peripheral blood circulation. Although the direct effect of diet induced thermogenesis is small in comparison to being physically active, it is of interest to investigate the effects of adding a combination of spices to the rations, such as capsaicin from red pepper, cinnamon, ginger, and menthol. Also, of interest for stimulation of thermogenesis are caffeine, and polyphenolic compounds. Caffeine and tyrosine supplementation 1 h, resp. 2 h before a cognitively demanding task during CWOs could be used to mitigate decreases in cognitive performance. Alternatives that are of interest, but need more research, include chocolate polyphenols and omega-3 fatty acids.Conclusion: Even though some recommendations can be provided, it is evident that much information regarding the effectiveness and application of micronutrients in cold weather operations is still lacking. More focus should be placed on investigating (micro)nutritional solutions, practical feasibility, and implementation in operational military personnel to better understand the magnitude of the possible benefits in cold conditions.

Introduction: Large interindividual variation in human gut microbiota composition and its response to interventions limits the development of novel microbiota-targeted supplements. In vitro models reflecting this interindividual variation and predicting individual in vitro microbiota responses would allow for the assessment of the potential efficacy of such interventions. Methods: Here, we investigated whether in vitro microbiota modulation by a dietary fiber mixture is translatable to in vivo microbiota outcomes. A 12-week double blind, randomized, placebo-controlled, crossover study with a dietary fiber mixture of acacia gum (AG) and carrot powder was performed in healthy volunteers ( N = 54, 45–70 years, BMI 27.3 ± 1.4 kg/m ² ). The in vitro platform utilized fecal samples from the same individuals who participated in the in vivo study. Results: A significant effect on microbiota composition was shown in vivo, although with strong individual variation. The fiber intervention was mimicked in vitro by exposing each individuals’ baseline microbiota to the same dietary fiber as used for the 12-weeks in vivo intervention. A significant correlation was shown between the in vitro and human fecal microbiota composition after 8- and 12-weeks intervention ( p = 0.003 and p = 0.0107, respectively). Microbial taxa responding to the intervention in vitro and in vivo also showed clear overlap ( p = 0.002). Discussion: These results demonstrate that in vitro models may enable pre-study selection of donors whose microbiotas respond to a specific intervention.