Personalising advice to improve diet quality and cardiometabolic health

  • Marina Ferrari

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Cardiovascular disease (CVD) is a leading global health burden, driven by modifiable risk factors including poor diet. Despite national dietary guidelines, population adherence remains suboptimal, prompting exploration of personalised nutrition approaches. This thesis aimed to evaluate the role of personalised dietary advice in improving diet quality and cardiometabolic risk factors through the Personalising Advice to improve Diet Quality (PAD-Q) randomised controlled trial, conducted among adults at risk of CVD in Northern Ireland. The thesis encompassed four key objectives: (i) development of a personalised dietary feedback system based on food groups and food-based biomarkers, (ii) evaluation of its effectiveness on diet quality and cardiometabolic risk factors compared to standard dietary advice, (iii) comparison of diet quality assessed via Prime Diet Quality Score (PDQS) and diet quality assessed via applying the PDQS to Food Frequency Questionnaire (FFQ) data in the PAD-Q trial, and (iv) exploration of Personal and Public Involvement (PPI) opinions on improving dietary intervention design and dissemination strategies. The PAD-Q system identified personalised dietary goals, which confirmed poor baseline diet quality, but did not result in greater improvements in diet quality compared to non-personalised advice. However, remote delivery of dietary goals and individualised feedback led to positive changes in diet quality, regardless of personalisation. The PDQS applied to FFQ data effectively captured diet quality changes, supporting its utility in dietary interventions. PPI activity highlighted strategies to enhance intervention design and the challenge of balancing individual needs with resource constraints. This research advances understanding of personalised dietary advice for improving cardiometabolic health. While the PAD-Q system showed no additional benefit over standard advice in overall diet quality change, the findings underscore the potential for low-cost dietary interventions to improve diet quality. Future studies should identify subgroups that may derive the greatest benefit from personalised approaches to optimise health outcomes and resource allocation.

Date of AwardJul 2025
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsThe National Institute of Diabetes and Digestive and Kidney Diseases, Northern Ireland Public Health Agency, Science Foundation Ireland & PPI Ignite Network
SupervisorJayne Woodside (Supervisor) & Sarah Brennan (Supervisor)

Keywords

  • public health
  • personalised nutrition
  • cardiometabolic health
  • public health nutrition
  • diet quality

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