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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02951-6

摘要内容如下：

人们对食物的反应存在很大差异。然而，个性化饮食建议对健康的功效仍未得到充分研究。我们通过一项随机临床试验比较了个性化饮食计划（PDP）与一般建议（对照）对心脏代谢健康的影响。PDP使用食物特征、个体餐后血糖和甘油三酯（TG）对食物的反应、微生物群和健康史，在为期18周的基于应用程序的程序中产生个性化的食物评分。对照组通过在线资源、签到、视频课程和传单接受标准护理饮食建议（美国农业部美国人指南，2020-2025）。主要结果是基线和18周时的血清低密度脂蛋白胆固醇和TG浓度。参与者（n=347），年龄41-70岁，通常代表美国平均人口，被随机分配到PDP（n=177）或对照组（n=170）。两组间的意向治疗分析（n=347）显示TGS显著降低（平均差异=-0.13mmolL-1；对数转换95%置信区间=-0.07至-0.01，p=0.016）。低密度脂蛋白胆固醇变化不明显。包括体重、腰围、糖化血红蛋白（HbA1c）、饮食质量和微生物组（β-多样性）在内的次要结果有所改善（P<0.05），特别是在高度依从性的PDP参与者中。然而，血压、胰岛素、葡萄糖、C肽、载脂蛋白A1和B以及餐后TG在两组之间没有差异。未报告严重的干预相关不良事件。与标准饮食建议相比，遵循个性化饮食可以改善心脏代谢健康。ClinicalTrials.gov注册：NCT05273268。

英文原文如下：

Abstracts

Large variability exists in people's responses to foods. However, the efficacy of personalized dietary advice for health remains understudied. We compared a personalized dietary program (PDP) versus general advice (control) on cardiometabolic health using a randomized clinical trial. The PDP used food characteristics, individual postprandial glucose and triglyceride (TG) responses to foods, microbiomes and health history, to produce personalized food scores in an 18-week app-based program. The control group received standard care dietary advice (US Department of Agriculture Guidelines for Americans, 2020-2025) using online resources, check-ins, video lessons and a leaflet. Primary outcomes were serum low-density lipoprotein cholesterol and TG concentrations at baseline and at 18 weeks. Participants (n = 347), aged 41-70 years and generally representative of the average US population, were randomized to the PDP (n = 177) or control (n = 170). Intention-to-treat analysis (n = 347) between groups showed significant reduction in TGs (mean difference = -0.13 mmol l-1; log-transformed 95% confidence interval = -0.07 to -0.01, P = 0.016). Changes in low-density lipoprotein cholesterol were not significant. There were improvements in secondary outcomes, including body weight, waist circumference, HbA1c, diet quality and microbiome (beta-diversity) (P < 0.05), particularly in highly adherent PDP participants. However, blood pressure, insulin, glucose, C-peptide, apolipoprotein A1 and B, and postprandial TGs did not differ between groups. No serious intervention-related adverse events were reported. Following a personalized diet led to some improvements in cardiometabolic health compared to standard dietary advice. ClinicalTrials.gov registration: NCT05273268 .

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