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Personalized Dietary Feedback Mediates the Association of Dietary Self-Monitoring Adherence and Weight Loss: A Post Hoc Analysis of the Personal Diet Study
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DOI：10.1016/j.tjnut.2026.101364.png)
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Abstract
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Background: Dietary self-monitoring is central to effective personalized nutrition, providing critical data to inform tailored feedback and support behavior change. Objectives: To examine the impact of dietary self-monitoring adherence and the indirect effect of personalized scores to predict postprandial glycemic response (PPGR) on weight loss. Methods: Post hoc analysis of the Personal Diet Study that investigated the impact of a machine algorithm-based diet that integrates clinical and microbiome features (Personalized) compared with a standard, low-fat diet (Standardized) on weight loss. All participants received behavioral counseling and were encouraged to self-monitor dietary intake via a smartphone application. Personalized received algorithm-based scores (1-5) on predicted PPGR to foods logged (PPGR score; 1-2 indicating optimal; 3-5 suboptimal). Dietary self-monitoring adherence was the percentage of days logging >= 50% of target calories, classified as high or low. PPGR score quality was calculated by the proportion of optimal predicted PPGR scores per day; defined as high-PPGR quality days when this exceeded the group average. Mediation analysis assessed whether PPGR quality mediated the relationship between dietary self-monitoring adherence and weight loss. Results: Participants with high self-monitoring adherence lost an average of 4.2% of their baseline weight, compared with 1.9% among those with low adherence (P = 0.016). High self-monitoring adherence was associated with a greater likelihood of achieving >= 5% weight loss (adjusted odds ratio: 3.67; 95% confidence interval: 1.63, 8.50). Within Personalized, high-PPGR quality mediated 53.4% of the total effect of self-monitoring adherence on weight loss (P < 0.001). Conclusion: Consistent self-monitoring coupled with personalized feedback may significantly enhance weight loss in a precision nutrition approach.
Keywords:
precision nutrition
prediabetes
weight management
precision medicine
obesity
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