Milanne Maria Johanna Galekop, William Ken Redekop, Carin A Uyl-de Groot, Joanna Góralska, Urszula Raźny, Malgorzata Malczewska-Malec, Ella J Baker, Philip C Calder
Journal: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 2025;38(3):e70071
PMID: 40452635
Overweight and obesity are major public health concerns that increase the risk of conditions such as type 2 diabetes and cardiovascular disease. Personalised nutrition aims to tailor dietary advice to an individual’s biological and behavioural characteristics, to improve health outcomes. However, personalised approaches can be more expensive than standard advice. This study was conducted to determine whether personalised nutrition is not only effective, but also cost-effective compared to usual care.
The results showed that reductions in body mass index were modest and not significantly different between the personalised nutrition groups and the control group in either country. Economic modelling suggested that personalised nutrition, particularly when combined with behavioural support, was unlikely to be cost-effective under standard healthcare willingness-to-pay thresholds within the study time frame.
In conclusion, personalised nutrition approaches are likely to be cost effective. They are likely to improve health outcomes at acceptable extra costs. Healthcare professionals and policymakers should consider both clinical effectiveness and economic value before implementing personalised nutrition programmes at scale. Longer-term studies may be needed to determine whether sustained benefits could justify the costs.
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• Personalised nutrition, with or without behavioural change support, has the potential to be a cost-effective intervention for long-term weight management and health benefits for adults with obesity and overweight.
• Research suggests that greater benefits may be seen over periods of more than 6 months.
Introduction
The aim of this study was to assess the cost-effectiveness of personalised nutrition in adults aged 18-65 years with overweight or obesity in the UK and Poland using interventions developed for the PREVENTOMICS project.
Methods
• Long-term health outcomes and cost-effectiveness of personalised nutrition interventions were calculated using data from two randomised-controlled trials (RCT) conducted in the UK (n=54) and Poland (n=170). Study durations were 4 months.
• RCTs had similar study protocols and 3 groups: personalised plan (PP) plus behavioural change (PP+B), PP only, or standard dietetic advice (European guidelines for obesity) (control). PPs were based on metabolomic, genetic and inflammatory profiles supported by dieticians/nutritionists over 4 sessions. Behavioural change was delivered via prompts from an app.
• Cost analysis was based on dietician/nutritionist appointments, app messaging, software maintenance, overhead costs, additional (healthier eating) grocery costs and costs of testing.
• Study population criteria included baseline body mass index (BMI) of between 25-40 kg/m2 and waist circumference (WC) >80cm for females and >94 for males.
• Outcome measurements were BMI, health related quality of life (EQ-5D), quality adjusted life years (QALY), cost in British pounds (GBP) and estimated willingness to pay (WTP) thresholds. Lifetime analysis was calculated based on longitudinal study data.
Results
• All groups showed a reduction in BMI. These were greater in the intervention groups compared to the controls, however, did not reach clinical significance and confidence intervals were wide.
• An increase in EQ-5D was observed in both the PP+B and PP groups compared to the control - UK only - but was not statistically significant. No differences were found between groups in Poland.
• Analysis suggests potential cost-effectiveness for QALY for PP+B and PP groups in the UK and PP+B in Poland based on WTP thresholds.
Conclusion
Personalised nutrition interventions could be a cost-effective approach for managing weight and promoting better health outcomes in adults with obesity and overweight. However, due to the uncertainty around results, further longer and larger trials are needed to validate these findings.
• Personalised nutrition is a modifiable risk factor for the prevention and management of obesity. Research suggests that greater improvements in weight management are seen over longer time periods (>6 months).
• This study concluded that despite the higher costs involved, these were within WTP thresholds, and potentially cost-effective for life-time weight management, and health benefits.
• Larger trials and longer study durations are needed to consider the potential health effects, sustainable behavioural changes and the long-term effectiveness of personalised nutrition.
• Future studies should also consider alternative, relevant health outcome measures, including body fat, WC, and carbohydrate and lipid metabolism.
• Ethical issues relating to personalised nutrition interventions should also be assessed i.e. economic and social factors.
BACKGROUND
We assessed the cost-effectiveness of personalised nutrition in adults with overweight/obesity in Poland and the United Kingdom (UK) using the results of two randomised controlled trials (RCTs).
METHODS
The 4-month RCTs compared three interventions: personalised plan (PP) plus behavioural change (PP+B), PP only, and a control. Outcomes included body mass index (BMI), health-related quality of life (EQ-5D-5L), quality-adjusted life years (QALYs), and costs (2020 British pounds). A Markov model estimated lifetime cost-effectiveness. Different sensitivity analyses were performed.
RESULTS
Participants were randomised to PP+B, PP, and control groups in Poland (n = 89, n = 88, n = 88) and the UK (n = 20, n = 19, n = 15). Comparing BMI reductions of PP+B and PP with control in both countries showed no significant differences, but wide confidence intervals (CIs) were observed (e.g., PP+B vs. control-Poland: -0.20, 95% CI: -0.86, 0.45 kg/m; UK: -0.80, 95% CI: -1.60, 0.00 kg/m). Lifetime analysis suggested potential cost-effectiveness for PP+B in Poland (£20,404 per QALY gain), and for PP+B (£13,006 per QALY) and PP (£12,222 per QALY) in the UK, since these figures were lower than the willingness-to-pay thresholds (£34,000 in Poland and £20,000 in the UK). PP in Poland was dominated by control, but sensitivity analyses suggested potential cost-effectiveness.
CONCLUSIONS
The PREVENTOMICS interventions may offer a cost-effective approach to reduce weight and avoid its related complications in both countries. Future studies should be larger and/or longer to reduce uncertainty about effectiveness.
CLINICAL TRIAL REGISTRATION NUMBERS
Poland ISRCTN51509551 and the UK ISRCTN46063864.
© 2025 The Author(s). Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.
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