Dagmar J. Smid1*, Johanneke E. Oosterman1*, Regina J.M. Kamstra1, Iris M. De Hoogh1, Arjan Huizing1, Martien Caspers1, Tim J. van den Broek1, Robert Kleemann1, Pepijn van Empelen1, Josien ter Beek2, Wilrike J. Pasman1, Suzan Wopereis1
1Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands. 2GGD Noord- and Oost-Gelderland (Community Health Service), Zutphen, The Netherlands. *Contributed equally.
Background: The combined lifestyle intervention program SLIMMER is effective in changing lifestyle behavior. However, achieving and maintaining healthier lifestyle behavior is difficult. Personalization, i.e. adapting lifestyle advice to an individual’s needs and preferences, may lead to better adherence and therefore contribute to achieving sustainable healthy lifestyle habits. We investigated whether a personalized version of the SLIMMER intervention, based upon a person’s biomedical, contextual and behavioral data, goals, and at home monitoring, affected adherence to the lifestyle advice and health status.
Methods: In this cluster-randomized controlled intervention study, 61 intervention and 60 control participants, 18-70 years, having overweight or obesity, were included and followed during the first 6 months of their SLIMMER program. Body composition and clinical markers were measured and adherence to the program was assessed by using different validated questionnaires to quantify lifestyle behavior and user-experience.
Results: At 6 months, body weight (-4.7 kg, p < 0.001), BMI (-1.5 kg/m2, p < 0.001), and fasting glucose (-0.29 mmol/l, p = 0.003) significantly improved in the intervention group, and to a larger extent than in the control group. The drop-out rate was significantly lower in the intervention group (11%) than in the control group (26%, p < 0.001). More biomarkers related to inflammation improved in the intervention group compared to the control group.
Discussion/conclusion: Personalization of the SLIMMER program improved to a greater extent body weight and BMI as compared to the regular program, which could not be explained by differences in adherence. The drop-out rate was lower in the intervention compared to the control group, suggesting that the personalized approach did contribute to adherence. The personalized SLIMMER program resulted in favorable alterations in markers related to low-grade inflammation, potentially leading to favorable health outcomes in the personalized group.