Abstract
Personalized and precision nutrition aim to examine and improve health on an
individual level, and this requires reconsideration of traditional dietary intervention or behavioral study designs. The limited frequency of measurements in group-level human nutrition trials cannot be used to infer individual response to interventions, while in behavioral studies, retrospective data collection does not provide an accurate measure of how everyday behaviors affects individual health. This review introduces the concept of N-of-1 study designs, which involve the repeated measurement of a health outcome or behavior on an individual level. Observational designs can be used to monitor a participant’s usual health or behavior in a naturalistic setting, with repeated measurements conducted in ‘real time’ using Ecological Momentary Assessment. Interventional designs can introduce a dietary or behavioral intervention with predictors and outcomes of interest measured repeatedly during, or after, one or more intervention and control periods. Due to their flexibility, N-of-1 designs can be applied to both short-term physiological studies and longer-term studies of eating behaviors. As a growing number of disease markers can be measured outside of the clinic, with self-reported data being delivered via electronic devices, it is now easier than ever to generate large amounts of data on an individual level. Statistical techniques can be utilized to analyze change in single individuals, or aggregate data from sets of N-of-1 trials, enabling hypotheses to be tested on a small number of heterogeneous individuals. Although their design necessitates extra methodological and statistical considerations, N-of-1 studies could be used to investigate complex research questions and study underrepresented groups. This may help to reveal novel associations between participant characteristics and health outcomes, with repeated measures providing power and precision to accurately determine individual health status.
individual level, and this requires reconsideration of traditional dietary intervention or behavioral study designs. The limited frequency of measurements in group-level human nutrition trials cannot be used to infer individual response to interventions, while in behavioral studies, retrospective data collection does not provide an accurate measure of how everyday behaviors affects individual health. This review introduces the concept of N-of-1 study designs, which involve the repeated measurement of a health outcome or behavior on an individual level. Observational designs can be used to monitor a participant’s usual health or behavior in a naturalistic setting, with repeated measurements conducted in ‘real time’ using Ecological Momentary Assessment. Interventional designs can introduce a dietary or behavioral intervention with predictors and outcomes of interest measured repeatedly during, or after, one or more intervention and control periods. Due to their flexibility, N-of-1 designs can be applied to both short-term physiological studies and longer-term studies of eating behaviors. As a growing number of disease markers can be measured outside of the clinic, with self-reported data being delivered via electronic devices, it is now easier than ever to generate large amounts of data on an individual level. Statistical techniques can be utilized to analyze change in single individuals, or aggregate data from sets of N-of-1 trials, enabling hypotheses to be tested on a small number of heterogeneous individuals. Although their design necessitates extra methodological and statistical considerations, N-of-1 studies could be used to investigate complex research questions and study underrepresented groups. This may help to reveal novel associations between participant characteristics and health outcomes, with repeated measures providing power and precision to accurately determine individual health status.
| Original language | English |
|---|---|
| Journal | Advances in Nutrition |
| Publication status | Accepted/In press - 10 Dec 2020 |
Keywords
- N-of-1
- precision nutrition
- personalized nutrition
- Ecological Momentary Assessment
- self-report measures
- study design
- review