OBJECTIVES

Despite the well-known link between dietary patterns and diseases, nutrition interventions often have a poor individual-level effectiveness. Personalization of nutrition interventions may improve both effectiveness and cost-effectiveness. We performed a systematic review of health economic evaluations (HEE) of interventions with a personalized nutrition component in adults to assess their methodology and findings.

METHODS

We performed a systematic search (March 2019) in five databases, including EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL and Google Scholar. Inclusion criteria were a full HEE, a personalized nutrition component and adults. HEEs involving hospital nutrition or severe undernutrition were excluded. No time limits were applied but we included only English-language publications. The CHEERS checklist was used to assess the quality of the HEEs.

RESULTS

1777 publications were found, of which 200 were selected for full-text screening. Finally, 38 HEEs were included as well as some HEEs found in previous systematic reviews. Most HEEs were based on clinical trials and only a few used modelling to estimate effects beyond the trial’s follow-up period. Approximately half of the studies focused on overweight or diabetes patients while the other half examined various patient populations. The large majority of the personalized interventions focused on the psychological aspects of personalization, like the preferences of people gathered from questionnaires or telephone calls. Approximately half of the studies used quality-adjusted life-years (QALYs) as an outcome measure while the other half used only clinical outcomes. Most authors (>70%) concluded that their intervention was cost-effective.

CONCLUSIONS

Interventions with personalized nutrition components often tend to be cost-effective. However, there is wide variation in how personalized nutrition is defined and what type of personalized interventions is investigated in HEEs. Very few HEEs have examined personalized interventions that utilize a combination of psychological insights and biological insights (such as nutrigenomics) relating to patient heterogeneity.