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BRIEF RESEARCH REPORT article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1398450
This article is part of the Research Topic Smart Devices for Personalized Nutrition and Healthier Lifestyle Behavior Change View all 4 articles

Simulation model to assess the validity of the clinical Portfolio Diet Score used in the PortfolioDiet.app for dietary self-tracking: a secondary analysis of a randomized controlled trial in hyperlipidemic adults

Provisionally accepted
Meaghan E. Kavanagh Meaghan E. Kavanagh 1Andrea Glenn Andrea Glenn 1Laura Chiavaroli Laura Chiavaroli 1Gloria Morgan Gloria Morgan 1Robert Josse Robert Josse 1Vasanti Malik Vasanti Malik 1Christopher P. Marinangeli Christopher P. Marinangeli 2Cyril W. Kendall Cyril W. Kendall 1David J. Jenkins David J. Jenkins 1John L. Sievenpiper John L. Sievenpiper 3*
  • 1 University of Toronto, Toronto, Ontario, Canada
  • 2 Protein Industries Canada, Regina, Saskatchewan, Canada
  • 3 Unity Health Toronto, Toronto, Canada

The final, formatted version of the article will be published soon.

    The Portfolio Diet combines cholesterol-lowering plant foods for the management of cardiovascular disease risk. However, the translation of this dietary approach into clinical practice necessitates a user-friendly method for patients to autonomously monitor their adherence. Objective: This study aimed to develop and validate the clinical-Portfolio Diet Score (c-PDS) as a food-based metric to facilitate self-tracking of the Portfolio Diet. Methods: Using a simulation model to estimate the c-PDS, the validity was assessed in a secondary analysis of a completed trial of the Portfolio Diet in 98 participants with hyperlipidemia over 6 months. Concurrent and predictive validity of the estimated c-PDS were assessed against the reference measure (weighed 7-day diet records) and concomitant changes in LDL-C from baseline to six months. Bland-Altman analysis was used to assess the limits of agreement between the two methods. Results: The c-PDS was positively correlated with dietary adherence as measured using the 7-day diet records (r=0.94, P<0.001). The c-PDS was negatively correlated with change in LDL-C (r=-0.43, P<0.001) with a 1-point increase in the c-PDS being associated with a -0.04 mmol/L (CI:-0.06,-0.03; P<0.001) or a 1.09% reduction in LDL-C. Visual evaluation of the Bland-Altman plots showed reasonable agreement.These findings indicate good validity of the c-PDS for primary prevention adults with hyperlipidemia and have informed the messaging and goals within the PortfolioDiet.app, a clinical health application for delivering the Portfolio Diet. Future research will assess if the c-PDS when used as part of the PortfolioDiet.app is effective in promoting behaviour change and subsequent health-related outcomes.

    Keywords: Nutrition1, Portfolio Diet2, Dietary patterns3, lipids4, cholesterol reduction5, self-monitoring6 (Min.5-Max. 8)

    Received: 09 Mar 2024; Accepted: 22 Jul 2024.

    Copyright: © 2024 Kavanagh, Glenn, Chiavaroli, Morgan, Josse, Malik, Marinangeli, Kendall, Jenkins and Sievenpiper. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: John L. Sievenpiper, Unity Health Toronto, Toronto, Canada

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