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Evaluating the Effectiveness of AI-assisted Food Recommendation System on Personalized Nutrition

Last registered on June 26, 2026

Pre-Trial

Trial Information

General Information

Title
Evaluating the Effectiveness of AI-assisted Food Recommendation System on Personalized Nutrition
RCT ID
AEARCTR-0015970
Initial registration date
September 26, 2025

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
October 01, 2025, 7:39 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
June 26, 2026, 4:38 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Region

Primary Investigator

Affiliation
TAMU

Other Primary Investigator(s)

PI Affiliation
Texas A&M University
PI Affiliation
Texas A&M University
PI Affiliation
Texas A&M University
PI Affiliation
Texas A&M University

Additional Trial Information

Status
Completed
Start date
2026-03-17
End date
2026-06-06
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Nutritional needs vary for each person, shaped by their genetic profile, metabolic processes, and microbiome composition. Recent technological advances have stimulated innovative solutions for personalized dietary guidance, with Food Recommendation Systems (FRS) leveraging AI to provide tailored recommendations based on users' preferences and health goals. Yet, the current FRS is limited in integrating health profiles, preferences, and nutrition needs. To address this, the project aims to develop and evaluate the impact of applying an AI and natural language processing (NLP)-driven FRS that personalizes dietary suggestions based on individual health parameters, nutritional goals, and preferences. The impact of this project relies on improving dietary adherence, enhancing user satisfaction, and addressing specific health conditions. Our proposed AI-enabled system will assist users in recommending nutritionally customized foods while also considering suitable options for users with allergies and health concerns. The proposed method utilizes a novel deep generative network architecture to provide personalized recommendations to users based on their health profiles and preferences (precision nutrition). The system will promote healthier eating habits and address diet-related health issues through evidence-based personalized food prescriptions. Our approach is summarized as follows: First, we will utilize two publicly accessible datasets: the nutrition-based food dataset and the person's health profile and preference dataset. The first contains nutritional values (e.g., protein, carbohydrates, fat, fiber, and energy). The second contains information on age, body mass index, basal metabolic rate, targeted energy intake, physical activity level (PAL), and the existence of disease/deficiency (cardiovascular, diabetes, and iron) and food/taste preferences. Second, data will be normalized and fed to the variational autoencoder network, capturing informative features about the users' dietary needs. An NLP algorithm will be trained to adapt to user preferences. A recurrent neural network will generate recommendations to ensure the energy and nutrients align with the user's needs. Loss functions will be deployed to align our system with trustworthy AI principles by ensuring personalized food suggestions closely match expert nutritional guidelines for each user. A user interface (web or app) integrating the recommendation engine will be developed, making it a usable system with end-to-end functionality. Finally, we will implement and evaluate the impact of the developed algorithm on the dietary quality of a representative sample of the US population, including vulnerable groups (healthy living). This step consists of using a randomized controlled trial (RCT) design with a treated group (i.e., those who receive personalized dietary recommendations prescribed by the developed AI system) and a control group (those who receive standard dietary recommendations). Relevance to the IHA Mission: This project aligns with the IHA mission by contributing to key areas such as "Reducing diet-related chronic diseases," "Lowering health care costs," and "Eliminating diet-related health inequities." Through the development and evaluation of personalized dietary recommendations generated by AI, this project directly supports the IHA' s goal of integrating innovative technologies into health-promoting solutions. Further, the project has the potential to bridge the gap between responsible agriculture, healthy living, and public health outcomes, fostering collaborations across disciplines to enhance human health. In the future, we will aim to make prescriptions cost-efficient and, therefore, affordable (responsive agriculture).
External Link(s)

Registration Citation

Citation
Melo, Grace et al. 2026. "Evaluating the Effectiveness of AI-assisted Food Recommendation System on Personalized Nutrition." AEA RCT Registry. June 26. https://doi.org/10.1257/rct.15970-3.0
Experimental Details

Interventions

Intervention(s)
Intervention (Hidden)
We will screen approximately 1,900 U.S. adults through the Forthright Access platform. After an eligibility screener (≥ 18 years; basic English; regular access to a smartphone and internet; generally healthy adults for whom the Dietary Guidelines for Americans are appropriate — excluding individuals requiring medically supervised or restrictive diets, e.g., diabetes, celiac disease/gluten sensitivity, chronic kidney disease requiring dietary restriction, prescribed/highly-restrictive diets, or pregnancy), Forthright's server-side block randomizer will assign eligible participants 1:1 to two parallel arms. We anticipate an analytic sample of approximately 780 (~390 per arm).
Both arms use the same mobile/web application. It has two components: a Track Mode for all participants (log meals, view nutrient and diet-quality summaries) and a Personalized Recommendation Mode for the treatment arm only.

Treatment arm — the app with Track Mode and the AI-driven Personalized Recommendation Mode: real-time personalized meal suggestions from an LLM/NLP engine (OpenAI) constrained to USDA FPED, the Dietary Guidelines, and AMDR ranges (educational only).
Control arm — the same app shell in Track Mode only (tracking features + general, non-personalized guidance); no AI-personalized recommendations.

Single-blind from the participant's side; the data-analysis team is masked to arm codes. Dietary intake and behavioral items are collected at baseline (Week 0) and at the post-intervention endline [registered Week 12; implemented after ~7 weeks under the approved modification]. Intake is measured with ASA24; treatment participants are asked to use the app ≥ once/week and indicate whether they followed each recommendation; app analytics are logged automatically. Emails are collected only for app registration and reminders.
Intervention Start Date
2026-04-17
Intervention End Date
2026-06-04

Primary Outcomes

Primary Outcomes (end points)
The primary outcome we are going to monitor is the difference between the HEI-2020 score at baseline (week 0) and week 12. HEI- 2020 measures the dietary quality compared with the key dietary recommendations and dietary patterns by the Dietary Guidelines for Americans. The scores range from 0 to 100, with higher values indicating closer adherence to the guideline. We will also monitor the changes in different categories, such as changes in the fruit component and the vegetable component via the HEI-2020 Fruit sub-score and the HEI-2020 Vegetable sub-score. App engagement data and behavioral questions will serve as the explanatory variables in the study.
Primary Outcomes (explanation)
Dietary Quality: Change in Healthy Eating Index-2020 (HEI-2020) score from baseline (Week 0) to end of intervention (Week 12), computed from two 24-hour dietary recalls delivered in Forthright using the USDA Automated Multiple-Pass Method (ASA24) .
Adherence: Proportion of AI-recommended meals actually consumed over the 12-week period, as recorded in the FRS app’s daily meal-tracking logs.

Secondary Outcomes

Secondary Outcomes (end points)
The secondary outcomes (HEI subscores) will also be analyzed using identical models. The behavioral variables will be employed as the explanatory variables in the models. We will also conduct heterogeneous effects based on specific groups such as age, gender, and BMI categories, and nutrition habits based on our survey questions. The diff-in-diff model will also be conducted within these groups. The results will be interpreted as exploratory.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We will screen approximately 1,900 U.S. adults through the Forthright Access platform. After an eligibility screener (≥ 18 years; basic English; regular smartphone and internet access; generally healthy adults for whom the Dietary Guidelines for Americans are appropriate — excluding those requiring medically supervised or restrictive diets, e.g., diabetes, celiac/gluten sensitivity, CKD requiring dietary restriction, prescribed or highly restrictive diets, or pregnancy), Forthright's server-side block randomizer will assign eligible participants 1:1 to two parallel arms. Accounting for ≈50% eligibility and ≈10% attrition, we anticipate an analytic sample of ≈780 (≈390 per arm).
Both arms use the same mobile/web application, which includes a Track Mode for all participants (log meals; view nutrient and diet-quality summaries) and a Personalized Recommendation Mode for the treatment arm only.

Treatment arm – the app with Track Mode plus the AI/NLP-driven Personalized Recommendation Mode (OpenAI engine constrained to USDA FPED, the Dietary Guidelines, and AMDR ranges; educational only).
Control arm – the same app shell in Track Mode only (tracking + general, non-personalized guidance); no AI-personalized recommendations.

Single-blind from the participant's side; participants are told only that they will receive "nutrition guidance"; the control arm is not informed another group receives AI recommendations. Forthright/the technology team handle randomization; the data-analysis team is masked to arm codes. Dietary intake and behavioral questions are collected at baseline (Week 0) and at the post-intervention endline [registered Week 12; implemented after ~7 weeks under the approved modification]. Intake is measured with ASA24; treatment participants are asked to use the app ≥ once/week and to indicate whether they followed each recommendation; app analytics are logged automatically for engagement/uptake analyses.
Experimental Design Details
Randomization Method
Randomization was performed by the research team, using a computer-generated, stratified randomization procedure implemented in R with a fixed seed for reproducibility. Eligible participants who passed the electronic screener and provided e-consent were stratified by gender, age group (18–34, 35–49, 50+), and household income group (<$35k, $35k–$74k, $75k–$149k, ≥$150k); within each stratum (the cross-classification of gender × age × income), participants were allocated 1:1 to the treatment and control arms by random permutation of balanced assignment labels. Forthright provided panel recruitment and survey administration only; the study team generated and managed the allocation sequence and arm assignments. Participants were blind to allocation (single-blind from the participant side), and the data-analysis team was masked to the arm codes.
Original structure (as registered). Each completed survey earned $2.50 plus one loyalty point. Participants who completed both the baseline and endline surveys qualified for an app-engagement reward based on their app activity: the top 1% → $50, those ranked top 1–10% → $5, with ties split equally.
Modification at the (early) endline. End-survey incentives were augmented: the first 200 eligible participants who fully completed the end survey by Thursday, June 4, 2026 received $15 each, and all who completed it by that date were entered into a random drawing for one $150 gift card — in addition to the original app-engagement rewards (top 1% → $50; top 10% → $5).
Randomization Unit
Two arms are included: Treatment arm — the app with Track Mode and the AI-driven Personalized Recommendation Mode: real-time personalized meal suggestions from an LLM/NLP engine (OpenAI) constrained to USDA FPED, the Dietary Guidelines, and AMDR ranges (educational only).
Control arm — the same app shell in Track Mode only (tracking features + general, non-personalized guidance); no AI-personalized recommendations.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Not applicable — individual-level randomization (no clustering). The unit of randomization is the individual participant; participants were stratified by gender × age × income and assigned 1:1 within strata.
Sample size: planned number of observations
700 U.S. adults per arm (1,400 U.S. adults in total ) through the Forthright platform.
Sample size (or number of clusters) by treatment arms
Sample size: N≈700 for treatment group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
0.2
IRB

Institutional Review Boards (IRBs)

IRB Name
Texas A&M University HUMAN RESEARCH PROTECTION PROGRAM
IRB Approval Date
2025-12-11
IRB Approval Number
STUDY2025-1209
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
June 04, 2026, 12:00 AM +00:00
Data Collection Complete
Yes
Data Collection Completion Date
June 06, 2026, 12:00 AM +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
no clusters
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
149 participants analyzed for the primary outcome (84 control, 65 treatment). Up to 183 had an endline ASA24 recall (the outcome); 149 also had a matched baseline HEI.
Final Sample Size (or Number of Clusters) by Treatment Arms
Randomized: 967 control / 945 treatment. Analyzed (primary outcome): 84 control / 65 treatment.
Data Publication

Data Publication

Is public data available?
No

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Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials