{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T10:02:08Z","timestamp":1765965728746,"version":"3.48.0"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon Europe Research and Innovation Program","award":["101080645"],"award-info":[{"award-number":["101080645"]}]},{"DOI":"10.13039\/501100004587","name":"Carlos III Health Institute","doi-asserted-by":"crossref","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["2020.03966.CEECIND"],"award-info":[{"award-number":["2020.03966.CEECIND"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Rising obesity rates among young adults increase long-term health risks, especially cardiometabolic conditions such as type 2 diabetes mellitus. Digital interventions can offer scalable solutions to promote and support healthy behaviors by integrating personalized diet, physical activity promotion, and behavioral support. Objective: To assess the feasibility, user friendliness, adherence, and satisfaction of the Healthy Lifestyle Recommender System (HLRS). Secondary outcomes will include measures of metabolic health and obesity. Methods: A 3-month, single-arm pilot study conducted across European countries, including Bulgaria, Germany, Italy, Netherlands, Portugal, and Spain, enrolling 351 young adults (18\u201325 years old, BMI 18.5\u201329.9 kg\/m2). The intervention includes a mobile app for meal planning (Nutrida v.1), gamified physical activity encouragement (GameBus), and real-time monitoring via a wearable smartwatch device. Primary outcomes are adherence and engagement, measured through app usage and participant feedback; secondary outcomes include anthropometry, physical activity, dietary patterns, psychological well-being, and selected biomarkers of metabolic health. Expected Outcomes: Improved engagement is expected to enhance lifestyle behaviors, supporting weight management and overall well-being. Findings will guide future large-scale interventions. Conclusions: This study will contribute to minimizing the impact of obesity in Europe.<\/jats:p>","DOI":"10.3390\/jpm15120625","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T15:52:59Z","timestamp":1765813979000},"page":"625","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Empowering Healthy Lifestyle Behavior Through Personalized Intervention Portfolios Using a Healthy Lifestyle Recommender System to Prevent and Control Obesity in Young Adults: Pilot Study Protocol from the HealthyW8 Project"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3534-1588","authenticated-orcid":false,"given":"Silvia","family":"Garc\u00eda","sequence":"first","affiliation":[{"name":"Foundation of the Healthy Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (CIBER of Physiopathology of Obesity and Nutrition), Institute of Health Carlos III, 28029 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0954-039X","authenticated-orcid":false,"given":"Marina","family":"R\u00f3denas-Munar","sequence":"additional","affiliation":[{"name":"Foundation of the Healthy Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (CIBER of Physiopathology of Obesity and Nutrition), Institute of Health Carlos III, 28029 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7825-0697","authenticated-orcid":false,"given":"Torsten","family":"Bohn","sequence":"additional","affiliation":[{"name":"Nutrition and Health Research Group, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1312-4913","authenticated-orcid":false,"given":"Astrid","family":"Kemperman","sequence":"additional","affiliation":[{"name":"Research Group on Urban Planning and Transportation, Eindhoven University of Technology, 5612 AE Eindhoven, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4559-4303","authenticated-orcid":false,"given":"Daniela","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9119-6752","authenticated-orcid":false,"given":"Suzan","family":"Evers","sequence":"additional","affiliation":[{"name":"Research Group on Urban Planning and Transportation, Eindhoven University of Technology, 5612 AE Eindhoven, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9370-1337","authenticated-orcid":false,"given":"Elsa","family":"Lamy","sequence":"additional","affiliation":[{"name":"Mediterranean Institute for Agriculture Environment and Development, University of Evora, 7002-554 Evora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3143-4058","authenticated-orcid":false,"given":"Mar\u00eda","family":"P\u00e9rez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Mediterranean Institute for Agriculture Environment and Development, University of Evora, 7002-554 Evora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7169-675X","authenticated-orcid":false,"given":"Sarah","family":"Forberger","sequence":"additional","affiliation":[{"name":"Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1847-0230","authenticated-orcid":false,"given":"Maria Giovanna","family":"Onorati","sequence":"additional","affiliation":[{"name":"University of Gastronomic Sciences, 12042 Pollenzo, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-1110","authenticated-orcid":false,"given":"Andrea","family":"Devecchi","sequence":"additional","affiliation":[{"name":"University of Gastronomic Sciences, 12042 Pollenzo, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5480-183X","authenticated-orcid":false,"given":"Tiziana","family":"De Magistris","sequence":"additional","affiliation":[{"name":"Instituto Agroalimentario de Arag\u00f3n, IA2 (CITA-Universidad de Zaragoza), 50059 Zaragoza, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8476-2513","authenticated-orcid":false,"given":"Jihan","family":"Halimi","sequence":"additional","affiliation":[{"name":"Instituto Agroalimentario de Arag\u00f3n, IA2 (CITA-Universidad de Zaragoza), 50059 Zaragoza, Spain"}]},{"given":"Yoanna","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Regional Cluster North-East, 9002 Varna, Bulgaria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6166-0884","authenticated-orcid":false,"given":"Boyko","family":"Doychinov","sequence":"additional","affiliation":[{"name":"Regional Cluster North-East, 9002 Varna, Bulgaria"}]},{"given":"Cristina","family":"Bouzas","sequence":"additional","affiliation":[{"name":"Foundation of the Healthy Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (CIBER of Physiopathology of Obesity and Nutrition), Institute of Health Carlos III, 28029 Madrid, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6940-0761","authenticated-orcid":false,"given":"Josep A.","family":"Tur","sequence":"additional","affiliation":[{"name":"Foundation of the Healthy Research Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (CIBER of Physiopathology of Obesity and Nutrition), Institute of Health Carlos III, 28029 Madrid, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"key":"ref_1","unstructured":"United Nations (2025, May 09). Definition of Youth. Available online: https:\/\/www.un.org\/esa\/socdev\/documents\/youth\/fact-sheets\/youth-definition.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s11892-017-0938-4","article-title":"The Transition into Young Adulthood: A Critical Period for Weight Control","volume":"17","author":"Lanoye","year":"2017","journal-title":"Curr. Diabetes Rep."},{"key":"ref_3","unstructured":"Stanford, F.C., Taylor, C., Hoelscher, D.M., Anderson, C.A.M., Booth, S., Deierlein, A., Fung, T., Gardner, C., Giovannucci, E., and Raynor, H. (2025, May 09). Dietary Patterns with Ultra-Processed Foods and Growth, Body Composition, and Risk of Obesity: A Systematic Review, Available online: https:\/\/nesr.usda.gov\/2025-dietary-guidelines-advisory-committee-systematic-reviews\/dietary-patterns-ultraprocessed_growth-obesity."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103240","DOI":"10.1016\/j.healthplace.2024.103240","article-title":"Local retail food environment exposure and diet quality in rural and urban adults: A longitudinal analysis of the ORISCAV-LUX cohort study","volume":"87","author":"Tharrey","year":"2024","journal-title":"Health Place"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"669","DOI":"10.3945\/ajcn.116.134684","article-title":"Identification of dietary patterns associated with obesity in a nationally representative survey of Canadian adults: Application of a priori, hybrid, and simplified dietary pattern techniques","volume":"105","author":"Jessri","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dixon, H., Scully, M., Wakefield, M., Kelly, B., Pettigrew, S., Chapman, K., and Niederdeppe, J. (2018). The impact of unhealthy food sponsorship vs. pro-health sponsorship models on young adults\u2019 food preferences: A randomised controlled trial. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-6298-4"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1111\/sms.14475","article-title":"Weekday and weekend physical activity patterns and their correlates among young adults","volume":"33","author":"Suorsa","year":"2023","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_8","unstructured":"World Health Organization (2022). Obesity and Overweight. WHO European Regional Obesity Report 2022, WHO. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_9","unstructured":"World Health Organization (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240015128."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1479-5868-1-17","article-title":"Diet and physical activity behavior among users of prescription weight loss medications","volume":"1","author":"Blanck","year":"2004","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_11","unstructured":"(2025, May 09). NHS-UK Treatment Obesity. Available online: https:\/\/www.nhs.uk\/conditions\/obesity\/treatment\/."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1467-789X.2012.00990.x","article-title":"Lifestyle intervention for preventing weight gain in young adults: A systematic review and meta-analysis of RCTs","volume":"13","author":"Hebden","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/j.1467-789X.2009.00673.x","article-title":"Weight loss interventions in young people (18 to 25 year olds): A systematic review","volume":"11","author":"Poobalan","year":"2010","journal-title":"Obes. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e080644","DOI":"10.1136\/bmjopen-2023-080644","article-title":"\u2018Let me recommend\u2026\u2019: Use of digital nudges or recommender systems for overweight and obesity prevention-a scoping review protocol","volume":"14","author":"Forberger","year":"2024","journal-title":"BMJ Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e9633","DOI":"10.1097\/MD.0000000000009633","article-title":"EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol","volume":"97","author":"Ramirez","year":"2018","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e37716","DOI":"10.2196\/37716","article-title":"mHealth Apps Targeting Obesity and Overweight in Young People: App Review and Analysis","volume":"11","author":"Burazor","year":"2023","journal-title":"JMIR mHealth uHealth"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e56556","DOI":"10.2196\/56556","article-title":"Usability and Effectiveness of eHealth and mHealth Interventions That Support Self-Management and Health Care Transition in Adolescents and Young Adults with Chronic Disease: Systematic Review","volume":"26","author":"Li","year":"2024","journal-title":"J. Med. Internet Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e58362","DOI":"10.2196\/58362","article-title":"Examining Individuals\u2019 Use of the Internet for Health Care Activities Over Time: Results from the US National Health Interview Survey","volume":"12","author":"Junkins","year":"2025","journal-title":"JMIR Hum. Factors"},{"key":"ref_19","unstructured":"Watson, R.R. (2015). Physical activity assessment and impact. Diet and Exercise in Cystic Fibrosis, Academic Press. [1st ed.]. Available online: https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/B9780128000519000341?via%3Dihub."},{"key":"ref_20","unstructured":"Holzinger, A. (2008). Construction and evaluation of a user experience questionnaire. HCI and Usability for Education and Work, Springer. Available online: https:\/\/link.springer.com\/chapter\/10.1007\/978-3-540-89350-9_6."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e50430","DOI":"10.2196\/50430","article-title":"A Digital Health Intervention Platform (Active and Independent Management System) to Enhance the Rehabilitation Experience for Orthopedic Joint Replacement Patients: Usability Evaluation Study","volume":"11","author":"Papadopoulos","year":"2024","journal-title":"JMIR Hum. Factors"},{"key":"ref_22","unstructured":"Casadei, K., and Kiel, J. (2025, May 09). Anthropometric measurement, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK537315\/."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Alqaderi, H., Hegazi, F., Al-Mulla, F., Chiu, C.J., Kantarci, A., Al-Ozairi, E., Abu-Farha, M., Bin-Hasan, S., Alsumait, A., and Abubaker, J. (2022). Salivary Biomarkers as Predictors of Obesity and Intermediate Hyperglycemia in Adolescents. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.800373"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"13981","DOI":"10.34117\/bjdv8n2-363","article-title":"Relevance of obesity and overweight to salivary and plasma proteomes of human young adults from Brazil","volume":"8","author":"Sade","year":"2022","journal-title":"Braz. J. Dev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e083558","DOI":"10.1136\/bmjopen-2023-083558","article-title":"Multicomponent (bio)markers for obesity risk prediction: A scoping review protocol","volume":"14","author":"Vahid","year":"2024","journal-title":"BMJ Open"},{"key":"ref_26","unstructured":"(2025, May 05). Research Electronic Data Capture. Available online: https:\/\/project-redcap.org\/."},{"key":"ref_27","unstructured":"National Cancer Institute (2025, May 09). 24-Hour Dietary Recall (24HR) At a Glance, Available online: https:\/\/dietassessmentprimer.cancer.gov\/profiles\/recall\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.18844\/gjpr.v8i2.3434","article-title":"The psychometric properties of the Big Five inventory-10 (BFI-10) including correlations with subjective and psychological well-being","volume":"8","author":"Balgiu","year":"2018","journal-title":"Glob. J. Psychol. Res. New Trends Issues"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/1479-5868-8-115","article-title":"Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): A systematic review","volume":"8","author":"Lee","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.genhosppsych.2010.03.006","article-title":"The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review","volume":"32","author":"Kroenke","year":"2010","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_32","unstructured":"Schrepp, M. (2025, May 09). User Experience Questionnaire Handbook [Internet]. Available online: https:\/\/www.ueq-online.org\/Material\/Handbook.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Marcus, A. (2014). Applying the User Experience Questionnaire (UEQ) in different evaluation scenarios. Design, User Experience, and Usability. Theories, Methods, and Tools for Designing the User Experience, Springer. Lecture Notes in Computer Science.","DOI":"10.1007\/978-3-319-07668-3"},{"key":"ref_34","unstructured":"World Health Organization (1998). Programme on Mental Health: WHOQOL User Manual, 2012 Revision [Internet], World Health Organization. Available online: https:\/\/iris.who.int\/handle\/10665\/77932."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1080\/10408398.2021.1966737","article-title":"Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: A systematic review and meta-analysis","volume":"63","author":"Cui","year":"2023","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Chung, J., Ahn, S., Joung, H., and Shin, S. (2023). Development of a Semi-Quantitative Food-Frequency Questionnaire for Korean Adults with Obesity. Nutrients, 15.","DOI":"10.3390\/nu15224848"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1017\/S0007114509993837","article-title":"Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain","volume":"103","author":"Zazpe","year":"2010","journal-title":"Br. J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Garcia, S., Vidovi\u0107, B., Tijerina, A., Tur, J.A., and Bouzas, C. (2024). Development and Evaluation of the Reliability of a Semi-Quantitative Food Frequency Questionnaire to Assess the Intake in the Serbian Population. Nutrients, 16.","DOI":"10.3390\/nu16152490"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/625\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T09:57:02Z","timestamp":1765965422000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,13]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jpm15120625"],"URL":"https:\/\/doi.org\/10.3390\/jpm15120625","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2025,12,13]]}}}