1540-P: Ultra-Processed Food in the PHENO-Diet Trial: A Secondary Analysis

Introduction and Objective: In the PHENO-Diet trial (PMID: 37007741), a phenotype-tailored lifestyle intervention (PLI) resulted in greater weight loss than a standard lifestyle intervention (SLI). This secondary analysis compared ultra-processed food (UPF) intake between interventions. Methods: This secondary analysis of a 12-week, non-randomized trial included adults with BMI 30 kg/m² assigned to SLI (n=81) or PLI (n=84). Both groups followed a low-calorie diet with behavioral modification; PLI received phenotype-specific dietary and behavioral recommendations (e.g., time-restricted feeding, premeal protein, emotional eating-focused therapy, or high-intensity interval training with post-workout protein). Dietary intake was assessed using 24-hour recalls at baseline, 1 month, and 3 months; UPF intake was calculated as kcal/day and percentage of total energy intake. Analyses included participants with baseline and ≥1 post-intervention recall. Between-group comparisons used t-tests, and associations with 3-month UPF reduction were evaluated using multivariable linear models adjusted for age, sex, and baseline BMI. Results: At baseline, there were no differences between PLI and SLI in total energy intake, UPF intake, or the proportion of calories from UPF. At baseline, mean energy intake was 1960 ± 735 kcal in PLI and 1798 ± 869 kcal in SLI; mean UPF intake was 1139 ± 806 kcal in PLI and 1023 ± 609 kcal in SLI, with similar UPF proportions (54.0 ± 27.3% vs 56.3 ± 25.8%), all P 0.05. At 1 month, there was a non-significant greater reduction in UPF intake in PLI compared to SLI (P = 0.40). At 3 months, there was a significant greater reduction in UPF intake in PLI compared to SLI (−755 ± 957 vs. −119 ± 738 kcal; P = 0.02). A mixed-effects model adjusted for sex, age, and baseline BMI confirmed a time-by-phenotype interaction (P = 0.03), indicating greater UPF reduction with PLI. Conclusion: A phenotype-tailored lifestyle intervention that previously demonstrated superior weight loss was also associated with greater reductions in ultra-processed food intake. Disclosure J. Villamarin: None. L.E. Sefried: None. A.N. McRae: None. T.W. Fredrick: None. J.M. Garcia Cordova: None. M. Romanos: None. J.D. Pazmino Zurita: None. M. Espinosa: None. T. Quezada: None. M.M. Schaefer: None. J. Stutzman: None. D.D. Hensrud: None. S. Kumar: Consultant; Current; Rhythm Pharmaceuticals, Inc. M.D. Hurtado Andrade: Research Support; Current; Eli Lilly and Company. Advisory Panel; Ended; Novo Nordisk. Other - I support Novo Nordisk with publications, data generation. I am paid to present these data at meetings; Current; Novo Nordisk. Research Support; Current; Endogenex. Research Support; Ended; Phenomix Sciences. Advisory Panel; Ended; Roche Pharmaceuticals. Consultant; Ended; Verge Genomics. A. Acosta: Other - Licensed Patent / Technology; Current; Phenomix Sciences, Gila Therapeutics. Advisory Panel; Current; Boehringer Ingelheim International GmbH, Structure Therapeutics. Research Support; Ended; Novo Nordisk. Research Support; Current; Rhythm Pharmaceuticals, Inc., Regeneron Pharmaceuticals Inc. Funding NIDDK-R01DK139028 and Mayo Clinic