Comparison of ChatGPT and dietitians in formulating diet plans and recommendations for patients with cardiometabolic diseases.

BACKGROUND: Artificial Intelligence (AI) is transforming personalized medicine, yet its efficacy constitutes a dynamic factor in the field of health and personalized medicine. OBJECTIVE: This study compared ChatGPT's ability to construct dietetic plans and provide nutritional advice against professional dietitians. METHODS: Three dietitians and ChatGPT generated diet plans and gave recommendations for (i) obesity/dyslipidemia, (ii) obesity/ dyslipidemia/ hypertension, and (iii) obesity/dyslipidemia/type 2 diabetes which were compared with each other and official recommendations. Prompts were developed via systematic iterative refinement. Macro- and micronutrient content was analyzed using "Explore Food" software. ChatGPT's performance was also evaluated across sexes and four ethnic groups (Caucasian, Asian, Afro-American, Mexican). The non-parametric Mann-Whitney U Test was used. RESULTS: Dietitians recommended more carbohydrates, sugars, saturated fats, sodium, chloride, and iodine, while ChatGPT suggested higher polyunsaturated fats for obesity/ dyslipidemia and obesity/dyslipidemia/ hypertension. In addition, for obesity/ dyslipidemia/ hypertension dietitians proposed more energy and fiber compared to ChatGPT. In the case of obesity/dyslipidemia/diabetes dietitians proposed more sugars. Dietitians' plans were higher in vitamin C and other minerals in the case of obesity/ dyslipidemia. Vitamin D was low in all plans. Accuracy relative to official guidelines was comparable: 50-100% for dietitians versus 55-83% for ChatGPT across all conditions. No recommendation was made for adherence to the Mediterranean diet from ChatGPT, in contrast to dietitians. Overall, ChatGPT proposed higher energy plans for men than women (p<0.05). However, ethnic subgroup analysis showed this difference was significant only for Caucasian and Mexican cases. CONCLUSIONS: In conclusion, ChatGPT had a comparable ability to dietitians to design diet plans and provide nutritional counseling for people with obesity, hypertension, or type 2 diabetes. Its performance in specific ethnic groups may be limited. The value of human clinical judgment and interpersonal interaction in nutrition counseling is essential for patient engagement and optimal outcomes.