Development and Validation of a Novel, Third-Generation Lifestyle (Exercise and Nutrition) Prescription for Precision Medicine in Indians with cardio metabolic diseases (DEVELOP Study).

Cardiometabolic diseases (CMDs) such as hypertension, dyslipidaemia, and type 2 diabetes significantly increase cardio- and cerebrovascular risk. Conventional manually written first-generation lifestyle prescriptions show sub- optimal adherence, while second-generation electronic prescriptions without artificial intelligence (AI) are limited in India. Third-generation lifestyle prescriptions integrate wearable, clinical and physiological parameters, genetic information, and evidence-based guidelines using AI/machine-learning (ML) tools to generate precise, individualised recommendations, an approach unexplored in India. This study proposes the development of a culturally relevant Third-Generation Precision Lifestyle Prescription (TGPLP) that can be customised by treating physicians. Objective 1 is to develop TGPLP using detailed prospective data from 2,000 participants across CMD stages, integrating genetic, wearable, clinical, and lifestyle datasets through AI/ML. Objective 2 is to evaluate the preliminary efficacy of TGPLP on adherence to physical activity and diet over 12 weeks through a pilot randomised controlled trial in 200 particpants. Objective 3 is to assess cost, acceptability, and scalability to inform a future multi-centre RCT.