You Qian, Li Xuemei, Shi Lei, Rao Zhiyong, Hu Wen
Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
J Ren Nutr. 2025 Mar 10. doi: 10.1053/j.jrn.2025.02.008.
Prominent large language models, such as OpenAI's Chat Generative Pre-trained Transformer (ChatGPT), have shown promising implementation in the field of nutrition. Special care should be taken when using ChatGPT to prescribe protein-restricted diets for kidney-impaired patients. The objective of the current study is to simulate a chronic kidney disease (CKD) patient and evaluate the capabilities of ChatGPT in the context of dietary prescription, with a focus on protein contents of the diet.
We simulated a scenario involving a CKD patient and replicated a clinical counseling session that covered general dietary principles, dietary assessment, energy and protein recommendation, dietary prescription, and diet customization based on dietary culture. To confirm the results derived from our qualitative observations, 10 colleagues were recruited and provided with identical dietary prescription prompts to run the process again. The actual energy and protein levels of the given meal plans were recorded and the difference from the targets were compared.
ChatGPT provides general principles overall aligning with best practices. The recommendations for energy and protein requirements of CKD patients were tailored and satisfactory. It failed to prescribe a reliable diet based on the target energy and protein requirements. For the quantitative analysis, the prescribed energy levels were generally lower than the targets, ranging from -28.9% to -17.0%, and protein contents were tremendously higher than the targets, ranging from 59.3% to 157%.
ChatGPT is competent in offering generic dietary advice, giving satisfactory nutrients recommendations and adapting cuisines to different cultures but failed to prescribe nutritionally accurate dietary plans for CKD patients. At present, patients with strict protein and other particular nutrient restrictions are not recommended to rely on the dietary plans prescribed by ChatGPT to avoid potential health risks.
诸如OpenAI的聊天生成预训练变换器（ChatGPT）等著名的大语言模型已在营养领域展现出了有前景的应用。在使用ChatGPT为肾脏受损患者开具蛋白质限制饮食处方时应格外谨慎。本研究的目的是模拟一名慢性肾脏病（CKD）患者，并评估ChatGPT在饮食处方方面的能力，重点关注饮食中的蛋白质含量。
我们模拟了一个涉及CKD患者的场景，并重现了一次临床咨询过程，该过程涵盖了一般饮食原则、饮食评估、能量和蛋白质推荐、饮食处方以及基于饮食文化的饮食定制。为了确认我们定性观察得出的结果，招募了10位同事，并向他们提供相同的饮食处方提示，以便再次进行该过程。记录给定饮食计划的实际能量和蛋白质水平，并将其与目标值的差异进行比较。
ChatGPT提供的总体原则与最佳实践基本一致。针对CKD患者的能量和蛋白质需求的建议是量身定制的且令人满意。但它未能根据目标能量和蛋白质需求开具可靠的饮食处方。对于定量分析，开具的能量水平普遍低于目标值，范围从-28.9%到-17.0%，而蛋白质含量则大大高于目标值，范围从59.3%到157%。
ChatGPT能够提供一般性的饮食建议，给出令人满意的营养推荐，并根据不同文化调整菜肴，但未能为CKD患者开具营养精确的饮食计划。目前，不建议有严格蛋白质和其他特定营养限制的患者依赖ChatGPT开具的饮食计划，以避免潜在的健康风险。
