Effect of a Multicomponent mHealth Intervention on the Composition of Diet in a Population with Overweight and Obesity—Randomized Clinical Trial EVIDENT 3

A balanced diet can help in the prevention of chronic diseases. The aim of this study was to evaluate the effect of an mHealth intervention on the distribution of macronutrients and the intake of food groups. A total of 650 participants were included in this multi-center, clinical, randomized, controlled trial (Evident 3 study). All participants were given brief advice about diet and exercise. The intervention group received, in addition, an app (Evident 3) for the self-recording of their diet and an activity tracker wristband for 3 months. Follow-up visits were performed at 3 and 12 months to collect the diet composition using the Food Frequency Questionnaire. There were decreases in the intake of total calories, fat, protein and carbohydrates in both groups throughout the study, without significant differences between them. The intervention group reduced the intake of cholesterol (−30.8; 95% CI −59.9, −1.7) and full-fat dairies (−23.3; 95% CI −42.8, −3.8) and increased the intake of wholemeal bread (3.3; 95% CI −6.7, 13.3) and whole-grain cereals (3.4; 95% CI −6.8, 13.7) with respect to the control group. No differences were found in the rest of the nutritional parameters. The brief advice is useful to promote a healthier diet, and the app can be a support tool to obtain changes in relevant foods, such as integral foods, and the intake of cholesterol. Trial registration: ClinicalTrials.gov with identifier NCT03175614.

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Effect of an mHealth-Based Intervention on Excessive Gestational Weight Gain Prevention among Overweight and Obese Women: A Randomized Controlled Trial (Preprint)

10.2196/preprints.34883 ◽

2021 ◽

Author(s):

Hung Hui Chen ◽

Ching-Fang Lee ◽

Jian-Pei Huang ◽

Li-Kang Chi ◽

Yvonne Hsiung

Keyword(s):

Physical Activity ◽

Weight Gain ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Obese Women ◽

Third Trimester ◽

Overweight Women ◽

Mhealth Intervention ◽

Excessive Gestational Weight Gain

BACKGROUND Excessive gestational weight gain (GWG) is a public health concern since it can lead to adverse consequences and health problems for expecting mothers and their unborn infants. There is a need to evaluate the effects of a GWG management intervention to reduce the burden and risk among overweight and obese women during pregnancy. OBJECTIVE To explore the efficacy of a mobile health (mHealth) intervention to prevent excessive GWG, overweight and obese pregnant women were invited to use an app and wearable activity tracker (WAT). METHODS A randomized controlled trial with an experimental study design. Ninety-two pregnant women were recruited, and all overweight and obese participants from the two prenatal outpatient clinics in northern Taiwan had, at less than 17 weeks gestation, a prepregnancy body mass index (BMI) ≥ 25 kg/m2. These participants were randomly assigned (1:1) by a random number table; the experimental group received an mHealth-based program using the MyHealthyWeight (MHW) app and a WAT to wear during pregnancy. The control group received standard antenatal treatments without any mHealth-based elements. Two hospital follow-up visits were scheduled at 24-26 weeks in the second trimester and 34-36 weeks in the third trimester. Sociodemographic characteristics, pregnancy physical activity questionnaire (PPAQ), a self-efficacy questionnaire and body weight were measures of interest. A generalized estimating equation (GEE) was used to examine the trajectories and the intervention effect on GWG. RESULTS No difference in GWG was found between the intervention and control groups at baseline. The weight gain trajectory in the entire cohort of women with obesity exhibited a quadratic pattern; compared with the control group, a slight increase in the intervention group was found in the second trimester. Throughout the whole pregnancy, the mHealth intervention group had a significantly lower proportion of excessive GWG in total and weekly weight gain. In particular, obese women in the intervention group, compared with obese women in the control group, gained less weight (average difference of 8.76 kg) in the third trimester. The GEE model indicated that obese women who were aged 35 years, had prepregnancy exercise habits, had perceived self-efficacy of diet, and had more physical activity had lower GWG (p<.05). CONCLUSIONS The mHealth program has shown positive results in significantly managing GWG among obese and overweight women. Among obese women, the second semester trajectory of weight gain and the lower proportion of excessive GWG were more notable than those of overweight women. Although the intervention seems to be more effective among women with obesity, our results show the potential to prevent excessive GWG during pregnancy in both overweight and obese women. Guidance may be provided to health-care professionals who wish to promote healthy diet and physical activity behaviors. CLINICALTRIAL The protocol of the study was registered in ClinicalTrials. gov (NCT04553731).

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A Nutrition Education Intervention Using NOVA Is More Effective Than MyPlate Alone: A Proof-of-Concept Randomized Controlled Trial

Nutrients ◽

10.3390/nu11122965 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2965

Author(s):

Aydin Nazmi ◽

Marilyn Tseng ◽

Derrick Robinson ◽

Dawn Neill ◽

John Walker

Keyword(s):

Nutrition Education ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Education Intervention ◽

Proof Of Concept ◽

Food Groups ◽

Randomized Controlled ◽

The Impact ◽

Level Of Processing

The ability to classify foods based on level of processing, not only conventional MyPlate food groups, might be a useful tool for consumers faced with a wide array of highly processed food products of varying nutritional value. The objective of this study was to assess the impact of a proof-of-concept nutrition education intervention on nutrition knowledge, assessed by correct classification of foods according to MyPlate food groups, MyPlate ‘limit’ status (for fat, sugar, sodium), and level of processing (NOVA categories). We utilized a randomized, controlled design to examine the impact of a MyPlate vs. combined MyPlate + NOVA intervention vs. control group. Intervention groups received educational flyers via email and participants were assessed using electronic baseline and follow-up surveys. The MyPlate + NOVA intervention group performed at least as well as the MyPlate group on classifying conventional food groups and ‘limit’ status. Moreover, the MyPlate + NOVA group far outperformed the other groups on classifying NOVA categories. Longer-term trials are needed, but our results suggest that NOVA principles may be more easily understood and applied than those of MyPlate. Education strategies focusing on level of food processing may be effective in the context of the modern food environment.

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Assessment of the Effectiveness of a Computerised Decision-Support Tool for Health Professionals for the Prevention and Treatment of Childhood Obesity. Results from a Randomised Controlled Trial

Nutrients ◽

10.3390/nu11030706 ◽

2019 ◽

Vol 11 (3) ◽

pp. 706 ◽

Cited By ~ 4

Author(s):

George Moschonis ◽

Maria Michalopoulou ◽

Konstantina Tsoutsoulopoulou ◽

Elpis Vlachopapadopoulou ◽

Stefanos Michalacos ◽

...

Keyword(s):

Decision Support ◽

Childhood Obesity ◽

Randomised Controlled Trial ◽

Healthcare Professionals ◽

Controlled Trial ◽

Intervention Group ◽

Decision Support Tool ◽

Control Group ◽

Support Tool ◽

Randomised Controlled

We examined the effectiveness of a computerised decision-support tool (DST), designed for paediatric healthcare professionals, as a means to tackle childhood obesity. A randomised controlled trial was conducted with 65 families of 6–12-year old overweight or obese children. Paediatricians, paediatric endocrinologists and a dietitian in two children’s hospitals implemented the intervention. The intervention group (IG) received personalised meal plans and lifestyle optimisation recommendations via the DST, while families in the control group (CG) received general recommendations. After three months of intervention, the IG had a significant change in dietary fibre and sucrose intake by 4.1 and −4.6 g/day, respectively. In addition, the IG significantly reduced consumption of sweets (i.e., chocolates and cakes) and salty snacks (i.e., potato chips) by −0.1 and −0.3 portions/day, respectively. Furthermore, the CG had a significant increase of body weight and waist circumference by 1.4 kg and 2.1 cm, respectively, while Body Mass Index (BMI) decreased only in the IG by −0.4 kg/m2. However, the aforementioned findings did not differ significantly between study groups. In conclusion, these findings indicate the dynamics of the DST in supporting paediatric healthcare professionals to improve the effectiveness of care in modifying obesity-related behaviours. Further research is needed to confirm these findings.

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Physical Activity Adherence Rates in Older Kidney Transplant Recipients: A Pilot Randomized Controlled Trial

Innovation in Aging ◽

10.1093/geroni/igaa057.3263 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 884-884

Author(s):

Tara O’Brien ◽

Karen Rose ◽

Alai Tan

Keyword(s):

Kidney Transplant ◽

Controlled Trial ◽

Intervention Group ◽

Attention Control ◽

Control Group ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Activity Tracker ◽

Walking Activity ◽

Attention Control Group

Abstract Daily walking activities are associated with improving cardiovascular and well-being in older kidney transplant recipients. Multicomponent interventions using technology and goal setting holds promise for sustaining daily walking activity among this population. The purpose of this randomized controlled trial pilot study was to evaluate the feasibility of a multicomponent intervention called SystemCHANGE™ + activity tracker for daily walking activity in older (age 60 and over) kidney recipients from baseline to 12 months. The intervention group implement a personal-system solution and wore a mobile activity tracker daily for 12 months. The attention-control group received educational information on healthy living as a transplant recipient and was asked to wear a mobile activity tracker daily for 12 months. Participants were randomized 1:1 to the intervention or control group. The sample consisted of 53 participants (n = 27 intervention, and n = 26 control). At the 12-month follow-up visit, the total study attrition rate was 23%. The adherence rates at 12 months were 96.5% in the intervention group and 80.8% in the attention- control group. The intervention group increased their steps from baseline to 12 months by 334 steps per day. The attention-control group demonstrated a decrease in steps by 563 steps per day. We found a mean difference of 1041± 2440 (Cohen’s d = 0.43) in daily steps between the groups from baseline to 12 months. The data suggests SystemCHANGE™ in combination with activity trackers may be feasible for older kidney transplant recipients to enhance and sustain physical activity with daily walking.

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Effects of a 12-week Avocado Randomized-controlled Trial on Cognitive Function and Lutein Status Among Adults with Overweight and Obesity (OR05-01-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz029.or05-01-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Caitlyn Edwards ◽

Anne Walk ◽

Sharon Thompson ◽

Ginger Reeser ◽

John Erdman ◽

...

Keyword(s):

Cognitive Function ◽

Selective Attention ◽

Flanker Task ◽

Controlled Trial ◽

Intervention Group ◽

Overweight And Obesity ◽

Controlled Study ◽

Control Group ◽

Daily Consumption ◽

Randomized Controlled

Abstract Objectives Overweight and obesity affect over two-thirds of the US population. This is concerning, as excess adiposity increases risk for dementia in later life. Thus, it is important to elucidate dietary approaches that benefit cognition. Lutein is a xanthophyll carotenoid thought to impact cognitive function. Daily consumption of avocado has been shown to improve cognitive function and lutein status but it is not clear whether these benefits extend to populations with overweight and obesity. Thus, we evaluated the influence of daily avocado consumption on cognitive function, serum lutein concentrations, and retinal xanthophyll status among adults with overweight and obesity using a randomized-controlled study. Methods Adults (N = 72, 25–45 years, 31 males) with overweight or obesity (BMI 25 kg/m2) were randomized to an intervention group (N = 38) that received a daily meal with one avocado or a control group (N = 34) that received an isocaloric meal without avocado for 12 weeks. Fasting serum lutein concentrations were evaluated through high-performance liquid chromatography. Macular pigment optical density (MPOD) was assessed through heterochromatic flicker photometry. Selective attention was assessed by a modified Flanker task. Results Group by time interactions were seen for serum lutein concentrations (P = 0.002) and flanker accuracy (P = 0.006) whereby the intervention group exhibited a more substantial increase in serum lutein concentrations (0.04 ug/ml; 95% CI, 0.02 to 0.06) and overall task accuracy (2.4%; 95% CI, 0.4 to 4.5). However, there was no relationship between task performance and changes in serum lutein concentration (P = 0.23), nor changes in MPOD. Conclusions Daily consumption of a meal containing avocado improved selective attention and serum lutein concentrations among adults with overweight and obesity. The cognitive benefits of avocado consumption were apparent even prior to changes in retinal lutein status. Given that avocados are comprised of a variety of nutrients, additional work is necessary to determine non-carotenoid dependent mechanisms by which avocados may impact cognitive function. Funding Sources This work was supported by funds from the Hass Avocado Board, the Department of Kinesiology and Community Health at the University of Illinois, and the USDA National Institute of Food and Agriculture, Hatch project 1009249.

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Social Mobile Approaches to Reducing Weight (SMART) 2.0: protocol of a randomized controlled trial among young adults in university settings

Trials ◽

10.1186/s13063-021-05938-7 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Shadia J. Mansour-Assi ◽

Natalie M. Golaszewski ◽

Victoria Lawhun Costello ◽

David Wing ◽

Hailey Persinger ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Activity Tracker ◽

Randomized Controlled ◽

Wearable Activity Tracker ◽

Secondary Outcomes ◽

Weight Loss Interventions

Abstract Background Excess weight gain in young adulthood is associated with future weight gain and increased risk of chronic disease. Although multimodal, technology-based weight-loss interventions have the potential to promote weight loss among young adults, many interventions have limited personalization, and few have been deployed and evaluated for longer than a year. We aim to assess the effects of a highly personalized, 2-year intervention that uses popular mobile and social technologies to promote weight loss among young adults. Methods The Social Mobile Approaches to Reducing Weight (SMART) 2.0 Study is a 24-month parallel-group randomized controlled trial that will include 642 overweight or obese participants, aged 18–35 years, from universities and community colleges in San Diego, CA. All participants receive a wearable activity tracker, connected scale, and corresponding app. Participants randomized to one intervention group receive evidence-based information about weight loss and behavior change techniques via personalized daily text messaging (i.e., SMS/MMS), posts on social media platforms, and online groups. Participants in a second intervention group receive the aforementioned elements in addition to brief, technology-mediated health coaching. Participants in the control group receive a wearable activity tracker, connected scale, and corresponding app alone. The primary outcome is objectively measured weight in kilograms over 24 months. Secondary outcomes include anthropometric measurements; physiological measures; physical activity, diet, sleep, and psychosocial measures; and engagement with intervention modalities. Outcomes are assessed at baseline and 6, 12, 18, and 24 months. Differences between the randomized groups will be analyzed using a mixed model of repeated measures and will be based on the intent-to-treat principle. Discussion We hypothesize that both SMART 2.0 intervention groups will significantly improve weight loss compared to the control group, and the group receiving health coaching will experience the greatest improvement. We further hypothesize that differences in secondary outcomes will favor the intervention groups. There is a critical need to advance understanding of the effectiveness of multimodal, technology-based weight-loss interventions that have the potential for long-term effects and widespread dissemination among young adults. Our findings should inform the implementation of low-cost and scalable interventions for weight loss and risk-reducing health behaviors. Trial registration ClinicalTrials.govNCT03907462. Registered on April 9, 2019

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Effects on Metabolic Health after a 1-Year-Lifestyle Intervention in Overweight and Obese Children: A Randomized Controlled Trial

Journal of Nutrition and Metabolism ◽

10.1155/2012/913965 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Maria Waling ◽

Catharina Bäcklund ◽

Torbjörn Lind ◽

Christel Larsson

Keyword(s):

Controlled Trial ◽

Venous Blood ◽

Intervention Group ◽

Overweight And Obesity ◽

Lifestyle Changes ◽

Control Group ◽

Obese Children ◽

Metabolic Markers ◽

Significant Difference ◽

And Control

Objective.To evaluate the effect of a family-based intervention on anthropometric and metabolic markers in overweight and obese children.Methods.Overweight or obese 8–12 years olds (n= 93) were randomized into intervention or control groups. The intervention group participated in a program aiming for lifestyle changes regarding food habits and physical activity. Anthropometric measures and venous blood samples were collected from all children at baseline and after 1 year.Results.BMI z-scores decreased in both groups, 0.22 (P= 0.002) and 0.23 (P= 0.003) in intervention and control group, respectively, during the 1-year study, but there was no difference in BMI between the groups at 1-year measurement (P= 0.338). After 1 year, there was a significant difference in waist circumference, waist/hip ratio, and apolipoprotein B/A1 ratio between intervention and control group.Conclusions.The intervention had limited effects on anthropometrics and metabolic markers, which emphasizes the need of preventing childhood overweight and obesity.

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Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/16715 ◽

2020 ◽

Vol 22 (2) ◽

pp. e16715 ◽

Cited By ~ 7

Author(s):

Yan Guo ◽

Y Alicia Hong ◽

Weiping Cai ◽

Linghua Li ◽

Yuantao Hao ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Depressive Symptoms ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

People Living With Hiv ◽

Mhealth Intervention ◽

Randomized Controlled ◽

Hair Samples ◽

Living With Hiv

Background People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. Objective The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. Methods We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants’ hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants’ progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. Results Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=−5.77, 95% CI −7.82 to −3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported. Conclusions The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF)

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Prediabetes Conversion to Normoglycemia Is Superior Adding a Low-Carbohydrate and Energy Deficit Formula Diet to Lifestyle Intervention—A 12-Month Subanalysis of the ACOORH Trial

Nutrients ◽

10.3390/nu12072022 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2022 ◽

Cited By ~ 2

Author(s):

Martin Röhling ◽

Kerstin Kempf ◽

Winfried Banzer ◽

Aloys Berg ◽

Klaus-Michael Braumann ◽

...

Keyword(s):

Lifestyle Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Overweight And Obesity ◽

Energy Deficit ◽

Control Group ◽

Number Needed To Treat ◽

Formula Diet ◽

Low Carbohydrate

Lifestyle interventions have been shown to reverse hyperglycemia to normoglycemia. However, these effects are not long-lasting and are accompanied with high dropout rates. As formula diets have been shown to be simple in usage and effective in improving glycemic control, we hypothesised that adding a low-carbohydrate and energy deficit formula diet to a low-intensity lifestyle intervention is superior in reversing prediabetes compared with lifestyle intervention alone. In this predefined subanalysis of an international, multicenter randomised controlled trial (Almased Concept against Overweight and Obesity and Related Health Risk (ACOORH) study (ID DRKS00006811)), 141 persons with prediabetes were randomised (1:2) into either a control group with lifestyle intervention only (CON, n = 45) or a lifestyle intervention group accompanied with a formula diet (INT, n = 96). Both groups were equipped with telemonitoring devices. INT received a low-carbohydrate formula diet substituting three meals/day (~1200 kcal/day) within the first week, two meals/day during week 2–4, and one meal/day during week 5–26 (1300–1500 kcal/day). Follow-up was performed after 52 weeks and 105 participants (75%, INT: n = 74; CON: n = 31) finished the 26-week intervention phase. Follow-up data after 52 weeks were available from 93 participants (66%, INT: n = 65; CON: n = 28). Compared with CON, significantly more INT participants converted to normoglycemia after 52 weeks (50% vs. 31%; p < 0.05). The risk reduction led to a number-needed-to-treat of 5.3 for INT. Lifestyle intervention with a low-carbohydrate formula diet reduces prediabetes prevalence stronger than lifestyle intervention alone and is effective for type 2 diabetes prevention.

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A Home Visiting Parenting Program and Child Obesity: A Randomized Trial

10.1542/9781610022781-a_home ◽

2018 ◽

pp. 117-126

Author(s):

Monica Roosa Ordway ◽

Lois S. Sadler ◽

Margaret L. Holland ◽

Arietta Slade ◽

Nancy Close ◽

...

Keyword(s):

Young Children ◽

Low Socioeconomic Status ◽

Home Visiting ◽

Maternal Mental Health ◽

Controlled Trial ◽

Intervention Group ◽

Overweight And Obesity ◽

Control Group ◽

Home Visiting Program ◽

Overweight Or Obesity

BACKGROUND Young children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the “Minding the Baby” (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life. METHODS This study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years. RESULTS More children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher (P < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13–0.78). CONCLUSIONS Using the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.

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