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

Abstract

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.

Effectiveness of interactive technology-assisted interventions on promoting healthy food choices: a scoping review and meta-analysis

“…Most of the included studies were conducted in the USA (n 7, 41•2 %) and Australia (n 6, 35•3 %), and there was a relatively proportionate number of studies performed with subject with (n 8, 47•1 %) and without the criteria of having overweight (n 9, 52•9 %). Four articles were assessed to have a high RoB (23•5 %) (33,(36)(37)(38) , four articles were assessed to have a low RoB (23•5 %) (39)(40)(41)(42) and nine had an unclear RoB (Appendix 3). The interventional durations ranged from 2 weeks to 1 year and the attrition rates ranging from 3•9 % (32) to 76 % (35) .…”

“…Various modes of delivery were used, including smartphone apps (n 12, 70•6 %), websites (n 7, 41•2 %) and hardcopy handouts (n 3, 7•3 %) (Table 2). The technology-assisted components of the interventions were designed to improve food choices through self-monitoring (32,33,35,(37)(38)(39)(41)(42)(43)(44) , goal setting (32,33,37,39,41,43) , feedback (32,33,35,37,42,43) , education (33,34,37,45) , inhibitory control (36,40,44,46) , nudging (47,48) and social support (44) . Two studies seemed to have been conducted on the same population (39,41) .…”

“…Six studies (34,37,38,40,44,48) reported interventional effects on total calories consumed per d (one study reported the total calories of food to be consumed per d in the users’ shopping cart (48) ) of which two studies (37,40) reported significantly reduced total calorie consumption in participants from the intervention groups. A meta-analysis of the six studies showed a non-significant (t = –0·61, P = 0·57) pooled interventional effect size on total calories consumption per d (g = –0·08; 95 % CI –0·44, 0·27; I 2 = 87·3 %; refer to Table 3, Fig.…”

“…Seven studies (35,38,39,43,44,47,48) reported interventional effects on vegetables consumption of which four studies (35,39,44,48) reported significantly higher vegetables consumption per d in participants from the intervention groups. A meta-analysis of five studies showed a non-significant (t = 0•99, P = 0•37) pooled interventional effect size on vegetables consumption per d (g = 6•29; 95 % CI -10•00, 22•59; I 2 = 97•9 %; refer to Table 3, Fig.…”

Literature review on methodologies and tools for national dietary surveys; results of ERA EU‐menu‐project

“…Two weight management tools were identified: an application used in the EVIDENT Eat andTrack (EaT, 2017-2020, 18-65 Sánchez et al 2022). The tool was combined with a smartband to assess physical activity.…”