Effects of Smartphone-Based Remote Interventions on Dietary Intake, Physical Activity, Weight Control, and Related Health Benefits Among the Older Population With Overweight and Obesity in China: Randomized Controlled Trial

Abstract

Background Traditional health management requires many human and material resources and cannot meet the growing needs. Remote medical technology provides an opportunity for health management; however, the research on it is insufficient. Objective The objective of this study was to assess the effects of remote interventions on weight management. Methods In this randomized controlled study, 750 participants were randomly assigned to a remote dietary and physical activity intervention group (group DPI), remote physical activity intervention group (group PI), or control group (group C). At baseline (time 1), day 45 (time 2), and day 90 (time 3), data were collected, including data on dietary intake, physical activity, indexes related to weight control, and health benefits. Results A total of 85.6% (642/750) of participants completed the follow-up. Compared with group C, group DPI showed a significant decrease in energy intake (−581 vs −82 kcal; P<.05), protein intake (−17 vs −3 g; P<.05), fat intake (−8 vs 3 g; P<.05), and carbohydrate intake (−106.5 vs −4.7 g; P<.05) at time 3. Compared with time 1, groups DPI and PI showed a significant decrease in cereal and potato intake (P<.05). Compared with time 1, the physical activity levels related to transportation (group PI: 693 vs 597 metabolic equivalent [MET]–min/week, group C: 693 vs 594 MET-min/week; P<.05) and housework and gardening (group PI: 11 vs 0 MET-min/week, group C: 11 vs 4 MET-min/week; P<.05) in groups PI and C were improved at time 3. Compared with groups PI and C, group DPI showed a significant decrease in weight (−1.56 vs −0.86 kg and −1.56 vs −0.66 kg, respectively; P<.05) and BMI (−0.61 vs −0.33 kg/m2 and −0.61 vs −0.27 kg/m2, respectively; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in body weight (−4.11 vs −1.01 kg and −4.11 vs −0.83 kg, respectively; P<.05) and BMI (−1.61 vs −0.40 kg/m2 and −1.61 vs −0.33 kg/m2, respectively; P<.05) at time 3. Compared with group C, group DPI showed a significant decrease in triglyceride (−0.06 vs 0.32 mmol/L; P<.05) at time 2. Compared with groups PI and C, group DPI showed a significant decrease in systolic blood pressure (−8.15 vs −3.04 mmHg and −8.15 vs −3.80 mmHg, respectively; P<.05), triglyceride (−0.48 vs 0.11 mmol/L and −0.48 vs 0.18 mmol/L, respectively; P<.05), and fasting blood glucose (−0.77 vs 0.43 mmol/L and −0.77 vs 0.14 mmol/L, respectively; P<.05). There were significant differences in high-density lipoprotein cholesterol (−0.00 vs −0.07 mmol/L; P<.05) and hemoglobin A1c (−0.19% vs −0.07%; P<.05) between groups DPI and C. Conclusions Remote dietary and physical activity interventions can improve dietary intake among participants with overweight and obesity, are beneficial for weight control, and have potential health benefits. Trial Registration Chinese Clinical Trial Registry ChiCTR1900023355; https://www.chictr.org.cn/showproj.html?proj=38976

Can Digital Technologies Be Useful for Weight Loss in Individuals with Overweight or Obesity? A Systematic Review

“…As for the results, a weight reduction related to the technologies used was observed in the majority of the studies [ 39 , 41 , 43 , 45 , 46 , 49 , 52 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 64 , 65 , 66 , 67 , 68 ]. Additionally, six studies described a reduction in body fat among participants [ 39 , 41 , 57 , 58 , 64 , 67 ] and in nine papers, a decrease in BMI was also showed beyond weight loss [ 41 , 49 , 52 , 54 , 55 , 56 , 57 , 64 , 66 , 68 ]. Moreover, some authors reported waist or hip circumference reductions in the intervention groups [ 39 , 41 , 46 , 57 , 58 , 64 , 67 ].…”

“…After the full-text assessment of the 133 articles that remained, 102 articles were excluded, 42 of them because they did not pertain to our question, 12 because the individuals were affected by other comorbidities, 16 because they were a different type of study from RCT, 7 because they considered a young age population (<18 years), 4 because did not have control groups, and 21 because they did not consider the assessment of changes in PA. Finally, we included 31 articles that met the inclusion criteria ( Figure 1 ) [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ].…”

“…The included articles were published between 2013 [ 54 ] and 2023 [ 61 , 68 ], and 15 of them were performed in the USA [ 40 , 41 , 42 , 45 , 46 , 51 , 54 , 55 , 58 , 62 , 63 , 64 , 65 , 67 ], 9 in Europe [ 38 , 39 , 47 , 49 , 56 , 57 , 59 , 61 , 66 ], 5 in Asia [ 43 , 47 , 52 , 60 , 68 ] and 2 in Australia [ 44 , 50 ]. Both genders were represented in most studies, except in two studies that did not report this information [ 50 , 54 ], and two studies that included only women [ 47 , 48 ].…”

“…The findings of this review suggest that using digital technologies may be useful for supporting interventions aimed at reducing excess weight when employed to modify weight-related behaviors, namely PA and diet. In fact, the majority of the controlled trials analyzed reported significantly better outcomes related to weight loss among participants who used some kind of electronic devices or applications than among non-users [ 39 , 41 , 43 , 45 , 46 , 49 , 52 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 64 , 65 , 66 , 67 , 68 ].…”

Análisis de las interrupciones generadas por el uso de los smartphones entre los profesionales sanitarios de Atención Primaria

“…Dado que el paciente puede tener cierta precaución al dar opinión sobre su profesional de referencia, se hizo énfasis en el anonimato de la respuesta, destacando que una parte significativa de los pacientes pueden considerar su uso como una falta de respeto. Otro aspecto a considerar es que resulta difícil diferenciar el uso del smartphone como app sanitaria o para fin sanitario 15 , 16 (consulta de guía clínica o protocolo) del uso particular, y este hecho puede no ser bien diferenciado por el paciente.…”