Using Continuous Glucose Monitoring to Motivate Physical Activity in Overweight and Obese Adults: A Pilot Study

Abstract

Background: Regular physical activity (PA) is associated with a lower risk of several types of cancers. However, two-thirds of overweight/obese adults are not sufficiently active; this, in combination with the unfavorable effect of excess body weight, puts them at a greater risk for cancer. One reason that these individuals do not engage in enough PA may be their lack of motivation to change their current behavior due to the perception of putting in effort for possible future gain without obvious short-term benefits. There is a need for innovative ways to help individuals recognize the immediate health benefits of PA and thus increase their motivation.Methods: This pilot intervention tested a PA education module that included a one-on-one counseling session highlighting the acute effects of PA on glucose patterns, followed by a 10-day selfmonitoring period with a continuous glucose monitor (CGM) and a Fitbit tracker. Participants rated the acceptability of the education module on a 5-point Likert scale and completed surveys assessing stages of change for motivational readiness.Results: Nineteen overweight/obese adults (84% female) completed the study. Participants gave high ratings to the counseling session for improving their PA-related knowledge (mean ¼ 4.22), increasing motivation (mean ¼ 4.29), and providing personally relevant information (mean ¼ 4.35). The summary acceptability scores for the self-monitoring period were 4.46 for CGM and 4.51 for Fitbit. Participants reported a significant decrease in the precontemplation stage and an increase in the action stage (P < 0.05).Conclusions: CGM is a feasible tool for PA interventions. Impact: Information from CGM could be used as biologicalbased feedback to motivate PA.See all articles in this CEBP Focus section, "Modernizing Population Science."

A digital lifestyle behaviour change intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback

“…Several participants discussed increasing their physical activity, interrupting sitting time and making changes to when and what food was consumed. This may be in part because participants found the glucose feedback motivating to make changes [ 33 , 34 ]. It could also be because the two devices provided feedback that was actionable and continuously available [ 35 ] and offered information on the health consequences of behaviour [ 36 ].…”

A Low-Glucose Eating Pattern Improves Biomarkers of Postmenopausal Breast Cancer Risk: An Exploratory Secondary Analysis of a Randomized Feasibility Trial

“…One possibility is that GGE may act through the Health Belief Model; wherein, people experience a change in perceived risk by associating their dietary intake to health risk outcomes. Future research will be needed to understand and leverage the use of biological feedback as a cancer prevention strategy better [54].…”

Continuous Glucose Monitoring in Healthy Adults—Possible Applications in Health Care, Wellness, and Sports

“…Postprandial hyperglycemia was shown to be associated with cardiovascular diseases [54]. The direct feedback and visualization of success (positive effect of physical activity on glucose dynamics) may be a motivating factor for increasing regular physical activity [60,61]. Bailey et al [60] evaluated the efficacy of an 8-week exercise program using CGM compared to a standard exercise program in terms of exercise adherence among individuals with impaired glucose tolerance (n = 13).…”

“…Although both groups improved their health-related quality of life, waist circumference, and fitness, the CGM group showed significantly higher increases in program attendance and registration rates for additional exercise programs than the control group. In the investigation by Liao et al [61], CGM systems were used in combination with fitness trackers in healthy, nondiabetic, overweight subjects (n = 19) during a free-living 10-day period to assess their influence on exercise motivation and physical activity. The results of the study indicated that the use of CGM systems (in combination with a fitness tracker) can support users in transitioning from the precontemplation stage (no intention of changing behavior) to the action stage (changing behavior).…”