JMIR Publications

ABSTRACT

Background:

Metabolic disorders are established precursors to cardiovascular diseases yet are highly preventable with sustained lifestyle modifications.

Objective:

We assessed the effectiveness of a smartphone-based weight management application on metabolic parameters on persons at high-risk yet without physician diagnosis nor pharmacological treatment for metabolic syndrome in community settings.

Methods:

In this three-arm parallel-group, single-blind, randomised controlled trial, we recruited participants aged 30 to 59 years with at least two conditions among abdominal obesity, high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, and high fasting glucose defined by the third report of the National Cholesterol Education Program expert panel. Participants were randomly assigned (1:1:1) by block randomisation to either non-users, application users of diet and exercise self-logging function, and application users both self-logging and receiving personalized feedback from professional dieticians and exercise regimen coordinators. Assessments were done at baseline, 6, 12, and 24 weeks. The primary outcome was changes in systolic blood pressure. Analysis was performed via intention-to-treat.

Results:

Between October 28th, 2017 and May 28th, 2018, 160 participants have participated in the baseline screening examination. Among, 129 (80.63%), who satisfy the study eligibility criteria, were assigned to control (CO; n=41), self-logging feature (AO; n=45), or self-logging with personalized coaching (APC; n=43). The primary outcome of interest, systolic blood pressure, did show decreasing trend from baseline yet was comparable amongst the three groups at any follow-up examinations (CO: -10.95±2.09 mmHg; AO: -7.29±1.83 mmHg; APC: -7.19±1.66 mmHg). Instead, the group receiving combined features of self-logging of dietary and lifestyle coaching underwent significantly greater body weight reduction (CO: -0.12±0.30 kg; AO: -0.35±0.36 kg; APC: -0.96±0.37 kg), specifically via body fat mass reduction (CO: -0.13±0.34 kg; AO: -0.64±0.38 kg; APC: -0.79±0.38 kg).

Conclusions:

The mobile-based health management application combined with persistent lifestyle modification feedback was found to be ineffective in systolic blood pressure lowering yet effective in weight or body fat mass reduction in the context of primary prevention. These results warrant the implementation of similar models of care on a broader scale in non-patient settings. Clinical Trial: This study was registered with the ClinicalTrials.gov (NCT03300271).