Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 13, 2020
Date Accepted: Jul 7, 2020
Effectiveness of mobile health interventions promoting physical activity and lifestyle interventions to reduce cardiovascular risk indicators among individuals with metabolic syndrome: a systematic review and meta-analysis
ABSTRACT
Background:
Physical activity and lifestyle interventions, such as a healthy diet, have proven to be effective approaches to manage metabolic syndrome. However, those interventions require a great commitment from patients and clinicians due to their economic costs, time consumption and lack of immediate results.
Objective:
The aim of this review was to analyse the effect of mobile-based health interventions that aimed to reduce cardio-metabolic risk through the promotion of physical activity and healthy lifestyle behaviours.
Methods:
PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials and SPORTdiscus databases were searched for experimental studies evaluating cardio-metabolic risk indicators among patients with metabolic syndrome who were included in technology assisted physical activity and lifestyle interventions. Effect sizes, pooled mean changes and their respective 95% confidence intervals were calculated using the DerSimonian and Laird method. Outcomes included the following clinical and biochemical parameters: body composition (weight, waist circumference [WC] and body mass index [BMI]), blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]), glucose tolerance (fasting plasma glucose [FPG] and glycated haemoglobin A1c [HbA1c]) and lipid profile (total cholesterol, LDL-c, and HDL-c and triglycerides).
Results:
A total of nine studies were included in the meta-analysis. Due to the scarcity of studies, only pooled mean pre-post change in intervention groups was estimated. Significant mean changes were observed for weight (-4.53 kg, 95%CI: -8.47, -0.60; ES: -0.39), BMI (-1.70 kg/m2, 95%CI: -3.20, -0.20; ES: -0.46), WC (-5.77 cm, 95%CI: -9.76, -1.77; ES: -0.54), SBP (-7.33 mmHg (95%CI: -13.25, -1.42; ES: -0.43), DBP (-3.90 mmHg, 95%CI: -7.70, -0.11; ES: -0.44), HbA1c (-2.18 mg/dL ,95%CI: -4.41, 0.06; ES: -0.35), FPG (-3.65 mg/dL ,95%CI: -4.79, -2.51; ES: -0.39) and HDL-c (4.19 mg/dl, 95% CI: 2.43, 5.95; ES: 0.23).
Conclusions:
Overall, mobile-based health interventions aimed at promoting physical activity and healthy lifestyle changes resulted in a strong positive effect on cardio-metabolic risk indicators among metabolic syndrome patients. Nevertheless, further research is required to compare this approach with usual care in order to support the incorporation of these technologies in health systems.
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