Background Cardiovascular disease, cancer, diabetes mellitus, and obesity are common chronic diseases, and their prevalence is reaching an epidemic level worldwide. As the impact of chronic diseases continues to increase, finding strategies to improve care, access to care, and patient empowerment becomes increasingly essential. Health care providers use mobile health (mHealth) to access clinical information, collaborate with care teams, communicate over long distances with patients, and facilitate real-time monitoring and interventions. However, these apps focus on improving general health care concerns, with limited apps focusing on specific chronic diseases and the nutrition involved in the disease state. Hence, available evidence on the effectiveness of mHealth apps toward behavior change to improve chronic disease outcomes is limited. Objective The objective of this scoping review was to provide an overview of behavior change effectiveness using mHealth nutrition interventions in people with chronic diseases (ie, cardiovascular disease, diabetes mellitus, cancer, and obesity). We further evaluated the behavior change techniques and theories or models used for behavior change, if any. Methods A scoping review was conducted through a systematic literature search in the MEDLINE, EBSCO, PubMed, ScienceDirect, and Scopus databases. Studies were excluded from the review if they did not involve an app or nutrition intervention, were written in a language other than English, were duplicates from other database searches, or were literature reviews. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, the systematic review process included 4 steps: identification of records through the database search, screening of duplicate and excluded records, eligibility assessment of full-text records, and final analysis of included records. Results In total, 46 studies comprising 256,430 patients were included. There was diversity in the chronic disease state, study design, number of participants, in-app features, behavior change techniques, and behavior models used in the studies. In addition, our review found that less than half (19/46, 41%) of the studies based their nutrition apps on a behavioral theory or its constructs. Of the 46 studies, 11 (24%) measured maintenance of health behavior change, of which 7 (64%) sustained behavior change for approximately 6 to 12 months and 4 (36%) showed a decline in behavior change or discontinued app use. Conclusions The results suggest that mHealth apps involving nutrition can significantly improve health outcomes in people with chronic diseases. Tailoring nutrition apps to specific populations is recommended for effective behavior change and improvement of health outcomes. In addition, some studies (7/46, 15%) showed sustained health behavior change, and some (4/46, 9%) showed a decline in the use of nutrition apps. These results indicate a need for further investigation on the sustainability of the health behavior change effectiveness of disease-specific nutrition apps.

This scoping review investigates the volume of evidence for home-based exercise and nutrition programs and their effect on muscle quality among senior adults to inform implementation and future research. It aims to answer the research question: What are the evidence, challenges, and needs for research regarding a home-based exercise and nutrition intervention program to improve muscle outcomes in senior adults? This scoping review was conducted following the PRISMA extension for Scoping Review. The following databases were searched: PubMed, Scopus, MEDLINE, CINAHL, EMBASE, and the Cochrane Library. Applied filters were used to help condense the research articles. A total of 13 studies met the inclusion criteria for this scoping review. Most exercise interventions were either resistance or multi-component exercise programs. The nature of the nutrition intervention varied between different supplements, foods, education, or counseling. Muscle outcomes included muscle mass in nine studies, muscle function in all the studies, muscle strength in ten studies, and biochemical analyses in two studies. Two studies found improvements in muscle mass; two studies revealed improvements in all their muscle function tests; and three studies revealed improvements in muscle strength. Muscle biopsy in a study revealed enhanced muscle fibers, but both studies did not reveal any biomarker improvements. The scoping review findings revealed mixed results on the effectiveness of a home-based exercise and nutrition program. However, the current evidence does have many gaps to address before recommending this form of intervention for senior adults as an effective way to prevent and manage sarcopenia. Since this review identified multiple knowledge gaps, strengths, and limitations in this growing field, it can be a starting point to help build future study designs and interventions in this population.

Objectives Obesity has been identified as a risk factor for vitamin D deficiency. Those seeking bariatric surgery for obesity treatment have an additional risk for low vitamin D levels post-op due to factors that affect compliance with taking supplemental vitamins and minerals. As personalized nutrition (PN) may change behaviors and have an impact on health outcomes, this study will examine the relationships among genetic variants that predispose individuals to vitamin D deficiency, PN, knowledge of the risk of vitamin D deficiency, and supplemental vitamin adherence in patients who have undergone bariatric surgery. Methods This will be a one year cross-sectional study with approximately 50 participants with severe obesity having bariatric surgery. Inclusion criteria will include subjects aged 18 years and older seeking sleeve gastrectomy at The Advanced Bariatric Surgery Center in Lubbock, Texas. Exclusion criteria will be those who are not candidates for surgery and nicotine, alcohol, and/or drug dependency. The data collected will include buccal swab genetic tests, two assays for vitamin D receptor (VDR) single polymorphisms (SNPs), vitamin D levels, diet and vitamin and mineral adherence, and dual-energy X-ray absorptiometry (DEXA) scans. This information will be analyzed and compared to patients’ outcomes at pre-op and post-op appointments. Results N/A. Conclusions Upon completing this study, we expect to have identified how micronutrient genetic testing can be used in conjunction with PN to improve the bariatric surgery population's vitamin D levels. This outcome can further nutrition education and PN to improve overall health knowledge and interventional outcomes on critical nutritional parameters. Furthermore, the results could potentially produce greater adherence to vitamin and mineral regimens, and improve bone density among individuals who have undergone bariatric surgery. Funding Sources This study was funded by start-up funds from Texas Tech University.

BACKGROUND Sarcopenia is the progressive and generalized loss of muscle mass, strength, and function. In the US, 15.51% of older adults have been diagnosed with sarcopenia. Culinary medicine (CM) is a novel evidence-based medical field that combines the science of medicine with food and cooking to prevent and treat potential chronic diseases. Thus, a CM program can be an innovative strategy to improve protein intake in independent older adults through at-home cooking and successfully reduce barriers to protein intake, enabling older adults to enhance their diet and muscle quality. OBJECTIVE Therefore, our study aimed to examine how an online CM intervention, emphasizing convenient ways to increase lean red meat intake, could improve protein intake with the promotion of physical activity to see how this intervention could affect older adults’ muscle strength and mass. METHODS A 16-week single-center, parallel-group, randomized study was conducted, comparing an online culinary medicine intervention group (CMG) teaching about enhancing protein intake to a control group (CNG) while monitoring each group’s muscle strength, muscle mass, and physical activity for muscle quality. The final participant total for the data analysis was 24 in the CMG and 23 in the CNG. RESULTS No between-group difference in muscle mass (p = 0.881) and strength (dominant: p = 0.920 and non-dominant: p = 0.715) change from the pre-study was detected. No statistically significant difference in protein intake was seen between the groups (p = 0.498). A borderline non-significant time-by-intervention interaction was observed for daily protein intake (p = 0.08). However, a statistically significant time effect was observed (p = <0.001). Post hoc testing showed that daily protein intake was significantly higher at weeks 2-16 vs. week 1 (p < 0.05) in the cohort. At week 16, intake was 16.9 g (95% CI, 5.77 to 27.97) higher than at pre-study. CONCLUSIONS A CM program aimed to enhance protein intake and muscle quality did not affect protein intake and muscle quality. Insufficient consistent protein intake, low physical activity, intervention adherence, and questionnaires’ accuracy could explain the results. Future studies could include an interdisciplinary staff, different recruitment strategies, and different muscle mass measurements. CLINICALTRIAL ClinicalTrials.gov NCT05593978

BACKGROUND Cardiovascular disease (CVD), cancers, diabetes mellitus (DM), and obesity are commonly known chronic diseases, and their prevalence is reaching a significant epidemic level in the United States. As the impact of chronic diseases continues to increase, finding strategies to improve care, access to care, and patient empowerment becomes increasingly essential. Health care providers use mHealth to access clinical information, collaborate with care teams, communicate long-distance with patients, and facilitate real-time monitoring and interventions. However, these apps focus on improving general health care concerns, with limited apps focusing on specific chronic diseases and the nutrition involved with the disease state. Hence, the available evidence on the effectiveness of mHealth apps towards behavior change to improve chronic disease outcomes is limited. OBJECTIVE The objective of this scoping review was to give an overview of behavior change effectiveness using mHealth nutrition interventions in people with chronic diseases (i.e., CVD, DM, cancer, and obesity). We further evaluated behavior change techniques and theories or models used for behavior change, if any. METHODS A scoping review was performed using a systematic literature search in Medline, EBSCO, and PubMed databases. Studies were excluded from the review if the study did not involve an app or nutrition intervention, was written in a language other than English, was a duplicate from other database searches, or if the paper was a literature review. Following the PRISMA 2020 method, the systematic review process included four steps: (1) identification of records through the databases search, (2) screening of duplicate and excluded records, (3) eligibility assessment of full-text records, and (4) final analysis of included records. RESULTS In total, 42 studies comprising 256,063 patients were included. There was diversity in the chronic disease state, study design, number of subjects, the variety of in-app features, behavioral change theories (BCTs), and behavior models used in the studies. Additionally, our review found that less than half of the studies based their nutrition app on using a behavioral theory or its constructs. Twenty-six percent (11/42) of the studies measured maintenance of health behavior change. Of these studies, 64% (7/11) sustained behavior change for approximately 6-12 months. Thirty-six percent (4/11) of these studies showed a decline in behavior change and/or discontinued app use. CONCLUSIONS The results suggest that mHealth apps involving nutrition can significantly improve health outcomes for people with chronic diseases. Tailoring nutrition apps for specific populations is recommended for effective behavior change and improvement of health outcomes. Additionally, some studies showed sustained health behavior change, and some showed a decline in the use of nutrition apps. These results indicate a need for further investigation on the sustainability of health behavior change effectiveness of disease-specific nutrition apps. CLINICALTRIAL NA