Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: ‘feedback’ e-12HR (IG) and ‘non-feedback’ e-12HR (CG). Only the ‘feedback’ e-12HR had two specific automatic functions: 1. Evaluation of the user’s AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.
There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).
BACKGROUND The World Health Organization has called for addressing the growing burden of non-communicable diseases (NCDs) by promoting healthy lifestyles among the population. Healthcare workers are a subgroup of the population where lifestyle promotion is essential for three main reasons: for their own health, for the success of healthcare organizations, and for patient health. Regarding this last point (about patient health), primary care professionals (PCPs) are the first line of care that can positively influence patients' behavior and lifestyle habits. However, PCPs, do not have a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. This study focused only on the dietary aspect. OBJECTIVE Primary objective, to evaluate the effect of using the e-12HR app to improve diet (specifically, to promote adherence to the Mediterranean diet (AMD)) among PCPs. The Mediterranean diet has been extensively studied and there is strong evidence of it being a dietary pattern for the prevention of NCDs, besides its significant environmental, sociocultural and local economics benefits. Secondary objectives, to establish the usability of e-12HR and determine AMD among PCPs. METHODS Individual-level randomized, controlled and single-blind clinical trial with two parallel groups: control group (CG), using the ‘non-feedback’ version of e-12HR, and intervention group (IG), using the ‘feedback’ version of e-12HR. 28-day follow-up period. Participants were PCPs (medicine or nursing) at one of the selected primary care centers (Andalusia, Spain, Southern Europe), both genders, over 18 years-old and possess a Smartphone. RESULTS 71 participants (47 doctors and 24 nurses), 38.0% women and 62.0% men: 40 in the CG and 31in the IG. At baseline, the AMD was medium (mean index of 9.45 and with the 66.2% of participants with medium/high index). There were significant statistical improvements (CG versus IG, in favor of the IG) at week four (no significant statistical differences at baseline): +25.6% for the AMD index (P value = 0.002) and +213.1% for the percentage with medium/high AMD index (P value = 0.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P value = 0.022), vegetables (+352.0%, P value = 0.001), nuts (+184.0%, P value = 0.022) and legumes (+75.1%, P value = 0.028). The responses to the usability rating questionnaire for e-12HR were very satisfactory. CONCLUSIONS The results support recommending the use of e-12HR as a tool to contribute to improving diet and preventing NCDs among these PCPs (which, at the same time, could positively influence patient dietary behavior and prevent diet-related NCDs among those same patients). CLINICALTRIAL ClinicalTrials.gov, NCT05532137.
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