Dietary habits after a physical activity mHealth intervention: a randomized controlled trial

Abstract

Background A healthy diet and a sufficient amount of physical activity are important factors to reduce complications of type 2 diabetes. Diet and physical activity are associated behaviours. Individuals who are physically active have also been shown to have healthier eating habits than sedentary individuals. We aimed to evaluate the indirect effect of a smartphone-based physical activity intervention on dietary habits in patients with type 2 diabetes. Methods We performed analyses of secondary outcomes in a randomized controlled trial. The active intervention was use of a smartphone application to promote physical activity during 12 weeks. Dietary intake was assessed at baseline and after three months using a validated semi-quantitative food frequency questionnaire comprising 94 items. We analysed changes in the intake of fruit and vegetables, snacks, fibre, whole grains, vitamin C, saturated fat, unsaturated fat and total energy. We also assessed overall dietary habits using a dietary index developed by the Swedish National Board of Health and Welfare. Results were compared between the intervention and control group, as well as stratified by sex within the study groups. Paired t-tests and analysis of covariance were performed. Results A total of 181 patients were recruited to the DiaCert-study, whereof 146 patients had complete dietary data and were included in the analyses. Women in the intervention group had a higher fruit and vegetable intake (p = 0.008) and a higher dietary index (p = 0.007), at three-months compared to women in the control group. They had increased their daily intake of fruit and vegetables by on average 87.4 g/day (p = 0.04) and improved their dietary index by on average 0.8 points (p = 0.01) from baseline to follow-up. No effect was found in men. Conclusions Women, but not men, receiving a smartphone-based physical activity intervention improved their total intake of fruit and vegetables. The transfer effect, i.e. an intervention aimed at promoting one health behavior that facilitates changes in other health behaviors, may differ between the sexes. Trial registration ClinicalTrials.gov Identifier: NCT03053336; 15/02/2017.

No Changes in Body Composition and Adherence to the Mediterranean Diet after a 12-Week Aerobic Training Intervention in Women with Systemic Lupus Erythematosus: The EJERCITA-LES Study

“…To the best of our knowledge, no intervention studies have focused on enhancing adherence to the Mediterranean Diet in this population. Although exercise can indirectly modify dietary habits [22][23][24][25][26], the present study showed no influence of the exercise intervention on the adherence to the Mediterranean diet. In line with these findings, a previous work conducted in perimenopausal women [38] reported no changes in overall adherence to the Mediterranean Diet following a four-month concurrent exercise intervention.…”

“…It is worth mentioning that in the present study adherence to the Mediterranean diet was slightly and consistently enhanced in the exercise group, although this increase did not reach statistical significance. Given that previous research has shown that physical activity interventions can indirectly increase fruit and vegetable consumption [23][24][25][26], it is possible that exercise primarily influences specific food groups within the Mediterranean Diet, rather than the diet as a whole. Therefore, it could be hypothesized that: (i) our exercise intervention could be a stimulus that only produces slight but insufficient modifications in dietary patterns and/or (ii) Mediterranean Diet could be a very specific pattern to be indirectly modified through exercise.…”

“…Interestingly, promoting change in one health behavior can indirectly lead to the adoption of other health behaviors, known as the "transfer effect" [22]. In this sense, physical activity interventions have also evidenced changes in dietary preferences (such as increased fruit and vegetable intake [23][24][25][26]) enclosed in the Mediterranean diet. However, it is unclear to which extent an exercise intervention could specifically influence adherence to this dietary pattern in patients with SLE.…”

“…Therefore, the aim of the present study was to evaluate the effects of a 12-week aerobic training intervention following the ACSM guidelines on anthropometry, body composition and adherence to the Mediterranean diet in women with SLE. It was hypothesized that the intervention would improve anthropometry, body composition [27] and adherence to the Mediterranean diet [23][24][25][26] in women with SLE.…”