Feasibility and acceptability of a televideo physical activity and nutrition program for recent kidney transplant recipients

Abstract

Background Post-transplant weight gain affects 50–90% of kidney transplant recipients adversely affecting survival, quality of life, and risk for diabetes and cardiovascular disease. Diet modification and physical activity may help prevent post-transplant weight gain. Methods for effective implementation of these lifestyle modifications are needed. The objective of this study is to assess the feasibility and acceptability of a remotely delivered nutrition and physical activity intervention among kidney transplant recipients. Secondary aims were to estimate the effectiveness of the intervention in producing changes in physical activity, qualify of life, fruit and vegetable intake, and consumption of whole grains and water from baseline to 6 months. Methods A randomized controlled study for stable kidney transplant recipients between 6 and 12 months post-transplantation was conducted. Participants were randomly assigned 1:1 to a technology-based, lifestyle modification program (intervention) or to enhanced usual care (control). Results The first 10 kidney transplant recipients screened were eligible and randomized into the intervention and control groups with no significant between-group differences at baseline. Health coaching attendance (78%) and adherence to reporting healthy behaviors (86%) were high. All participants returned for final assessments. The weight in controls remained stable, while the intervention arm showed weight gain at 3 and 6 months. Improvements were found for physical activity, quality of life, and fruit and vegetable intake in both groups. All participants would recommend the program to other transplant recipients. Conclusions Our data suggest that a remotely delivered televideo nutrition and physical activity intervention is feasible and valued by patients. These findings will aid in the development of a larger, more prescriptive, randomized trial to address weight gain prevention. Trial registration Clinicaltrials.gov Identifier NCT03697317. Retrospectively registered on October 5, 2018.

Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis

“…Six studies reported body weight only [39,41,44,47,48,50], four reported BMI [43,45,49,51], and six reported both body weight and BMI [36,42,43,46,52,53] post-intervention. Seven out of the sixteen studies recorded body weight or BMI at an interim time point of three to six months, and at a one-year follow-up [36,39,45,49,50,52,54].…”

“…Methodological variation was evident across the ten RCTs included in this systematic review and meta-analysis. One study included a 12-month diet only intervention [45], three studies [36,39,46] included exercise only interventions ranging from three to twelve months, and six RCTs included combined interventions [43,44,48,49,53,54]. The RCTs with combined interventions varied significantly in duration between fourteen weeks [44], six months [48,53], eight months [43], and one year [49,54].…”

“…One study included a 12-month diet only intervention [45], three studies [36,39,46] included exercise only interventions ranging from three to twelve months, and six RCTs included combined interventions [43,44,48,49,53,54]. The RCTs with combined interventions varied significantly in duration between fourteen weeks [44], six months [48,53], eight months [43], and one year [49,54]. Two studies [48,54] did not report the specifics of the PA component of the combined intervention.…”

“…Some were dietitian-led face-to-face visits or telephone calls [45,48,54], one was provided by a physiotherapist [39], two were provided by exercise professionals [46,49], and one RCT did not specify the intervention provider [36]. Two recent RCTs [43,53] included combined interventions with a digital delivery component. Serper et al [44], provided both the two intervention groups with access to a combined online platform.…”

“…Serper et al [44], provided both the two intervention groups with access to a combined online platform. Gibson et al [53] provided both groups with a tablet to track healthy behaviours weekly. The intervention group were provided with dietary and PA interventions delivered by video teleconference calls [53].…”