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Telehealth methods to deliver dietary interventions in adults with chronic disease: a systematic review and meta-analysis.
Am J Clin Nutr 2016; 104(6):1693-1702AJ

Abstract

BACKGROUND

The long-term management of chronic disease requires the adoption of complex dietary recommendations, which can be facilitated by regular coaching to support behavioral changes. Telehealth interventions can overcome patient-centered barriers to accessing face-to-face programs and provide feasible delivery methods, accessible regardless of geographic location.

OBJECTIVE

This systematic review assessed the effectiveness of telehealth dietary interventions at facilitating dietary change in chronic disease.

DESIGN

A structured systematic search was conducted for all randomized controlled trials evaluating multifactorial dietary interventions in adults with chronic disease that provided diet education in an intervention longer than 4 wk. Meta-analyses that used the random-effects model were performed on diet quality, dietary adherence, fruit and vegetables, sodium intake, energy, and dietary fat intake.

RESULTS

A total of 25 studies were included, involving 7384 participants. The telehealth dietary intervention was effective at improving diet quality [standardized mean difference (SMD): 0.22 (95% CI: 0.09, 0.34), P = 0.0007], fruit and vegetable intake [mean difference (MD) 1.04 servings/d (95% CI: 0.46, 1.62 servings/d), P = 0.0004], and dietary sodium intake [SMD: -0.39 (-0.58, -0.20), P = 0.0001]. Single nutrients (total fat and energy consumption) were not improved by telehealth intervention; however, after a telehealth intervention, important clinical outcomes were improved, such as systolic blood pressure [MD: -2.97 mm Hg (95% CI: -5.72, -0.22 mm Hg), P = 0.05], total cholesterol [MD: -0.08 mmol/L (95% CI: -0.16, -0.00 mmol/L), P = 0.04], triglycerides [MD: -0.10 mmol/L (95% CI: -0.19, -0.01 mmol/L), P = 0.04], weight [MD: -0.80 kg (95% CI: -1.61, 0 kg), P = 0.05], and waist circumference [MD: -2.08 cm (95% CI: -3.97, -0.20 cm), P = 0.03].

CONCLUSIONS

Telehealth-delivered dietary interventions targeting whole foods and/or dietary patterns can improve diet quality, fruit and vegetable intake, and dietary sodium intake. When applicable, they should be incorporated into health care services for people with chronic conditions. This review was registered at http://www.crd.york.ac.uk/PROSPERO/ as CRD42015026398.

Authors+Show Affiliations

Faculty of Health Sciences and Medicine.Faculty of Health Sciences and Medicine.Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Australia; and.Faculty of Health Sciences and Medicine, kcampbel@bond.edu.au. Nutrition and Dietetics Department, Princess Alexandra Hospital, Brisbane, Australia.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27935523

Citation

Kelly, Jaimon T., et al. "Telehealth Methods to Deliver Dietary Interventions in Adults With Chronic Disease: a Systematic Review and Meta-analysis." The American Journal of Clinical Nutrition, vol. 104, no. 6, 2016, pp. 1693-1702.
Kelly JT, Reidlinger DP, Hoffmann TC, et al. Telehealth methods to deliver dietary interventions in adults with chronic disease: a systematic review and meta-analysis. Am J Clin Nutr. 2016;104(6):1693-1702.
Kelly, J. T., Reidlinger, D. P., Hoffmann, T. C., & Campbell, K. L. (2016). Telehealth methods to deliver dietary interventions in adults with chronic disease: a systematic review and meta-analysis. The American Journal of Clinical Nutrition, 104(6), pp. 1693-1702.
Kelly JT, et al. Telehealth Methods to Deliver Dietary Interventions in Adults With Chronic Disease: a Systematic Review and Meta-analysis. Am J Clin Nutr. 2016;104(6):1693-1702. PubMed PMID: 27935523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Telehealth methods to deliver dietary interventions in adults with chronic disease: a systematic review and meta-analysis. AU - Kelly,Jaimon T, AU - Reidlinger,Dianne P, AU - Hoffmann,Tammy C, AU - Campbell,Katrina L, Y1 - 2016/11/09/ PY - 2016/04/11/received PY - 2016/10/04/accepted PY - 2016/12/10/entrez PY - 2016/12/10/pubmed PY - 2017/6/15/medline KW - chronic disease KW - diet KW - diet quality KW - dietary KW - fruit KW - telehealth KW - vegetables SP - 1693 EP - 1702 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 104 IS - 6 N2 - BACKGROUND: The long-term management of chronic disease requires the adoption of complex dietary recommendations, which can be facilitated by regular coaching to support behavioral changes. Telehealth interventions can overcome patient-centered barriers to accessing face-to-face programs and provide feasible delivery methods, accessible regardless of geographic location. OBJECTIVE: This systematic review assessed the effectiveness of telehealth dietary interventions at facilitating dietary change in chronic disease. DESIGN: A structured systematic search was conducted for all randomized controlled trials evaluating multifactorial dietary interventions in adults with chronic disease that provided diet education in an intervention longer than 4 wk. Meta-analyses that used the random-effects model were performed on diet quality, dietary adherence, fruit and vegetables, sodium intake, energy, and dietary fat intake. RESULTS: A total of 25 studies were included, involving 7384 participants. The telehealth dietary intervention was effective at improving diet quality [standardized mean difference (SMD): 0.22 (95% CI: 0.09, 0.34), P = 0.0007], fruit and vegetable intake [mean difference (MD) 1.04 servings/d (95% CI: 0.46, 1.62 servings/d), P = 0.0004], and dietary sodium intake [SMD: -0.39 (-0.58, -0.20), P = 0.0001]. Single nutrients (total fat and energy consumption) were not improved by telehealth intervention; however, after a telehealth intervention, important clinical outcomes were improved, such as systolic blood pressure [MD: -2.97 mm Hg (95% CI: -5.72, -0.22 mm Hg), P = 0.05], total cholesterol [MD: -0.08 mmol/L (95% CI: -0.16, -0.00 mmol/L), P = 0.04], triglycerides [MD: -0.10 mmol/L (95% CI: -0.19, -0.01 mmol/L), P = 0.04], weight [MD: -0.80 kg (95% CI: -1.61, 0 kg), P = 0.05], and waist circumference [MD: -2.08 cm (95% CI: -3.97, -0.20 cm), P = 0.03]. CONCLUSIONS: Telehealth-delivered dietary interventions targeting whole foods and/or dietary patterns can improve diet quality, fruit and vegetable intake, and dietary sodium intake. When applicable, they should be incorporated into health care services for people with chronic conditions. This review was registered at http://www.crd.york.ac.uk/PROSPERO/ as CRD42015026398. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/27935523/Telehealth_methods_to_deliver_dietary_interventions_in_adults_with_chronic_disease:_a_systematic_review_and_meta_analysis_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.116.136333 DB - PRIME DP - Unbound Medicine ER -