Abstract
Background
Digital health interventions may facilitate management of chronic conditions; however, no reviews have systematically assessed the effectiveness of dietary interventions delivered by digital health platforms for improving dietary intake and clinical outcomes for adults with diet-related chronic conditions.
Methods
Databases CINAHL, CENTRAL, Embase and MEDLINE were searched from inception to April 2021 to identify controlled trials for dietary education delivered by digital health (mobile or electronic health) to adults with diet-related chronic conditions. Random effects analysis was performed for diet quality, food groups, nutrients, and clinical outcomes. Screening, data extraction and quality checking were completed in duplicate.
Results
Thirty-nine studies were included involving 7,333 participants. Significant changes were found for Mediterranean diet adherence score [standardised mean difference (SMD): 0.79; 95% confidence inter val (CI): 0.18, 1.40], overall fruit and vegetable intake [mean difference (MD): 0.63 serves/day; 95% CI: 0.27, 0.98], fruit intake alone [MD: 0.58 serves/day; 95% CI: 0.39, 0.77] and sodium intake [SMD: -0.22 milligrams/day; 95% CI: -0.44, -0.01]. Improvements were also found for waist circumference [MD: -2.24cm; 95% CI: -4.14, -0.33], body weight [MD: -1.94kg; 95% CI: -2.63, -1.24] and haemoglobin A1c [MD: -0.17%; 95% CI: -0.29, -0.04]. Validity of digital assessment tools to measure dietary intake were not reported. The quality of evidence was considered to have low to moderate certainty.
Conclusions
Modest improvements in diet and clinical outcomes may result from intervention via digital health for those with diet-related chronic conditions. However, additional robust trials with better reporting of digital dietary assessment tools are needed to support implementation within clinical practice.
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