University of Connecticut, Storrs, CT, United States.
Hartford Hospital, Hartford, CT, United States.
J Med Internet Res. 2024 Oct 9;26:e51321. doi: 10.2196/51321.
The literature on whether physical activity (PA) and PA and diet (PA+Diet) mobile apps improve cardiovascular disease (CVD) risk factors is promising.
The aim of this meta-review is to provide an evidence synthesis of systematic reviews and meta-analyses examining the influence of PA and PA+Diet apps on the major CVD risk factors.
We systematically searched 5 databases until January 12, 2022. Included systematic reviews and meta-analyses (1) reported the CVD risk factor outcomes of BMI, waist circumference, body weight, blood pressure (BP), hemoglobin A (HbA), fasting blood glucose, blood lipids, or PA; (2) enrolled healthy participants ≥18 years who may or may not have the metabolic syndrome, diabetes mellitus, or preexisting CVD risk factors; (3) reviewed PA or PA+Diet app interventions integrating behavioral change techniques (BCT) to deliver their information; and (4) had a nonapp control.
In total, 17 reviews (9 systematic reviews and 8 meta-analyses) published between 2012 and 2021 qualified. Participants were middle-aged, mostly women ranging in number from 10 to 62,219. Interventions lasted from 1 to 24 months, with the most common behavioral strategies being personalized feedback (n=8), self-monitoring (n=7), and goal setting (n=5). Of the PA app systematic reviews (N=4), the following CVD risk factors improved: body weight and BMI (n=2, 50%), BP (n=1, 25%), HbA (n=1, 25%), and blood lipids (n=1, 25%) decreased, while PA (n=4, 100%) increased. Of the PA+Diet app systematic reviews (N=5), the following CVD risk factors improved: body weight and BMI (n=3, 60%), BP (n=1, 20%), and HbA (n=3, 60%) decreased, while PA (n=3, 60%) increased. Of the PA app meta-analyses (N=1), the following CVD risk factors improved: body weight decreased (-0.73 kg, 95% CI -1.45 to -0.01; P=.05) and PA increased by 25 minutes/week (95% CI 0.58-1.68; P<.001), while BMI (-0.09 kg/m, 95% CI -0.29 to 0.10; P=.35) and waist circumference (-1.92 cm, 95% CI -3.94 to 0.09; P=.06) tended to decrease. Of the PA+Diet app meta-analyses (n=4), the following CVD risk factors improved: body weight (n=4, 100%; from -1.79 kg 95% CI -3.17 to -0.41; P=.01 to -2.80 kg 95% CI -4.54 to -1.06, P=.002), BMI (n=1, 25%; -0.64 kg/m, 95% CI -1.09 to -0.18; P=.01), waist circumference (n=1, 25%; -2.46 cm, 95% CI -4.56 to -0.36; P=.02), systolic/diastolic BP (n=1, 25%; -4.22/-2.87 mm Hg, 95% CI -6.54 to -1.91/ -4.44 to -1.29; P<.01), and HbA (n=1, 25%; -0.43%, 95% CI -0.68 to -0.19; P<.001) decreased.
PA and PA+Diet apps appear to be most consistent in improving PA and anthropometric measures with favorable but less consistent effects on other CVD risk factors. Future studies are needed that directly compare and better quantify the effects of PA and PA+Diet apps on CVD risk factors.
PROSPERO CRD42023392359; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392359.
关于体力活动 (PA) 和 PA 与饮食 (PA+Diet) 移动应用程序是否能改善心血管疾病 (CVD) 风险因素的文献很有前景。
本元分析旨在提供系统评价和荟萃分析的证据综合，以评估 PA 和 PA+Diet 应用程序对主要 CVD 风险因素的影响。
我们系统地检索了 5 个数据库，直到 2022 年 1 月 12 日。纳入的系统评价和荟萃分析：(1)报告了 CVD 风险因素的结果，包括 BMI、腰围、体重、血压 (BP)、血红蛋白 A (HbA)、空腹血糖、血脂或 PA；(2)纳入了健康参与者，年龄在 18 岁及以上，可能患有代谢综合征、糖尿病或预先存在的 CVD 风险因素，也可能没有；(3)审查了 PA 或 PA+Diet 应用程序干预措施，这些措施整合了行为改变技术 (BCT) 来传递信息；(4)有非应用程序对照。
共有 17 篇评论（9 篇系统评价和 8 篇荟萃分析）发表于 2012 年至 2021 年期间，符合纳入标准。参与者为中年人，主要为女性，人数从 10 到 62219 不等。干预时间从 1 到 24 个月不等，最常见的行为策略是个性化反馈 (n=8)、自我监测 (n=7) 和目标设定 (n=5)。在 PA 应用程序的系统评价中（N=4），以下 CVD 风险因素得到改善：体重和 BMI（n=2，50%）、BP（n=1，25%）、HbA（n=1，25%）和血脂（n=1，25%）降低，而 PA（n=4，100%）增加。在 PA+Diet 应用程序的系统评价中（N=5），以下 CVD 风险因素得到改善：体重和 BMI（n=3，60%）、BP（n=1，20%）和 HbA（n=3，60%）降低，而 PA（n=3，60%）增加。在 PA 应用程序的荟萃分析中（N=1），以下 CVD 风险因素得到改善：体重减轻（-0.73kg，95%CI-1.45 至-0.01；P=.05）和 PA 每周增加 25 分钟（95%CI0.58-1.68；P<.001），而 BMI（-0.09kg/m，95%CI-0.29 至 0.10；P=.35）和腰围（-1.92cm，95%CI-3.94 至 0.09；P=.06）则倾向于降低。在 PA+Diet 应用程序的荟萃分析中（n=4），以下 CVD 风险因素得到改善：体重（n=4，100%；从-1.79kg95%CI-3.17 至-0.41；P=.01 到-2.80kg95%CI-4.54 至-1.06，P=.002）、BMI（n=1，25%；-0.64kg/m，95%CI-1.09 至-0.18；P=.01）、腰围（n=1，25%；-2.46cm，95%CI-4.56 至-0.36；P=.02）、收缩压/舒张压（n=1，25%；-4.22/-2.87mmHg，95%CI-6.54 至-1.91/-4.44 至-1.29；P<.01）和 HbA（n=1，25%；-0.43%，95%CI-0.68 至-0.19；P<.001）降低。
PA 和 PA+Diet 应用程序似乎在改善 PA 和人体测量指标方面最为一致，对其他 CVD 风险因素的影响则有利但不太一致。需要进一步研究，直接比较和更好地量化 PA 和 PA+Diet 应用程序对 CVD 风险因素的影响。
PROSPERO CRD42023392359；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392359。
