Noda Yuko, Kometani Mitsuhiro, Nomura Akihiro, Noda Masao, Oka Rie, Kadono Mayuko, Yoneda Takashi
Department of Health Promotion and Medicine of the Future, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
College of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa, Japan.
PLOS Digit Health. 2024 Dec 6;3(12):e0000648. doi: 10.1371/journal.pdig.0000648. eCollection 2024 Dec.
Lifestyle-related diseases, such as diabetes, are mostly caused by poor lifestyle habits; therefore, modifying these habits is important. In Japan, a system of specific health checkups (SHC) and specific health guidance (SHG) was introduced in 2008. The challenges faced include low retention rates and difficulty in maintaining results. Digital technologies can support self-management and increase patient convenience, although evidence of the usefulness of this technology for SHG is limited. This study evaluated the usefulness of nutritional guidance using a smartphone application (app) added to conventional SHG. We recruited eligible participants for SHG in Japan from November 2018 to March 2020. We assigned them to "Intervention Group: Application-Supported Nutrition Therapy" or "Control Group: Human Nutrition Therapy" based on their desire to use the app. The primary outcome was a change in non-high-density lipoprotein cholesterol (non-HDL-C) levels post-intervention. The secondary outcomes were a change in lipid profile, metabolic indices, and frequency of logins to the app. We assessed 109 participants in two cohorts: 3-month (short-term) and 6-month (long-term). The short-term cohort had 23 intervention and 29 control participants, while the long-term cohort had 35 and 22, respectively. There was a significant improvement in non-HDL-C levels in the short-term intervention group compared to the control group. There was no significant difference in non-HDL-C levels in the long-term groups or at 1 year. There were significant improvements in body weight (BW) in the short-term cohort until 1 year compared within the groups. The retention rate remained high in the short-term cohort (92%) but decreased to 57.8% at 6 months in the long-term cohort. Using an app system to facilitate dietary recordings and guidance for patients at risk of lifestyle-related diseases led to improved lipid levels and BW. These benefits persisted to some extent after 1 year. This app may partially supplement conventional SHG.
生活方式相关疾病，如糖尿病，大多由不良生活习惯引起；因此，改变这些习惯很重要。在日本，2008年引入了特定健康检查（SHC）和特定健康指导（SHG）系统。面临的挑战包括留存率低以及难以维持成果。数字技术可以支持自我管理并提高患者便利性，尽管该技术对SHG有用性的证据有限。本研究评估了在传统SHG基础上添加智能手机应用程序（应用）进行营养指导的有用性。我们在2018年11月至2020年3月期间招募了日本符合SHG条件的参与者。根据他们使用应用的意愿，将他们分为“干预组：应用支持的营养疗法”或“对照组：人工营养疗法”。主要结局是干预后非高密度脂蛋白胆固醇（non-HDL-C）水平的变化。次要结局是血脂谱、代谢指标的变化以及应用的登录频率。我们在两个队列中评估了109名参与者：3个月（短期）和6个月（长期）。短期队列中有23名干预参与者和29名对照参与者，而长期队列分别有35名和22名。与对照组相比，短期干预组的non-HDL-C水平有显著改善。长期组或1年时non-HDL-C水平无显著差异。在短期队列中，直至1年，组内比较体重（BW）有显著改善。短期队列的留存率仍然很高（92%），但长期队列在6个月时降至57.8%。使用应用系统促进对生活方式相关疾病风险患者的饮食记录和指导可改善血脂水平和体重。这些益处1年后在一定程度上仍然存在。该应用可能部分补充传统的SHG。
