Li Xue, Lu Ling, Sun Liang, Xie Yunxia, Huang Kang, Yuan Changzheng, Chen Liying, Lin Xu
Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou, 310024 China.
Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032 China.
Phenomics. 2025 Jan 30;5(2):154-168. doi: 10.1007/s43657-024-00162-0. eCollection 2025 Apr.
Mobile health technologies provided innovative solutions for lifestyle interventions and offered reliable methods to evaluate behavioral phenotypes during such interventions. To systematically quantify the impacts of behavioral compliance on weight-loss and metabolic profiles during lifestyle intervention, a total of 395 Chinese adults with overweight/obesity (BMI ≥ 24 kg/m) or central obesity (waistline ≥ 90 cm for men or ≥ 80 cm for women) were randomly assigned to a smartphone app-based arm (SAA, n = 197) or smartphone app plus dietitian arm (SADA, n = 198) for 6 months. Compliance scores (0-5) were determined based on fulfilling five behavioral tasks: completing online courses, wearing a smart band, and recording weight, food intake, and blood pressure. SADA had greater weight-loss (- 4.94% vs. - 2.28%, < 0.001) and lower triglyceride, but higher HDL-C levels (both < 0.05) than SAA after six months. Between-group weight-loss differences were attenuated at compliance scores ≥ 3 (SADA: - 6.30% vs. SAA: - 4.79%, = 0.07). Mediation analysis suggested that compliance scores explained approximately 30% of the additional weight loss in the SADA ( < 0.001), and self-weighing was the primary mediator ( < 0.05). Higher educational levels, greater initial weight loss, self-perceived simplicity, and satisfaction with the program were potential determinants of intervention compliance. Overall, the superior weight loss and metabolic improvements in the SADA group could be mediated by behavioral compliance, which was possibly influenced by some demographic and intervention response features. Our findings highlighted the roles of behavioral phenotypes and adherence in app-based lifestyle interventions, and added evidence for the future development of more precise strategies in long-term weight management.
The online version contains supplementary material available at 10.1007/s43657-024-00162-0.
移动健康技术为生活方式干预提供了创新解决方案，并为评估此类干预期间的行为表型提供了可靠方法。为了系统地量化生活方式干预期间行为依从性对体重减轻和代谢谱的影响，共有395名超重/肥胖（BMI≥24kg/m）或中心性肥胖（男性腰围≥90cm或女性腰围≥80cm）的中国成年人被随机分配到基于智能手机应用程序的组（SAA，n = 197）或智能手机应用程序加营养师组（SADA，n = 198），为期6个月。依从性得分（0 - 5）基于完成五项行为任务来确定：完成在线课程、佩戴智能手环以及记录体重、食物摄入量和血压。6个月后，SADA组的体重减轻幅度更大（-4.94%对-2.28%，P<0.001），甘油三酯水平更低，但高密度脂蛋白胆固醇水平更高（均P<0.05）。在依从性得分≥3时，组间体重减轻差异减弱（SADA：-6.30%对SAA：-4.79%，P = 0.07）。中介分析表明，依从性得分解释了SADA组额外体重减轻的约30%（P<0.001），自我称重是主要中介因素（P<0.05）。较高的教育水平、更大的初始体重减轻、自我感知的简单性以及对该计划的满意度是干预依从性的潜在决定因素。总体而言，SADA组更好的体重减轻和代谢改善可能由行为依从性介导，而行为依从性可能受到一些人口统计学和干预反应特征的影响。我们的研究结果突出了行为表型和依从性在基于应用程序的生活方式干预中的作用，并为长期体重管理中更精确策略的未来发展增加了证据。
在线版本包含可在10.1007/s43657-024-00162-0获取的补充材料。
