title: An interactive diary for diet management (DAI): a new telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce.
abstract: BACKGROUND
  The aim of this multicenter, longitudinal, single-arm, pre-post comparison was to test a telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce.
  
  
  METHODS
  DAI (MeTeDa srl, San Benedetto del Tronto, Italy) is a software for mobile phones to support patients following a specific dietetic program. It facilitates the communication between the patient and dietician via short text messages. Overall, three specialized dieticians enrolled 140 consecutive patients with body mass index (BMI) >or=25 kg/m(2) who voluntered to follow a specific diet program to be managed with DAI. At baseline and after 20 weeks, data on body weight, waist circumference, BMI, fasting blood glucose, lipid profile, food habits, and physical activity were collected and compared by the Wilcoxon test or the McNemar test.
  
  
  RESULTS
  Overall, 115 individuals (82.1%) completed the follow-up. The mean (95% confidence interval) reduction in body weight was -2.5 (-3.2; -1.8) kg, whereas the reduction in waist circumference was -3.7 (-4.6; -2.9) cm, and that in BMI was 1.0 (-0.7; -1.2) kg/m(2). The software was useful as an educational tool: participants achieving the Mediterranean diet targets increased from 14.4% to 69.8% after 20 weeks. On average, each patient recognized and chose fresh local vegetables eight times per week during the follow-up. Participants regularly communicated with dieticians through short text messages.
  
  
  CONCLUSIONS
  This study allowed the documentation of the efficacy of a new telemedicine system in supporting people who need to lose body weight. The tool was also suitable for a more articulated initiative of "nutritional education" aiming to promote the healthy properties of the Mediterranean diet and the consumption of local produce.
authors.affiliation: Dipartimento di Farmacologia Clinica ed Epidemiologia, Centro Studi e Ricerche AMD, Consorzio Mario Negri Sud, Santa Maria Imbarco, Italy. mrossi@negrisud.it
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Rossi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Perozzi
authors.forename: Carla
authors.initials: C
authors.lastname: Consorti
authors.forename: Teresa
authors.initials: T
authors.lastname: Almonti
authors.forename: Paolo
authors.initials: P
authors.lastname: Foglini
authors.forename: Nena
authors.initials: N
authors.lastname: Giostra
authors.forename: Paola
authors.initials: P
authors.lastname: Nanni
authors.forename: Susanna
authors.initials: S
authors.lastname: Talevi
authors.forename: Dante
authors.initials: D
authors.lastname: Bartolomei
authors.forename: Giacomo
authors.initials: G
authors.lastname: Vespasiani
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D038441:Diet, Mediterranean; D004038:Diet, Reducing / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018579:Patient Selection; D011795:Surveys and Questionnaires; D017216:Telemedicine; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology*