title: Weight loss by telemonitoring of nutrition and physical activity in patients with metabolic syndrome for 1 year.
abstract: OBJECTIVE
  Mobile technology can improve lifestyle programs, but the monitoring techniques and carer feedback need to be optimized. To this end, we investigated the efficacy of telemonitoring physical activity and nutrition over 12 months in patients with metabolic syndrome in a randomized, parallel-group, open trial.
  
  
  METHODS
  Screening all over Germany yielded 184 patients with metabolic syndrome. All patients attended a single 2-hour instruction meeting in their region concerning a combination diet and the importance of physical activity. Thereafter they were randomized into a control group (controls, n = 62) or one of 2 different intervention groups. Both intervention groups were issued accelerometers, which measured physical activity, recorded daily weight and calorie intake, and transmitted these data to a central server for use by patient carers. In the Active Body Control Program of University of Magdeburg (ABC) intervention group (n = 60), information and motivation was ensured by weekly letters. In the 4sigma telephone coaching (4S) intervention group (n = 58), this was accomplished by monthly telephone calls from the carers. Clinical and biochemical data for all patients were collected at 0, 4, 8, and 12 months without any regular face-to-face meetings between patients and carers. The primary endpoint was weight loss and the secondary endpoint was the presence of metabolic syndrome.
  
  
  RESULTS
  After 12 months the dropout rates in the control, 4S, and ABC groups were respectively 35%, 17%, and 18%. The adjusted relative weight losses after 12 months were respectively 3.7%, 8.6%, and 11.4% (all p < 0.000 versus baseline). ABC was more effective than 4S (p = 0.041); 43% of the patients completing the study in the ABC group lost more than 15% of their baseline weight. The diagnosis of metabolic syndrome was no longer applicable in 58% of the cases in the ABC group, in 41% of the 4S group, and in 33% of the controls.
  
  
  CONCLUSIONS
  Telemonitoring of physical activity and nutrition markedly improves weight loss and markers of metabolic syndrome.
authors.affiliation: a Otto-von-Guericke University , Magdeburg , GERMANY.
authors.forename: Claus
authors.initials: C
authors.lastname: Luley
authors.forename: Alexandra
authors.initials: A
authors.lastname: Blaik
authors.forename: Alexander
authors.initials: A
authors.lastname: Götz
authors.forename: Florian
authors.initials: F
authors.lastname: Kicherer
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kropf
authors.forename: Berend
authors.initials: B
authors.lastname: Isermann
authors.forename: Gabriele
authors.initials: G
authors.lastname: Stumm
authors.forename: Sabine
authors.initials: S
authors.lastname: Westphal
mesh_terms: D061725:Accelerometry; D000328:Adult; D003142:Communication; D004038:Diet, Reducing; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000628:therapy*; D010352:Patient Dropouts; D017216:Telemedicine / Q000379:methods*; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: metabolic syndrome; telemonitoring; weight loss