TY  - JOUR
AU  - Lim, Su Lin
AU  - Johal, Jolyn
AU  - Ong, Kai Wen
AU  - Han, Chad Yixian
AU  - Chan, Yiong Huak
AU  - Lee, Yin Mei
AU  - Loo, Wai Mun
PY  - 2020
DA  - 2020/4/13
TI  - Lifestyle Intervention Enabled by Mobile Technology on Weight Loss in Patients With Nonalcoholic Fatty Liver Disease: Randomized Controlled Trial
JO  - JMIR Mhealth Uhealth
SP  - e14802
VL  - 8
IS  - 4
KW  - diet
KW  - NAFLD
KW  - mHealth
KW  - mobile app, weight loss
KW  - liver enzymes
KW  - lifestyle intervention
AB  - Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) reaches up to 30% in the Asian adult population, with a higher prevalence in obese patients. Weight reduction is typically recommended for patients at high risk or diagnosed with NAFLD, but is a challenge to achieve. Objective: We aimed to evaluate the effect of a lifestyle intervention with a mobile app on weight loss in NAFLD patients. Methods: This prospective randomized controlled trial included 108 adults with NAFLD confirmed by steatosis on ultrasound and a body mass index ≥23 kg/m2 who were recruited from a fatty liver outpatient clinic. The patients were randomly allocated to either a control group (n=53) receiving standard care, consisting of dietary and lifestyle advice by a trained nurse, or an intervention group (n=55) utilizing the Nutritionist Buddy (nBuddy) mobile app in addition to receiving dietary and lifestyle advice by a dietitian. Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST), waist circumference, and blood pressure were measured at baseline, and then at 3 and 6 months. Intention-to-treat and per-protocol analyses were used for statistical comparisons. Results: The intervention group had a 5-fold higher likelihood (relative risk 5.2, P=.003, 95% CI 1.8-15.4) of achieving ≥5% weight loss compared to the control group at 6 months. The intervention group also showed greater reductions in weight (mean 3.2, SD 4.1 kg vs mean 0.5, SD 2.9 kg; P<.001), waist circumference (mean 2.9, SD 5.0 cm vs mean –0.7, SD 4.4 cm; P<.001), systolic blood pressure (mean 12.4, SD 14.8 mmHg vs mean 2.4, SD 12.4 mmHg; P=.003), diastolic blood pressure (mean 6.8, SD 8.9 mmHg vs mean –0.9, SD 10.0 mmHg; P=.001), ALT (mean 33.5, SD 40.4 IU/L vs mean 11.5, SD 35.2 IU/L; P=.004), and AST (mean 17.4, SD 27.5 U/L vs mean 7.4, SD 17.6 IU/L, P=.03) at 6 months. Conclusions: Lifestyle intervention enabled by a mobile app can be effective in improving anthropometric indices and liver enzymes in patients with NAFLD. This treatment modality has the potential to be extended to a larger population scale. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12617001001381;https://tinyurl.com/w9xnfmp 
SN  - 2291-5222
UR  - http://mhealth.jmir.org/2020/4/e14802/
UR  - https://doi.org/10.2196/14802
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32281943
DO  - 10.2196/14802
ID  - info:doi/10.2196/14802
ER  -