Background: Web-based platforms have been proposed as tools to facilitate lifestyle improvement, however, their efficacy in individuals with high cardiometabolic risk has not been adequately tested. The Baptist Employee Healthy Heart Study (BEHHS) was designed to assess the addition of a personalized, interactive, web-based, lifestyle-management program to the existing health-expertise web platform available to BHSF employees with metabolic syndrome (METS) or type 2 diabetes (DM2)
Methods: In this 1:1 randomized, non-blinded trial, the intervention arm was provided access to a web-based personalized and interactive lifestyle program that provided targeted and personalized dietary, weight management and physical activity counseling. The intervention was in addition to access to an online wellness program, a non-interactive website that provided information on healthy diet and physical activity. The control group only had access to the online wellness program. At baseline, each participant had their demographic data collected via questionnaire. At each study visit (baseline, 4 months and 12 months) participants completed questionnaires on lifestyle indices such as diet and physical activity, had their weight, height, waist circumference, body fat (by plethysmography) and blood pressure measured. Laboratory testing was done for traditional lipids and glucose at each visit.
Results: Of the 182 participants that were randomized, 163 (82 in the intervention arm and 81 in the control arm) completed the baseline survey and had complete laboratory data at baseline. Loss to follow-up was 12% at 4 months 34% at 12 months. As shown the table, intention to treat analysis using both single imputation (last observation carried forward) and multiple imputation techniques showed no difference in BMI, other measures of adiposity, blood pressure, lipids, physical activity and diet scores. When analyses were restricted to completers alone, no significant change in the results were observed.
Conclusion: The addition of web-based, personalized lifestyle program to an already existing lifestyle educational platform did not significantly impact healthy lifestyle promotion and cardiometabolic risk in employees with MetS or DM2.