Nurse-led counselling and smartphone-based coaching for dietary behaviours, weight management, and cardiometabolic risk in middle-aged Chinese in Hong Kong: a randomized controlled trial

AIMS: To evaluate the effectiveness of a 6-month multi-component intervention combining nurse-led counselling and smartphone-based coaching in improving dietary behaviours, weight management, and cardiometabolic risk among middle-aged Chinese adults in Hong Kong. METHODS AND RESULTS: This randomized controlled trial randomly assigned 221 participants to intervention (n = 110) or control (n = 111) groups. The intervention group received health assessments (anthropometry, body composition, blood pressure, blood glucose/lipids), immediate nurse-led face-to-face counselling at baseline, 3, and 6 months, and thrice-weekly smartphone coaching. Controls (n = 111) received health assessments only. Outcomes included dietary behaviours, weight management, and cardiometabolic biomarkers. Linear mixed-effects models were used to assess the intervention effects.The intervention group showed significant improvements in prioritizing food nutrition at 3 months [β = 0.22, 95% CI (0.06, 0.38)] and 6 month [β = 0.23, 95% CI (0.07, 0.39)], and food freshness at 3 month [β = 0.24, 95% CI (0.09, 0.39)] vs. controls. The intervention group also exhibited a greater decrease in animal/poultry fat intake at 3 months [β = -0.21, 95% CI (-0.38, -0.03)]. Significant reductions in blood glucose [β = -0.46 mmol/L, 95% CI (-0.79, -0.12)], total cholesterol [β = -7.80 mg/dL, 95% CI (-14.78, -0.82)], and triglycerides [β = -22.04 mg/dL, 95% CI (-39.95, -4.12)] were observed in the intervention group at 6 months. CONCLUSION: The nurse-smartphone integrated intervention effectively improved dietary behaviours and cardiometabolic profiles, offering a scalable strategy for cardiometabolic disorders prevention in Hong Kong Chinese populations. REGISTRATION: ClinicalTrials.gov NCT05400187.