PMID- 32857059 OWN - NLM STAT- MEDLINE DCOM- 20210107 LR - 20210107 IS - 1438-8871 (Electronic) IS - 1439-4456 (Print) IS - 1438-8871 (Linking) VI - 22 IP - 8 DP - 2020 Aug 28 TI - Web-Based Interventions for Dietary Behavior in Adults With Type 2 Diabetes: Systematic Review of Randomized Controlled Trials. PG - e16437 LID - 10.2196/16437 [doi] LID - e16437 AB - BACKGROUND: Type 2 diabetes mellitus (T2DM) is among the most prevalent noncommunicable health conditions worldwide, affecting over 500 million people globally. Diet is a key aspect of T2DM management with dietary modification shown to elicit clinically meaningful outcomes such as improved glycemic control, and reductions in weight and cardiovascular disease risk factors. Web-based interventions provide a potentially convenient and accessible method for delivering dietary education, but its effects on dietary behavior in people with T2DM are unknown. OBJECTIVE: The objective of this review was to determine the effectiveness of web-based interventions on dietary behavior change and glycemic control in people with T2DM. METHODS: Per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, systematic literature searches were performed using Medline, Embase, The Cochrane Library, and CINAHL to retrieve papers from January 2013 to May 2019. Randomized controlled trials of web-based interventions in adults with T2DM with reported dietary assessment were included. Population and intervention characteristics, dietary guidelines and assessments, and significant clinical outcomes were extracted. Differences between groups and within groups were assessed for dietary behavior and clinical outcomes. RESULTS: There were 714 records screened, and five studies comprising 1056 adults were included. Studies measured dietary changes by assessing overall diet quality, changes in specific dietary components, or dietary knowledge scores. Significant improvements in dietary behavior were reported in four out of the five studies, representing healthier food choices, improvements in eating habits, reductions in carbohydrates, added sugar, sodium, saturated fat and overall fat intake, and/or increases in dietary knowledge. Three studies found significant mean reductions for hemoglobin A1c ranging from -0.3% to -0.8%, and/or weight ranging from -2.3 kg to -12.7 kg, fasting blood glucose (-1 mmol/L), waist circumference (-1 cm), and triglycerides (-60.1 mg/dL). These studies provided varied dietary recommendations from standard dietary guidelines, national health program guidelines, and a very low carbohydrate ketogenic diet. CONCLUSIONS: This review provided evidence that web-based interventions may be an effective way to support dietary behavior change in people with T2DM, potentially leading to changes in glycemic control and other clinical outcomes. However, the evidence should be viewed as preliminary as there were only five studies included with considerable heterogeneity in terms of the diets recommended, the dietary assessment measures used, the complexity of the interventions, and the modes and methods of delivery. CI - (c)Jedha Dening, Sheikh Mohammed Shariful Islam, Elena George, Ralph Maddison. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.08.2020. FAU - Dening, Jedha AU - Dening J AUID- ORCID: 0000-0003-0072-460X AD - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. FAU - Islam, Sheikh Mohammed Shariful AU - Islam SMS AUID- ORCID: 0000-0001-7926-9368 AD - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. FAU - George, Elena AU - George E AUID- ORCID: 0000-0002-1385-2371 AD - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. FAU - Maddison, Ralph AU - Maddison R AUID- ORCID: 0000-0001-8564-5518 AD - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia. LA - eng PT - Journal Article PT - Systematic Review DEP - 20200828 PL - Canada TA - J Med Internet Res JT - Journal of medical Internet research JID - 100959882 SB - IM MH - Adult MH - Diabetes Mellitus, Type 2/*therapy MH - Humans MH - Internet-Based Intervention/*trends MH - Nutrition Policy/*trends MH - Randomized Controlled Trials as Topic PMC - PMC7486668 OTO - NOTNLM OT - HbA1c OT - diet OT - dietary behavior OT - eHealth OT - glycemic control OT - self-management OT - type 2 diabetes OT - web-based COIS- Conflicts of Interest: JD is a co-owner of Diabetes Meal Plans (DMP), a web-based low carbohydrate nutrition support service for people with T2DM. No study reviewed in this manuscript was associated with DMP. EDAT- 2020/08/29 06:00 MHDA- 2021/01/08 06:00 PMCR- 2020/08/28 CRDT- 2020/08/29 06:00 PHST- 2019/09/29 00:00 [received] PHST- 2020/06/03 00:00 [accepted] PHST- 2020/05/30 00:00 [revised] PHST- 2020/08/29 06:00 [entrez] PHST- 2020/08/29 06:00 [pubmed] PHST- 2021/01/08 06:00 [medline] PHST- 2020/08/28 00:00 [pmc-release] AID - v22i8e16437 [pii] AID - 10.2196/16437 [doi] PST - epublish SO - J Med Internet Res. 2020 Aug 28;22(8):e16437. doi: 10.2196/16437.