Research Article Details

Article ID: A03379
PMID: 34024536
Source: Clin Nutr ESPEN
Title: Telemedicine as a tool for dietary intervention in NAFLD-HIV patients during the COVID-19 lockdown: A randomized controlled trial.
Abstract: BACKGROUND & AIMS: Given reports of changes in dietary habits during covid-19 lockdown, our aim was to assess weight changes, over a 3-month Covid-19 national lockdown in a cohort of NAFLD-HIV patients on a dietary intervention trial. METHODS: After NAFLD screening in an outpatient Infectious Diseases Clinic, NAFLD patients were randomly allocated to general dietary recommendations (SC group) or to a structured dietary intervention based on the Mediterranean diet (intervention group). During lockdown, follow-up consultations in the intervention group were done by video and/or phone. After 3 months of lockdown, all patients (intervention and SC group) consented to a telephone interview which aimed to characterize eating habits and lifestyle changes and evaluate stress and depression. Biochemical data when available, was compared between the peri-period of confinement. RESULTS: One hundred and twelve patients were screened. From the 55 NAFDL identified, 27 were allocated to dietary intervention and 28 to SC and were followed before lockdown for a mean period of 5.0&#160;&#177;&#160;1.5 months in which SC group gained a median of 0.65&#160;kg vs. a median loss of 1.5&#160;kg in the intervention group (p&#160;<&#160;0.001). During lockdown, 93.3% of patients in the SC group referred that "diet got worse" vs. 6.7% in the intervention group p&#160;<&#160;0.01), and 35.3% vs. 15.7% (p&#160;=&#160;0.014) reported increase in appetite, respectively. Both groups gained weight, SC group vs. 0.7&#160;&#177;&#160;1.7&#160;kg in the intervention group, p&#160;<&#160;0.001). Higher weight gain was associated with changes in the dietary pattern (3.8&#160;&#177;&#160;2.1&#160;kg vs. 2.0&#160;&#177;&#160;1.3&#160;kg in "no change in dietary pattern"; p&#160;=&#160;0.002). Glucose blood levels increased after lockdown in the SC group, with a mean increase of 15&#160;mg/dl (p&#160;=&#160;0.023). The remaining metabolic parameters remained unchanged. CONCLUSION: The maintenance of dietary intervention, using telemedicine, can mitigate the adverse change in dietary habits and physical activity pattern, preventing a substantial increase in body weight.
DOI: 10.1016/j.clnesp.2021.03.031