Effectiveness and Implementation of a Community-based Health Coach-led Artificial Intelligence (AI)-Powered Digital Self-Regulation Program for Individuals With Metabolic Syndrome (MetS) (LIGHTER-MetS)

This study aims to evaluate the effectiveness of the Lifestyle Intervention for Gentle, Healthy Transformation and Enhanced Weight Reduction-metabolic syndrome (LIGHTER-MetS) program on dietary self-regulation and cardiovascular risk among individuals with metabolic syndrome (MetS). The LIGHTER-MetS program, a community-based, grassroots-led initiative, integrates health coaching with the eTRIP© app to promote sustainable lifestyle changes focusing on diet, exercise, and emotion regulation.

Study Overview

• Status: Recruiting
• Conditions: Metabolic Syndrome; Metabolic Syndrome (MetS)
• Intervention / Treatment: Behavioral: LIGHTER-MetS

• Study Type: Interventional
• Enrollment (Estimated): 316
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jocelyn Chew; Phone Number: +6565168687; Email: dbi-lab@nus.edu.sg

Study Locations

• Singapore
  • Singapore, Singapore, 117597
    • Recruiting
    • National University of Singapore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. are between 21 to 65 years of age;
2. have a waist circumference ≥90 cm in men and ≥80 cm in women;

3. have 2 or more of the following to be classified as having metabolic syndrome:

   • triglyceride level of ≥1.7 mmol/L or on specific treatment for this lipid abnormality;
   • high density lipoprotein (HDL) cholesterol <1.03 mmol/L in men, and <1.29 mmol/L in women, or on specific treatment for this lipid abnormality;
   • blood pressure of ≥130/85 mmHg or on treatment of previously diagnosed hypertension;
   • fasting blood glucose level of ≥ 5.6 mmol/L or previously diagnosed type 2 diabetes;
4. are not receiving other structured lifestyle modification programs;
5. consent to audio-recording;
6. English speaking and literate.

Exclusion Criteria:

1. underwent or are scheduled for metabolic surgery within 1 year;
2. are pregnant or planning for pregnancy at the time of recruitment;
3. are unable to speak English;
4. do not own a smartphone; and
5. are unable to provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: LIGHTER-MetS; The LIGHTER-MetS program includes community-based health coaching by the PI or a trained healthcare professional (e.g. nurse, physiotherapist etc.) at baseline visit and for 3 months following the baseline visit. Throughout the first 3 months, participants will also use the eTRIP© app to log meals, monitor physical activity, and receive personalized feedback. During the 3-month intervention period, there will be one-to-one slots for the health coach to follow up on participants' health plan.	Behavioral: LIGHTER-MetS; The LIGHTER-MetS program includes community-based health coaching by the PI or a trained healthcare professional (e.g. nurse, physiotherapist etc.) at baseline visit and for 3 months following the baseline visit. Throughout the first 3 months, participants will also use the eTRIP© app to log meals, monitor physical activity, and receive personalized feedback. During the 3-month intervention period, there will be one-to-one slots for the health coach to follow up on participants' health plan.
No Intervention: Control; Participants will receive personalised health plans provided as part of usual care when they see a family physician. As part of the HealthierSG initiative, health plans are typically formulated to target early disease prevention and chronic condition management through history taking, physical examination, appropriate diagnostic testing, treatment, referrals and lifestyle modification goals and activity planning.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self regulation of Eating Behaviour Questionnaire (SREBQ)	The Self-Regulation of Eating Behaviour Questionnaire (SREBQ) is a validated self-administered instrument used to assess individuals' self-regulation in relation to eating behavior. It evaluates the extent to which individuals monitor, control, and regulate their eating behaviors in everyday contexts. Higher scores indicate greater self-regulation of eating behavior.	At baseline, 3, 6, and 12 months.
Cardiovascular Risk	Cardiovascular risk will be assessed via the ASCVD-risk calculator and the Singapore-modified Framingham Risk Score 2023 (SG-FRS-2023). Higher scores indicate a greater estimated cardiovascular risk.	At baseline, 3, 6, and 12 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Weight		At baseline, 3, 6, and 12 months.
Waist Circumference		At baseline, 3, 6, and 12 months.
Blood Pressure	Both systolic and diastolic blood pressure will be assessed.	At baseline, 3, 6, and 12 months.
Three Factor Eating Questionnaire (TFEQ)	The Three-Factor Eating Questionnaire (TFEQ) is a validated self-administered instrument used to assess eating-related behaviors. It measures three domains: cognitive restraint of eating, uncontrolled eating, and emotional eating. Higher scores indicate greater levels of the respective eating behavior.	At baseline, 3, 6 and 12 month.
Consideration of Future Consequences Scale (CFCS-6)	The Consideration of Future Consequences Scale - 6 item (CFCS-6) is a validated self-administered questionnaire used to assess the extent to which individuals consider the potential future outcomes of their current behaviors. It evaluates the degree to which individuals weigh immediate versus future consequences when making decisions. Higher scores indicate greater consideration of future consequences.	At baseline, 3, 6 and 12 month.
Self-Report Behavioural Automaticity Index (SRBAI)	The Self-Report Behavioural Automaticity Index (SRBAI) is a validated self-administered questionnaire used to assess the automaticity of behavior. It evaluates the extent to which a behavior is performed automatically, with little conscious thought or deliberation. Higher scores indicate greater behavioral automaticity.	At baseline, 3, 6 and 12 month.
International Physical Activity Questionnaire Short-Form (IPAQ-SF)	The International Physical Activity Questionnaire - Short Form (IPAQ-SF) is a validated self-administered questionnaire used to assess self-reported physical activity levels. It captures the frequency and duration of walking, moderate-intensity activity, and vigorous-intensity activity performed over the past 7 days.	At baseline, 3, 6 and 12 month.
Generalized Anxiety Disorder 2-item (GAD-2)	The Generalized Anxiety Disorder - 2 item (GAD-2) is a validated self-administered screening questionnaire used to assess the frequency of core anxiety symptoms over the past two weeks. Higher scores indicate greater anxiety symptom severity.	At baseline, 3, 6 and 12 month.
Patient Health Questionnaire-2 (PHQ-2)	The Patient Health Questionnaire - 2 item (PHQ-2) is a validated self-administered screening questionnaire used to assess the frequency of depressive symptoms over the past two weeks. Higher scores indicate greater depressive symptom severity.	At baseline, 3, 6 and 12 month.
Perceived Stress Scale (PSS-10)	The Perceived Stress Scale - 10 item (PSS-10) is a validated self-administered questionnaire used to assess perceived stress levels over the past month. It measures the extent to which individuals perceive situations in their lives as stressful. Higher scores indicate greater perceived stress.	At baseline, 3, 6 and 12 month.
Euro Quality of life 5 Dimensions-5 Levels (EQ-5D-5L)	The EuroQol 5 Dimensions - 5 Levels (EQ-5D-5L) is a standardized self-administered instrument used to assess health-related quality of life. It measures five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, each with five response levels.	At baseline, 3, 6 and 12 month.
Big Five Inventory - 44 item (BFI-44)	The Big Five Inventory - 44 item (BFI-44) is a validated self-administered questionnaire used to assess personality traits across five domains: openness, conscientiousness, extraversion, agreeableness, and neuroticism. Higher scores indicate greater expression of the respective personality traits.	At baseline, 3, 6 and 12 month.
BMI	Measured using InBody 120.	At baseline, 3, 6 and 12 month.
Percentage Body Fat	Measured using InBody 120.	At baseline, 3, 6 and 12 month.
Body Fat Mass	Measured using InBody 120.	At baseline, 3, 6 and 12 month.
Visceral Fat Level	Measured using InBody 120.	At baseline, 3, 6 and 12 month.
Homeostatic Model Assessment of Insulin Resistance	Measured using (fasting blood insulin X fasting blood glucose)/22.5.	At baseline, 3 and 12 months.
Fasting Blood Glucose (mmol/L)	Fasting blood glucose is a biochemical measure of blood glucose concentration after an overnight fast, measured using standard laboratory blood analysis. Higher values indicate poorer glycaemic control.	At baseline, 3, 6 and 12 month.
Glycated haemoglobin (HbA1c) (%)	Glycated haemoglobin (HbA1c) reflects average blood glucose levels over the preceding two to three months and is measured using standard laboratory blood analysis. Higher values indicate poorer long-term glycaemic control.	At baseline, 3, 6 and 12 month.
Triglycerides (mmol/L)	Triglycerides are a lipid biomarker measured using standard laboratory blood analysis to assess circulating triglyceride levels. Higher values indicate poorer lipid profiles and increased cardiometabolic risk.	At baseline, 3, 6 and 12 month
High-density lipoprotein cholesterol (HDL-C) (mmol/L)	High-density lipoprotein cholesterol (HDL-C) is a lipid biomarker measured using standard laboratory blood analysis to assess protective cholesterol levels. Lower values indicate poorer lipid profiles and increased cardiometabolic risk.	At baseline, 3, 6 and 12 month.

Collaborators and Investigators

• Sponsor: National University Health System, Singapore

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027

Study Registration Dates

• First Submitted: June 24, 2025
• First Submitted That Met QC Criteria: February 7, 2026
• First Posted (Actual): February 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Metabolic Diseases; Glucose Metabolism Disorders; Insulin Resistance; Hyperinsulinism; Nutritional and Metabolic Diseases; Metabolic Syndrome
• Other Study ID Numbers: NUS-IRB-2024-866

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No