Effektiviteten af telenutrition til behandling af overvægtige patienter med fedme og/eller høj kardiometabolisk risiko (TOOLBAR)
Effekten af telenutrition (OBE-COACH) til behandling af overvægtige patienter med fedme og/eller høj kardiometabolisk risiko
The OBE-COACH program is an automated online nutritional coaching service that was evaluated in its first version (MXS-CARE program) in a clinical trial coordinated by our team, in type 2 diabetic patients with abdominal obesity. Results have confirmed the efficiency of the program to improve lifestyle habits, including the 4-month diet, and to reduce weight and HbA1c levels.
Based on our experience and the scientific literature, the investigators assume that adherence to the program may diminish in the long term to the point of calling into question its efficiency. So IRIADE compagny developed an enhanced program called OBE-COACH. The OBE-COACH program has been specifically designed to facilitate long-term user adherence. The OBE-COACH program, integrates a bidirectional interactive link between the patient and an automated support system (IRIADE-MED system) associated with an inexpensive remote human support.
In the TOOLBAR study, the investigators will evaluate the efficiency of the OBE-COACH solution in a population of obese patients or overweight persons with at least one cardiometabolic risk factor.
A group of patients will have access to the OBE-COACH program. It will be compared to a control group which will receive an e-learning program with free access to advice sheets via the web, to a menu generator, videos and a catalog of physical activity, (resources made available by the web site www.mangerbouger.fr (public health France, ministry in charge of health) . Indeed, the investigators judged that the loss of patients during follow-up would be greater if e-learning was not offered in the control group.
Studieoversigt
Status
Betingelser
Detaljeret beskrivelse
The management of patients in the TOOLBAR study will be in accordance with French recommendations: a patient who is overweight should benefit from a dietary, physical activity, psychological assistance and medical monitoring advices which can be provided by a general practitioner. In the control group, subjects have access to an e-learning program, including free access via the web to a nutritional information portal and to automated tools providing information and advice for adopting a balanced, low-carb diet and to practice physical activity in line with the guidelines of the national health nutrition plan (PNNS). However, this group will not have access to the OBE-COACH program. The usual follow-up with the attending doctor will be continued.
Patients will be assessed at baseline, 6 months and 12 months. In an ancillary study they could be also assessed at 24 months.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Paris, Frankrig, 75013
- Hôpital La Pitié Salpêtrière
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Men or women 18 to 75 years
- Obesity defined by a body mass index > 30 kg / m2 or a BMI> 25 kg / m2 with the presence of at least one major cardiometabolic risk factors among the followings: dyslipidemia, hypertension, diabetes, prediabetes
- Stable weight in the last six months (weight variation < 4 kg peak-to-peak)
- Access and current use of internet, possession of an email address and a smartphone.
- Understanding and reading French
- Patient not currently following a nutritional monitoring and not having planned to be engaged in a nutritional monitoring during the coming year
Exclusion Criteria:
- Excessive alcohol consumption > 30 g / day -Pregnant or breastfeeding woman
- symptomatic cardiovascular disease : angina, lower extremity arterial occlusive disease, stroke or myocardial infarction dating of less than 6 months.
- Uncontrolled psychiatric illness
- Patients receiving or about to receive during the study period a systemic or local treatment susceptible to interfere with the evaluation of the primary criteria (corticosteroids, antipsychotics, tricyclic antidepressants) except if these treatments have been stable for at least 6 months without a plan to modify the dose during the 12 months of the study
- Adhering to a prescribed diet for weight loss, in the past 3 months
- Person with a severe eating disorder: bulimia, binge eating disorder according to DSM-V criteria - Presence of celiac disease, Crohn's disease or other metabolic disorder or condition affecting nutritional needs such as allergies or food intolerances (except partial lactose intolerance)
- Anticipated difficulties in following the patient
- Lack of social coverage in France
- Lack of written or electronic informed consent
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: OBE-COACH program
The OBE-COACH experimental group: access to the complete OBE-COACH program |
OBE-COACH works through private exchanges between the user and an automatic generator of recommendations, advice and messages of encouragement. Web focus groups are propoposed by specialist to respond to the questions of the participants and a tele-interview at 6 months with a dietetician to encourage and assist the patient to make the best use of the program. The program is divided into missions to perform. These missions are grouped into 10 families. The completion of each mission and the correct answers to the quiz offer points and bonuses. To promote better adherence to the program, missions are not repetitive. They are proposed to surprise the user and constantly renew his desire to connect to the program and achieve goals. The intensity level of the program is selected by the user at any time. Connected devices provide to patient are auto-tensiometer and balance. These devices will not be connected to the OBE-COACH program. The auto-tensiometer (Tensio-screen, Terraillon) is a connected tensiometer allowing the patient to measure by himself with an armband his systolic and diastolic blood pressure and his heart rate. The balance (Web coach premium, Terraillon) is a connected scale to collect body weight. The Activity Tracer (activi-T band, Terraillon) is a a wristband connected activity tracer worn on the wrist that tracks the patient's physical activity and calculates the number of steps, distance traveled and calories burned. The Activity Tracer will not be connected to the OBE-COACH program. |
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Aktiv komparator: e-learning program
The control group: access to an e-learning program with free access via the web to advice sheets, a menu generator and a catalog of physical activity (resources made available by the site www.mangerbouger.fr ; Public Health France, Ministry of Health) and provision of connected devices (auto-tensiometer and balance). |
Connected devices provide to patient are auto-tensiometer and balance. These devices will not be connected to the OBE-COACH program. The auto-tensiometer (Tensio-screen, Terraillon) is a connected tensiometer allowing the patient to measure by himself with an armband his systolic and diastolic blood pressure and his heart rate. The balance (Web coach premium, Terraillon) is a connected scale to collect body weight. The Activity Tracer (activi-T band, Terraillon) is a a wristband connected activity tracer worn on the wrist that tracks the patient's physical activity and calculates the number of steps, distance traveled and calories burned. The Activity Tracer will not be connected to the OBE-COACH program. e-learning program with free access via the web to advice sheets, a menu generator and a catalog of physical activity (resources made available by the site www.mangerbouger.fr ; Public Health France, Ministry of Health) |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Weight reduction of at least 5% between 0 and 12 months.
Tidsramme: 12 months
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Weight reduction of at least 5% between 0 and 12 months. The weight, in Kg, will be measured in a state of fastness ≥ 8h, in participants wearing light clothing without shoes on the same scales calibrated at inclusion and 12 months of follow-up. |
12 months
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Ændring mellem 0 og 12 måneders proteinindtag, i g/dag, evalueret med det validerede NAQA-spørgeskema
Tidsramme: 12 måneder
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12 måneder
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Ændring mellem 0 og 12 måneders saccharoseindtag i g/dag, evalueret med det validerede NAQA-spørgeskema
Tidsramme: 12 måneder
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12 måneder
|
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Ændring mellem 0 og 12 måneders lipidindtag i g/dag, evalueret med det validerede NAQA-spørgeskema
Tidsramme: 12 måneder
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12 måneder
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Ændring mellem 0 og 12 måneders calciumindtag i mg/dag, evalueret med det validerede NAQA-spørgeskema
Tidsramme: 12 måneder
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12 måneder
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Skift mellem 0 og 12 måneders forbrug af sukkerholdige drikkevarer i antal glas/dag
Tidsramme: 12 måneder
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12 måneder
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Skift mellem 0 og 12 måneders alkoholforbrug i antal glas/dag
Tidsramme: 12 måneder
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12 måneder
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Skift mellem 0 og 6 måneders forbrug af sukkerholdige drikkevarer i antal glas/dag
Tidsramme: 6 måneder
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6 måneder
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Skift mellem 0 og 6 måneders alkoholforbrug i antal glas/dag
Tidsramme: 6 måneder
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6 måneder
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Skift mellem 0 og 12 måneders tobaksforbrug i antal cigaretter/dag
Tidsramme: 12 måneder
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12 måneder
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Skift mellem 0 og 6 måneders tobaksforbrug i antal cigaretter/dag
Tidsramme: 6 måneder
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6 måneder
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Ændring mellem 0 og 12 måneders Overholdelse af WHOs anbefalinger for fysisk aktivitet, målt i Metabolic Equivalent of Task, MET, evalueret med GPAQ-spørgeskemaet.
Tidsramme: 12 måneder
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12 måneder
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Ændring mellem 0 og 6 måneders Overholdelse af WHOs anbefalinger for fysisk aktivitet, målt i Metabolic Equivalent of Task, MET, evalueret med GPAQ-spørgeskemaet.
Tidsramme: 6 måneder
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6 måneder
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Overholdelse af OBE-COACH-programmet efter 12 måneder, evalueret ved den gennemsnitlige procentdel af spørgsmål (sendt af IRIADE) med svar fra emnet om ugen i løbet af den foregående måned.
Tidsramme: 12 måneder
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12 måneder
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Overholdelse af OBE-COACH-programmet efter 12 måneder, evalueret ved antallet af deltagelse i webfokusgrupper i løbet af de sidste 6 måneder.
Tidsramme: 12 måneder
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12 måneder
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Overholdelse af OBE-COACH-programmet efter 6 måneder, evalueret ved den gennemsnitlige procentdel af spørgsmål (sendt af IRIADE) med svar fra emnet om ugen i den foregående måned.
Tidsramme: 6 måneder
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6 måneder
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Overholdelse af OBE-COACH-programmet efter 6 måneder, vurderet ud fra antallet af deltagelse i webfokusgrupper i løbet af de sidste 6 måneder.
Tidsramme: 6 måneder
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6 måneder
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Skift mellem 0 og 12 måneders madimpulsivitet evalueret af TFEQ21-spørgeskemaet
Tidsramme: 12 måneder
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12 måneder
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Skift mellem 0 og 6 måneders madimpulsivitet evalueret af TFEQ21-spørgeskemaet
Tidsramme: 6 måneder
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6 måneder
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Udvikling mellem 0 og 12 måneder af Symptomer på angst, målt med HAD-spørgeskemaet (score 0 til 21)
Tidsramme: 12 måneder
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12 måneder
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Weight reduction of at least 5% between 0 and 6 months.
Tidsramme: 6 months
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Weight, in Kg, measured in the same conditon at baseline and 6 months. |
6 months
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Weight change between 0 and 6 months
Tidsramme: 6 months
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Weight, in Kg, measured in the same conditon at baseline and 6 months. |
6 months
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Weight change between 0 and 12 months
Tidsramme: 12 months
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Weight, in Kg, measured in the same conditon at baseline and 12 months. |
12 months
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Waist change between 0 and 6 months
Tidsramme: 6 months
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Waist, in cm, measured midway between the last ribs and the anterior superior iliac crest |
6 months
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Waist change between 0 and 12 months
Tidsramme: 12 months
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Waist, in cm, measured midway between the last ribs and the anterior superior iliac crest |
12 months
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Triglycerids change between 0 and 12 months
Tidsramme: 12 months
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Plasma fasting levels of triglycerides in g/L |
12 months
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HDL cholesterol change between 0 and 12 months
Tidsramme: 12 months
|
Plasma fasting levels of HDL cholesterol in g/L |
12 months
|
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LDL cholesterol change between 0 and 12 months
Tidsramme: 12 months
|
Plasma fasting levels of LDL cholesterol in g/L |
12 months
|
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non-HDL cholesterol change between 0 and 12 months
Tidsramme: 12 months
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Plasma fasting levels of non-HDL cholesterol in g/L (total cholesterol less HDL-C) |
12 months
|
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Blood glucose change between 0 and 12 months
Tidsramme: 12 months
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Plasma fasting levels of glucose in g/L |
12 months
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HbA1c change between 0 and 12 months
Tidsramme: 12 months
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Plasma fasting levels of HbA1c in percentage |
12 months
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Systolic blood pressure change between 0 and 12 months
Tidsramme: 12 months
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Systolic blood pressure in mmHg as the average of the last 2 automatic measurements out of 3 taken at the level of one arm and spaced about 2 min in the cabinet or by the patient with the auto-tensiometer |
12 months
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Diastolic blood pressure change between 0 and 12 months
Tidsramme: 12 months
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Diastolic blood pressure in mmHg as the average of the last 2 automatic measurements out of 3 taken at the level of one arm and spaced about 2 min in the cabinet or by the patient with the auto-tensiometer |
12 months
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Triglycerids change between 0 and 6 months
Tidsramme: 6 months
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Plasma fasting levels of triglycerides in g/L |
6 months
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HDL cholesterol change between 0 and 6 months
Tidsramme: 6 months
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Plasma fasting levels of HDL cholesterol in g/L |
6 months
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LDL cholesterol change between 0 and 6 months
Tidsramme: 6 months
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Plasma fasting levels of LDL cholesterol in g/L |
6 months
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non-HDL cholesterol change between 0 and 6 months
Tidsramme: 6 months
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Plasma fasting levels of non-HDL cholesterol in g/L (total cholesterol less HDL-C) |
6 months
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Blood glucose change between 0 and 6 months
Tidsramme: 6 months
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Plasma fasting levels of glucose in g/L |
6 months
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HbA1c change between 0 and 6 months
Tidsramme: 6 months
|
Plasma fasting levels of HbA1c in percentage |
6 months
|
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Systolic blood pressure change between 0 and 6 months
Tidsramme: 6 months
|
Systolic blood pressure in mmHg as the average of the last 2 automatic measurements out of 3 taken at the level of one arm and spaced about 2 min in the cabinet or by the patient with the auto-tensiometer |
6 months
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Diastolic blood pressure change between 0 and 6 months
Tidsramme: 6 months
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Diastolic blood pressure in mmHg as the average of the last 2 automatic measurements out of 3 taken at the level of one arm and spaced about 2 min in the cabinet or by the patient with the auto-tensiometer |
6 months
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Change in adherence to the Mediterranean diet : Score PREDIMED
Tidsramme: 12 months
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Change between 0 and 12 months of adherence to mediterranean diet,evaluated by the dietetic score PREDIMED (validated checklist of 14 items). Higher scores indicate greater adherence to the diet assigned |
12 months
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Change in adherence to the Mediterranean diet : fruits and vegetables consumption
Tidsramme: 12 months
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Change between 0 and 12 months in terms of perrcentage of consumption of fruits and vegetables on the recommended 400 g/day |
12 months
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Change in adherence to the Mediterranean diet : Score PREDIMED
Tidsramme: 6 months
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Change between 0 and 6 months of adherence to mediterranean diet,evaluated by the dietetic score PREDIMED (validated checklist of 14 items). Higher scores indicate greater adherence to the diet assigned |
6 months
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Change in adherence to the Mediterranean diet : fruits and vegetables consumption
Tidsramme: 6 months
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Change between 0 and 6 months in terms of percentage of consumption of fruits and vegetables on the recommended 400 g/day |
6 months
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Change between 0 and 12 months of Energy intake
Tidsramme: 12 months
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Energy intake, in Kcal/day, evaluated with the validated NAQA questionnaire |
12 months
|
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Change between 0 and 12 months of cholesterol intake
Tidsramme: 12 months
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Cholesterol intake, in mg/day, evaluated with the validated NAQA questionnaire |
12 months
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Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Marylou Para, MD, PhD, Assistance Publique - Hôpitaux de Paris
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- K160908J
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Data are available upon reasonable request. The procedures carried out with the French data privacy authority (CNIL, Commission nationale de l'informatique et des libertés) do not provide for the transmission of the database, nor do the information and consent documents signed by the patients.
Consultation by the editorial board or interested researchers of individual participant data that underlie the results reported in the article after deidentification may nevertheless be considered, subject to prior determination of the terms and conditions of such consultation and in respect for compliance with the applicable regulations.
IPD-delingstidsramme
Beginning 3 months and ending 3 years following article publication. Requests out of these time frame can also be submitted to the sponsor
IPD-delingsadgangskriterier
Researchers who provide a methodologically sound proposal
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
- ICF
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