Impact of Dietetic Counseling Combined With Digital Tools on Obesity-Related Indices in Greek Adults: The GATEKEEPER Study.

Abstract

This study aimed to evaluate the effectiveness of dietetic counseling with digital tools on obesity-related and metabolic outcomes in adults aged ≥ 55 years at high risk for metabolic syndrome (MetS). In this 3-month randomized controlled trial, 984 adults aged ≥ 55 years with ≥ 1 MetS risk factor were randomized (1:1:1) to: standard care (monthly dietetic counseling), standard care plus web-based platform, or standard care plus platform and digital devices. Analyses included 954 participants and used linear mixed-effect models under a missing-at-random assumption adjusted for age and sex. The primary outcome was change in waist circumference. Secondary outcomes included BMI, body composition indices, physical activity, and glycemic markers. Waist circumference decreased in all groups (-6.29, -4.92, -4.69 cm), with smaller reductions in the platform (MD -1.38 cm; 95% CI -2.37 to -0.38) and platform + devices groups (MD -1.61 cm; 95% CI -2.61 to -0.60). BMI, body composition indices, and glycemic markers improved similarly across groups. Physical activity increased more in the platform + devices group (MD +55.52 MET-min/week; 95% CI 15.32 to 95.72). Dietetic counseling improved anthropometric and metabolic outcomes in adults at risk for MetS. Digital tools enhanced physical activity but did not provide additional short-term metabolic benefits. ClinicalTrials.gov identifier: NCT05031299.