Background:Malnutrition (excess or defect) and sedentariness act as an accelerator in the older people frailty process. A systemic solution has been developed to engage older people in a healthier lifestyle using serious games and food monitoring. The study aimed to evaluate protocol influence on variables related to unhealthy behaviors improving dietary habits through a remote nutritional coaching approach and stimulating the population to increase physical activity through Exergames.Methods:Thirty-two subjects (25 Treatments and 7 Controls, aging 65–80 years), of which 15 (11 Treatments and 4 Controls) living in the UK (ACCORD and ExtraCare Villages placed in Shenley Wood (Milton Keynes), St. Crispin (Northampton), and Showell Court (Wolverhampton)) and 17 (14 Treatments and 3 Controls) in Italy (Genoa, Liguria), were recruited and characterized in terms of nutritional status, physical, somatometric, hemodynamic and biochemical measurements, and body composition. Participants were stimulated to adopt the Mediterranean dietary pattern, by a food diary diet-app, and perform regular physical activity, by the Exergame app, for three months. At the end of the trial, users underwent the same test battery. Data were tested for normality of distribution by the Shapiro-Wilk test. Comparisons between groups were performed at baseline by unpaired Student’s t-test for continuous variables, chi-square test, or Fisher’s exact test for categorical variables. Analysis of Variance (ANOVA) for repeated measures was used to analyze the significance of changes over time between groups. Results:At the end of the trial, significant reductions of systolic (15 mmHg, P = 0.001), diastolic (5 mmHg, P = 0.025), mean (10 mmHg, P = 0.001) blood pressure, and rate-pressure product (RPP) (1,105 mmHg *bpm, P = 0.017) values were observed in DOREMI users. A trend of improvement of physical performance by the short physical performance battery (SPPB) was observed for balance and walk subtests. A significant decrease (0.91 kg, P = 0.043) in Body Mass Index (BMI) was observed in overweight subjects (BMI >25 kg/m 2) after DOREMI intervention in the entire population. The Mini Nutritional Assessment (MNA) score (1, P = 0.004) significantly increased after intervention, while waist measure (3 cm, P <0.001) significantly decreased in the DOREMI users. A reduction in glycated hemoglobin (Hb) was registered (0.20%, P = 0.018) in the DOREMI UK users. Conclusions:Improvement of healthy behavior by technological tools, providing feedback between user and remote coach and increasing user’s motivation, appears potentially effective. This information and communication technologies (ICT) approach offers an innovative solution to stimulate healthy eating and lifestyle behaviors, supporting clinicians in patient management.

Nutrition;Physical activity;Elderly;Healthy aging;Information and communication technologies

Vozzi Federico;Palumbo Filippo;Ferro Erina;Kreiner Karl;Giugni Franca;Dutton Rachel;Hall Shirley;Musian Daniele;Parolini Marina;Riso Patrizia;Parodi Oberdan

Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy;Institute of Science and Information Technology ISTI-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy;Austrian Institute of Technology AIT, Giefinggasse 4, Wien, Austria;Fry Accord, 178 Birmingham Road, West Bromwich, West Midlands, United Kingdom;The ExtraCare Charitable Trust, 7 Harry Weston Road, Binley, Coventry, United Kingdom;SI4Life Scrl, Corso Podestà 1/21-22-23, Genoa, Italy;Institute of Clinical Physiology IFC-CNR, ASST Grande Ospedale Metropolitano Niguarda, Piazzale Ospedale Maggiore 3, Milan, Italy;Department of Food, Environmental and Nutritional Sciences DEFENS, University of Milan, Via Luigi Mangiagalli, 25, Milan, Italy;Fondazione Toscana Gabriele Monasterio FTGM, Via Giuseppe Moruzzi 1, Pisa, Italy

智慧医学（英文）

[1]Vozzi Federico;Palumbo Filippo;Ferro Erina;Kreiner Karl;Giugni Franca;Dutton Rachel;Hall Shirley;Musian Daniele;Parolini Marina;Riso Patrizia;Parodi Oberdan-.Nutritional and physical improvements in older adults through the DOREMI remote coaching approach: a real-world study)[J].智慧医学（英文）,2022(04):181-192

DOREMI,coaching,sedentariness,Exergames,ExtraCare,Villages,Shenley,Keynes,Crispin,Northampton,Showell,Wolverhampton,Genoa,Liguria,somatometric,diary,Exergame,mmHg ,subtests

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