Impact of Dietetic Counseling Combined With Digital Tools on Obesity-Related Indices in Greek Adults: The GATEKEEPER Study
In brief
Digital tools raise activity by 55 MET-minutes weekly without extra waist loss
In a 3-month trial of 954 Greek adults over 55 at risk for metabolic syndrome, monthly dietitian counseling reduced waist circumference in all groups, but adding a web platform or devices did not produce larger waist reductions. The platform-plus-devices group increased physical activity by about 55 MET-minutes per week, while metabolic measures improved similarly across groups.
- Journal
- Obesity (Silver Spring, Md.) (Q1)
- Published
- 18 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Rafaela Makri, Iliana Evangelou, Eva Karaglani, Maria Vlachava, George E Dafoulas, Ioanna Drympeta, et al.
- PMID
- 42759999
- DOI
- 10.1002/oby.70284
Why clinicians should know about it
- Picked for Family Practice (top studies of the week, 20 September 2026): RCT of dietetic counseling with digital tools in older adults
Abstract
OBJECTIVE: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05031299.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.