Effectiveness of wearable technology for lifestyle modification in improving health outcomes among adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials

Abstract

Background: Obesity is a rising concern worldwide and wearable technologies can be an innovative solution. Methodological limitations were found in previous reviews, further investigation is necessary. Aims: To assess the effectiveness of wearable technology intervention in improving weight, body mass index (BMI), waist circumference (WC), physical activity (PA) and energy intake among overweight or obese adults. Data sources: Ten electronic databases were searched from inception to December 2020 using a three-step search strategy. Eligibility criteria: All types of randomised controlled trials (RCT) in English languages were included. Population including overweight and/or obese adults. Intervention was wearable technology for lifestyle modification. Comparator included waitlist, usual care and placebo group. Outcomes included weight, body mass index, energy intake and physical activity. Data extraction: A standardized extraction was developed to extract the data based on Cochrane Handbook. Appraisal: The Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluations were adopted for individual and overall evidence. Synthesis methods: Meta-analyses were performed using RevMan software. The overall effect was evaluated using Z statistics and heterogeneity was assessed using Cochran Q and I2 tests. Subgroup and sensitivity analyses were attempted to explain heterogeneity. Results: A total of 30 RCTs was included among 5,391 adults from 11 countries. Meta-analyses found a significant improvement in weight, BMI, WC, PA, fat percent and blood pressure. Subgroup analyses suggested that intervention was effective for non-Asian adults aged ≥ 50 years in hospital setting by combining PA, dietary advice and weight management for 3-12 months. Majority (84.44%) had low risk of bias and overall evidence ranged from low to high. Implications: Results provide knowledge in designing future intervention and contributing clinical practice. Future research: Future trial requires a large sample size. Conclusion: Wearable technology is an effective intervention in adults with obesity and overweight.