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Title: Effectiveness of eHealth nutritional interventions for middle-aged and older adults: Systematic review and meta-analysis
Authors: Robert, Caroline 
Erdt, Mojisola
Lee, James
Cao, Yuanyuan
Naharudin, Nurhazimah Binte
Theng, Yin-Leng
Keywords: EHealth
Nutrition apps
Nutritional intervention
Older adults
Systematic review
Issue Date: 17-May-2021
Publisher: JMIR Publications Inc.
Citation: Robert, Caroline, Erdt, Mojisola, Lee, James, Cao, Yuanyuan, Naharudin, Nurhazimah Binte, Theng, Yin-Leng (2021-05-17). Effectiveness of eHealth nutritional interventions for middle-aged and older adults: Systematic review and meta-analysis. Journal of Medical Internet Research 23 (5) : e15649. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background: The risk of development of chronic diseases related to poor nutrition increases with age. In the face of an aging population, it is important for health care sectors to find solutions in delivering health services efficiently and effectively to middle-aged and older adults. Objective: The aim of this systematic review and meta-analysis was to consolidate the literature that reported the effectiveness of eHealth apps in delivering nutritional interventions for middle-aged and older adults. Methods: A literature search from five databases (PubMed, CINAHL, Cochrane, Web of Science, and Global Health) from the past 5 years was performed. Studies were selected for inclusion that used eHealth to deliver nutritional interventions to adults aged 40 years and above, and reported health and behavioral outcomes. Two independent reviewers searched for research articles and assessed the eligibility of studies to be included in the review. A third reviewer resolved disagreements on study inclusion. We also assessed the quality of the included studies using the CONSORT 2010 checklist. Results: A total of 70 studies were included for analysis. The study quality ranged from 44% to 85%. The most commonly used eHealth intervention type was mobile apps (22/70, 31%). The majority of studies (62/70, 89%) provided multicomponent health interventions, which aimed to improve nutrition and other health behaviors (eg, exercise, smoking cessation, medication adherence). Meta-analysis results indicated high and significant heterogeneity; hence, conclusions based on these results should be considered with caution. Nonetheless, the results generally showed that eHealth interventions improved anthropometric and clinical outcomes, but not behavioral outcomes such as fruit and vegetable consumption. Conclusions: The use of eHealth apps to deliver health interventions has been increasing in recent years, and these apps have the potential to deliver health services to a larger group of people. Our findings showed that the effectiveness of eHealth apps to deliver health interventions for middle-aged to older adults was supported by the improvement of anthropometric and clinical outcomes. Future work could aim to develop research frameworks in administering eHealth interventions to address heterogeneity in this field of research. © Caroline Robert, Mojisola Erdt, James Lee, Yuanyuan Cao, Nurhazimah Binte Naharudin, Yin-Leng Theng. Originally published in the Journal of Medical Internet Research (, 17.05.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Source Title: Journal of Medical Internet Research
ISSN: 1438-8871
DOI: 10.2196/15649
Rights: Attribution 4.0 International
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