Telemedicine as a tool for dietary intervention in NAFLD-HIV patients during the COVID-19 lockdown: a randomized controlled trial

Summary Background & Aims Given reports of changes in dietary habits during covid-19 lockdown, our aim was to assess weight changes, over a 3-month Covid-19 national lockdown in a cohort of NAFLD-HIV patients on a dietary intervention trial Methods After NAFLD screening in an outpatient Infectious Diseases Clinic, NAFLD patients were randomly allocated to general dietary recommendations (SC group) or to a structured dietary intervention based on the Mediterranean diet (intervention group) During lockdown, follow-up consultations in the intervention group were done by video and/or phone After 3 months of lockdown, all patients (intervention and SC group) consented to a telephone interview which aimed to characterize eating habits and lifestyle changes and evaluate stress and depression Biochemical data when available, was compared between the peri-period of confinement Results One hundred and twelve patients were screened From the 55 NAFDL identified, 27 were allocated to dietary intervention and 28 to SC and were followed before lockdown for a mean period of 5 0±1 5months in which SC group gained a median of 0 65kg vs a median loss of 1 5kg in the intervention group (p<0 001) During lockdown, 93 3% of patients in the SC group referred that “diet got worse” vs 6 7% in the intervention group p<0 01), and 35 3% vs 15 7% (p=0 014) reported increase in appetite, respectively Both groups gained weight, SC group vs 0 7±1 7kg in the intervention group, p<0 001) Higher weight gain was associated with changes in the dietary pattern (3 8 ±2 1kg vs 2 0±1 3kg in “no change in dietary pattern”;p=0 002) Glucose blood levels increased after lockdown in the SC group, with a mean increase of 15mg/dl (p=0 023) The remaining metabolic parameters remained unchanged Conclusion The maintenance of dietary intervention, using telemedicine, can mitigate the adverse change in dietary habits and physical activity pattern, preventing a substantial increase in body weight