Summary: In this 93-patient Turkish randomized controlled trial, adults with metabolic syndrome who received more frequent dietitian counseling improved more than minimally counseled controls. Both intervention arms achieved greater reductions in waist circumference, BMI, and body weight (all p<0.001 to p=0.002), and adding weekly telehealth to monthly visits was associated with further fasting glucose and blood pressure benefits. Counseling frequency independently predicted improvement in metabolic syndrome criteria (adjusted R²=0.313; p<0.001).
PICO Summary
| Element | Detail |
|---|---|
| Population | 93 adults with metabolic syndrome; single-centre randomized controlled trial, Turkey; 12-week follow-up. |
| Intervention | Two graded arms of medical nutrition therapy: standard intervention (IG, n=31) with four in-person visits (baseline, weeks 4, 8, 12); intensive intervention (IIG, n=30) with the same four visits plus weekly telehealth calls. |
| Comparison | Control group (CG, n=32) receiving minimal contact: two in-person visits only (baseline and week 12). |
| Outcome | Both intervention arms reduced waist circumference (p<0.001), BMI (p<0.001) and body weight (p=0.002) more than control. The intensive (telehealth) arm additionally improved fasting plasma glucose (p<0.001; η²=0.215) and blood pressure (systolic p<0.001, η²=0.276; diastolic p<0.001, η²=0.148). In multivariable regression, counseling frequency independently predicted improvement in metabolic syndrome criteria (F=9.395; p<0.001; adjusted R²=0.313). No confidence intervals, absolute risk reductions, or NNT were reported; effect sizes are partial eta-squared. No adverse effects were reported. |
Counseling frequency + telehealth in metabolic syndrome
RCT · metabolic syndrome · 12 weeks
More frequent dietitian counseling improved waist, BMI and weight versus minimal contact, and adding weekly telehealth was associated with further glucose and blood-pressure gains. Single-centre, 93 patients, 12 weeks, no confidence intervals reported.
Expert Commentary
This trial supports a sensible dose-response message: in metabolic syndrome, more frequent dietitian contact yields greater short-term anthropometric improvement, and layering weekly telehealth onto monthly visits is associated with additional glycaemic and blood-pressure gains. The randomized design and the independent contribution of counseling frequency in regression strengthen the signal beyond a simple before-after observation. The headline should still be read with restraint. This is a single-centre study of only 93 patients followed for 12 weeks, so durability of weight, glucose, and blood-pressure changes, and any effect on hard cardiometabolic endpoints, remains untested. As a behavioral nutrition intervention it cannot be blinded, which invites performance and attention bias, and the extra telehealth arm by design received more total contact, so the marginal benefit attributed to telehealth is partly a benefit of more counseling overall. Reported effect sizes are partial eta-squared rather than between-group differences with confidence intervals, which limits clinical interpretation. Can I use this with my patients? Cautiously yes, for a motivated adult with metabolic syndrome who can engage with scheduled visits plus remote check-ins, recognising the evidence is short-term and exploratory rather than proof of lasting risk reduction. I would like to see a larger multicentre trial with longer follow-up and a contact-matched comparator before treating telehealth intensity as the active ingredient.
References
Yıldız-Güler K, Vural-Keskinler M, Fisunoğlu M. Nutrition Counseling Frequency and Telehealth Integration on Cardiometabolic Outcomes in Metabolic Syndrome: A Randomized Controlled Trial in Turkey. Medicina (Kaunas). 2025;61(12):2124. doi:10.3390/medicina61122124
