{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:59:04Z","timestamp":1790413144544,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["857223"],"award-info":[{"award-number":["857223"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effectiveness of dietetic counseling with digital tools on obesity\u2010related and metabolic outcomes in adults aged \u2265\u200955\u2009years at high risk for metabolic syndrome (MetS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this 3\u2010month randomized controlled trial, 984 adults aged \u2265\u200955\u2009years with \u2265\u20091 MetS risk factor were randomized (1:1:1) to: standard care (monthly dietetic counseling), standard care plus web\u2010based platform, or standard care plus platform and digital devices. Analyses included 954 participants and used linear mixed\u2010effect models under a missing\u2010at\u2010random 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Waist circumference decreased in all groups (\u22126.29, \u22124.92, \u22124.69\u2009cm), with smaller reductions in the platform (MD \u22121.38\u2009cm; 95% CI \u22122.37 to \u22120.38) and platform + devices groups (MD \u22121.61\u2009cm; 95% CI \u22122.61 to \u22120.60). BMI, body composition indices, and glycemic markers improved similarly across groups. Physical activity increased more in the platform + devices group (MD +55.52 MET\u2010min\/week; 95% CI 15.32 to 95.72).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dietetic counseling improved anthropometric and metabolic outcomes in adults at risk for MetS. Digital tools enhanced physical activity but did not provide additional short\u2010term metabolic benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\/\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT05031299\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70284","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:50:56Z","timestamp":1789779056000},"page":"1849-1859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Dietetic Counseling Combined With Digital Tools on Obesity\u2010Related Indices in Greek Adults: The\n                    <scp>GATEKEEPER<\/scp>\n                    Study"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-1953","authenticated-orcid":false,"given":"Rafaela","family":"Makri","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1458-8995","authenticated-orcid":false,"given":"Iliana","family":"Evangelou","sequence":"additional","affiliation":[{"name":"Lab of Clinical Nutrition\u2010Dietetics, Department of Nutrition\u2010Dietetics, School of Physical Education, Sport Science and Dietetics University of Thessaly  Trikala Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5395-7023","authenticated-orcid":false,"given":"Eva","family":"Karaglani","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1749-0319","authenticated-orcid":false,"given":"Maria","family":"Vlachava","sequence":"additional","affiliation":[{"name":"Lab of Clinical Nutrition\u2010Dietetics, Department of Nutrition\u2010Dietetics, School of Physical Education, Sport Science and Dietetics University of Thessaly  Trikala Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-8888","authenticated-orcid":false,"given":"George E.","family":"Dafoulas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Health Sciences University of Thessaly  Larissa 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