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To improve the outreach for populations in need, many mobile health apps targeting weight loss have been developed with limited scientific evaluation of these apps. The present feasibility study investigated the effects of a novel approach incorporating\u00a0a regular \u2018whole food-based\u2019 low-calorie diet combined with app-based digital education and behavioral change program on glucose metabolism and disease management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twenty-four individuals with type 2 diabetes followed this approach supported by weekly coaching calls for 12\u00a0weeks. Phenotyping included bioimpedance analysis, mixed-meal tolerance test, magnetic resonance spectroscopy and transient elastography for assessing liver fat content and liver stiffness.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over 12\u00a0weeks, participants reduced their body weight by 9% (97\u2009\u00b1\u200913 to 88\u2009\u00b1\u200912\u00a0kg), body mass index (BMI; 33\u2009\u00b1\u20095 to 29\u2009\u00b1\u20094\u00a0kg\/m<jats:sup>2<\/jats:sup>), total fat mass (31\u2009\u00b1\u200910 to 27\u2009\u00b1\u200910%) (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and liver fat by 50% alongside with decreased liver stiffness. Target HbA1c (&lt;\u20096.5%) was achieved by 38% and resolution of NAFLD (liver fat content\u2009&lt;\u20095.6%) was observed in 30% of the participants.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This novel approach combining digital education with a low-calorie diet results in effective improvements of body weight, glycemic control and NAFLD and could complement existing care for patients with type 2 diabetes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT04509245<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00394-021-02521-3","type":"journal-article","created":{"date-parts":[[2021,4,11]],"date-time":"2021-04-11T10:02:28Z","timestamp":1618135348000},"page":"3811-3818","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Improving insulin sensitivity, liver steatosis and fibrosis in type 2 diabetes by\u00a0a food-based digital education-assisted lifestyle intervention program: a feasibility study"],"prefix":"10.1007","volume":"60","author":[{"given":"Oana P.","family":"Zaharia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuliya","family":"Kupriyanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanislava","family":"Karusheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Markgraf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kantartzis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas L.","family":"Birkenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trenell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Sahasranaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Cheyette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"K\u00f6ssler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K\u00e1lm\u00e1n","family":"B\u00f3dis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Burkart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Hee","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Roden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5185-8168","authenticated-orcid":false,"given":"Julia","family":"Szendroedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik H.","family":"Pesta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,11]]},"reference":[{"issue":"2","key":"2521_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1159\/000443344","volume":"9","author":"European Association for the Study of the L","year":"2016","unstructured":"European Association for the Study of the L (2016) EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. 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Metabolism: clinical and experimental 63 (4):554\u2013561. doi:https:\/\/doi.org\/10.1016\/j.metabol.2014.01.002","DOI":"10.1016\/j.metabol.2014.01.002"}],"container-title":["European Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-021-02521-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00394-021-02521-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-021-02521-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T15:07:29Z","timestamp":1631545649000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00394-021-02521-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,11]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["2521"],"URL":"https:\/\/doi.org\/10.1007\/s00394-021-02521-3","relation":{},"ISSN":["1436-6207","1436-6215"],"issn-type":[{"value":"1436-6207","type":"print"},{"value":"1436-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,11]]},"assertion":[{"value":"26 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Michael Roden serves as investigator of studies supported by Boehringer-Ingelheim Pharma, Nutriticia \/ Danone and Sanofi and has served as advisor\/consultant for Bristol-Myers Squibb, Eli Lilly, Gilead, Intercept Pharma, Novo Nordisk, Novartis, Poxel, Prosciento, Sanofi, Servier and TARGET NASH. Michael Trenell is co-founder of Changing Health Ltd, a spin-out company from Newcastle University and Newcastle upon Tyne NHS Hospitals Trust. Chris Cheyette authored the recipe book \u2018Carbs & Cals\u2019 and is managing director at Chello Publishing Limited.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was\u00a0approved by local institutional review boards (ethics boards Heinrich-Heine-University D\u00fcsseldorf, reference number 4508, amendment 20, and University Hospital T\u00fcbingen reference number 385\/2018BO2), registered with clinical trials.gov NCT04509245 and was performed according to the Declaration of Helsinki. All persons gave their informed consent prior to their inclusion in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}