Introduction: Obesity in childhood and adolescence represents one of the most challenging public health problems of our century, and is associated with significant morbidity and mortality, as well as increased public health costs. To address the obesity epidemic more effectively, the World Health Organization suggests the development and implementation of reliable e-Health systems (digital technologies, such as electronic health records (EHRs), clinical decision support systems (CDSS) and mobile health tools) that would monitor the daily behavior objectively. Our objective was to determine the effectiveness of BigO system in the prevention and management of childhood obesity. Methods: Our study was part of the four-year European BigO project (http://bigoprogram.eu, Horizon2020, No.727688). One thousand seven hundred and twenty-seven (n=1727) children and adolescents (mean age ± SD: 12.6 ± 2.4; 898 males, 829 females) were studied prospectively following approval by the local Ethics Human Research Committee. The data collection system included the BigO technology platform, which interfaces with a Smartphone and Smartwatch, and records data objectively (using inertial sensors and GPS) for each patient. Data were transmitted to BigO servers to extract behavioral indicators. Participants used the BigO system for at least 4 weeks. Subsequently, they entered a personalized lifestyle intervention program of diet, physical exercise and sleep for 6 months and used the system again for 4 weeks. Results: Subjects were classified as having obesity (n=1277, 73.9%), overweight (n=413, 23.9%) or normal BMI (n=37, 2.1%) according to WHO cut-off points. At the end of the study, the proportion of subjects with obesity decreased, while the proportion of subjects with overweight and normal BMI increased. The BigO system monitored the daily behavior of all subjects objectively and effectively, and provided detailed information on their diet, physical activity and sleep habits, as well as the availability of exercise facilities in their communities and their living conditions. Conclusion: These novel e-health applications and digital technologies were effective at collecting and analyzing objective data about the daily behavior of children and adolescents with overweight and obesity. Therefore, they may be useful to use in clinical practice and to design public health policies to address the epidemic of childhood obesity.
Kassari et al. (Mon,) studied this question.