Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION): Study protocol for a randomized controlled trial of a web-based platform integrating nutrition, physical activity, and mindfulness for individuals with obesity.

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m2 and aged 40-65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity.

The Chilean Diet: Is It Sustainable?

Food systems are one of the main contributors to climate change. Sustainable diets are one strategy to mitigate climate change. Assessments and estimations at a national level are lacking, especially in the Global South, probably due to a lack of national surveys of food consumption and a limited interest in sustainable diets information. The objective of this study is to estimate and describe the carbon and water footprint of the Chilean population's diet in an overall estimation desegregated by region, age, sex, socioeconomic level and their main characterizations. This study is based on a secondary data analysis from the National Survey of Food Consumption made in 2010. The carbon and water footprint of the food subgroups/person/day were estimated. The results are compared by sex, age group, socioeconomic level, and macro zone. A carbon footprint of 4.67 kg CO2eq and a water footprint of 4177 L, both per person/day, were obtained. Animal-sourced foods, such as dairy and red meat, were responsible for 60.5% of the total carbon footprint and 52.6% of the water footprint. The highest values for both footprints were found in the following groups: men, adolescents, young adults, people with a higher socioeconomic level, and residents in the southern area of the country. The carbon footprint and water footprint values in Chile generated by food consumption would be above the world averages. Transforming the Chilean food system into a more sustainable one with changes in eating patterns is urgently required to attain this transformation.