Effectiveness of mH( )ealth diet interventions in cancer survivors: A systematic review and meta-analysis of randomized controlled trials

Objective: To evaluate the effects of mobile health (mHealth) diet interventions on cancer survivors' diet intake, weight change, waist circumference, hip circumference, and quality of life (QoL).Methods: The PubMed, Embase, Web of Science, Cochrane Library, Scopus, ProQuest, China National Knowledge Infrastructure, Wanfang, and SinoMed databases were searched from their inception to September 25, 2022. Randomized controlled trials (RCTs) on the effects of mHealth diet interventions in cancer survivors were identified. Two researchers independently selected the included studies and appraised their quality. The meth-odological quality of the included studies was assessed using the Revised Cochrane risk-of-bias tool for RCTs (RoB2).Results: A total of 15 RCTs involving 2363 cancer survivors were included. MHealth diet interventions signifi-cantly improved fruit and vegetable intake (standardized mean difference [SMD] = 0.19, 95% confidence interval [CI] [0.05, 0.33], P < 0.01), and QoL (SMD = 0.13, 95% CI [0.01, 0.26], P = 0.04) and reduced fat intake (SMD =-0.22, 95% CI [-0.34,-0.11], P < 0.01), weight (SMD =-0.35, 95% CI [-0.48,-0.22], P < 0.01), waist circumference (MD =-1.43, 95% CI [-2.33,-0.53], P < 0.01), and hip circumference (MD =-3.54, 95% CI [-4.88,-2.19], P < 0.01) in cancer survivors. No significant differences were observed in energy intake (P = 0.46) or whole grain intake (P = 0.14). Conclusions: MHealth diet interventions may be an effective strategy for cancer survivors. Large-scale RCTs with rigorous study designs are needed to examine the effect of diet intervention delivered via mHealth.