E-mail Reminders Can Improve Health Habits

By Margarita Nahapetyan

E-mail reminders on diet and exercise appear to actually work by helping people improve their health habits, according to a study by Kaiser Permanente. Individuals who received regular messages suggesting small ways to eat more healthfully or getting more exercise, increased their activity level and made healthier food choices.

The study, carried out in 2006 and published this week in the June issue of the American Journal of Preventive Medicine, appears to be the first randomized, controlled study to analyze the effect of e-mail on people's health. The findings have demonstrated that individuals who have a support system in place are "better able to maintain the behaviors that keep them working toward or maintaining a healthy weight." According to the latest data from the U.S. National Center for Health Statistics, an estimated 33 per cent of all adults in the United States are overweight, 34 per cent are obese, and 6 per cent suffer from extreme obesity.

The Kaiser Permanente Division of Research study was a randomized controlled trial of the ALIVE (A Lifestyle Intervention Via E-mail) program that involved nearly 800 Kaiser Permanente Northern California employees at their workplace. All the participants were randomly assigned into 2 groups - the intervention group and the control group. Through the ALIVE program, developed by NutritionQuest, e-mails on a weekly basis were sent to the 351 employees in intervention group. The rest 436 employees in the control group were sent only immediate e-mail feedback in the beginning of the study indicating whether or not their reported physical activity and health habits met national guidelines.

Participants were asked to work on one of three paths: increasing their exercise levels, that implied walking for 10 minutes a day at lunch time, or walking to the store instead of driving; increasing fruit and vegetable intake, with recommendations of 3 servings a week for a snack; and reducing the intake of sugar and products high in fat. All the members of an e-mail group and the participants in the control-group, were surveyed again at the end of the 4-month test period and again sicteen weeks later.

After the period of four months, the group that had been receiving reminders via e-mails, demonstrated significant improvements in all the three above mentioned paths. Among individuals who showed the best results, were those who, at the very beginning, were not meeting recommended dietary and exercise levels. The employees who were not regularly active before receiving the intervention increased their participation in moderate intensity physical activity by nearly 1 hour per week, compared to those who had not been e-mailed. E-mail group has also showed drop in the amount of time they spent in sedentary activities, such as watching television and videos, by about two hours a week. The investigators found that these changes had a lasting effect 4 months after the intervention ended.

Susan Finn, president and chief executive of the American Council for Fitness & Nutrition in Washington, D.C., said that she is not surprised that the e-mail program succeeded, "especially in a workplace setting where people have easy access to a computer plus the support of their colleagues."

The study was funded by the Centers for Disease Control and Prevention (CDC).