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Background: The effectiveness of telehealth in managing obesity in Saudi patients is still under investigation. This study compared the effectiveness of telehealth and in-person obesity management programs for adults., Methods: This clinical trial involved 62 adults, 29 receiving in-person intervention at the clinic and 33 receiving telehealth via videoconference calls. Anthropometric measurements, biochemical parameters, and dietary and lifestyle habits were assessed at baseline and after 12 weeks. Patients have been educated about goal-setting, healthy eating behaviors, personalized meal plans, and increasing physical activity levels., Results: It showed that 45% and 49% of the in-person and telehealth groups lost more than 5% of their initial body weight. Weight, % body fat, and waist circumference were significantly reduced in the in-person and telehealth groups ( p < 0.001). No significant differences between the groups were found in the parameters mentioned above. Within-group analysis showed that light physical activity levels improved in both groups significantly ( p < 0.001), and the moderate physical activity level improved significantly among the telehealth group ( p < 0.039). No significant differences were observed between the groups regarding physical activity level, blood pressure measurement, and biochemical markers, except for the RBC blood level ( p = 0.026). The telehealth group had significantly higher attendance rates for counseling sessions (97% vs. 75% for the in-person group, p < 0.01). Participants' dropout rates were higher for the in-person group 21%, compared to the telehealth group 13%. Telehealth participants' satisfaction regarding the benefits of the obesity management program in losing weight was higher at 87% compared to the in-person group at 76%., Conclusions: In conclusion, applying a telehealth obesity management program can support patients struggling with obesity who may have limited access to traditional healthcare services, while ensuring that telehealth care replicates the quality of in-person care.

Objective: The aim of this trial was to characterize the beneficial effects of probiotics on decreasing endotoxin levels and other cardiometabolic parameters in Arab patients with type 2 diabetes mellitus (T2DM)., Methods: Saudi adults with naïve T2DM (n = 30; 12 males and 18 females) were randomly allocated to receive twice daily placebo or 2.5 × 10 9  cfu/g of Ecologic ® Barrier (multi-strain probiotics; n = 31; 14 males and 17 females) in a double-blind manner over a 6 month period, respectively. Anthropometrics were measured and fasting blood samples were collected to analyze endotoxin, glycemic parameters [glucose, insulin, c-peptide and homeostasis model assessment for insulin resistance (HOMA-IR)], lipids [triglycerides, total cholesterol, low and high-density lipoprotein (LDL and HDL, respectively) cholesterol and total/HDL-cholesterol ratio], inflammatory markers [tumor-necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP)] and adipocytokines [leptin, adiponectin and resistin] at baseline and after 3 and 6 months of intervention., Results: Multi-strain probiotics supplementation for 6 months caused a significant decrease in circulating levels of endotoxin by almost 70% over 6 months, as well as glucose (38%), insulin (38%), HOMA-IR (64%), triglycerides (48%), total cholesterol (19%), total/HDL-cholesterol ratio (19%), TNF-α (67%), IL-6 (77%), CRP (53%), resistin (53%), and a significant increase in adiponectin (72%) as compared with baseline. Only HOMA-IR had a clinically significant reduction (-3.4, 64.2%) in the probiotics group as compared to placebo group at all time points. No other clinically significant changes were observed between the probiotic or placebo group at 3 and 6 months in other markers., Conclusion: Multi-strain probiotic supplementation over 6 months as a monotherapy significantly decreased HOMA-IR in T2DM patients, with the probiotic treatment group highlighting reduced inflammation and improved cardiometabolic profile. As such, multi-strain probiotics is a promising adjuvant anti-diabetes therapy., Trial Registration: ClinicalTrials.gov Identifier: NCT01765517., (Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.)