# Study protocol on effectiveness of a holistic lifestyle intervention using eHealth system for older adults with metabolic syndrome and psychosomatic symptoms: a randomized controlled trial

## TL;DR

This study tests a digital lifestyle program to improve health and reduce symptoms in older adults with metabolic syndrome and psychosomatic issues.

## Contribution

The study introduces a novel eHealth intervention combining lifestyle changes and psychosomatic care for older adults with metabolic syndrome in a Chinese context.

## Key findings

- The intervention includes self-care, plant-based diets, physical activity, acupressure, and mindfulness.
- A mixed-methods approach will assess outcomes like weight loss and cardio-metabolic risk factors.
- Results may inform broader community health practices and theory-building.

## Abstract

Metabolic syndrome (MetS) is increasingly prevalent worldwide, characterized by hormonal imbalances and psychosomatic issues that often result in chronic pain and fatigue, and are associated with a heightened risk of depression and anxiety. While previous lifestyle interventions on MetS have shown health benefits, they often lack sustainability and neglect psychosomatic aspects. This highlights the necessity for innovative treatment protocols that can address these complexities. This study aims to examine the effects of the digital Holistic Healthy Life Education (e2HLE) intervention on various outcomes among community-dwelling older adults with MetS and psychosomatic symptoms in Hong Kong.

A waitlist randomized controlled trial featuring two parallel arms—an experimental group (EG) and a waitlist control group (WLCG)—will recruit 150 participants aged 60 and older with MetS and psychosomatic symptoms from five elderly centers. Participants will be randomly assigned to either the EG or WLCG. The 12-week intervention comprises weekly theme-based sessions focused on self-care, whole food plant-based diets, physical activity, self-administered acupressure, and mindfulness practices. These components are supported by an eHealth system that offers educational materials and facilitates self-monitoring of bio-signals and lifestyle changes, along with a comprehensive booklet. A two-day workshop supported by a multidisciplinary team will be conducted prior to the intervention. The intervention strategies utilize a combination of modules, incorporating in-person individual and group meetings, tele-counseling, technology-driven support groups, and buddy-assisted health coaching. A mixed-methods approach will be employed, with EG participants undergoing pretest and posttest assessments through surveys, health examinations, and blood tests, supplemented by qualitative process evaluations. WLCG participants will receive usual care for the first three months before cross over to the intervention arm. Data will be collected between baseline and the 12-week follow-up, with quantitative analysis conducted using SPSS and generalized estimating equations models.

This study is the first to investigate weight loss and alleviate cardio-metabolic risk factors and psychosomatic impacts among older adults in a Chinese context, guided by the concept of intrinsic capacity. If the intervention proves more effective than the control group, it could facilitate broader implementation in community settings and enhance theory-building and clinical practice.

ClinicalTrials.gov ID: NCT06499961. First submitted 2024-05-7.

The online version contains supplementary material available at 10.1186/s12877-025-06613-1.