Real-World Outcomes of Virtual Medical Nutrition Therapy in Dyslipidemia, Hypertension, or Diabetes
- 1Nourish Inc
Abstract
ImportanceDyslipidemia, hypertension, and diabetes are highly prevalent conditions for which medical nutrition therapy (MNT) is guideline-recommended, yet access remains limited, and real-world evidence on technology-enabled MNT models at scale is sparse.
ObjectiveTo characterize lipid, blood pressure, and glycemic outcomes among adults receiving virtual MNT (vMNT) across three cardiometabolic conditions.
DesignRetrospective cohort study of adults with a first Nourish appointment before November 2025, followed for 6 months.
SettingNational vMNT platform.
ParticipantsAdults meeting enrollment criteria for dyslipidemia, hypertension, or diabetes and remaining engaged in care with [≥]1 follow-up measurement at 3 or 6 months. Final cohorts: dyslipidemia (n=6,501), hypertension (n=13,704), diabetes (n=2,444); 18,965 unique patients overall.
ExposurevMNT delivered by a registered dietitian via telehealth visits, with technology-enabled support between visits.
Main Outcomes and MeasuresOutcomes were LDL cholesterol, total cholesterol, HDL cholesterol, and triglycerides (dyslipidemia); systolic and diastolic blood pressure (SBP, DBP) (hypertension); and HbA1c (diabetes), assessed at enrollment, 3, and 6 months. Weight was a secondary outcome. The proportion achieving guideline-recommended targets (HbA1c <7.0%, SBP <130 mmHg) was also assessed.
ResultsAmong 18,965 patients (mean [SD] age, 42.9 [11.6] years; 15,770 [83.2%] female), significant changes from baseline to 6 months included: LDL cholesterol (-14.0 mg/dL [SE, 0.56]); total cholesterol (-19.4 mg/dL [SE, 0.61]); HDL cholesterol (-0.5 mg/dL [SE, 0.15]); triglycerides (-28.6 mg/dL [SE, 1.06]); SBP (-5.5 mmHg [SE, 0.16]); DBP (-4.5 mmHg [SE, 0.11]); and HbA1c (-1.37 percentage points [SE, 0.04]) (all P<.001). Among those with elevated SBP, 57.3% achieved <130 mmHg by 6 months; among those with elevated HbA1c, 54.7% achieved <7.0%. Outcomes among patients with stable medication regimens were similar to the full cohort.
Conclusions and RelevanceIn this study of 18,965 patients, vMNT delivered through a technology-enabled care model was associated with clinically meaningful improvement across three prevalent cardiometabolic conditions. These findings support technology-enabled virtual care as a scalable approach to delivering effective MNT.
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BibTeX
@misc{adams2026realworld,
title = {{Real-World Outcomes of Virtual Medical Nutrition Therapy in Dyslipidemia, Hypertension, or Diabetes}},
author = {R. N. Adams and D. Mozaffarian and C. Bollinger},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364516},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364516v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Real-World Outcomes of Virtual Medical Nutrition Therapy in Dyslipidemia, Hypertension, or Diabetes
AU - R. N. Adams
AU - D. Mozaffarian
AU - C. Bollinger
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364516
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364516v1
AB - ImportanceDyslipidemia, hypertension, and diabetes are highly prevalent conditions for which medical nutrition therapy (MNT) is guideline-recommended, yet access remains limited, and real-world evidence on technology-enabled MNT models at scale is sparse. ObjectiveTo characterize lipid, blood pressure, and glycemic outcomes among adults receiving virtual MNT (vMNT) across three cardiometabolic conditions. DesignRetrospective cohort study of adults with a first Nourish appointment before November 2025, followed for 6 months. SettingNational vMNT platform. ParticipantsAdults meeting enrollment criteria for dyslipidemia, hypertension, or diabetes and remaining engaged in care with [≥]1 follow-up measurement at 3 or 6 months. Final cohorts: dyslipidemia (n=6,501), hypertension (n=13,704), diabetes (n=2,444); 18,965 unique patients overall. ExposurevMNT delivered by a registered dietitian via telehealth visits, with technology-enabled support between visits. Main Outcomes and MeasuresOutcomes were LDL cholesterol, total cholesterol, HDL cholesterol, and triglycerides (dyslipidemia); systolic and diastolic blood pressure (SBP, DBP) (hypertension); and HbA1c (diabetes), assessed at enrollment, 3, and 6 months. Weight was a secondary outcome. The proportion achieving guideline-recommended targets (HbA1c <7.0%, SBP <130 mmHg) was also assessed. ResultsAmong 18,965 patients (mean [SD] age, 42.9 [11.6] years; 15,770 [83.2%] female), significant changes from baseline to 6 months included: LDL cholesterol (-14.0 mg/dL [SE, 0.56]); total cholesterol (-19.4 mg/dL [SE, 0.61]); HDL cholesterol (-0.5 mg/dL [SE, 0.15]); triglycerides (-28.6 mg/dL [SE, 1.06]); SBP (-5.5 mmHg [SE, 0.16]); DBP (-4.5 mmHg [SE, 0.11]); and HbA1c (-1.37 percentage points [SE, 0.04]) (all P<.001). Among those with elevated SBP, 57.3% achieved <130 mmHg by 6 months; among those with elevated HbA1c, 54.7% achieved <7.0%. Outcomes among patients with stable medication regimens were similar to the full cohort. Conclusions and RelevanceIn this study of 18,965 patients, vMNT delivered through a technology-enabled care model was associated with clinically meaningful improvement across three prevalent cardiometabolic conditions. These findings support technology-enabled virtual care as a scalable approach to delivering effective MNT.
ER -