Researchers in Australia tested whether people in rural areas could improve their heart health by talking to nutrition experts through video calls instead of in-person visits. Adults at risk for heart disease received five personalized nutrition consultations over six months via telehealth. After one year, those who had the video consultations ate significantly more nutritious foods compared to those who only received written nutrition information. The study also found that people felt better about their quality of life and became more engaged in managing their own health. This research shows that telehealth nutrition counseling could be an effective way to help people in remote areas reduce their heart disease risk.

The Quick Take

  • What they studied: Whether video consultations with nutrition experts could help rural adults eat healthier foods and reduce their risk of heart disease
  • Who participated: Adults living in rural areas of New South Wales, Australia, who were identified by their doctors as having moderate-to-high risk of developing heart disease
  • Key finding: People who had five video nutrition consultations over 6 months increased their healthy food intake by 5.9% more than those who only received written nutrition information, and they also reported better quality of life and more confidence in managing their health
  • What it means for you: If you live in a rural area and are concerned about heart health, telehealth nutrition counseling may be a practical option to help you eat better without traveling long distances. However, this was tested in Australia, so results may vary in other regions

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research studies. Researchers randomly assigned rural medical practices to either provide telehealth nutrition counseling or usual care. The intervention group received five personalized video consultations with registered dietitians (nutrition experts) spread over 6 months. Each consultation was tailored to the individual’s specific health needs and dietary habits. The comparison group received a one-time personalized nutrition report but no ongoing video consultations. All participants were managed by their regular doctor and were followed up after 12 months to measure changes.

The study measured several important outcomes: how much participants increased their intake of nutrient-dense foods (whole grains, vegetables, fruits, lean proteins), their weight loss, quality of life, health literacy (understanding health information), and patient activation (how involved they felt in managing their own health). Researchers used statistical methods called Bayesian linear mixed models to analyze the data, which allowed them to account for differences between individuals and practices.

This was a pragmatic trial, meaning it was designed to reflect real-world conditions in actual medical practices rather than a controlled laboratory setting. This makes the results more applicable to everyday healthcare situations.

This research matters because rural populations often face barriers to accessing specialized healthcare services, including nutrition counseling. By testing telehealth delivery, researchers could determine whether distance and travel time no longer need to be obstacles to getting expert nutrition advice. The randomized controlled trial design is important because it allows researchers to determine whether the video consultations actually caused the improvements, rather than just observing that people improved. This type of evidence is what doctors and health systems use to decide whether to implement new treatments.

This study has several strengths: it used a randomized controlled trial design, which is a gold standard in research; it was conducted in real medical practices with actual patients; it measured multiple important outcomes beyond just weight loss; and it followed participants for a full year. The study was registered in a clinical trials registry before it began, which increases transparency. However, the sample size was not specified in the abstract, which makes it difficult to assess statistical power. The study was conducted in Australia, so results may not directly apply to other countries with different healthcare systems or populations. The study focused on rural adults at moderate-to-high CVD risk, so results may not apply to urban populations or those at lower risk.

What the Results Show

The main finding was that people who received five telehealth nutrition consultations increased their intake of nutrient-dense foods by 7.0% of their total daily calories over 12 months, compared to only a 1.3% increase in the usual care group. The difference between the two groups was 5.9%, which was statistically significant. This means the video consultations helped people eat more whole grains, vegetables, fruits, and lean proteins—the foods that protect heart health.

Beyond just eating better, participants who received the telehealth consultations also reported improvements in their quality of life. This suggests that working with a nutrition expert made them feel better overall, not just physically but emotionally and mentally as well. Additionally, the intervention group showed significant improvements in patient activation, which means they felt more confident and involved in making decisions about their own health. This is important because people who feel in control of their health tend to stick with healthy behaviors long-term.

The study also measured weight loss and other health markers, though the abstract doesn’t provide specific numbers for these secondary outcomes. The fact that multiple measures improved suggests the intervention had broad positive effects beyond just changing what people eat.

While the abstract focuses on the primary outcomes, the study also examined quality of life and patient activation as secondary measures. The improvements in these areas are significant because they suggest the intervention didn’t just change eating habits—it also improved how people felt about themselves and their ability to manage their health. Better quality of life and higher patient activation are associated with better long-term health outcomes and greater likelihood of maintaining healthy behaviors.

This study appears to be the first to exclusively test telehealth-delivered nutrition counseling by registered dietitians in a primary care setting with rural patients at elevated cardiovascular disease risk. Previous research has shown that in-person nutrition counseling can improve heart health, but this study extends that evidence to show that video-based counseling can be equally effective. The findings align with broader research showing that telehealth can be effective for various health conditions, but this study specifically validates its use for nutrition therapy in a rural, primary care context.

The study has several limitations to consider. First, the sample size was not reported in the abstract, making it unclear how many people participated and whether the study had enough power to detect meaningful differences. Second, the study was conducted in rural Australia, so the results may not apply to rural areas in other countries with different healthcare systems, populations, or access to technology. Third, the study measured dietary intake through self-reported data, which can be less accurate than objective measurements. Fourth, we don’t know how long the benefits lasted beyond the 12-month follow-up period. Finally, the study doesn’t provide information about dropout rates or whether some participants were more likely to benefit than others.

The Bottom Line

For rural adults at moderate-to-high risk of heart disease: Consider seeking telehealth nutrition counseling from a registered dietitian if available in your area. The evidence suggests this approach can help you eat more nutritious foods and improve your overall quality of life. Work with your primary care doctor to determine if this is appropriate for your specific situation. Confidence level: Moderate—this is based on a well-designed study, but results are from Australia and may vary in other settings.

This research is most relevant to: (1) Rural adults who have been identified as having moderate-to-high risk of heart disease; (2) Healthcare providers in rural areas looking for ways to deliver nutrition services; (3) Patients who have difficulty traveling to in-person appointments; (4) People with limited access to registered dietitians. This research may be less relevant to: (1) Urban populations with easy access to in-person nutrition counseling; (2) People with very low heart disease risk; (3) Individuals without reliable internet or technology access for video consultations.

Based on this study, you can expect to see measurable improvements in your diet quality within 6 months of starting telehealth nutrition consultations. The study measured changes over 12 months, so continued benefits may develop over a full year. However, maintaining these improvements requires ongoing effort and engagement with the recommendations provided by your nutrition expert. The improvements in quality of life and health confidence may be noticed sooner, sometimes within weeks of starting the program.

Want to Apply This Research?

  • Track the percentage of your daily calories that come from nutrient-dense foods (whole grains, vegetables, fruits, lean proteins, healthy fats). Set a goal to increase this percentage by 5-7% over 6 months. Log your meals daily and review weekly to see progress toward this target.
  • Use the app to schedule and prepare for your telehealth nutrition consultations. Set reminders for video appointments, take notes during consultations, and log action items or dietary changes recommended by your dietitian. Between appointments, use the app to track meals and get feedback on whether you’re meeting the nutrition goals discussed with your expert.
  • Create a long-term tracking system that measures: (1) Percentage of calories from core/nutrient-dense foods (primary metric); (2) Weekly meal quality scores; (3) Confidence in making healthy food choices; (4) Overall quality of life ratings. Review these metrics monthly to identify patterns and adjust your approach as needed. Share this data with your healthcare provider during follow-up visits.

This research describes the effects of telehealth-based nutrition counseling in a specific rural Australian population. Individual results may vary based on location, access to technology, personal health status, and adherence to recommendations. This information is not a substitute for professional medical advice. Before starting any nutrition intervention or making significant dietary changes, consult with your primary care doctor or a registered dietitian to ensure the approach is appropriate for your individual health situation. If you have existing heart disease or are taking medications that affect nutrition, professional medical supervision is especially important. The effectiveness of telehealth nutrition counseling may depend on reliable internet access and comfort with video technology.