The future is now! Can chatbots help us make healthy lifestyle changes?

The Bottom Line

  • Every year, 41 million people are killed by chronic diseases across the globe.    

  • Adopting healthy lifestyle behaviours related to diet, physical activity levels, and sleep can help reduce the risk of developing chronic diseases. 

  • Chatbots, which help to increase access to health information, may help improve physical activity and diet across various populations.

Eat a selection of healthy foods—like protein foods, whole grain foods, and lots of fruits and vegetables—every day. Opt for water when choosing a drink (1). Perform a minimum of 150 minutes of moderate-to-vigorous aerobic physical exercise per week. Don’t engage in prolonged periods of sitting. Get seven to eight hours of quality sleep every night (2). Sound familiar?


The list above outlines some of the lifestyle-related recommendations included in various guidelines that aim to help people living in Canada lead physically and mentally healthy lives (1;2). Adopting healthy lifestyle behaviours helps to reduce our risk of developing chronic diseases. This is especially important as we’re confronted with the reality that chronic diseases kill 41 million people across the world every year (3).


That said, deciding to make healthy lifestyle modifications and then successfully achieving them is easier said than done. Multiple barriers, such as lack of access to effective in-person support from healthcare professionals, play a role in hindering our efforts (4;5). Enter bots! Don’t worry, we’ve come along way since the Tin Man in the Wizard of Oz. We’re talking about chatbots, also referred to as conversational agents or virtual assistants. Think of chatbots as tools that reproduce or imitate human communication through text, voice or speech, and visuals (e.g., avatars, images) (4;6;7). Some even integrate artificial intelligence, technology with the ability to learn, make predictions, and identify and evaluate language (4;8;9). Chatbot strategies can be delivered through smartphones, apps, telephone-linked computer systems, text-messages, smart speakers, and websites (4).


Sounds like a sci-fi fan’s dream, but can chatbots improve lifestyle behaviours like physical activity, diet, and sleep across various populations? Let’s breakdown the results of a recent systematic review that looked at this question (4).


What the research tells us

If we look at chatbot-based strategies overall, they appear to help produce small to moderate improvements in health behaviours like physical activity, diet, and sleep. Under the umbrella of physical activity, it may be possible to increase total physical activity, moderate-to-vigorous physical activity, and daily step counts. For diet, the benefits may include an increase in fruit and vegetable consumption.


Great, but do the results hold up when we break things down further?


Well, we see that both chatbot only strategies and multi-component chatbot strategies, which combine a chatbot with another strategy, may work to increase total physical activity, daily steps, and fruit and vegetable consumption. Moreover, for increasing fruit and vegetable consumption, in particular, text-based chatbots and chatbots that incorporate artificial intelligence appear to be more effective than chatbot strategies that use speech/voice and don’t integrate artificial intelligence. Unfortunately, the improvements in sleep quality and duration disappear when we separate chatbot only strategies from those that look at multi-component strategies.


While more high-quality research is needed to validate and build-on the findings discussed here, early results are promising (5).

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References

  1. Government Canada. Canada’s good guide: Food guide snapshot. [Internet] 2024. [cited April 2024]. Available from: https://food-guide.canada.ca/en/food-guide-snapshot/
  2. Canadian Society for Exercise Physiology. 24-Hour Movement Guidelines. [Internet] 2021. [cited April 2024]. Available from: https://csepguidelines.ca/guidelines/adults-18-64/
  3. World Health Organization. Noncommunicable diseases. [Internet] 2023. [cited April 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
  4. Singh B, Olds T, Brinsley, J, et al. Systematic review and meta-analysis of the effectiveness of chatbots on lifestyle behaviours. Digit Med. 2023; 6:118. doi: 10.1038/s41746-023-00856-1.  
  5. Sadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: A systematic review. J Evaluation Clin Pract. 2014; 20:793-802. doi: 10.1111/jep.12222. 
  6. Aggarwal A, Tam CC, Wu D, et al. Artificial intelligence-based chatbots for promoting health behavioral changes: Systematic review. J Med Internet Res. 2023; 25:e40789. doi: 10.2196/40789.
  7. Laranjo L, Dunn AG, Tong, HL, et al. Conversational agents in healthcare: A systematic review. J Am Med Inf Assoc. 2018; 25:1248-1258. doi: 10.1093/jamia/ocy072.
  8. Milne-Ives M, de Cock C, Lim, E, et al. The effectiveness of artificial intelligence conversational agents in health care: Systematic review. J Med Internet Res. 2018; 22:e20346. doi: 10.2196/20346.
  9. Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Health J. 2019; 6:94-98. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.