The Active Control Group
The participants in the active control group received the usual support. The usual support was based on intensive SHG, and the participants in both groups received initial online face-to-face counseling by a health care professional (ie, a registered dietician) who had completed the established Ministry of Health, Labor and Welfare (MHLW) training course. Participants were briefed about their health condition and lifestyle through a review of their SHG results. They were instructed to set achievable personalized behavioral goals. After the initial counseling, a health care professional provided email support three times at 2, 6, and 12 weeks. Implementation points according to the MHLW in the active control group were comparable to the required points of ≥180 in the SHG. Daily recording of body weight and steps were recommended. Measurements of BP in the morning and evening were also recommended.