Dietary mobile apps may help people with chronic diseases decrease their weight, waist circumference, and calorie intake    

El Khoury CF, Karavetian M, Halfens RJG, et al. The effects of dietary mobile apps on nutritional outcomes in adults with chronic diseases: A systematic review and meta-analysis J Acad Nutr Diet. 2019;119:626-651.

Review question

How do dietary mobile applications (apps) impact nutritional outcomes in adults with chronic diseases?

Background

Research has shown that dietary strategies like in-person counseling are one of the most effective ways to prevent and manage chronic diseases. A key challenge to delivering these strategies is that they take up a lot of time and resources for both health care providers and clients. Mobile apps delivered using a smartphone may be a promising alternative to in-person dietary counselling. As many people have smartphones, mobile apps could help provide easy access to interactive diet-related activities that promote positive nutrition.

How the review was done

This is a systematic review of 22 studies—the majority of which were randomized controlled trials (RCTs). These studies were published between 2011 and 2017, and included 1,873 participants. Eleven of the RCTs were included in a meta-analysis.

• All participants were between 18 and 80 years of age, had one or more chronic disease (pre/type 1/type 2 diabetes, obesity, heart disease, risk of breast cancer, or history of endometrial cancer or breast cancer), and—when reported—a Body Mass Index (BMI) outside of the normal range.
• Participants used one or more dietary mobile apps that were either publically available in app stores (Jawbone UP, Fatsecret’s, MyFitnessPal, Loseit!, Fitbit app, Fitbit tracker, RunKeeper) or that were created specifically for the study (MyMealMate, SaltSwitch, Diabetes Mellitus Dietary Management Guide, Patient-Centered Smartphone-Based Diabetes Care System, Vegethon, YouPlus Health, Glucose Buddy, Few Touch, MyMealMate, Alive-PD). Each app focused on either education or assistance with self-monitoring diet and exercise, or both. They were accessed through smartphones and used for durations of one month to one year.
• Researchers measured changes in one or more of the following areas: food/nutrition (such as fruit, vegetable, and calorie consumption), biochemical data (such as average blood sugar levels), body composition (such as weight, BMI, and waist circumference), and physical activity.  
• Results were often compared to people in no-app control groups—such as other technologies, paper-based diaries, or no self-monitoring tools.

What the researchers found

Overall, the meta-analysis found that dietary mobile apps may reduce weight, waist circumference, and calorie consumption in the short-term among people with chronic diseases, compared to no-app control groups. Although improvements in BMI, average blood sugar levels, and fruit and/or vegetable intake were also seen, they did not reach statistical significance, so it cannot be said that mobile apps help improve these outcomes at this point in time.  

The apps included in the meta-analysis all focused on self-monitoring, and the majority used some type or element of a behavioural theory. Many also incorporated in-app counselling. While these results are promising, more research is needed on dietary mobile apps to: assess long-term effectiveness, content, and quality; look at their effects on different nutritional outcomes and chronic diseases; and determine if they are safe to use.   

Conclusion

In people with chronic diseases, dietary mobile apps may be beneficial for self-monitoring, helping to improve various aspects of nutrition such as weight, waist circumference, and calorie consumption.