Smartphone Application For Weight Loss Research Articles

Abstract A16: Use of a smartphone application for weight loss versus a paper-based dietary diary: A randomized trial

Abstract Objectives: The World Health Organization (WHO) announced in 2018 that one-third of deaths from cancer are due to dietary and behavioral risks including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use. Therefore, effective intervention strategies to maintain a balanced diet and healthy weight are needed to reduce the burden of cancer. There is increasing evidence that mobile health (mHealth) tools have value in dietary monitoring and assessment. This study aims to evaluate the effectiveness of the smartphone application (app) for weight loss versus a paper-based dietary diary among adults with a body mass index (BMI) of 23 kg/m2 or above. Methods: A total of 33 men and 17 women aged 18-39 years participated in a six-week randomized trial. We randomly assigned participants to one of two groups: (A) smartphone app group (n=25) or (B) paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using “Well-D”—a self-dietary monitoring app developed by our team. The paper-diary group was instructed to record foods or supplements that they consumed using the self-recorded diary. The primary outcomes were weight, BMI, and waist circumference. We also examined changes in nutrient intakes including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals using 3-day 24-hour recalls (24HR) across time at pre- and post-intervention. Differences between pre- and post-interventions within each group were compared using a paired t-test or Wilcoxon signed rank test. Differences in changes between the two groups were analyzed using an independent t-test. Results: Body weight, BMI, and waist circumference were not significantly different between the app group and paper-diary group (p>0.2). We observed a significant decrease in BMI in the paper-diary group (p=0.02) but not in the Well-D group (p=0.26) upon comparing pre-intervention anthropometric measures with the post-intervention measures. The waist circumferences decreased significantly in both groups (p<0.01). The caloric intake decreased from pre- to post-intervention in both groups (p=0.04 for the Well-D group and p=0.06 for the paper-diary group). However, the changes in nutrient intakes were not statistically significant between the two groups. Conclusions: There were no differences in body weight, BMI, waist circumference, and nutrient intakes between the app group and the paper-diary group. Body weight and BMI were reduced from pre- to post-intervention in the paper-diary group and waist circumference was reduced in both groups. Funding: This research was supported by the MSIT (Ministry of Science and ICT), Korea, under the ITRC (Information Technology Research Center) support program (IITP-2018-2014-1-00720) supervised by the IITP (Institute for Information & Communications Technology Promotion). Citation Format: Jeong Sun Ahn, Heejin Lee, Jiae Kim, Haemin Park, Dong Woo Kim, Jung Eun Lee. Use of a smartphone application for weight loss versus a paper-based dietary diary: A randomized trial [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A16.

Changes in Weight and Health-Related Behavior Using Smartphone Applications in Patients With Colorectal Polyps

ObjectiveTo assess the effectiveness of using a smartphone application for weight loss as well as a change in health-related behavior in patients with colorectal polyps over 3 months. DesignRandomized, controlled pilot trial. SettingThe Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea. ParticipantsAdults aged 25–65 years who were diagnosed with colorectal polyps. InterventionsA comparison of smartphone application data, with exercise and food intake diary data over 3 months. Main Outcome MeasuresPrimary outcomes were weight reduction and an increase in physical activity. Secondary outcomes included changes in dietary intake, such as that of vegetables, fruits, and fatty food. AnalysisStudent t test was used for continuous variables, and chi-square test for categorical variables. ResultsParticipants using the smartphone application experienced significant weight reduction compared with participants in the control group (mean change = –1.25 vs –0.42 kg; SD = 0.42 vs 1.23 kg). Moreover, use of the application and strict adherence to it significantly increased the level of physical activity (mean change = 1.57 vs 0.71 strenuous exercises/wk; SD = 1.09 vs 0.96 strenuous exercise/wk). Conclusions and ImplicationsSmartphone applications could be potential tools for weight control and physical activity in patients with colorectal polyps. Future larger randomized, controlled trials over a prolonged period are warranted to confirm these findings.

Professional dietary coaching within a group chat using a smartphone application for weight loss: a randomized controlled trial.

PurposeTo test the effectiveness of professional dietary coaching via group chat using a smartphone application (app) for weight loss.MethodsThis study was a 12-week, assessor-blind, parallel-group, waitlist-controlled randomized trial that included a 4-week follow-up period (trial registration, UMIN000025340). Data were collected between October 2016 and May 2017 and were analyzed between July 2017 and January 2018. Participants were 112 overweight, obese, or abdominally obese Japanese adults, aged 20 to 64 years, with at least one cardiometabolic risk factor. Participants were randomized to the coaching group (n=75) or control group (n=37), with a ratio of 2:1. The coaching group received a commercial weight loss program characterizing dietary coaching by a certified nutrition professional via group chat delivered on a smartphone app. Participants posted photos of every meal into the group chat, and the certified professional gave immediate direct feedback and encouragement. The primary outcome was an 8-week weight change. Secondary outcomes included 8-week changes in cardiometabolic risk factors. The frequency of meal photo uploads was recorded as a measure of adherence.ResultsOf the 112 randomized participants, 93 (83.0%) and 81 (72.3%) completed 8-week and 12-week visits, respectively. Intention-to-treat analysis demonstrated significantly larger 8-week weight loss in the coaching group (−1.4 kg; 95% confidence interval [CI]: −2.0, −0.8 kg) than that in the control group (−0.1 kg; 95% CI: −0.6, 0.4 kg). Significantly larger improvements in triglyceride and glycated hemoglobin A1c levels were also obtained in the coaching group. These benefits, except for the triglyceride level, were maintained until week 12. The frequent upload of meal photos was associated with a larger 8-week weight loss in a dose–response fashion (P-value for trend <0.001).ConclusionThis smartphone-delivered commercial weight loss program characterized as dietary coaching via group chat resulted in modest but significant weight loss. Facilitating participants’ active involvement in the program is necessary to achieve greater health benefits.

Efficacy of gamification-based smartphone application for weight loss in overweight and obese adolescents: study protocol for a phase II randomized controlled trial.

Overweight and obesity are significant public health concerns that are prevalent in younger age cohorts. Preventive or therapeutic interventions are difficult to implement and maintain over time. On the other hand, the majority of adolescents in the United States have a smartphone, representing a huge potential for innovative digitized interventions, such as weight loss programs delivered via smartphone applications. Although the number of available smartphone applications is increasing, evidence for their effectiveness in weight loss is insufficient. Therefore, the proposed study aims to assess the efficacy of a gamification-based smartphone application for weight loss in overweight and obese adolescents. The trial is designed to be a phase II, single-centre, two-arm, triple-blinded, randomized controlled trial (RCT) with a duration of 6 months. The intervention consists of a smartphone application that provides both tracking and gamification elements, while the control arm consists of an identically designed application solely with tracking features of health information. The proposed trial will be conducted in an urban primary care clinic of an academic centre in the United States of America, with expertise in the management of overweight and obese adolescents. Eligible adolescents will be followed for 6 months. Changes in body mass index z score from baseline to 6 months will be the primary outcome. Secondary objectives will explore the effects of the gamification-based application on adherence, as well as anthropometric, metabolic and behavioural changes. A required sample size of 108 participants (54 participants per group) was calculated. The benefits of the proposed study include mid-term effects in weight reduction for overweight and obese adolescents. The current proposal will contribute to fill a gap in the literature on the mid-term effects of gamification-based interventions to control weight in adolescents. This trial is a well-designed RCT that is in line with the Consolidated Standards of Reporting Trials statement.

Development of a New Branded UK Food Composition Database for an Online Dietary Assessment Tool.

The current UK food composition tables are limited, containing ~3300 mostly generic food and drink items. To reflect the wide range of food products available to British consumers and to potentially improve accuracy of dietary assessment, a large UK specific electronic food composition database (FCDB) has been developed. A mapping exercise has been conducted that matched micronutrient data from generic food codes to “Back of Pack” data from branded food products using a semi-automated process. After cleaning and processing, version 1.0 of the new FCDB contains 40,274 generic and branded items with associated 120 macronutrient and micronutrient data and 5669 items with portion images. Over 50% of food and drink items were individually mapped to within 10% agreement with the generic food item for energy. Several quality checking procedures were applied after mapping including; identifying foods above and below the expected range for a particular nutrient within that food group and cross-checking the mapping of items such as concentrated and raw/dried products. The new electronic FCDB has substantially increased the size of the current, publically available, UK food tables. The FCDB has been incorporated into myfood24, a new fully automated online dietary assessment tool and, a smartphone application for weight loss.

Smartphone Technology and Text Messaging for Weight Loss in Young Adults: A Randomized Controlled Trial.

Using smartphone technology and text messaging for health is a growing field. This type of technology is well integrated into the lives of young adults. However, few studies have tested the effect of this type of technology to promote weight loss in young adults OBJECTIVE:: The purpose of this study is to test the effectiveness of a behaviorally based smartphone application for weight loss combined with text messaging from a health coach on weight, body mass index (BMI), and waist circumference in young adults as compared with a control condition. Sixty-two young adults, aged 18 to 25 years, were randomized to receive (1) a smartphone application + health coach intervention and counseling sessions or (2) control condition with a counseling session. All outcome measures were tested at baseline and 3 months. These included weight, BMI, waist circumference, dietary habits, physical activity habits, and self-efficacy for healthy eating and physical activity. The sample was 71% female and 39% white, with an average age of 20 years and average BMI of 28.5 kg/m. Participants in the smartphone + health coach group lost significantly more weight (P = .026) and had a significant reduction in both BMI (P = .024) and waist circumference (P < .01) compared with controls. The results of this weight loss trial support the use of smartphone technology and feedback from a health coach on improving weight in a group of diverse young adults.

Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial.

Many smartphone applications (apps) for weight loss are available, but little is known about their effectiveness. To evaluate the effect of introducing primary care patients to a free smartphone app for weight loss. Randomized, controlled trial. (ClinicalTrials.gov: NCT01650337). 2 academic primary care clinics. 212 primary care patients with body mass index of 25 kg/m2 or greater. 6 months of usual care without (n= 107) or with (n= 105) assistance in downloading the MyFitnessPal app (MyFitnessPal). Weight loss at 6 months (primary outcome) and changes in systolic blood pressure and behaviors, frequency of app use, and satisfaction (secondary outcomes). After 6 months, weight change was minimal, with no difference between groups (mean between-group difference, -0.30 kg [95% CI, -1.50 to 0.95 kg]; P= 0.63). Change in systolic blood pressure also did not differ between groups (mean between-group difference, -1.7 mm Hg [CI, -7.1 to 3.8 mm Hg]; P= 0.55). Compared with patients in the control group, those in the intervention group increased use of a personal calorie goal (mean between-group difference, 2.0 d/wk [CI, 1.1 to 2.9 d/wk]; P< 0.001), although other self-reported behaviors did not differ between groups. Most users reported high satisfaction with MyFitnessPal, but logins decreased sharply after the first month. Despite being blinded to the name of the app, 14 control group participants (13%) used MyFitnessPal. In addition, 32% of intervention group participants and 19% of control group participants were lost to follow-up at 6 months. The app was given to patients by research assistants, not by physicians. Smartphone apps for weight loss may be useful for persons who are ready to self-monitor calories, but introducing a smartphone app is unlikely to produce substantial weight change for most patients. Robert Wood Johnson Foundation Clinical Scholars Program, National Institutes of Health/National Center for Advancing Translational Sciences for the UCLA Clinical and Translational Science Institute, and the Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly under the National Institutes of Health/National Institute on Aging.

Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial.

BackgroundThere is growing interest in the use of information communication technologies to treat obesity. An intervention delivered by smartphone could be a convenient, potentially cost-effective, and wide-reaching weight management strategy. Although there have been studies of texting-based interventions and smartphone applications (apps) used as adjuncts to other treatments, there are currently no randomized controlled trials (RCT) of a stand-alone smartphone application for weight loss that focuses primarily on self-monitoring of diet and physical activity.ObjectiveThe aim of this pilot study was to collect acceptability and feasibility outcomes of a self-monitoring weight management intervention delivered by a smartphone app, compared to a website and paper diary.MethodsA sample of 128 overweight volunteers were randomized to receive a weight management intervention delivered by smartphone app, website, or paper diary. The smartphone app intervention, My Meal Mate (MMM), was developed by the research team using an evidence-based behavioral approach. The app incorporates goal setting, self-monitoring of diet and activity, and feedback via weekly text message. The website group used an existing commercially available slimming website from a company called Weight Loss Resources who also provided the paper diaries. The comparator groups delivered a similar self-monitoring intervention to the app, but by different modes of delivery. Participants were recruited by email, intranet, newsletters, and posters from large local employers. Trial duration was 6 months. The intervention and comparator groups were self-directed with no ongoing human input from the research team. The only face-to-face components were at baseline enrollment and brief follow-up sessions at 6 weeks and 6 months to take anthropometric measures and administer questionnaires.ResultsTrial retention was 40/43 (93%) in the smartphone group, 19/42 (55%) in the website group, and 20/43 (53%) in the diary group at 6 months. Adherence was statistically significantly higher in the smartphone group with a mean of 92 days (SD 67) of dietary recording compared with 35 days (SD 44) in the website group and 29 days (SD 39) in the diary group (P<.001). Self-monitoring declined over time in all groups. In an intention-to-treat analysis using baseline observation carried forward for missing data, mean weight change at 6 months was -4.6 kg (95% CI –6.2 to –3.0) in the smartphone app group, –2.9 kg (95% CI –4.7 to –1.1) in the diary group, and –1.3 kg (95% CI –2.7 to 0.1) in the website group. BMI change at 6 months was –1.6 kg/m2 (95% CI –2.2 to –1.1) in the smartphone group, –1.0 kg/m2 (95% CI –1.6 to –0.4) in the diary group, and –0.5 kg/m2 (95% CI –0.9 to 0.0) in the website group. Change in body fat was –1.3% (95% CI –1.7 to –0.8) in the smartphone group, –0.9% (95% CI –1.5 to –0.4) in the diary group, and –0.5% (95% CI –0.9 to 0.0) in the website group.ConclusionsThe MMM app is an acceptable and feasible weight loss intervention and a full RCT of this approach is warranted.Trial RegistrationClinicalTrials.gov NCT01744535; http://clinicaltrials.gov/ct2/show/NCT01744535 (Archived by WebCite at http://www.webcitation.org/6FEtc3PVB)