Nutritional Epidemiology Group School of Food Science and Nutrition Janet Cade & Michelle Carter...

Nutritional Epidemiology GroupSchool of Food Science and Nutrition

Janet Cade & Michelle Carter

“My Meal Mate”a smartphone tool for dietary assessment and weight management

Nutritional Epidemiology Group

School of Food Science and Nutrition

Background

In UK, 89% of population has a mobile phone

• 27% owning a smartphone (2010)

• doubled in last 2 years

Weight management patients want alternatives to face-to-face treatment.

Smartphone – allow self-monitoring of food and exercise.

Nutritional Epidemiology Group

School of Food Science and Nutrition

Design of MMM app

Focus groups x 3• Semi-structured design, thematic analysis

Objective: • to explore views and preferences of potential users to inform

development of the smartphone application

Interview:• What do you think about this approach to weight loss?

• What kind of feedback would you find useful?

• How often would you like to receive feedback?

• What do you like and dislike about similar commercially available applications? (“my fitness pal”, “lose-it”, “spark-people” and “calorie-counter”)

Nutritional Epidemiology Group

School of Food Science and Nutrition

Results

7 women + 2 men participated: 36y (SD 11)• 7 actively trying to lose weight

• Only 2 had used an ‘app’ before

• Positive response re weight loss – convenient, motivating

• Searchable branded food database – quick and easy to use

• Feedback • desirable, not too frequent or negative

• Tailored with some human input

Nutritional Epidemiology Group

School of Food Science and Nutrition

MyMealMate

Nutritional Epidemiology Group

School of Food Science and Nutrition

Set own weight loss goal and energy target

Features of “My Meal Mate”

Nutritional Epidemiology Group

School of Food Science and Nutrition

Features of “My Meal Mate”

Self monitoring – diet and activity

Electronic food diary

Nutritional Epidemiology Group

School of Food Science and Nutrition

Electronic food diary

• large searchable database

Features of “My Meal Mate”

Nutritional Epidemiology Group

School of Food Science and Nutrition

Electronic food diary

• photo reminders

• Add favourites

• Recent items

Features of “My Meal Mate”

Nutritional Epidemiology Group

School of Food Science and Nutrition

Instant nutritional feedback and progress

Features of “My Meal Mate”

Nutritional Epidemiology Group

School of Food Science and Nutrition

Weekly feedback by SMS based on % of calorie target achieved

Nutritional Epidemiology Group

School of Food Science and Nutrition

Help!

U-tube help videos

Portion size guidance popular

Nutritional Epidemiology Group

School of Food Science and Nutrition

Validation Study

Sample = 50 (staff and students at University)

• use MMM x 7 days• diet reference measure – 2 x 24 hour telephone recalls

Activity reference measure – accelerometery

Nutritional Epidemiology Group

School of Food Science and Nutrition

Results – useability(n=49)

Questionnaire item Mean (95%CI)

On average how long does it take you to enter a meal (min) ? 7 (6, 9)

On average how long did you spend each day on the app (min) ? 22 (19, 26)

How many days did it take until you felt comfortable using the phone (days) ? 1.1, (0.9, 1.4)

How many days did it take until you felt comfortable using "MMM" (days) ? 1.6, (1.3, 1.9)

Nutritional Epidemiology Group

School of Food Science and Nutrition

Comparison of methods

MMM Recall MMM-recall Correlation MMM and recall

Mean (SD)

Mean (SD) Mean 95% CI P r 95% CI P

Day 1 (n=49)Energy (kcal/d) 1997 2013 -16 -132, 100 0.78 0.8 0.6, 0.9 <0.001

Protein (g/d) 78 80 -2 -7, 4 0.49 0.8 0.7, 0.9 <0.001

CHO (g/d) 242 247 -5 -23, 13 0.57 0.6 0.4, 0.8 <0.001

Fat (g/d) 69 72 -3 -11, 5 0.44 0.7 0.5, 0.8 <0.001

Nutritional Epidemiology Group

School of Food Science and Nutrition

Mean difference between MMM and 24h recall for day 1

-100

0-5

000

500

1000

Ene

rgy

(kca

l/d) d

iffer

ence

(MM

M-r

ecal

l) fo

r day

1

1247.5 4214.5Energy (kcal/d) average MMM and recall for day 1

Nutritional Epidemiology Group

School of Food Science and Nutrition

Pilot trial

Sample: • 128 overweight from large employers in Leeds

Method:• RCT ÷ 3 groups

• MMM vs paper food diary vs online food diary

Outcomes:• acceptability & feasibility • Process measures – drop-outs, adherence, frequency

of use• Characteristics of successful users?

Nutritional Epidemiology Group

School of Food Science and Nutrition

Sample characteristics

BMI 34kg/m2 (SD 5) - self-reported 33!

Age 42 years

29 men, 99 women

31% usually/always on a diet

10% current smoker

40% already owned a smartphone; 61% had used an app

58% professional & managerial occupations

• 6 week and 6 month follow up……..

Nutritional Epidemiology Group

School of Food Science and Nutrition

New project……UK Web based 24h diet & physical activity recall

Project phases:

1. Development of tool

2. Validation

3. Pilot testing in 2 cohorts – UKWCS; ICHNT Clinical Biobank