Using smartphone apps to promote lifestyle changes

It has been well established that one-on-one medical nutrition therapy services and behavioural counselling provided by a dietitian are effective in improving outcomes for chronic health issues such as obesity, heart disease and diabetes.

However, it is not uncommon to see patients relapse between dietetic consults, or even post the completion of the consults with the dietitians. There should be a way for patients to self-monitor their progress and compliance, keeping in mind the goals and strategies discussed with the dietitian during the consult.¹

Smartphone apps and nutrition care 

In Australia, there is an increased dependence on smartphones. In fact, a survey reported that 45% of the population claimed they cannot live without their smartphone. Therefore, it makes perfect sense that dietitians are now taking advantage of the era of mobile health, commonly known as ‘mHealth’, which is defined as incorporating the use of wireless technology to achieve various health goals.

Consistently working towards health goals each day can be difficult in today’s busy lifestyle without daily reminders. Yet a simple app, which pops up reminders from time to time on a person’s phone screen like ‘drink water’, can be useful in improving a person’s hydration status.²

In August 2014, there were more than 43,000 apps listed in the health and fitness category of apps downloadable from major app stores such as the Apple and Android app stores. From 2017 onwards, there were more than 325,000 apps downloadable from those app stores. Two-thirds of those commercial apps are related to nutrition and lifestyle. According to a survey completed by 139 dietitians, 40.5% of respondents had recommended nutrition- or food-related apps to clients, and 54.2% had a client ask about or use a nutrition- or food-related application.^2,3

Unique smartphone app features 

Smartphone health apps have a range of benefits:

• Apps for logging dietary intake and physical activity: A large international web-based study done among 381 dietitians found that food logging apps such as Easy Diet Diary can be useful as they reduce the time that dietitians usually have to spend in collecting dietary information in the consultation, and hence the consultation time can be spent on negotiating goals and strategies and discussing positive behaviour changes. The apps’ food records can be accessed by the dietitian. Smartphone apps such ‘My Fitness Pal’ can be used to maintain food logs as well as track physical activity levels.⁴
• Multicomponent apps: The Noom Coach app provides users with access to private and group messages, as well as phone calls that provide counselling to track progress. A study found that the Diabetes Prevention program administered through the app was able to bring about a significant amount of weight loss when measured at the start of using the app, and then at 16 and 24 weeks.⁴

The road ahead

Smartphone apps can be used in conjunction with the individualised dietitian sessions and can support patient compliance of the goals set with the dietitian. However, the patient’s demographics and how tech-savvy they are will determine how useful the app is.

There is a huge potential for apps to support the services of private practice dietitians. The apps can be particularly useful for younger adults as they serve as a reminder to make heathier food choices and increase physical activity levels, as well as provide nutrition education to the app users. There is potential for the apps to facilitate behavioural change if used for a long period of time.

*Juhi Bhambhaney is an accredited practising dietitian. She works at the Maroubra Medical Centre and ENT clinic.

References

1. Chen J, Lieffers J, Bauman A, Hanning R, Allman-Farinelli M. (2017) The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three-country study. Journal of Human Nutrition and Dietetics 30(4):439-52
2. Brown L, Capra S, Williams L. Profile of the Australian dietetic workforce: 1991–2005. Nutrition & Dietetics. 2006; 63:166-178. 
3. World Health Organisation. mHealth: new horizons for health through mobile technologies. http://www.who.int/goe/publications/goe_mhealth_web.pdf. Accessed December 10, 2015.
4. Australian Communications and Media Authority. Mobile apps: putting the ‘smart’ in smartphones. http://www.acma.gov.au/theACMA/engage-blogs/engage

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