The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study

• Published in: Nutrients Vol. 10; no. 10; p. 1473
• Main Authors: Recio-Rodriguez, Jose I., Agudo Conde, Cristina, Calvo-Aponte, Maria J., Gonzalez-Viejo, Natividad, Fernandez-Alonso, Carmen, Mendizabal-Gallastegui, Nere, Rodriguez-Martin, Beatriz, Maderuelo-Fernandez, Jose A., Rodriguez-Sanchez, Emiliano, Gomez-Marcos, Manuel A., Garcia-Ortiz, Luis
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 10.10.2018
• Subjects: carbohydrates; counseling; Counseling - methods; Diet - methods; Diet Records; Dietary Carbohydrates - analysis; Dietary Fats - analysis; Dietary Proteins - analysis; Energy Intake; Exercise; Female; food frequency questionnaires; healthy diet; Humans; Male; Micronutrients - analysis; Middle Aged; Mobile Applications; mobile telephones; nutrient content; Nutrients - analysis; physical activity; Primary Health Care - methods; randomized clinical trials; saturated fats; Smartphone; Surveys and Questionnaires; dietary carbohydrates; smartphone applications; diet; diet records; general population; dietary fats
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu10101473

Background: This study evaluates the effectiveness of adding a diet smartphone application to standard counseling to modify dietary composition over the long term (12 months). Methods: A randomized, controlled, multicenter clinical trial was conducted involving the participation of 833 subjects from primary care clinics (415 to the intervention (counseling + application) group (IG) and 418 to the control (counseling) group (CG)). Both groups were counseled about a healthy diet and physical activity. For the 3-month intervention period, the IG was also trained to use a diet smartphone application that involved dietary self-monitoring and tailored feedback. Nutritional composition was estimated using a self-reported food frequency questionnaire. Results: An analysis of repeated measures revealed an interaction between the group and the percentages of carbohydrates (p = 0.031), fats (p = 0.015) and saturated fats (p = 0.035) consumed. Both groups decreased their energy intake (Kcal) at 12 months (IG: −114 (95% CI: −191 to −36); CG: −108 (95% CI: −184 to −31)). The IG reported a higher percentage intake of carbohydrates (1.1%; 95% CI: 0.1 to 2.0), and lower percentage intakes of fats (−1.0%; 95% CI: −1.9 to −0.1) and saturated fats (−0.4%; 95%CI: −0.8 to −0.1) when compared to the CG. Conclusions: Better results were achieved in terms of modifying usual diet composition from counseling and the diet smartphone application compared to counseling alone. This was evaluated by a self-reported questionnaire, which indicated an increased percentage intake of carbohydrates, and decreased percentage intakes of fats and saturated fats.