Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program

Abstract

Objective Self-monitoring of physical activity (PA) and diet are key components of behavioral weight loss programs. The purpose of this study was to assess the relationship between diet (mobile app, website, or paper journal) and PA (mobile app vs no mobile app) self-monitoring and dietary and PA behaviors. Materials and methods This study is a post hoc analysis of a 6-month randomized weight loss trial among 96 overweight men and women (body mass index (BMI) 25-45 kg/m 2 ) conducted from 2010 to 2011. Participants in both randomized groups were collapsed and categorized by their chosen selfmonitoring method for diet and PA. All participants received a behavioral weight loss intervention delivered via podcast and were encouraged to self-monitor dietary intake and PA. Results Adjusting for randomized group and demographics, PA app users self-monitored exercise more frequently over the 6-month study (2.6±0.5 days/week) and reported greater intentional PA (196.4±45.9 kcal/day) than non-app users (1.2±0.5 days/week PA self-monitoring, p<0.01; 100.9±45.1 kcal/day intentional PA, p=0.02). PA app users also had a significantly lower BMI at 6 months (31.5±0.5 kg/m 2 ) than non-users (32.5±0.5 kg/m 2 ; p=0.02). Frequency of self-monitoring did not differ by diet self-monitoring method ( p=0.63); however, app users consumed less energy (1437±188 kcal/day) than paper journal users (2049±175 kcal/day; p=0.01) at 6 months. BMI did not differ among the three diet monitoring methods ( p=0.20). Conclusions These findings point to potential benefits of mobile monitoring methods during behavioral weight loss trials. Future studies should examine ways to predict which self-monitoring method works best for an individual to increase adherence. BACKGROUND AND SIGNIFICANCE

Information Technology and Lifestyle: A Systematic Evaluation of Internet and Mobile Interventions for Improving Diet, Physical Activity, Obesity, Tobacco, and Alcohol Use

“…Of 6 studies that compared combined interventions with conventional interventions, 4 reported significantly higher effect on adiposity in the combined intervention group. Of 5 RCTs evaluating combined interventions and diet, 3 found significant improvement in dietary intake 17, 18, 19, 20. Of 2 studies assessing combined interventions and conventional interventions, 1 reported significantly higher effect on diet in the combined intervention group and 1 reported no effect in either intervention group.…”

How behavioral science can advance digital health

“…For example, studies are mixed as to whether dietary tracking apps outperform traditional tracking strategies (i.e., paper and pencil) on measures of adherence and weight loss [3,4]. Another disconnect with the evidence base is that the behavioral strategies employed in apps have not been established as effective standalone interventions in their traditional forms.…”

Interest in a Twitter-delivered weight loss program among women of childbearing age

“…Two recent systematic reviews indicated that online social networks have been primarily used as an adjunct to in-person or web-based weight loss interventions, rather than as the primary treatment modality [18,19]. In previous studies, greater engagement in these online social networks predicted greater weight loss [20][21][22][23]. Thus, online social networks may represent an effective modality for delivering the entirety of an evidence-based weight loss program.…”