Short-Term Pilot Study to Evaluate the Impact of Salbi Educa Nutrition App in Macronutrients Intake and Adherence to the Mediterranean Diet: Randomized Controlled Trial

Abstract

Promoting a healthy diet is a relevant strategy for preventing non-communicable diseases. This study aims to evaluate the impact of an innovative tool, the SAlBi educa nutrition app, in primary healthcare dietary counseling to improve dietary profiles as well as adherence to the Mediterranean diet. A multi-center randomized control trial comprising 104 participants was performed. Both control (n = 49) and intervention (n = 55) groups attended four once-weekly sessions focusing on healthy eating habits and physical activity, over one month. As well as attending the meetings, the intervention group used the app, which provides self-monitoring and tailored dietary advice based on the Mediterranean diet model. In a second intervention (one arm trial), the potential of SAlBi educa was evaluated for three months during the COVID-19 pandemic. At 4 weeks, the intervention group had significantly increased their carbohydrate intake (7.7% (95% CI: 0.16 to 15.2)) and decreased their total fat intake (−5.7% (95% CI: −10.4 to −1.15)) compared to the control group. Significant differences were also found for carbohydrates (3.5% (95% CI: −1.0 to 5.8)), total fats (−5.9% (95% CI: −8.9 to −3.0)), fruits and vegetables (266.3 g/day (95% CI: 130.0 to 402.6)), legumes (7.7g/day (95% CI: 0.2 to 15.1)), starchy foods (36.4 g/day (95% CI: 1.1 to 71.7)), red meat (−17.5 g/day (95% CI: −34.0 to −1.1)), and processed meat (−6.6 g/day (95% CI: −13.1 to −0.1)) intakes during the COVID-19 pandemic. SAlBi educa is a useful tool to support nutrition counseling in primary healthcare, including in special situations such as the COVID-19 pandemic. Trial registration: ISRCTN57186362.

Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study

“…The results of the present study, in line with the results obtained by Alonso-Dominguez et al, have shown a significant improvement in both the ADM index and the proportion of participants that achieved high compliance (MDSS ≥ 9) among the participants (university students) who used ‘feedback’ e-12HR (IG) compared to the participants who used ‘non-feedback’ e-12HR (CG). Furthermore, this improvement was observed over shorter follow-up periods than in other studies [ 40 , 41 , 42 ].…”

“…Another study carried out by Gonzalez-Ramirez et al [ 42 ], who also used a smartphone app with certain similarities to e-12HR, showed that the ADM score was significantly enhanced at month 3 with 1.4 points of improvement (intervention group only—no control group-).…”

“…The positive results of these studies [ 40 , 41 , 42 ] suggest that smartphone applications might represent an opportunity to promote ADM. McAleese et al [ 43 ] carried out another study with the aim of evaluating the quality of commercially available applications (Google Play and Apple App Store) for the MD and the presence of behavioral change techniques (BCTs) used by these tools. The findings of this study suggest that currently available applications might provide information on the MD, but the incorporation of more BCTs is warranted to maximize the potential for behavioral change toward the MD.…”

A feasibility study to assess Mediterranean Diet adherence using an AI-powered system

“…The feedback from the dietitians was positive, and 4/5 dietitians reported that the weekly MDA score could motivate the users towards a healthier lifestyle. In another pilot study 36 that took place in Spain, participants were recruited to use a nutritional education app that offers MD-based dietary counseling. It was found that the participants had a significant increase in carbohydrate intake and a significant decrease in fat intake in a period of one month and improved their dietary habits significantly in three months.…”

Food Frequency Questionnaire Personalisation Using Multi-Target Regression

“…Food Frequency Questionnaires (FFQs) are inexpensive and probably one of the most commonly used dietary tools for self-assessment. Therefore, several applications incorporate FFQs to monitor dietary habits [ 1 , 2 ]. For example, Fondazione Bruno Kessler developed the Lifestyle Behaviour Change (LBC) application to offer people from the Trentino region an application to self-monitor several aspects of a healthy lifestyle, with nutrition habits being one of them.…”