Use of a Smartphone App for Weight Loss Versus a Paper-Based Dietary Diary in Overweight Adults: Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Mobile health (mHealth) tools may be useful platforms for dietary monitoring and assessment. OBJECTIVE This study aims to evaluate the effectiveness of a mobile dietary self-monitoring application (app) for weight loss versus a paper-based diary among adults with a body mass index (BMI) of 23 kg/m2 or above. METHODS A total of 33 men and 17 women aged 18-39 years participated in a six-week randomized trial. We randomly assigned participants to one of two groups: (A) Smartphone app group (n=25) or (B) paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using ‘Well-D’, a dietary self-monitoring app developed by our team. The paper-based diary group was instructed to record foods or supplements that they consumed using the self-recorded diary. The primary outcomes were weight, BMI, waist circumference, body fat mass and skeletal muscle mass. We also examined changes in nutrient intakes including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals using 3-day 24-hour recalls (24HR). Differences in changes between the two groups were analyzed using independent t-tests or Wilcoxon Mann-Whitney tests. All of the data were analyzed using intent-to-treat analysis. RESULTS The average number of days recorded (mean ± SD) was 18.5 ± 14.1 for the app group and 15.5 ± 10.1 for the paper-based diary group. The differences in changes in weight, BMI and waist circumference were not significantly different between the app group and paper-based diary group (P=0.33, 0.34, and 0.70, respectively). Similarly, changes in body fat mass or skeletal muscle mass did not differ between the two groups (P=0.71 and 0.054, respectively). Although energy intake was reduced in both groups, there was no significant difference in change of energy intake between the two groups (P=0.98). CONCLUSIONS There were no differences in changes in anthropometric measures and nutrient intake between the app group and the paper-based diary group. Both mobile dietary self-monitoring app and paper-based diary may be useful for improving anthropometric measures. CLINICALTRIAL KCT, KCT0003170; https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=11642&ltype=&rtype=