JMIR Publications

ABSTRACT

Background:

Digital nutrition applications that monitor or provide recommendations on diet have been found to be effective in behavior change and weight reduction among obese individuals. However, there is less evidence on how integration of personalized nutrition recommendations and changing the food purchasing environment through online meal planning and grocery delivery, meal kits, and grocery incentives impacts weight loss among obese individuals.

Objective:

The objective of this study was to examine weight loss and predictors of weight loss among obese users of a digital nutrition platform that integrates nutrition recommendations and changes in the food purchasing environment.

Methods:

We included 8,977 obese adults who used the digital Zipongo Foodsmart platform between November 2010 and April 2020. We retrospectively analyzed user characteristics and their associations with weight loss. Participants reported age, gender, height, at least two measures of weight, and usual dietary intake. A score to measure overall diet quality, Nutriscore, was calculated based on responses to a food frequency questionnaire. We used paired t-tests to compare differences in baseline and final weights and baseline and final Nutriscores. We used univariate and multivariate logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) of achieving 5% weight loss by age, gender, baseline body mass index (BMI), Nutriscore, change in Nutriscore, and duration of enrollment. We tested for potential effect modification of the association between enrollment duration and mean percent weight change by gender, age, baseline BMI, and change in Nutriscore.

Results:

Over a median of 9.9 months of enrollment, 59% of participants lost weight. Of the participants who used the Foodsmart platform for at least 24 months, 33.3% of them achieved 5% weight loss. In the fully-adjusted logistic regression model, we found that baseline BMI (OR: 1.02, 95% CI: 1.02-1.03, P<.001), greater change in Nutriscore (OR: 1.06, 95% CI: 1.05-1.07, P<.001), baseline Nutriscore (OR: 1.03, 95% CI: 1.02-1.03, P<.001), and enrollment length (OR: 1.04, 95% CI: 1.04-1.05, P<.001) were all significantly associated with higher odds of achieving at least 5% weight loss.

Conclusions:

This study found that a digital application that provides personalized nutrition recommendations and change in one’s food purchasing environment appears to be successful in meaningfully reducing weight among obese individuals.