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Accepted for/Published in: JMIR mHealth and uHealth

Date Submitted: Nov 12, 2023
Date Accepted: Jun 24, 2024

The final, peer-reviewed published version of this preprint can be found here:

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study

Ho DKN, Chiu WC, Kao JW, Tseng HT, Lin CY, Huang PH, Fang YR, Chen KH, Su TY, Yang CH, Yao CY, Su HY, Wei PH, Chang JS

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study

JMIR Mhealth Uhealth 2024;12:e54509

DOI: 10.2196/54509

PMID: 39233588

PMCID: 11391091

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: A Comparative Study

  • Dang Khanh Ngan Ho; 
  • Wan-Chun Chiu; 
  • Jing-Wen Kao; 
  • Hsiang-Tung Tseng; 
  • Cheng-Yu Lin; 
  • Pin-Hsiang Huang; 
  • Yu-Ren Fang; 
  • Kuei-Hung Chen; 
  • Ting-Ying Su; 
  • Chia-Hui Yang; 
  • Chih-Yuan Yao; 
  • Hsiu-Yueh Su; 
  • Pin-Hui Wei; 
  • Jung-Su Chang

ABSTRACT

Background:

Controlling saturated fat and cholesterol intake is crucial for preventing cardiovascular diseases (CVDs).

Objective:

The present study aimed to assess the accuracy of mobile nutrition applications (apps) in tracking these nutrients, with a focus on nutrient omissions and the reliability of universal commercial apps across nations.

Methods:

Nutrient data from four commercial apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa-FoodApp) were compared against corresponding national reference databases (United States Department of Agriculture Food and Nutrient Database for Dietary Studies (USDA-FNDDS) and Taiwan Food Composition Database (TaiwanFCD)). Percentages (%) of missing nutrients were recorded, and data inconsistencies were calculated using the coefficient of variation (CV). Paired t-tests compared the apps to national reference data, while a one-way analysis of variance (ANOVA) examined app-to-app discrepancies. Cross-national reliability was studied comparing Chinese and English versions of MyFitnessPal against the USDA-FNDDS and TaiwanFCD.

Results:

Across five apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fat with errors ranging -13.8% to -40.3% (all P<0.05). All apps underestimated cholesterol with errors ranging -26.3% to -60.3% (all P<0.05). COFIT-Chinese omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. MyFitnessPal-Chinese recorded the highest CVs (96.7% for saturated fat and 112.1% for cholesterol), followed by MyFitnessPal-English (70.2% and 97.7%) and LoseIt! (83.5% and 95.6%). Cholesterol variability was consistently high in dairy (71%–118%) and prepackaged foods (84%–118%) across all apps. When examining cross-national usage, discrepancies between apps appeared to be attributed to the platform's inherent errors rather than differences in reference nutrient databases.

Conclusions:

The findings underscore the importance of rigorous validation of mobile nutrition apps and highlights challenges in the use of cross-national diet-tracking apps in CVD prevention.


 Citation

Please cite as:

Ho DKN, Chiu WC, Kao JW, Tseng HT, Lin CY, Huang PH, Fang YR, Chen KH, Su TY, Yang CH, Yao CY, Su HY, Wei PH, Chang JS

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study

JMIR Mhealth Uhealth 2024;12:e54509

DOI: 10.2196/54509

PMID: 39233588

PMCID: 11391091

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