JMIR Publications

ABSTRACT

Background:

Nutrition-related apps are commonly used to provide information about the users’ dietary intake, but limited research has been performed on the evaluation of their reliability.

Objective:

To evaluate the relative reliability of popular nutrition-related apps for the assessment of energy and available macro- and micronutrients against a standard method.

Methods:

Dietary analysis of 24-hour weighed food records (n = 20) were compared between five nutrition-related apps: S Health, MyFitnessPal, FatSecret, Noom Coach and Lose It!, and DietPlan6 (reference method). Estimates of energy, macronutrients (carbohydrate, protein, fat, saturated fat and fibre) and micronutrients (sodium, calcium, iron, vitamin A and vitamin C) were compared using t-tests and Wilcoxon signed-rank tests, correlation coefficients and Bland-Altman plots. 24-hour weighed food records from 20 participants (female/male, 15/5; mean age, 36.3 years; mean body mass index, 22.9 kg/m2) recruited from previous controlled studies conducted at the Hugh Sinclair Unit of Human Nutrition, University of Reading, UK.

Results:

No significant difference in estimation of energy and saturated fat intake between DietPlan6 and the diet apps was observed. Estimates of protein and sodium intake were significantly lower using Lose It! and FatSecret than DietPlan6. Lose It! also gave significantly lower estimates for other reported outputs: carbohydrate, fat, fibre and sodium, compared with DietPlan6. For S Health and MyFitnessPal, calcium, iron and vitamin C were all significantly under-estimated compared with DietPlan6, although there was no significant difference for vitamin A. No other significant differences were observed between DietPlan6 and the apps. Correlation coefficients ranged from -0.12 for iron (S Health vs. DietPlan6) to 0.91 for protein (FatSecret vs DietPlan6). Noom Coach was limited to energy output but it had a high correlation with DietPlan6 (r=0.91) and S Health had the greatest variation of correlation, with energy at 0.79. Bland-Altman analysis revealed potential proportional bias for vitamin A.

Conclusions:

The findings suggest that the apps provide comparable estimates of energy and saturated fat intake compared with DietPlan6. With the exception of Lose It!, the apps also provided comparable estimates of carbohydrate, total fat and fibre. Two apps displayed a tendency to underestimate protein and sodium (FatSecret and Lose It!). Apart from vitamin A, the estimates of micronutrient intake (calcium, iron and vitamin C) by the two apps (S Health and MyFitnessPal) were inconsistent and less reliable. Lose It! was the less comparable app in relation to DietPlan6. As the use and availability of apps grows, this study helps clinicians and researchers to make better-informed decisions about using these apps in research and practice.