nutritional epidemiology group school of food science and nutrition janet cade & michelle carter...

Nutritional Epidemiology GroupSchool of Food Science and Nutrition

Janet Cade & Michelle Carter

“My Meal Mate”a smartphone tool for dietary assessment and weight management

Nutritional Epidemiology Group

School of Food Science and Nutrition

Background

In UK, 89% of population has a mobile phone

• 27% owning a smartphone (2010)

• doubled in last 2 years

Weight management patients want alternatives to face-to-face treatment.

Smartphone – allow self-monitoring of food and exercise.



Design of MMM app

Focus groups x 3• Semi-structured design, thematic analysis

Objective: • to explore views and preferences of potential users to inform

development of the smartphone application

Interview:• What do you think about this approach to weight loss?

• What kind of feedback would you find useful?

• How often would you like to receive feedback?

• What do you like and dislike about similar commercially available applications? (“my fitness pal”, “lose-it”, “spark-people” and “calorie-counter”)



Results

7 women + 2 men participated: 36y (SD 11)• 7 actively trying to lose weight

• Only 2 had used an ‘app’ before

• Positive response re weight loss – convenient, motivating

• Searchable branded food database – quick and easy to use

• Feedback • desirable, not too frequent or negative

• Tailored with some human input



MyMealMate



Set own weight loss goal and energy target

Features of “My Meal Mate”




Self monitoring – diet and activity

Electronic food diary




• large searchable database





• photo reminders

• Add favourites

• Recent items




Instant nutritional feedback and progress




Weekly feedback by SMS based on % of calorie target achieved



Help!

U-tube help videos

Portion size guidance popular



Validation Study

Sample = 50 (staff and students at University)

• use MMM x 7 days• diet reference measure – 2 x 24 hour telephone recalls

Activity reference measure – accelerometery



Results – useability(n=49)

Questionnaire item Mean (95%CI)

On average how long does it take you to enter a meal (min) ? 7 (6, 9)

On average how long did you spend each day on the app (min) ? 22 (19, 26)

How many days did it take until you felt comfortable using the phone (days) ? 1.1, (0.9, 1.4)

How many days did it take until you felt comfortable using "MMM" (days) ? 1.6, (1.3, 1.9)



Comparison of methods

MMM Recall MMM-recall Correlation MMM and recall

Mean (SD)

Mean (SD) Mean 95% CI P r 95% CI P

Day 1 (n=49)Energy (kcal/d) 1997 2013 -16 -132, 100 0.78 0.8 0.6, 0.9 <0.001

Protein (g/d) 78 80 -2 -7, 4 0.49 0.8 0.7, 0.9 <0.001

CHO (g/d) 242 247 -5 -23, 13 0.57 0.6 0.4, 0.8 <0.001

Fat (g/d) 69 72 -3 -11, 5 0.44 0.7 0.5, 0.8 <0.001



Mean difference between MMM and 24h recall for day 1

-100

0-5

000

500

1000

Ene

rgy

(kca

l/d) d

iffer

ence

(MM

M-r

ecal

l) fo

r day

1

1247.5 4214.5Energy (kcal/d) average MMM and recall for day 1



Pilot trial

Sample: • 128 overweight from large employers in Leeds

Method:• RCT ÷ 3 groups

• MMM vs paper food diary vs online food diary

Outcomes:• acceptability & feasibility • Process measures – drop-outs, adherence, frequency

of use• Characteristics of successful users?



Sample characteristics

BMI 34kg/m2 (SD 5) - self-reported 33!

Age 42 years

29 men, 99 women

31% usually/always on a diet

10% current smoker

40% already owned a smartphone; 61% had used an app

58% professional & managerial occupations

• 6 week and 6 month follow up……..



New project……UK Web based 24h diet & physical activity recall

Project phases:

1. Development of tool

2. Validation

3. Pilot testing in 2 cohorts – UKWCS; ICHNT Clinical Biobank

nutritional epidemiology group school of food science and nutrition janet cade & michelle carter...

Documents

nutrition mymealmate

nutrition features

meal mate slide

nutrition help

nutrition background

selfmonitoring of food

weight management slide

nutrition weekly feedback