Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents

Abstract

BackgroundEfforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking.ObjectivesThis study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio.MethodsCross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation.ResultsA total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for the zBMI (b=−0.03 [0.02], P=.04) and the healthy snack ratio (b=−0.84 [0.37], P=.03). Attitude to eat healthy for appearance mediated both the fitness app use frequency-zBMI (a × b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a × b=0.04 [0.01], P=.001) associations. No mediation was observed for the associations between the frequency of use of fitness or nutrition apps and the healthy snack or beverage ratio.ConclusionsCommercial fitness and nutrition apps show some association with healthier eating behaviors and BMI in adolescents. However, effective behavior change techniques should be included to affect key determinants of healthy eating.

Young People’s Attitudes and Motivations Toward Social Media and Mobile Apps for Weight Control: Mixed Methods Study (Preprint)

“…This agrees with a previous study where lifestyle apps were reported to be used by 27.6% of adolescents [35]. Those currently using lifestyle apps mostly use either the most popular apps available in app stores, or those recommended by friends and family.…”

Improving adolescents’ periodontal health: evaluation of a mobile oral health App associated with conventional educational methods: a cluster randomized trial

“…Positive results were also obtained in a recent study that used dietary, physical exercise and nutrition guidelines for adolescents, demonstrating that participants who had access to this tool adopted healthier eating behaviors and achieved better body mass index. In the same sense, a systematic review concluded that the use of cellphone App for smartphones can revolutionize health issues in adolescence, including prevention of pregnancy at this stage.…”

“…Smartphones are tools that allow access to information at any time and place and can be the basis for individualization and personalization of learning, and can positively influence individuals’ habits. When evaluating the use of cellphone Apps in adolescence as a strategy for health education, improved behaviors and incorporation of preventive measures regarding HPV, use of oral contraceptives, alcohol and tobacco habits, and reduction in body fat were verified.…”

Digital Inequalities in the Use of Self-Tracking Diet and Fitness Apps: Interview Study on the Influence of Social, Economic, and Cultural Factors

“…More recently, studies have been conducted among the general public to determine how social differences influence the use of digital self-tracking devices [12]. Ng et al [13], for instance, reported that physical activity trackers are used more by adolescents from affluent milieus.…”