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Nutrients 2018, 10(10), 1473; https://doi.org/10.3390/nu10101473

The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study

1
Primary Health Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACYL), Institute of Biomedical Research of Salamanca (IBSAL), Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP), 37003 Salamanca, Spain
2
Faculty of Health Sciences, Universidad de Burgos, 09292 Burgos, Spain
3
Primary Health Care Research Unit of Barcelona, Primary Healthcare University Research Institute IDIAP-Jordi Gol, 08007 Barcelona, Spain
4
Torre Ramona Health Center, Aragón Health Service, 50013 Zaragoza, Spain
5
Casa de Barco Health Center, Castilla y León Health Service, 47007 Valladolid, Spain
6
Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, 48014 Bilbao, Spain
7
Río Tajo Health Center, Castilla-La Mancha Health Service. University of Castilla-La Mancha, 13071 Talavera de la Reina, Spain
8
Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
9
Biomedical and Diagnostic Sciences Department, University of Salamanca, 37008 Salamanca, Spain
10
Spanish Research Network for Preventive Activities and Health Promotion in Primary Care, 08025 Barcelona, Spain
These two authors contribute equally to this paper.
Membership of the EVIDENT Investigators is provided in the Acknowledgments.
*
Author to whom correspondence should be addressed.
Received: 14 September 2018 / Revised: 4 October 2018 / Accepted: 8 October 2018 / Published: 10 October 2018
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Abstract

Background: This study evaluates the effectiveness of adding a diet smartphone application to standard counseling to modify dietary composition over the long term (12 months). Methods: A randomized, controlled, multicenter clinical trial was conducted involving the participation of 833 subjects from primary care clinics (415 to the intervention (counseling + application) group (IG) and 418 to the control (counseling) group (CG)). Both groups were counseled about a healthy diet and physical activity. For the 3-month intervention period, the IG was also trained to use a diet smartphone application that involved dietary self-monitoring and tailored feedback. Nutritional composition was estimated using a self-reported food frequency questionnaire. Results: An analysis of repeated measures revealed an interaction between the group and the percentages of carbohydrates (p = 0.031), fats (p = 0.015) and saturated fats (p = 0.035) consumed. Both groups decreased their energy intake (Kcal) at 12 months (IG: −114 (95% CI: −191 to −36); CG: −108 (95% CI: −184 to −31)). The IG reported a higher percentage intake of carbohydrates (1.1%; 95% CI: 0.1 to 2.0), and lower percentage intakes of fats (−1.0%; 95% CI: −1.9 to −0.1) and saturated fats (−0.4%; 95%CI: −0.8 to −0.1) when compared to the CG. Conclusions: Better results were achieved in terms of modifying usual diet composition from counseling and the diet smartphone application compared to counseling alone. This was evaluated by a self-reported questionnaire, which indicated an increased percentage intake of carbohydrates, and decreased percentage intakes of fats and saturated fats. View Full-Text
Keywords: diet; smartphone applications; diet records; dietary fats; dietary carbohydrates; general population diet; smartphone applications; diet records; dietary fats; dietary carbohydrates; general population
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Recio-Rodriguez, J.I.; Agudo Conde, C.; Calvo-Aponte, M.J.; Gonzalez-Viejo, N.; Fernandez-Alonso, C.; Mendizabal-Gallastegui, N.; Rodriguez-Martin, B.; Maderuelo-Fernandez, J.A.; Rodriguez-Sanchez, E.; Gomez-Marcos, M.A.; Garcia-Ortiz, L.; On Behalf of the EVIDENT Investigators. The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study. Nutrients 2018, 10, 1473.

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