The functionality and quality of nutrition-related mobile applications in China (Preprint)

BACKGROUND There are an increasing number of mobile applications that provide dietary guidance in supporting healthy lifestyle and disease management. However, the characteristics of these nutrition-related apps are not well analyzed. OBJECTIVE This study aimed to evaluate the functionality and quality of nutrition-related apps in China. METHODS Mobile apps providing dietary guidance were screened in Chinese iOS and android app stores using stepwise searching criteria in November 2017. Primary review was conducted by extracting information from the description of apps. Free apps that contain all the information of diet and nutrition, with the last update after 1st Jan 2016 were downloaded for further analysis on the nutritional functionality features based on the framework of Chinese Dietary Guidelines and on the market related features as well. The user version of the Mobile Application Rating Scale (uMARS) was used to assess the quality of apps. RESULTS Among the 44 downloaded nutrition-related apps screened from 628 apps with dietary guidance content, only 11(25%) were aimed exclusively for dietary guidance, the others were aimed for fitness guidance (17, 39%), disease management (11, 25%) and maternal health (5, 11%) respectively. The nutritional functionalities of the 44 apps included nutritional information enquiry (40, 91%), nutrition education (35, 80%), food record (34, 77%), diet analysis (34, 77%), and personalized recipes (21, 48%). Twelve out of 44 apps contained all of the above five nutrition related functionalities. The diet analysis and suggestions were mainly focused on energy (33/44, 75%), less on other factors like dietary structure (10/44, 23%). About 96% (42/44) of the apps provided social communication functionality and 59% (26/44) of the apps supported user incentives. Eight out of 44 apps (18%) also applied intelligent recognition technology. Using 5-point uMARS as scales of quality, the median scores of the 44 apps was 3.6 (IQR = 0.7). CONCLUSIONS Most nutrition-related apps are developed in the service of health management other than for dietary guidance exclusively. Although basic energy balance theory was generally applied, the nutritional functionality of the nutrition-related apps is relatively limited and not individualized. More efforts should be taken to integrate with the scientific nutritional knowledge and innovative technology in developing an app followed with complete and personalized dietary guidance.