De Cock Nathalie, Vangeel Jolien, Lachat Carl, Beullens Kathleen, Vervoort Leentje, Goossens Lien, Maes Lea, Deforche Benedicte, De Henauw Stefaan, Braet Caroline, Eggermont Steven, Kolsteren Patrick, Van Camp John, Van Lippevelde Wendy
Food Chemistry and Human Nutrition, Department of Food safety and Food quality, University of Ghent, Gent, Belgium.
School for Mass Communication Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium.
JMIR Mhealth Uhealth. 2017 Apr 25;5(4):e58. doi: 10.2196/mhealth.6005.
Efforts 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.
This 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.
Cross-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.
A 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.
Commercial 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.
需要努力改善零食和饮品习惯，以促进青少年的健康体重指数（BMI）。尽管商业健身和营养手机应用被广泛使用，但对于它们改善健康行为的潜力，尤其是在青少年中的潜力，人们知之甚少。此外，缺乏关于此类健身和营养应用影响行为的机制的证据。
本研究评估了使用商业健身或营养应用是否与青少年较低的BMI以及更健康的零食和饮品习惯相关。此外，研究探讨了对健康饮食的感知行为控制；为了健康食品的美味、整体健康或外表而对健康饮食的态度；健康饮食的社会规范以及对健康饮食的社会支持是否介导了健身或营养应用使用频率与BMI、健康零食及饮品比例之间的关联。
在比利时弗拉芒地区20所学校的代表性样本中，收集了青少年（N = 889；平均年龄14.7岁，标准差0.8；54.8%[481/878]为男孩；18.1%[145/803]超重）关于零食和饮品消费、健康饮食决定因素以及健身和营养应用使用情况的横断面自我报告数据。研究人员测量了身高和体重。健康零食比例和健康饮品比例的计算方法如下：健康零食或饮品克数/（健康零食或饮品克数 + 不健康零食或饮品克数）×100。采用多水平回归和结构方程模型分析所提出的关联，并探索多重中介作用。
共有27.6%（245/889）的青少年使用健身、营养应用或两者皆用。营养应用的使用频率与较高的健康饮品比例呈正相关（b = 2.96[1.11]，P = 0.008）以及较高的体重指数z分数（zBMI；b = 0.13[0.05]，P = 0.008）。在营养应用使用频率与zBMI（b = -0.03[0.02]，P = 0.04）以及健康零食比例（b = -0.84[0.37]，P = 0.03）之间发现了显著的交互作用。为了外表而对健康饮食的态度介导了健身应用使用频率与zBMI（a×b = 0.02[0.01]，P = 0.
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