Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Milan, Italy.
Department of Medicine, University of Udine, Udine, Italy.
Nutrition. 2021 Apr;84:111018. doi: 10.1016/j.nut.2020.111018. Epub 2020 Sep 10.
The availability of nutrition applications (apps) has increased in recent years. The aim of this study was to assess the accuracy of nutrient intake calculations from some of the leading apps.
We identified five apps according to some selection criteria: >4-star ratings, >1 million downloads, including a food composition database, and in Italian language. Apps were used for 2 wk each. Using a 3-d food diary, the nutritional values obtained from each app were compared to a reference method including the Food Composition Database for Epidemiologic Studies in Italy. Energy intake differences were calculated for single nutrient and 3-d food diary between single app and reference method after food-item matching. Bland-Altman plots were used to assess agreement of the methods.
Apps identified were FatSecret, Lifesum, MyFitnessPal, Yazio, and Melarossa. Apps tended to underestimate total energy intake compared with the reference method, from a minimum of -2 kcal for Lifesum, to a maximum of -5.4 kcal for Yazio (average per item). Apps tended to underestimate lipids, and to a lesser extent carbohydrate and fiber intake, except for Yazio and Lifesum, which overestimated the intake of protein. These discrepancies appear to be due to the use of no country-specific food composition databases and to user customization of the food list.
The present findings suggest that the leading nutrition apps present critical issues in assessing the intake of energy and nutrients. Implementation of a framework for quality assessment is necessary to drive the design and development of higher-quality apps. Further research on efficacy and use of apps to monitor food intake is also warranted and some recommendations are provided.
近年来，营养类应用程序（apps）的数量有所增加。本研究旨在评估一些领先的应用程序在计算营养素摄入量方面的准确性。
我们根据一些选择标准确定了五个应用程序：评分>4 星、下载量>100 万、包含食物成分数据库、且为意大利语。每个应用程序使用两周。使用 3 天食物日记，将每个应用程序获得的营养值与包括意大利流行病学研究食物成分数据库的参考方法进行比较。在进行食物项目匹配后，根据单个应用程序和参考方法计算单种营养素和 3 天食物日记的能量摄入差异。Bland-Altman 图用于评估方法的一致性。
确定的应用程序是 FatSecret、Lifesum、MyFitnessPal、Yazio 和 Melarossa。与参考方法相比，应用程序往往低估总能量摄入，从 Lifesum 的最小低估 -2 卡路里到 Yazio 的最大低估 -5.4 卡路里（平均每个项目）。应用程序往往低估脂质，以及碳水化合物和纤维的摄入量，但 Yazio 和 Lifesum 除外，它们高估了蛋白质的摄入量。这些差异似乎是由于没有使用特定国家的食物成分数据库以及用户对食物清单的自定义造成的。
本研究结果表明，领先的营养类应用程序在评估能量和营养素摄入方面存在重大问题。有必要实施质量评估框架，以推动设计和开发更高质量的应用程序。还需要进一步研究应用程序在监测食物摄入方面的效果和使用，并提供了一些建议。
