School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542.
Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
JMIR Mhealth Uhealth. 2024 Sep 4;12:e54509. doi: 10.2196/54509.
Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored.
This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts.
Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD.
Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs.
The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves.
控制饱和脂肪和胆固醇的摄入量对于预防心血管疾病很重要。尽管移动饮食追踪应用的使用越来越多，但不同国家对营养应用程序在跟踪饱和脂肪和胆固醇方面的可靠性仍研究不足。
本研究旨在研究不同国家背景下，专注于饱和脂肪和胆固醇摄入的营养应用程序的可靠性和一致性。该研究主要关注 3 个关键问题：数据遗漏、应用程序内饱和脂肪和胆固醇值的不一致性（变异性）以及不同国家背景下商业应用程序的可靠性。
将 4 个消费者级应用程序（COFIT、MyFitnessPal-Chinese、MyFitnessPal-English 和 LoseIt！）和 1 个学术应用程序（Formosa FoodApp）的营养数据与 2 个国家参考数据库（美国农业部[USDA]-食品和营养数据库用于饮食研究[FNDDS]和台湾食品成分数据库[FCD]）进行比较。记录缺失营养物的百分比，并使用变异系数计算数据不一致性。使用单向方差分析来检查应用程序之间的差异，并使用配对的双尾 t 检验来比较应用程序与国家参考数据。通过比较 MyFitnessPal 的中文和英文版本与 USDA-FNDDS 和台湾 FCD，研究了不同国家背景下的可靠性。
在 5 个应用程序中，分析了 42 个项目的 836 个食品代码。包括 COFIT、MyFitnessPal-Chinese、MyFitnessPal-English 和 LoseIt！在内的 4 个应用程序显著低估了饱和脂肪，误差范围为-13.8%至-40.3%（均 P<.05）。所有应用程序都低估了胆固醇，误差范围为-26.3%至-60.3%（均 P<.05）。COFIT 遗漏了 47%的饱和脂肪数据，而 MyFitnessPal-Chinese 则遗漏了 62%的胆固醇数据。牛肉、鸡肉和海鲜的变异系数在 MyFitnessPal-Chinese、MyFitnessPal-English 和 LoseIt！中分别为 78%至 145%、74%至 112%和 97%至 124%，表明不同食物组中饱和脂肪的变异性很高。同样，所有选定的应用程序中，乳制品（71%-118%）和预包装食品（84%-118%）中的胆固醇变异性也一直很高。在检查 MyFitnessPal 在不同国家背景下的可靠性时，MyFitnessPal 中的误差在不同国家的 FCD（USDA-FNDSS 和台湾 FCD）中是一致的。无论使用哪个 FCD 作为参考，这些误差仍然具有统计学意义，这表明应用程序的核心数据库是问题的根源，而不仅仅是外部 FCD 中的不匹配或差异。
研究结果表明，饮食追踪应用程序在报告饱和脂肪和胆固醇方面存在大量不准确和不一致的情况。这些问题引发了人们对在不同国家背景下以及在应用程序本身内使用消费者级营养应用程序预防心血管疾病的有效性的担忧。
