Chung Krista Ching Wai, Takemura Naomi, Lam Wendy Wing Tak, Ho Mandy Man, Lee Antoinette Marie, Chan Wynnie Yuen Yee, Fong Daniel Yee Tak
School of Nursing, University of Hong Kong, 5/F, HKUMed Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong, China (Hong Kong), 852 39176645.
School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong).
JMIR Mhealth Uhealth. 2025 Jul 31;13:e65505. doi: 10.2196/65505.
The World Health Organization recommends that cancer survivors maintain a healthy diet and weight control to prevent cancer recurrence. Albeit a growing interest in using mobile apps for health promotion, there is a need for comprehensive evidence on the effects of mobile apps, particularly on dietary behaviors.
This study aims to evaluate the efficacy, feasibility, and acceptability of mobile app-based dietary interventions among cancer survivors and explore the potential mobile app features worth incorporating.
In this systematic review and meta-analysis, we searched Embase, Cochrane Library, PubMed, and Web of Science from inception to September 2023 without language restriction. We identified studies that used mobile apps for dietary interventions as a major module for cancer survivors. In addition, 2 independent reviewers screened the studies, extracted data, and assessed methodological quality using Cochrane's risk of bias tools for randomized trials (RoB 2) and nonrandomized studies (ROBINS-I). A meta-analysis was conducted on body weight, BMI, nutritional outcomes, and quality of life using random-effects models.
Of the 2621 records identified, 22 studies involving 1204 cancer survivors were included. Notably, existing trials involved only breast and gastrointestinal cancer survivors. Preliminary evidence suggested that mobile app-based dietary interventions demonstrated a beneficial effect on energy intake (Hedges g=1.00, 95% CI 0.96-1.03) and weight changes (Hedges g=-0.43, 95% CI -0.45 to -0.41); as well as a potential to improve protein intake and quality of life among gastrointestinal cancer survivors. The usability, quality, and satisfaction of app use as measured by standardized questionnaires, including the System Usability Scale, the Mobile Application Rating Scale, and the Questionnaire for User Interface Satisfaction, were positive. While feedback messages and dietary goal setting were considered facilitators of mobile app use, concerns regarding the time required for app use and limited food logging options were raised.
Our review found the preliminary efficacy, feasibility, and acceptability of mobile app-based dietary interventions for cancer survivors. However, study heterogeneity should be recognized. More trials are warranted to confirm the effectiveness of these interventions and explore any differences based on cancer types, staging, treatment statuses, the mode of communication with dietitians, and the engagement of family or caregivers. Existing mobile apps could maintain important features such as feedback messages and dietary goal setting while considering the incorporation of artificial intelligence-powered food recognition in food logging and cancer-specific dietary recommendations.
世界卫生组织建议癌症幸存者保持健康饮食并控制体重，以预防癌症复发。尽管人们对使用移动应用程序促进健康的兴趣日益浓厚，但仍需要关于移动应用程序效果的全面证据，尤其是对饮食行为的影响。
本研究旨在评估基于移动应用程序的饮食干预对癌症幸存者的疗效、可行性和可接受性，并探索值得纳入的潜在移动应用程序功能。
在这项系统评价和荟萃分析中，我们检索了从创刊到2023年9月的Embase、Cochrane图书馆、PubMed和Web of Science，无语言限制。我们确定了将使用移动应用程序进行饮食干预作为癌症幸存者主要模块的研究。此外，两名独立评审员筛选了研究，提取了数据，并使用Cochrane随机试验偏倚风险工具（RoB 2）和非随机研究工具（ROBINS-I）评估了方法学质量。使用随机效应模型对体重、BMI、营养结局和生活质量进行了荟萃分析。
在识别出的2621条记录中，纳入了22项涉及1204名癌症幸存者的研究。值得注意的是，现有试验仅涉及乳腺癌和胃肠道癌幸存者。初步证据表明，基于移动应用程序的饮食干预对能量摄入（Hedges g = 1.00，95% CI 0.96 - 1.03）和体重变化（Hedges g = -0.43，95% CI -0.45至-0.41）有有益影响；对胃肠道癌幸存者的蛋白质摄入和生活质量也有改善潜力。通过标准化问卷（包括系统可用性量表、移动应用程序评分量表和用户界面满意度问卷）测量的应用程序使用的可用性、质量和满意度是积极的。虽然反馈消息和饮食目标设定被认为是移动应用程序使用的促进因素，但也有人提出了对应用程序使用所需时间和有限的食物记录选项的担忧。
我们的综述发现基于移动应用程序的饮食干预对癌症幸存者具有初步疗效、可行性和可接受性。然而，应认识到研究的异质性。需要更多试验来证实这些干预措施的有效性，并探索基于癌症类型、分期、治疗状态、与营养师的沟通方式以及家庭或照顾者参与情况的差异。现有移动应用程序可以保留反馈消息和饮食目标设定等重要功能，同时考虑在食物记录中纳入人工智能驱动的食物识别和特定癌症的饮食建议。
