Nutr Res Pract.  2023 Dec;17(6):1238-1254. 10.4162/nrp.2023.17.6.1238.

The effects of dietary self-monitoring intervention on anthropometric and metabolic changes via a mobile application or paper-based diary: a randomized trial

• Jin T
• Kang G
• Song S
• Lee H
• Chen Y
• Kim SE
• Shin MS
• Park YH
• Lee JE

• KMID: 2548889
• DOI: http://doi.org/10.4162/nrp.2023.17.6.1238

Abstract

BACKGROUND/OBJECTIVES
Weight loss via a mobile application (App) or a paper-based diary (Paper) may confer favorable metabolic and anthropometric changes.
SUBJECTS/METHODS
A randomized parallel trial was conducted among 57 adults whose body mass indices (BMIs) were 25 kg/m ² or greater. Participants randomly assigned to either the App group (n = 30) or the Paper group (n = 27) were advised to record their foods and supplements through App or Paper during the 12-week intervention period. Relative changes of anthropometries and biomarker levels were compared between the 2 intervention groups. Untargeted metabolic profiling was identified to discriminate metabolic profiles.
RESULTS
Out of the 57 participants, 54 participants completed the trial. Changes in body weight and BMI were not significantly different between the 2 groups (P = 0.11). However, body fat and low-density lipoprotein (LDL)-cholesterol levels increased in the App group but decreased in the Paper group, and the difference was statistically significant (P = 0.03 for body fat and 0.02 for LDL-cholesterol). In the metabolomics analysis, decreases in methylglyoxal and (S)-malate in pyruvate metabolism and phosphatidylcholine (lecithin) in linoleic acid metabolism from pre- to post-intervention were observed in the Paper group.
CONCLUSIONS
In the 12-week randomized parallel trial of weight loss through a App or a Paper, we found no significant difference in change in BMI or weight between the App and Paper groups, but improvement in body fatness and LDL-cholesterol levels only in the Paper group under the circumstances with minimal contact by dietitians or health care providers. Trial Registration: Clinical Research Information Service Identifier: KCT0004226

Keyword

Randomized controlled trial; mobile applications; weight loss; metabolomics

Figure

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  Fig. 1 Flow diagram of the study.BMI, body mass index.

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  Fig. 2 Manhattan plots, heat maps, and PCA score plots of metabolic profiles within each group. (A-C) Metabolic profiles within the App group. (D-F) Metabolic profiles within the Paper group. (A, D) Manhattan plots including all detected metabolites within the App or Paper group, respectively. The blue dot represents the metabolites significantly increased from pre- to post-intervention, and the red dot represents the metabolites significantly decreased. (B, E) Heat maps include significant metabolites within the App or Paper group, respectively. The green panel represents pre-intervention, and the red panel represents post-intervention. (C, F) PCA score plots within the App or Paper group, respectively. The green triangle represents the metabolite cluster at pre-intervention and the red triangle represents the metabolite cluster at post-intervention.PCA, principal component analysis; App, mobile application; Paper, paper-based diary.

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  Fig. 3 Metabolic pathway analysis within the App group and the Paper group. (A, B) Pathway impact score plots within the App group and the Paper group, respectively. The size and color of the bubble represent the pathway impact score and P-value obtained from metabolic pathway analysis. The annotated pathway represents the selected important metabolic pathway within the App and Paper group.App, mobile application; Paper, paper-based diary.

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  Fig. 4 Differences in changes in metabolite intensity between the App group and the Paper group. The bar graph represents the metabolites significantly changed from pre- to post-intervention within the App and Paper group. The y-axis represents metabolite intensity at pre- and post-intervention within each group. The within-group difference was calculated using pre- and post-intervention metabolite intensity by paired t-test and Wilcoxon signed-rank test. The between-group difference was calculated using metabolite intensity difference (post-intervention intensity – pre-intervention intensity) by independent t-test and Wilcoxon rank sum test.App, mobile application; Paper, paper-based diary.

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  Fig. 5 Change in body weight according to the number of recording days in the App group and the Paper group.App, mobile application; Paper, paper-based diary.

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