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Use of fitness and nutrition apps : associations with body mass index, snacking, and drinking habits in adolescents

Nathalie De Cock (UGent) , Jolien Vangeel, Carl Lachat (UGent) , Kathleen Beullens, Leentje Vervoort (UGent) , Lien Goossens (UGent) , Lea Maes (UGent) , Benedicte Deforche (UGent) , Stefaan De Henauw (UGent) , Caroline Braet (UGent) , et al.
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Abstract
Background: 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. Objectives: 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. Methods: 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) x100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. Results: 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 x b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a x 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. Conclusions: 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.
Keywords
mhealth, adolescents, snacks, beverages, body mass index, PHYSICAL-ACTIVITY, MOBILE APPS, WEIGHT MANAGEMENT, DIETARY-INTAKE, HEALTH, FOOD, QUESTIONNAIRE, DETERMINANTS, CONSUMPTION, PREDICTORS

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Citation

Please use this url to cite or link to this publication:

Chicago
De Cock, Nathalie, Jolien Vangeel, Carl Lachat, Kathleen Beullens, Leentje Vervoort, Lien Goossens, Lea Maes, et al. 2017. “Use of Fitness and Nutrition Apps : Associations with Body Mass Index, Snacking, and Drinking Habits in Adolescents.” Jmir Mhealth and Uhealth 5 (4).
APA
De Cock, N., Vangeel, J., Lachat, C., Beullens, K., Vervoort, L., Goossens, L., Maes, L., et al. (2017). Use of fitness and nutrition apps : associations with body mass index, snacking, and drinking habits in adolescents. JMIR MHEALTH AND UHEALTH, 5(4).
Vancouver
1.
De Cock N, Vangeel J, Lachat C, Beullens K, Vervoort L, Goossens L, et al. Use of fitness and nutrition apps : associations with body mass index, snacking, and drinking habits in adolescents. JMIR MHEALTH AND UHEALTH. 2017;5(4).
MLA
De Cock, Nathalie, Jolien Vangeel, Carl Lachat, et al. “Use of Fitness and Nutrition Apps : Associations with Body Mass Index, Snacking, and Drinking Habits in Adolescents.” JMIR MHEALTH AND UHEALTH 5.4 (2017): n. pag. Print.
@article{8519467,
  abstract     = {Background: 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. 
Objectives: 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. 
Methods: 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) x100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. 
Results: 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 x b=0.02 [0.01], P=.02) and the nutrition app use frequency-zBMI (a x 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. 
Conclusions: 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.},
  articleno    = {e58},
  author       = {De Cock, Nathalie and Vangeel, Jolien and Lachat, Carl and Beullens, Kathleen and Vervoort, Leentje and Goossens, Lien and Maes, Lea and Deforche, Benedicte and De Henauw, Stefaan and Braet, Caroline and Eggermont, Steven and Kolsteren, Patrick and Van Camp, John and Van Lippevelde, Wendy},
  issn         = {2291-5222},
  journal      = {JMIR MHEALTH AND UHEALTH},
  keyword      = {mhealth,adolescents,snacks,beverages,body mass index,PHYSICAL-ACTIVITY,MOBILE APPS,WEIGHT MANAGEMENT,DIETARY-INTAKE,HEALTH,FOOD,QUESTIONNAIRE,DETERMINANTS,CONSUMPTION,PREDICTORS},
  language     = {eng},
  number       = {4},
  pages        = {16},
  title        = {Use of fitness and nutrition apps : associations with body mass index, snacking, and drinking habits in adolescents},
  url          = {http://dx.doi.org/10.2196/mhealth.6005},
  volume       = {5},
  year         = {2017},
}

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