@Article{info:doi/10.2196/iproc.6135,
author="Salmenius-Suominen, Heli
and Lehtovirta, Mikko
and Veps{\"a}l{\"a}inen, Henna
and Konttinen, Hanna
and Erkkola, Maijaliisa",
title="Visual Food Diary for Social Support, Dietary Changes and Weight Loss",
journal="iproc",
year="2016",
month="Dec",
day="30",
volume="2",
number="1",
pages="e38",
keywords="mHealth; nutrition; food journal; peer support; obesity",
abstract="Background: To find out to what degree health-improving dietary behavior (eg, increasing consumption of vegetables and fruits) can be furthered in virtual peer support groups moderated by a nutrition professional using a mobile app. Objective: To find out, to what degree health improving dietary behaviour, for example increasing the use of vegetables and fruits can be furthered in virtual peer support groups moderated by a nutrition professional using a mobile application. Methods: In this feasibility study, volunteering adult men and women (body mass index [BMI]>25 kg/m{\texttwosuperior}) were recruited both from a diabetes outpatient clinic and from an occupational health care unit. Participants were divided into 3 groups. All participants used a smartphone app that allowed them to keep a visual food journal, share their meals and activity with group members, and receive virtual coaching from a nutrition professional. Outcomes were assessed via surveys at baseline, after the intervention, and 4 weeks later using a food frequency questionnaire (FFQ). Frequency of app use, weight, and waist circumference were estimated at baseline and after the intervention. Results: Mean weight loss (n=25) after intervention was 1.5 kg (95{\%} CI 0.79 to 2.29), or 1.7{\%} (95{\%} CI 0.89 to 2.5) in all subjects together, and 1.5{\%} in group 1 (95{\%} CI --0.02 to 2.9), 1.9{\%} in group 2 (95{\%} CI 0.56 to 3.25), and 1.7{\%} in group 3 (95{\%} CI --0.20 to 3.61), respectively. Mean waist circumference (n=22) reduced 2.4{\%} (95 {\%} CI 1.3 to 3.4). At the end of the 4-week intervention, the consumption of vegetables and fruits (n=26) had increased by 55{\%}, while the consumption of sweets and chocolate had decreased by 39{\%} as compared to baseline. Almost all participants (84{\%}) strongly agreed (40{\%}) or agreed (44{\%}) that they got support and encouragement from other group members. Similarly, altogether 92{\%} of participants strongly agreed (67{\%}) or agreed (25{\%}) that they felt like they belonged to the group. The engagement level was high, with the average user uploading 5.2 meals a day and recording a total of 9.3 sessions a day. There was some variation between the 3 groups. On average, users in groups 1, 2, and 3 uploaded 3.8 (n=8, 862 meals), 5.8 (n=8, 1315 meals) and 5.7 (n=11, 1774 meals) meals a day, respectively, within the 4 week period. In total, the participants uploaded 3951 meals and recorded 7066 sessions. Conclusions: Smartphone-based virtual peer support can be used as a tool to promote healthy eating both in outpatient clinic and occupational health settings. ",
issn="2369-6893",
doi="10.2196/iproc.6135",
url="http://www.iproc.org/2016/1/e38/",
url="https://doi.org/10.2196/iproc.6135"
}