Development of an application for mobile devices to monitor food intake: evaluation of available online applications

Introduction: The availability of food consumption and fitness related applications (APP) has increased in the last years, but scientific research is still limited regarding the evaluation of data reliability and about their use in clinical practice. Objectives: to evaluate the currently available applications for mobile devices, like smartphones and tablets, in order to develop a new APP (BDA-APP) based on the Food Composition Database for Epidemiological Studies in Italy (BDA). Methods: We identified five applications available on Google Play Store having more than 4-stars ratings, which included a food composition database and in Italian language. A quality score was applied to each of the following items: accuracy of contents, scientific quality, technical aspects and nutrient calculation. Using a 3-day food diary, the nutri tional values obtained from each APP were compared to those obtained by using Italian food composition data, by means of a reference soft ware (Microdiet, Downlee Systems Ltd, UK). The total quality score can range from a minimum of 0 to a maximum of 82 points. Results: The five applications identified were: Melarossa, Lifesum, Fat Secret, Yazio and MyFitnessPal. Except for Melarossa that includes Italian food composition data (CREA, Rome) and is supervised by the Societa Italiana di Scienze dell’Alimentazione, the other APPs were based on non-Italian food composition databases and were developed in other countries. Lifesum achieved the highest total score of 49 points. The evaluation of nutrient calculation was sub-optimal for all applications, and the highest score was obtained by FatSecret (8 out of 14 points). In general, the APPs report an overestimation or an underestimation of macronutrients: Yazio underreported fibre by 28%, Lifesum over reported carbohydrates by 16%. Misreporting was even higher for micronutrients. The cause of these errors could be due to the use of different food composition databases (USDA, UK, SE, DE) and to the possibility for users to upload their own composition data. Conclusions: The development process of a mobile APP needs to identify the characteristics that can make the APP competitive, scientifically valid and with reliable nutritional values. The BDA-APP could become a useful tool for dietitians to monitor the food intake of their patients.