Q&A: New app aims to help people hit nutrition targets

A free application that is designed to help people hit the recommended target of eating five portions of fruits and vegetables a day is now available for Android users.

Katherine M. Appleton, PhD, a professor in the department of psychology and faculty of science and technology at Bournemouth University, led the development of the app.

The SMART-5-A-DAY app tells users if they are eating the right foods and portion sizes to meet recommended nutrition guidelines from U. K. health authorities, which only about one-third of adults do, according to a press release. A previous study by Appleton and colleagues found that, even though most adults in the U.K. are aware of the recommended targets, they did not know how to achieve them.

A pilot randomized controlled trial testing a previous version of the app found that it had “some impacts on fruit and vegetable outcomes,” Appleton and colleagues wrote. The app’s benefits were small, but after reviewing patterns of app usage and qualitative feedback, the researchers made modifications that they believe will increase its benefits. The final product, according to Appleton and colleagues, “incorporates several behavior-change techniques (goal-setting, self-monitoring and personalized feedback) as well as aiming to improve knowledge.”

To learn more, Healio spoke with Appleton about how the app works and how it can help people improve their food consumption.

Healio: Can you describe the app and how it works?

Appleton: The app allows users to input fruits and vegetables in household measures, converts this to portions, as dictated by the five-a-day message, provides this information to increase understanding of portion sizes, provides information on the amount required for a full portion if less than a full portion is consumed, tracks intakes and provides motivational messaging to aid adherence. The conversion of consumption into portions as dictated by the message, and the provision of this information are unique features of the app. In contributing to daily totals, fruits and vegetables are also only added until one portion is reached, requiring the consumption of five different portions and understanding of the concept of variety. The information is intended to educate users, but also ensures this information is directly relevant to the user (ie, they only get the information on the fruits and vegetables that they consume), can be gained at the time and location of consumption, and is provided in a clear and accessible manner.

Healio: Why did you decide to work on this app? Why is this important to you?

Appleton: The app is based on earlier work demonstrating low fruit and vegetable consumption among the population to try and find strategies for increasing consumption. Secondly, while the majority of U.K. adults are aware of the five-a-day message and could recount this correctly in studies, knowledge of the details of the message (which foods are included, portion sizes, need for variety and reasons for consumption) was low. Lower knowledge was also associated with lower fruit and vegetable consumption.

Fruit and vegetable consumption was not independently associated with knowledge of any one aspect of the message, but respondents had lowest knowledge of the details of the message related to portion sizes and the need for variety. Prior to this work, some qualitative work specifically conducted in low consumers of fruits and vegetables also found particular difficulties with the portion size and variety components of the message.

Healio: How could this app be used in primary care?

Appleton: The app is about prevention rather than treatment and could be used in primary care but is intended really for use in the general population. Some primary care populations that may benefit particularly from fruit and vegetable consumption may find it useful.

Healio: Is there anything else you’d like to add?

Appleton: The app is primarily intended to teach people about portion sizes and appropriate fruit and vegetable consumption during the time that they use the app, such that following a limited period, they have this knowledge and can use it for themselves. Ongoing use of the app is possible, but this is not our aim. The app is free of charge for users and is currently available until March 29. It is only suitable for Android phones.

References:

• Appleton KM, et al. J Hum Nutr Diet. 2018;doi: 10.1111/jhn.12487.
• Appleton KM, et al. JMIR mHealth uHealth. 2019;doi:10.2196/14380.
• New app to help people eat the right portion sizes to get to 5 a day. https://www.eurekalert.org/news-releases/975080. Published Dec. 28, 2022. Accessed Jan. 4, 2023.
• Rooney C, et al. J Hum Nutr Diet. 2017; doi:10.1111/jhn.12393.