Improving Heart Disease Risk Through Quality-Focused Diet Logging: Pre-Post Study of a Diet Quality Tracking App

Area of Science:

• Cardiovascular health
• Behavioral science
• Digital health

Background:

• Diet-tracking mobile apps are popular but often focus on calorie counting, which can hinder long-term use.
• Diet quality, emphasizing healthy dietary patterns over precise quantification, shows promise for improving heart disease risk.
• The Healthy Heart Score (HHS) assesses cardiovascular risk based on food categories, not detailed portion sizes.

Purpose of the Study:

• To design and evaluate a mobile app that supports a quality-focused dietary approach using the HHS framework.
• To enable users to log simplified diet quality and visualize its real-time impact on future heart disease risks.
• To assess the app's feasibility and efficacy in improving clinical and behavioral factors related to heart disease risk and user adoption.

Main Methods:

• Recruited 38 overweight/obese participants with high heart disease risk.
• Participants used the app for 5 weeks, logging food categories predictive of HHS.
• Measured weight, blood sugar, blood pressure, HHS, and diet score (DS) at baseline and week 5.

Main Results:

• 79% of participants used the app weekly, showing significant improvements in diet score (DS) and HHS.
• Improvements in DS (P=.008) and HHS (P=.02) were observed by week 5.
• No significant changes were noted in weight, blood sugar, or blood pressure; only 26% reviewed their HHS scores more than once.

Conclusions:

• The developed logging tool effectively improved dietary choices and diet quality.
• Participants perceived logging diet categories as irrelevant to improving HHS and showed low interest in viewing their risk scores.
• Designing effective mHealth apps requires addressing user-specific behavior change goals and complexities of health risk monitoring.