Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review

A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applications to increase fruit and vegetable intake. PubMed and Web of Science were used to conduct this systematized review, and the inclusion criteria were: randomized controlled trials evaluating mobile phone applications focused on increasing fruit and/or vegetable intake as a primary or secondary outcome performed from 2008 to 2018. Eight studies were included in the final assessment. The interventions described in six of these studies were effective in increasing fruit and/or vegetable intake. Targeting stratified populations and using long-lasting interventions were identified as key aspects that could influence the effectiveness of these interventions. In conclusion, evidence shows the effectiveness of mHealth application interventions to increase fruit and vegetable consumption. Further research is needed to design effective interventions and to determine their efficacy over the long term

Restaurant-based interventions: a new approach to promote healthier and allergy-adapted meals

La oferta de menús saludables i la gestió d’al·lèrgens alimentaris en els restaurants és un repte. L’objectiu era evidenciar estratègies i tecnologies innovadores per millorar la oferta saludable i la gestió dels al·lèrgens en restaurants. Els estudis realitzats son: 1) Un estudi transversal va avaluar l’adherència a la dieta mediterrània, la qualitat nutricional i la gestió dels al·lèrgenes en 44 restaurants (Província Tarragona). Els criteris de dieta mediterrània i gestió d’al·lèrgens es complien parcialment. Els plats haurien d’augmentar la fibra i disminuir els greixos saturats. La formació del personal és necessària per millorar la gestió dels al·lèrgens. 2) Una revisió sistemàtica (35 Estudis Controlats i Aleatoritzats (ECAs) i 6 no-ECAs) i un metaanàlisis (16 ECAs) van avaluar les intervencions efectives en restaurants i cantines per millorar la disponibilitat, compra i ingesta d’àpats saludables. Aquelles aplicades en cantines escolares van augmentar la ingesta i disponibilitat d’aliments saludables, i van disminuir la ingesta de greixos, però la compra va ser parcialment efectiva. 3) Una revisió sistematitzada (8 ECAs) va avaluar intervencions amb aplicacions mòbils (apps) per augmentar la ingesta de fruites i verdures. Les efectives duraven 2-9 meses, incloïen població sana, comentaris, autoavaluació i suport remot. 4) Es va avaluar la qualitat de 14 apps sobre al·lèrgies o intoleràncies alimentaries mitjançant la “Mobile App Rating Scale” a partir d’una cerca sistemàtica. Aquestes apps van mostrar una qualitat acceptable, encara que la secció d’implicació hauria de millorar en aquelles de cerca de productes i restaurants. 5) Es va desenvolupar una web-app per avaluar nutricionalment els plats i identificar els al·lèrgens; aquesta va demostrar bona usabilitat, qualitat i validesa. Concloent, s’han identificat estratègies efectives i recomanacions per millorar la oferta saludable i la gestió dels al·lèrgens en els restaurants. L’ús de tecnologies innovadores ajuda a avaluar nutricionalment els plats i identificar els al·lèrgenes alimentaris.La oferta de menús saludables y la gestión de alérgenos alimentarios en los restaurantes es un reto. El objetivo fue evidenciar estrategias y tecnologías innovadoras para mejorar la oferta saludable y la gestión de alérgenos en restaurantes. Los estudios realizados son: 1) Un estudio transversal evaluó la adherencia a la dieta mediterránea, la calidad nutricional y la gestión de alérgenos en 44 restaurantes (Provincia Tarragona). Los criterios de dieta mediterránea y gestión de alérgenos se cumplían parcialmente. Los platos deberían aumentar la fibra y disminuir grasas saturadas. La formación del personal es necesaria para mejorar la gestión de alérgenos. 2) Una revisión sistemática (35 Estudios Controlados y Aleatorizados (ECAs) y 6 no-ECAs) y un metaanálisis (16 ECAs) evaluaron las intervenciones efectivas en restaurantes y comedores para mejorar la disponibilidad, compra e ingesta de comidas saludables. Las intervenciones aplicadas en comedores escolares aumentaron la ingesta y disponibilidad de alimentos saludables, y disminuyeron la ingesta de grasas, pero la compra fue parcialmente efectiva. 3) Una revisión sistematizada (8 ECAs) evaluó intervenciones con aplicaciones móviles (apps) para aumentar la ingesta de frutas y verduras. Las efectivas duraron 2-9 meses, incluían población sana y comentarios, autoevaluación y apoyo remoto. 4) Se evaluó la calidad de 14 apps sobre alergias o intolerancias alimentarias mediante la “Mobile App Rating Scale” a partir de una búsqueda sistemática. Estas apps mostraron una calidad aceptable, aunque la sección de implicación debe mejorarse en aquellas de búsqueda de productos y restaurantes. 5) Se desarrolló una web-app para evaluar nutricionalmente los platos e identificar los alérgenos; esta demostró buena usabilidad, calidad y validez. Concluyendo, se han identificado estrategias efectivas y recomendaciones para mejorar la oferta saludable y la gestión de los alérgenos en los restaurantes. El uso de tecnologías innovadoras ayuda a evaluar nutricionalmente los platos e identificar los alérgenos alimentarios.Eating out increased, but healthy menu offerings and food allergen management remain a challenge. This thesis aimed to provide evidence about potential innovative strategies and technologies for restaurant-based interventions to improve healthy meal offerings and food allergen management. Studies conducted and obtained findings included: 1) A cross-sectional study assessed the Mediterranean diet adherence, healthiness, nutritional quality, and food allergen management at 44 restaurants in Tarragona Province. Restaurants partially met the Mediterranean-adherent diet and food allergen management criteria. Dishes’ nutritional content should be improved by increasing fibre and decreasing saturated fat. Considering food allergen management as a point to improve, staff training is needed. 2) A systematic review (35 Randomized Controlled Trials (RCTs) and 6 non-RCTs) and meta-analysis (16 RCTs) evaluated effective interventions in restaurants and canteens to improve healthy meals’ availability, purchase, and intake. Interventions implemented mainly in school canteens increased dietary intake and healthy food availability, and decreased fat intake. Purchase of healthy foods was partially effective. 3) A systematized review (8 RCTs) evaluated app-based (mHealth) interventions in increasing fruit and vegetable intake. Effective interventions lasted two to nine months, targeted population with healthy dietary goals, and include dietary feedback, self-monitoring, and remote coaching support strategies. 4) A systematic search of 14 apps about food allergy or intolerance assessed their quality by the Mobile App Rating Scale (MARS). Apps showed acceptable quality, although engagement should be improved for food product and restaurant purpose apps. 5) A study described the Healthy Meals web app (eHealth) development, usability, quality assessment, and validation. The app proved its usability, quality, and validity in dishes’ nutritional content assessment. In conclusion, effective strategies were identified and recommendations were designed for restaurants to improve healthy meal offerings and food allergen management. mHealth and eHealth are innovative technologies to support dishes’ food allergen and nutritional content assessments

Impact of an Intervention on Healthy Offerings and Allergenic Food Management in Restaurants: A Parallel Randomized Controlled Study

The consumption of out-of-home meals is increasing. This study is aimed at assessing the effect of an intervention on healthy offerings and the management of food allergies and intolerances. Ten (control group) and eight restaurants (intervention group) were randomized in a 12-month parallel controlled trial. The outcomes were changes regarding adherence to the Mediterranean diet (AMed) and gluten management (SMAP) criteria, the traffic light rating category, nutrients, and gluten- and allergen-free content of dishes. After 12 months, and compared with baseline, there was an improvement of ≥25% in four items of the AMed criteria in the intervention group, whereas an increase in the offer of dairy desserts without added sugar, and a decrease in the first course offerings of vegetables and/or legumes were observed in the control group (p p p = 0.021) compared with baseline in the intervention group, in which intra- and inter-group improvements for desserts in traffic light ratings, nutrients, and allergens were observed (p < 0.05). Therefore, the intervention showed beneficial effects, improving the quality of menus toward the Mediterranean diet pattern and gluten and food allergy/intolerance management

Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review

A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applications to increase fruit and vegetable intake. PubMed and Web of Science were used to conduct this systematized review, and the inclusion criteria were: randomized controlled trials evaluating mobile phone applications focused on increasing fruit and/or vegetable intake as a primary or secondary outcome performed from 2008 to 2018. Eight studies were included in the final assessment. The interventions described in six of these studies were effective in increasing fruit and/or vegetable intake. Targeting stratified populations and using long-lasting interventions were identified as key aspects that could influence the effectiveness of these interventions. In conclusion, evidence shows the effectiveness of mHealth application interventions to increase fruit and vegetable consumption. Further research is needed to design effective interventions and to determine their efficacy over the long term