Engaging and retaining users on mobile health apps - nuggets of wisdom

May 04, 2022 2:24pm

Each time I watch the news, it seems like every day is a history-making day. There are so many factors impacting our daily lives that it can be difficult to keep up and make sense of it all.

In this week's newsletter:

Latest research, Roche partners with Fitterfly, New eNutri app published effectiveness data, Plantjammer changes strategy, A decade of health disparities and lots more!

Yours in health,

Mariette & the rest of the Qina team

Research update

Microbiome and metabolome features of the cardiometabolic disease spectrum

The present microbiome and metabolome study is focused on ischemic heart disease (IHD). This article shows that a vast majority of the intestinal microbiome and metabolome signatures, previously reported as characteristics of IHD, are in fact, already present in individuals with common dysmetabolic phenotypes, such as obesity and T2D.

Environmental factors shaping the gut microbiome in a Dutch population

This study "profiled bacterial composition, function, antibiotic resistance and virulence factors in the gut microbiomes of 8,208 Dutch individuals from a three-generational cohort comprising 2,756 families." The results show that "the microbiome is shaped primarily by the environment and cohabitation. Only around 6.6% of taxa are heritable, whereas the variance of around 48.6% of taxa is significantly explained by cohabitation. By identifying 2,856 associations between the microbiome and health, the researchers find that seemingly unrelated diseases share a common microbiome signature that is independent of comorbidities. Furthermore, 7,519 associations were identified between microbiome features and diet, socioeconomics and early life and current exposome, with numerous early-life and current factors being significantly associated with microbiome function and composition".

A systems genomics approach to uncover patient-specific pathogenic pathways and proteins in ulcerative colitis

This study describes "a precision medicine workflow, the integrated single nucleotide polymorphism network platform (iSNP), designed to determine the mechanisms by which SNPs affect cellular regulatory networks, and how SNP co-occurrences contribute to disease pathogenesis in ulcerative colitis (UC)".

Association of Sleep Duration and Quality With Subclinical Atherosclerosis

This study aimed to "evaluate the association of actigraphy-measured sleep parameters with subclinical atherosclerosis in an asymptomatic middle-aged population and investigate interactions among sleep, conventional risk factors, psychosocial factors, dietary habits, and inflammation". The study followed 3,974 bank employees in Spain from the PESA CNIC-Santander Study. The average age of the participants was 46 years with no known heart disease and two-thirds of the participants were men. Study subjects wore a device called an actigraph, which measures all movement for 7 days, to record their sleep, and were divided into 4 groups: (1) those who slept less than 6 hours, (2) those who slept 6 to 7 hours, (3) those who slept 7 to 8 hours, (4) and those who slept more than 8 hours. After risk factors were weighed in, the results showed that "those who slept less were more likely to have atherosclerosis throughout the body compared with those who slept 7 to 8 hours. Those with poor quality sleep were 34% more likely to have atherosclerosis than those who slept soundly, as measured by the frequency of movements recorded by the device".

Obesity – an unexplained epidemic

Since 1990, obesity prevalence has grown among U.S. adults (from 12% to 42%). The commonly accepted explanation is pervasive overeating. But, national data on energy intake and energy availability show plateauing or declines after 2000 (even as obesity continued rising and while physical activity modestly increased). So, can physiologic adaptations have created a biological milieu that interacts with industrialized foods and consequently increases obesity rates? Growing evidence suggests a complex, interrelated biologic interaction between food processing (including acellular nutrients, depleted prebiotics, additives), gut microbial composition and function, host metabolic expenditure, and inter-generational transmission of risk (including epigenetics, non-coding RNAs, microbial species), that should be explored further.

Challenges in Participant Engagement and Retention Using Mobile Health Apps: Literature Review

This review aims to identify notable factors and strategies used by mobile health (mHealth) apps to engage and retain participants. The results have shown that factors related to particular elements of the app (eg, feedback, appropriate reminders, and in-app support from peers or coaches) and research strategies (eg, compensation and niche samples), promote the retention of the participants. On the other hand, factors that obstructed retention were also identified (eg, lack of support features, technical difficulties, and usefulness of the app).

Developing a Dietary Lifestyle Ontology to Improve the Interoperability of Dietary Data: Proof-of-Concept Study

The main goal of this study was to address the interoperability challenge of questionnaire-based dietary data from different cultural backgrounds by combining ontological curation and metadata annotation of dietary concepts. Specifically, this study aimed to develop a Dietary Lifestyle Ontology (DILON). DILON was built with 262 concept classes and validated with ontology validation tools. Also, 68 data elements on dietary habits selected from Korean and English questionnaires, were crossed with DILON competency questions. The results show "a small overlap (72 concepts) in the concepts extracted from the questionnaires in 2 languages indicates that we need to pay closer attention to representing culture-specific dietary concepts".

The gut microbiome as a modulator of healthy ageing

This review explored studies about the gut microbiome of older individuals and targeted the restoration of microorganisms associated with healthier ageing. The conclusions suggested that "the gut microbiome is a transducer of environmental signals, modifies the risk of disease across all age groups and changes with host age. Age-related alterations in the gut microbiome are influenced by personal factors, including progressive physiological deterioration, as well as lifestyle-linked factors such as diet, medication, and reduced social contact". The proposed approaches for resetting gut microbiome-derived signals of ‘unhealthy’ ageing are through personalized or subpopulation-level microbiome-associated interventions, including dietary intervention with the microbial restoration of lost strains.

Global, distinctive, and personal changes in molecular and microbial profiles by specific fibres in humans

This study yields insights into the effects of fibre supplementation and the mechanisms behind fibre-induced cholesterol reduction. It shows the effects of individual, purified fibres (arabinoxylan (AX) and long-chain inulin (LCI) on the microbiome. The results show that "each fibre is associated with fibre-dependent biochemical and microbial responses. AX consumption is associated with a significant reduction in LDL and an increase in bile acids, contributing to its observed cholesterol reduction. LCI is associated with an increase in Bifidobacterium. However, at the highest LCI dose, there is increased inflammation and elevation in the liver enzyme alanine aminotransferase".

Where am I speaking next?

This event is in its second year and brings together industry, academia, entrepreneurs and innovators to solve the future of future of food.

I will be delivering a session on Personalised nutrition and participate as part of the Blendhub panel discussion

For more information on the event, and to claim your discount click here.

Technology News

Roche Diabetes Care and Fitterfly Partner to Improve Outcomes

Roche Diabetes Care India (RDC) and Fitterfly Healthtech, India's leading Digital Therapeutics (DTx) company have partnered to co-create a 90-day diabetes management programme for people with type 2 diabetes. The programme is designed to study the effects of various food groups on blood sugars with Fitterfly’s unique meal-mapping technology, and also provides supplement medical treatment with nutrition, fitness, and stress management solutions. The programme is more suited for individuals with newly diagnosed type 2 diabetes, new and fast-changing prescriptions for insulin, or those who have spotted new symptoms indicating long-term complications of diabetes.

PNU 15.2022: Innit Expands Partnership With Roche Diabetes Care France for Healthy Eating, Enabling Connection to Blood Glucose Meters

Nissin Foods and Toyota Partner to Realize Well-Being for All Through Food

Nissin Food Products Co., Ltd. (Nissin Foods) and Toyota Motor Corporation (Toyota) have initiated an agreement to improve the health and well-being of residents of Woven City (Shizuoka, Japan). This proposed plan will explore Nissin’s innovative food offering, based on the latest molecular nutritional science, providing meals with all the necessary nutrients, and with controlled calories, salt, sugar, and fat while maintaining the appearance and taste of the food (“Complete Nutrition Meals”). In the future "Complete Nutrition Meals" will be optimized with data based on each individual’s needs.

Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial

eNutri is a UK web-based app that aims to record accurate information about what people eat and drink. This study validates the app with "findings suggesting that eNutri app is an effective tool for the automated delivery of personalized nutrition (PN) advice. Furthermore, eNutri was demonstrated to improve short-term diet quality and increase engagement in healthy eating behaviours in UK adults, as compared with population-based healthy eating guidelines". The study showed that for participants receiving PN advice from e-Nutri, the overall m-AHEI (US modified Alternative Healthy Eating Index) score increased by 6.1% (compared with that in the control group - population-based healthy eating guidelines). Specifically, the m-AHEI components nuts and legumes and red and processed meat showed significant improvements. At follow-up, 64% of e-Nutri participants agreed that, compared with baseline, they were still following some of the advice received and 31% were still motivated to improve their diet.

Food-as-medicine startup Season Health nabs $34M backed by Andreessen Horowitz, Cityblock's Toyin Ajayi

The US-based company, Season Health scored $34 million to scale up its business. These funds will be used to rapidly expand payer and provider collaborations, grow its team, and ramp up national retail integrations, company executives said in a press release. Season Health works with dietitians to develop meal plans aimed at helping patients manage chronic conditions, such as diabetes and kidney issues. With a "food as medicine" approach, the startup combines digital food pharmacy with meal prescriptions and delivery logistics.

Related Articles:

PNU 09.2022: Season Health Wants to Help People Manage Chronic Diseases With Nutrition

Plant jammer changes strategy and business model

“Plant Jammer has changed tracks dramatically during the past 5 months. Some people noticed that our former employees have been searching and finding jobs. We have gone from an 18 person company to a 0 person company. However, we did NOT close shop. Plant Jammer continues to support sustainable food action by individuals and companies.”

Food & Consumer Trends

Women Are Calling Out ‘Medical Gaslighting’

“Medical gaslighting” is a term used for patients that felt that their symptoms were inappropriately dismissed as minor or primarily psychological by doctors. This article points to concerning topics about medical treatment, especially on women and black women. "Research suggests that diagnostic errors occur in up to one out of every seven encounters between a doctor and patient and that most of these mistakes are driven by the physician’s lack of knowledge. Women are more likely to be misdiagnosed than men in a variety of situations. Studies have shown that compared with men, women face longer waits to be diagnosed with cancer and heart disease, are treated less aggressively for traumatic brain injury, and are less likely to be offered pain medications. People of colour often receive poorer quality care, too; and doctors are more likely to describe Black patients as uncooperative or non-compliant, which research suggests can affect treatment quality. (...) Women say doctors frequently blame their health problems on their mental health, weight, or a lack of self-care, which can delay effective treatment".

Ardent Mills diversifies alt-grains portfolio with keto-friendly and gluten-free blends

This article shows that keto and gluten-free claims are gaining strength in the food industry and in the weight loss market. Innova Market Insights shows that many consumers no longer fear consuming fat and instead look to eliminate carbohydrates such as grains and sugars.

Resources

A Decade of Nutrition and Health Disparities Research at NIH, 2010–2019

Online Choice Architecture How digital design can harm competition and consumers

Choice architecture describes the contexts in which people make decisions and how choices are presented to them. In online settings, choice architecture is the environment in which users act, including the presentation and placement of choices and the design of interfaces. Online choice architecture (OCA) can be designed to help consumers, or alternatively, in ways that result in harm. This UK paper provides summaries of the evidence on 21 OCA practices (for example, defaults), organized into 3 sections: Choice Structure, Choice Information, and Choice Pressure.