Objective: There is a global need for individualized dietician education for the management and prevention of diabetes. Dietician consultation achieves better outcomes than primary care guidance alone, but long-term diet counseling to support sustained change is costly. Smartphones have provided new, scalable methods for achieving and maintaining lifestyle changes. The primary aim of this study was to determine whether the dietary recommendations made by a Digital Dietician were comparable to those made by a registered dietician in terms of safety, practicality, nutrition, health, and calorie control. A secondary aim was to determine the usefulness of the Digital Dietician to help individuals achieve lifestyle changes.

Methods: Two dieticians analyzed nearly 2,000 dietary recommendations given by the app over 4 months. A five point scale was assigned to each of the following categories: safety, practicality, nutrition, health, and calorie control. In addition, we also measured participant engagement with the app, changes in body weight over time, and participant reported results of their experience with the app.

Results: The overall composite score of the application’s recommendations was 17.9 out of 25 (higher scores indicate better recommendations). Recommendations scored most highly in the safety category, averaging 4.92 out of 5 points (SD ± 0.35), followed by practicality (4.00 ± 1.39), health (3.29 ± 1.09), and nutrition (3.± 1.13), with calorie control receiving the lowest scores (2.65 ± 1.35). Participants indicated that the app helped them achieve their health goals, and we observed an average weight loss of 0.31 pounds per week while the app was being used.

Conclusion: The recommendations given by the app were comparable to those of a dietician. The app also appears to have helped participants set and achieve their health goals. While there is certainly room for improvement, this and other nutrition applications for mobile devices have an exciting potential and offer a framework for evaluation.


C.C. Farfan: None. C. Axelrod: None. D.L. Frase: None. A. Mackenzie: Stock/Shareholder; Self; Johnson & Johnson Services, Inc.. G. Haroush: None. K. Castorino: None.

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