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      A Novel Mobile Phone App (OncoFood) to Record and Optimize the Dietary Behavior of Oncologic Patients: Pilot Study

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          Abstract

          Background

          Catabolism and tumor-specific therapy lead to reduced nutrient intake and weight loss in cancer patients. Maintaining a specific individualized diet can be challenging for the patient as the nutritional counseling options are limited. Monitoring of nutrient intake and frequent feedback are, however, vital for successful nutritional therapy because they support the patient’s compliance and realization of dietary therapeutic goals.

          Objective

          This study aimed at investigating the feasibility and applicability of a novel mobile phone app to assess and evaluate dietary behaviors in oncologic patients.

          Methods

          To determine dietary habits and food preferences in oncologic patients, initially 1400 nutritional records were evaluated and analyzed. The results provided the basis for creating a nutritional mobile phone app. Key requirements for the app included simple handling, recording the daily intake, and a comparison of nutrient targets and current status. In total, 39 cancer patients were recruited for the study; 15 patients dropped out prior to the study. All patients received a nutritional anamnesis, nutritional analysis, and nutritional counseling. Individual energy and nutrient aims were defined. The intervention group (n=12) additionally used the app. Weight and body composition of each group were evaluated after 4 weeks.

          Results

          The app group gained significantly more weight ( P=.045; mean weight 1.03 kg vs –1.46 kg). Also, skeletal muscle mass showed a significant increase in the app group ( P=.009; mean skeletal muscle mass 0.58 kg vs –0.61 kg) compared with the control group. There was no significant difference between groups relating to the daily protein intake ( P=.06). Additionally, there was a decrease in macronutrient intake during the study period in the control group.

          Conclusions

          Our study indicates that patients who track their daily dietary habits using a mobile phone app are more likely to reach their nutritional goals than the control patients. Further large-scale studies are needed to confirm these initial findings and test the applicability on a broader basis.

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          Most cited references22

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          Bioelectrical phase angle and impedance vector analysis--clinical relevance and applicability of impedance parameters.

          The use of phase angle (PhA) and raw parameters of bioelectrical impedance analysis (BIA) has gained attention as alternative to conventional error-prone calculation of body composition in disease. This review investigates the clinical relevance and applicability of PhA and Bioelectrical Impedance Vector Analysis (BIVA) which uses the plot of resistance and reactance normalized per height. A comprehensive literature search was conducted using Medline identifying studies relevant to this review until March 2011. We included studies on the use of PhA or BIVA derived from tetrapolar BIA in out- and in-patient settings or institutionalized elderly. Numerous studies have proven the prognostic impact of PhA regarding mortality or postoperative complications in different clinical settings. BIVA has been shown to provide information about hydration and body cell mass and therefore allows assessment of patients in whom calculation of body composition fails due to altered hydration. Reference values exist for PhA and BIVA facilitating interpretation of data. PhA, a superior prognostic marker, should be considered as a screening tool for the identification of risk patients with impaired nutritional and functional status, BIVA is recommended for further nutritional assessment and monitoring, in particular when calculation of body composition is not feasible. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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            The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial.

            Technology may improve self-monitoring adherence and dietary changes in weight loss treatment. Our study aimed to investigate whether using a personal digital assistant (PDA) with dietary and exercise software, with and without a feedback message, compared to using a paper diary/record (PR), results in greater weight loss and improved self-monitoring adherence. Healthy adults (N = 210) with a mean BMI of 34.01 kg/m(2) were randomized to one of three self-monitoring approaches: PR (n = 72), PDA with self-monitoring software (n = 68), or PDA with self-monitoring software and daily feedback messages (PDA+FB, n = 70). All participants received standard behavioral treatment. Self-monitoring adherence and change in body weight, waist circumference, and diet were assessed at 6 months; retention was 91%. All participants had a significant weight loss (P < 0.01) but weight loss did not differ among groups. A higher proportion of PDA+FB participants (63%) achieved ≥ 5% weight loss in comparison to the PR group (46%) (P < 0.05) and PDA group (49%) (P = 0.09). Median percent self-monitoring adherence over the 6 months was higher in the PDA groups (PDA 80%; PDA+FB 90%) than in the PR group (55%) (P < 0.01). Waist circumference decreased more in the PDA groups than the PR group (P = 0.02). Similarly, the PDA groups reduced energy and saturated fat intake more than the PR group (P < 0.05). Self-monitoring adherence was greater in the PDA groups with the greatest weight change observed in the PDA+FB group.
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              Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study.

              Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients.
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                Author and article information

                Contributors
                Journal
                JMIR Cancer
                JMIR Cancer
                JC
                JMIR Cancer
                JMIR Publications (Toronto, Canada )
                2369-1999
                Jul-Dec 2018
                20 November 2018
                : 4
                : 2
                : e10703
                Affiliations
                [1 ] Hector Center for Nutrition, Exercise, and Sports Department of Internal Medicine 1 University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg Erlangen Germany
                [2 ] Embedded Systems Institute Department of Informatics Friedrich-Alexander University Erlangen-Nürnberg Erlangen Germany
                [3 ] Machine Learning and Data Analytics Lab Department of Computer Science Friedrich-Alexander University Erlangen-Nürnberg Erlangen Germany
                [4 ] Department of Internal Medicine 1 University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg Erlangen Germany
                Author notes
                Corresponding Author: Till Orlemann till.orlemann@ 123456uk-erlangen.de
                Author information
                http://orcid.org/0000-0002-9856-4415
                http://orcid.org/0000-0001-8049-1775
                http://orcid.org/0000-0001-9710-0590
                http://orcid.org/0000-0002-1356-7597
                http://orcid.org/0000-0002-0417-0336
                http://orcid.org/0000-0003-0376-0577
                http://orcid.org/0000-0002-3021-8022
                http://orcid.org/0000-0003-4344-1474
                http://orcid.org/0000-0002-3432-7488
                Article
                v4i2e10703
                10.2196/10703
                6280033
                30459139
                9c7b46e1-0bf4-485d-843d-b7454aed6083
                ©Till Orlemann, Dejan Reljic, Björn Zenker, Julia Meyer, Bjoern Eskofier, Jana Thiemt, Hans Joachim Herrmann, Markus Friedrich Neurath, Yurdagül Zopf. Originally published in JMIR Cancer (http://cancer.jmir.org), 20.11.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on http://cancer.jmir.org/.as well as this copyright and license information must be included.

                History
                : 11 April 2018
                : 5 June 2018
                : 26 July 2018
                : 14 August 2018
                Categories
                Original Paper
                Original Paper

                cancer,mobile apps,diet,nutrition,protein intake,smartphone,mobile phone

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