A Smartphone App to Improve Intuitive Eating and Diet Quality: Design and Usability Study.

backgroundWeb-based and mobile phone-based apps have become widely available for dietary self-monitoring; however, their use may increase the risk of disordered eating. College students frequently demonstrate poor nutrient intake despite consumption of sufficient calories. One way to improve diet quality may be via the use of a smartphone app that encourages intuitive eating.

objectiveThe purpose of this study was to improve diet quality among college students through the use of a novel smartphone app that promotes intuitive eating rather than calorie counting and weight loss.

methodsThe In2Eat iOS mobile app was developed in SwiftUI and stored user data in a Firebase database. A total of 45 college students completed assessments of intuitive eating, diet quality, and disordered eating before and after 4 weeks of using the In2Eat app. Users evaluated the usability of the app with the System Usability Scale (SUS). Engagement with the app was recorded as the total number of days a meal was logged, the total number of meals logged, and the average number of meals logged per day.

resultsAfter our 4-week intervention, dietary qualities that protect against chronic disease increased by 28%, fruit consumption increased by 63%, and skin antioxidant levels increased by 6.1% (Hedges g=0.16; mean difference 0.33, 95% bias corrected and accelerated [BCa] CI 0.04-0.61; P=.03). Global intuitive eating did not change during the user study; however, the unconditional permission to eat subscale increased (Hedges g=-0.28; mean difference 0.28, 95% BCa CI 0.07-0.49; P=.01, adjusted P=.07). Overall, disordered eating also did not change with app use, although dietary restraint decreased (Hedges g=-0.23; mean difference 0.30, 95% BCa CI -0.61 to -0.04; P=.04, adjusted P=.22). The average SUS score for the In2Eat app was 67.2 (SD 15.5). The number of days a meal was logged was positively correlated with SUS scores (r=0.28; P=.06), and the total number of meals logged had a monotonic association with app usability (ρ=0.31; P=.04). When divided according to the low (mean 10.2, SD 5.3), medium (mean 26.3, SD 2.8), and high (mean 33.6, SD 3.8) number of days logging meals, participants with higher days of logging reported the app as more usable (H=6.75; P=.03). A regression analysis showed that 8% of the variance in system usability (R

conclusionsAn intuitive eating smartphone app can improve diet quality without increasing disordered eating. Results suggest that participants who logged more meals tended to rate the app as more usable. Further research is needed with a greater sample size after incorporating features to improve the app's usability.