# The Effect of a Mobile Health Dietary Education Intervention on Ultra-processed Food Consumption in Patients with Type 2 Diabetes: A Randomized Controlled Trial

## TL;DR

A mobile health app aimed at improving diet in people with type 2 diabetes did not significantly reduce their consumption of ultra-processed foods.

## Contribution

This study explores the effectiveness of an mHealth intervention in reducing ultra-processed food intake among type 2 diabetes patients.

## Key findings

- The mHealth dietary education intervention did not significantly reduce ultra-processed food consumption.
- Baseline and follow-up ultra-processed food energy intake percentages were similar between the intervention and control groups.
- Further research is needed to develop effective interventions targeting ultra-processed food intake in diabetes patients.

## Abstract

Globally, there is a significant rise in the consumption of ultra-processed foods (UPFs), which has been associated with negative health outcomes. Mobile health (mHealth) interventions could be used to target dietary intake and reduce UPF consumption.

This study aims to evaluate the effect of an mHealth education intervention for healthy eating on UPF consumption in individuals with type 2 diabetes mellitus (T2DM). This study presents the results of an exploratory analysis of data from the Healthy eating using APP technologY (HAPPY) Trial.

Conducting post-hoc analyses on data from the HAPPY trial, we examined the effect of a 12-week mHealth dietary education intervention. Dietary intake was assessed at baseline and after 3 months using 4-day food records. The NOVA classification was used to quantify UPF consumption. A total of 80 participants (intervention group n = 35 and control group n = 45) were included in analyses. The intervention effect on UPF consumption was determined by linear regression analysis.

The majority of participants were males (61.3%), the mean age was 63.0 years, and the mean body mass index 29.7 kg/m2. In the intervention group, the UPF percentage contribution to the total energy intake was 21.5 interquartile range (IQR): (16.5–31.0) at baseline and 19.7 (IQR: 12.6–30.2) at the 3-month follow-up. In the control group, the UPF percentage contribution was 17.4 (IQR: 13.7–30.5) at baseline and 16.8 (IQR: 9.6–24.9) at the 3-month follow-up. We found no effect of the intervention on UPF consumption.

This exploratory study, based on data from the HAPPY trial, indicates that the mHealth dietary education intervention did not significantly reduce UPF consumption in individuals with T2DM. Interventions specifically targeting UPF intake require further investigation and might provide a promising strategy for addressing this issue in the future.

This trial was registered at clinicaltrials.gov as NCT03784612 (https://clinicaltrials.gov/study/NCT03784612).