The Effect of Nutritional Mobile Apps on Populations With Cancer: Systematic Review

Abstract

Background: Limited access to nutrition support among populations with cancer is a major barrier to sustainable and quality cancer care. Increasing use of mobile health in health care has raised concerns about its validity and health impacts.

Objective: This systematic review aimed to determine the effectiveness of commercial or cancer-specific nutritional mobile apps among people living with cancer.

Methods: A systematic search of the CENTRAL, Embase, PubMed (MEDLINE), and Scopus databases was carried out in May 2024. All types of intervention studies were included, except observational studies, gray literature, and reference lists of key systematic reviews. Studies were eligible for inclusion if they involved (1) patients with or survivors of cancer and (2) nutrition-related mobile apps. Studies were excluded if the nutrition intervention was not delivered via mobile app or the app intervention was accompanied by dietary counseling. The review process was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Risk of Bias 2 and Risk of Bias in Nonrandomized Studies tools were used to assess the study quality. The Cochrane Review Manager (version 5.4) software was used to synthesize the results of the bias assessment.

Results: A total of 13 interventions were included, comprising 783 adults or teenagers with cancer. Most studies focused on breast cancer (6/13, 46%), overweight (6/13, 46%), and survivors (9/13, 69%). Data on anthropometry and body composition (7/13, 54%; 387 participants), nutritional status (3/13, 23%; 249 participants), dietary intake (7/13, 54%; 352 participants), and quality of life (6/13, 46%; 384 participants) were gathered. Experimental groups were more likely to report significant improvements in body weight or composition, dietary compliance, nutritional status, and quality of life than control groups.

Conclusions: Although mobile app platforms are used to deliver nutrition interventions, the evidence for long-term efficacy, particularly in populations with cancer, remains elusive. More robust randomized controlled trials with larger sample sizes, as well as more homogeneous population characteristics and outcome measures, are warranted.

Trial registration: PROSPERO CRD42023330575; https://tinyurl.com/55v56yaj.

Keywords: PRISMA; body composition; cancer; diet; intervention; mHealth; mobile app; mobile health; mobile phone; nutrition; quality of life.

Figure 1

Study flowchart adapted from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.

Figure 2

Risk-of-bias assessment of randomized controlled trials (n=7) using the Risk of Bias 2 tool, with a quality rating of low risk (–), high risk (+), or unclear risk (?).

Figure 3

Risk-of-bias assessment using the Risk of Bias in Nonrandomized Studies tool in 6 studies, with a quality rating of low risk (–), high risk (+), or unclear risk (?).