The effectiveness of mobile app-based interventions in facilitating behaviour change towards healthier and more sustainable diets: a systematic review and meta-analysis

Abstract

Background: Digital health apps have been shown to influence healthy eating, but whether they can promote environmentally friendly diets remains unclear. In countries where diets typically contain a high proportion of carbon-intensive foods (e.g., meat), transitioning to healthier alternatives (e.g., fruit, vegetables, and legumes) can substantially reduce food-related greenhouse gas emissions while also improving public health. Our systematic review and meta-analysis aimed to investigate the effectiveness of mobile apps in facilitating more sustainable and healthier diets among adults from high-income countries.

Methods: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, Global Health, GreenFILE, Web of Science, Cochrane Trials, and ClinicalTrials.gov from inception until Jan 20, 2025. We included studies that reported the effects of app-based behavioural interventions on the consumption of fruit, vegetables, legumes, nuts, fish, dairy, and/or meat, compared to a control, baseline period, or different intervention. For outcomes measured in at least two studies, we conducted random effects meta-analysis and meta-regression to understand population differences and the role of specific intervention components.

Results: Of the 7356 records screened, 21 were included. Nine studies scored ‘high’, 10 scored ‘fair’, and two scored ‘low’ for reporting transparency. Combined, the studies analysed 12,898 participants, interventions lasted from three days to six months, and outcomes were assessed up to 12 months post-intervention. Forty percent of studies targeted populations with at least one health risk factor and 81% of study populations did not meet dietary guidelines at baseline for their primary outcome. Meta-analyses indicated that app use led to increased fruit and vegetable consumption (0.48 portions/day, 95% CI 0.18, 0.78, p = 0.002) and a small decrease in meat consumption (-0.10 portions/day, 95% CI -0.16, -0.03, p = 0.004), with meat-focussed apps showing as more effective than general apps for meat reduction. Meta-regression also revealed that message-based content was particularly effective in promoting meat reduction. There were no pronounced effects on legume or dairy consumption, or differences across populations.

Conclusion: Our results indicate that apps could be a valuable addition to the multiple interventions required to promote sustainable diets. However, to strengthen the evidence for outcomes beyond fruit and vegetables, we need standardised reporting of populations and intervention components.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12966-025-01823-7.

Keywords: Behaviour change; Dietary change; Healthy eating; Interventions; MHealth; Meat consumption; Meta-analysis; Nutrition; Sustainable diets; Systematic review.

Fig. 1

PRISMA flow diagram

Fig. 2

Transparency assessment for the included studies

Fig. 3

Heat map showing the frequency of intervention components and their effectiveness ratios. The colours represent the frequency; the darker red represents higher frequency of the BCT*delivery technique combination, the darker blue represents higher frequency of each component overall, the darker orange represents higher frequency in the effective interventions, and the darker green represents higher effectiveness ratios

Fig. 4

Forest plot of the app intervention effect on fruit and vegetable consumption

Fig. 5

Forest plot of the app intervention effect on meat consumption

Fig. 6

Forest plot of the app intervention effect on legume consumption

Fig. 7

Forest plot of the app intervention effect on dairy consumption