(P13-059-25) Differences in Diet Quality and Energy Between a Gamified and Non-gamified Weight Loss Intervention: The 12-Month Mobile Lifestyle Intervention for Food and Exercise Study

Objectives: mHealth allows for the use of social gaming (using game-like elements in nongame contexts to promote supportive social interactions) to reward behaviors. Gamification may also enhance dietary self-monitoring during a weight loss intervention, but it is not known if this translates into improved dietary quality and reduced energy intake. mLife was a 12-month mobile weight loss intervention examining social gaming to promote social support.

Methods: Adults (n=243, mean BMI 34.7±6.0 kg/m², age 46.7±11.6 y, 87% female, 67% White/22% Black; 67% completion) were randomized to the mLife+points (points earned for social support activities) or mLife (no points for activities group. Participants in both groups were asked to self-monitor their diet daily. mLife+points participants could earn up to 8 points per day for completing social support activities (e.g., thumbs up if someone tracked their diet for the day). Three unannounced 24-hour dietary recalls were assessed at each timepoint (0, 6, 12 months) to calculate mean kcal and Healthy Eating index (HEI) score. Repeated measures, mixed models with restricted maximum likelihood estimation were used to conduct intent-to-treat analysis.

Results: There were no differences in energy intake (-347±91 kcals mLife+points vs -257±93 kcals mLife; P=0.49) or days of diet tracking (171±11.8 days mLife+points vs 140±11.6 kcals mLife; P=0.06) between groups. The group-by-time interaction for changes in 12-month HEI score was significant (6.1±1.6 mLife+points vs -1.45±1.6 mLife, P< 0.001). Examining the individual components of the HEI score, 12-month differences were mainly in the categories related to nutrients with changes in saturated fat score (2.7±0.4 mLife+points vs 1.4±0.4 mLife, P=0.02) and fatty acid score (-0.3±0.4 mLife+points vs -1.7±0.4 mLife, P=0.02). The only food group category that saw improvements was for total vegetables (0.4±0.2 mLife+points vs -0.1±0.2 mLife, P=0.049).

Conclusions: The use of points for social support provision led to greater self-monitoring and improvements in dietary quality, however, most changes were related to fat. Future studies should focus on tracking other nutrients and foods important for dietary quality (e.g., potassium, fruit) vs. focusing on reducing quantity (kcals, fat) of the diet.

Funding Sources: R01DK129302