Evaluation of Mobile Intermittent Fasting Applications in Chinese App Stores: Quality Evaluations and Content Analysis.

Abstract

Background: Obesity and related disorders are rising globally, especially in China, where they are linked to chronic diseases like diabetes and cardiovascular issues. As intermittent fasting (IF) gains popularity for weight management, the use of IF apps has increased, yet their quality varies significantly. A systematic evaluation of these apps is essential to assess their effectiveness and reliability.

Objective: This study aimed to conduct a comprehensive evaluation of IF apps available in the Chinese mobile app market. We concentrated on evaluating their features, quality, and overall user experience to help users avoid low-quality options and direct app developers to enhance their offers.

Methods: A systematic search was performed across 5 major app stores in China, including the Apple App Store, Huawei AppGallery, Oppo Software Store, Vivo App Store, and Xiaomi Market. "Fasting", "Intermittent Fasting", "Time-Restricted Feeding", "Time-Restricted Fasting", "Time-Restricted Eating" and "Meal Skipping" were used as keywords to identify relevant apps, which were then screened based on inclusion and exclusion criteria. The evaluation was conducted using the user version of the Mobile Application Rating Scale (uMARS). The uMARS assessment examined 4 key subscales: engagement, functionality, aesthetics, and information. Each app was independently evaluated by 2 raters who underwent uniform training to ensure consistency in scoring.

Results: A total of 35 apps were assessed for the study. These apps mostly contain features such as fasting timer (100.0%), recording weight (97.14%), fasting reminder (85.71%), and recording water intake (85.71%). All of the apps have an obvious privacy protection. Most of the apps (79%) have tools for quantifying users' health status. The results showed that the overall average uMARS score across the apps was 4.35 (SD 0.51). The subscale scores were as follows: engagement 4.42 (SD 0.47), functionality 4.65 (SD 0.31), aesthetics 4.19 (SD 0.64), and information 4.15 (SD 0.58). The functionality subscale had the highest mean score, while the aesthetic subscale showed the greatest range of scores, from 2.17 to 5.00. The overall uMARS score was significantly positively correlated with the subscale scores (r=0.786-0.953, P<.001). The user ratings in the app stores did not significantly correlate with the uMARS overall scores (r=-0.290, P=.091). Strong inter-rater reliability was confirmed by intraclass correlation coefficients (ICC=0.809-0.909 across subscales).

Conclusions: All the apps reveal high overall quality but gaps in professional engagement and social features. Limited clinical input may undermine the evidence-based accuracy and long-term applicability of some apps. Developers are encouraged to collaborate with health care professionals to enhance content reliability and incorporate social features to boost user engagement, while ensuring robust privacy protections and reasonable use of artificial intelligence.