Abstract Background In many people, stress is associated with changes in eating behaviour. Food products consumed during stress (comfort foods) are often unhealthy. It is rather unknown what comfort foods are consumed in Germany and what healthier food products are considered as alternatives to support stress-eaters in making healthier food choices. Methods This online survey was conducted in spring 2021 throughout Germany. Participants were digitally recruited by newsletters, homepages, social media, and mailing lists. The survey included a standardized questionnaire with items concerning e.g. sociodemography, stress, and nutrition. Comfort foods were pre-selected through literature search and food substitutes were defined and discussed by experts. Analyses examined comfort food consumption and substitute preferences dependent on sex, age, body mass index (BMI), and being a self-identified stress-eater. The statistical analysis was performed using R. Results Survey participants were mostly female (80.6%, 994/1234), had a mean age of 31.4 ± 12.8 years and a mean BMI of 23.4 ± 4.3 kg/m2. Participants stated, that the two favourite comfort foods were chocolate (consumed often/very often by 48.3%, 596/1234) and coffee (consumed often/very often by 45.9%, 566/1234). Regarding food substitutes, the most frequently named alternative food for chocolate and cookies was fresh fruits (for chocolate: 74.4%, 815/1096, for cookies: 62.6%, 565/902). Tea without added sugar (64.4%, 541/840) was the preferred substitute for coffee. Almost 50% of participants (48.1%, 594/1234) identified themselves as stress-eaters, of which 68.9% (408/592) stated to eat (very) often more than usual in subjective stress situations. Conclusions The results from this work suggest that specific comfort foods and substitutes are preferred by the participants in stressful situations. This knowledge about food choices and substitutes should be investigated in further studies to improve eating behaviour in stressful situations. Trial registration The survey was registered in the German Register of Clinical Studies (Registration number: DRKS00023984 ).

Background: To address the epidemic burden of diet-related diseases, adequate dietary intake assessments are needed to determine the actual nutrition intake of a population. In this context, the eNutri web app has been developed, providing online automated personalized dietary advice, based on nutritional information recorded via an integrated and validated food frequency questionnaire (FFQ). Originally developed for a British population and their dietary habits, the eNutri tool has specifically been adapted to the German population, taking into account national eating habits and dietary recommendations. Objective: The primary aim of this study is to evaluate the system usability and users' experience and feedback on the eNutri app in a small-scale preliminary study. The secondary aim is to investigate the efficacy of personalized nutrition (PN) recommendations versus general dietary advice in altering eating habits. Methods: The app was piloted for 4 weeks by 106 participants from across Germany divided into a PN group and a control group. The groups differed according to the degree of personalization of dietary recommendations obtained. Results: An overall System Usability Scale (SUS) score of 78.4 (SD 12.2) was yielded, indicating an above average user experience. Mean completion time of the FFQ was 26.7 minutes (SD 10.6 minutes). Across subgroups (age, sex, device screen sizes) no differences in SUS or completion time were found, indicating an equal performance for all users independent of the assigned experimental group. Participants' feedback highlighted the need for more personalized dietary advice for controls, while personalized nutritional recommendations improved the awareness of healthy eating behavior. Further improvements to the eNutri app were suggested by the app users. Conclusions: In total, the eNutri app has proven to be a suitable instrument to capture the dietary habits of a German population sample. Regarding functionality, system usability, and handling, direct user feedback was quite positive. Nutritional advice given was rated ambivalent, pointing to several weaknesses in the eNutri app, minimizing the system's full potential. A higher level of personalization within nutritional advice subjectively improved the app's usability. The insights gained will be used as a basis to further develop and improve this digital diet assessment tool.

Stressful situations can have an impact on an individual’s eating behavior. People vulnerable to the influence of stress tend to change the quantity and quality of their food intake. Variables such as sex and body mass index (BMI) seem to be related to this stress-eating behavior, but it is rather unclear what factors account to the parameters associated with stress-eating behavior. The aim of this survey was to identify further characteristics of adults in Germany related to stress-overeating, focusing on stress perception, coping, eating motives and comfort foods as well as personality types. This online survey was performed throughout Germany and comprised a 38-item pre-tested questionnaire. Stress-induced overeating was classified based on the Salzburg Stress Eating Scale (SSES). Moreover, validated questionnaires were used to identify additional characteristics of stress eaters. Participants were recruited using a convenience sampling approach, and data were collected between January and April 2021. The overall sample consisted of 1222 participants (female 80.8%, aged 31.5±12.8). 42.1% of participants were identified as stress-overeaters. Among the remaining group, 78.9% stated to eat less, 21.1% to eat equally when stressed. Female participants had a higher mean SSES score compared to male participants. The BMI was positively correlated to SSES, r(1220)=0.28, p>0.005. ‘Agreeableness’ (BigFive) was found to be a negative predictor of stress-overeating. The most pronounced difference in eating motives (The Eating Motivation Survey, TEMS) was found for ‘Affect Regulation’ and ‘Weight Control’. The results indicate that stress-overeating affects a large proportion of the surveyed population. BMI, personality and eating motives additionally characterize stress-overeaters and may contribute to develop new approaches to address unhealthy stress-related eating patterns.

Vegetarian diets have gained in popularity, especially among highly educated women, and are considered beneficial to health. Comparative studies assessing the diet of vegetarians against omnivores are rather limited and often provide ambivalent results. Therefore, this study examined the nutrient intake and nutritional quality of vegetarian and omnivorous diets in a group of 61 female students in Germany. Habitual dietary intake was evaluated using a validated graphical online food frequency questionnaire (FFQ). Differences in nutrient intakes were analyzed by Mann–Whitney-U-Tests. Odds Ratios (OR) were calculated for vegetarians exceeding dietary reference values (DRV) compared to omnivores. The overall nutritional quality was assessed using the Healthy-Eating-Index-2015 (HEI-2015). In omnivores, intakes of total energy from saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), long-chain omega-3 polyunsaturated fatty acids (LC-n3-PUFA), cholesterol, sucrose, lactose, retinol, and cobalamin were significantly higher than in vegetarians. Significantly lower intakes were observed for fiber, magnesium, and beta-carotene. Significant OR were detected for total fat (OR = 0.29), SFA (OR = 0.04), beta-carotene (OR = 4.55), and cobalamin (OR = 0.32). HEI-2015 scores were higher for vegetarians than for omnivores (79 points versus 74 points) and significant differences were recorded for the HEI-2015 components dairy, seafood & plant proteins, fatty acids, added sugars, and saturated fatty acids.

We want to understand the changing shopping behaviour, influenced by health-targeting nutrition apps on mobile devices. To achieve that, we have built a realistic Virtual Reality (VR) supermarket simulation and addressed core aspects such as handling virtual products, prevention of cybersickness, rounded off with an initial pilot study. On top of that, we built a virtual replica smartphone in VR with nutritionrelated functionality. This has been extended with an Augmented Virtuality (AV) feature, that enables us to track the screen of a participant's own smartphone, hence allowing us to integrate real-world apps and letting the user interact with them during the simulation. To achieve a high-quality tracking, we propose a hybrid approach, utilizing an add-on RGB camera on the VR headset fused with data provided through a WLAN connection in the case of self-made apps. This enables the users to manipulate the simulation from within the smartphone app, introducing a versatile, highly usability-centered controller because they can handle their phone naturally.

The quality of nutrition apps can be evaluated by applying scientifically validated instruments. The objective of this study was to perform an in-depth quality-analysis of nutrition-related apps and to identify communalities and limitations of different assessment tools. Based on a keyword search for “nutrition” within the German Google Play Store, ten nutrition-related apps were selected and evaluated for quality using the App Quality Evaluation (AQEL), Mobile App Rating Scale (MARS) and “ENLIGHT” tools. The analyses highlighted discrepancies in app qualities regarding performance, credibility, security and user benefits. Given the three evaluation tools, each of which focuses on different aspects of quality, they cover a broad spectrum of quality criteria is covered. However, there are also overlaps in the evaluation categories function and functionality, credibility and evidence-base. Due to distinct scoring systems within the tools, overlapping categories were not interchangeable and aggravated a comprehensive app quality rating. Our findings indicate that AQEL, MARS and ENLIGHT, on a stand-alone basis, are suitable tools to assess individual aspects of quality for nutrition apps, without being exhaustive. A series of additional important quality aspects was identified, which can make an important contribution towards the development of an overarching quality assessment tool specific for nutrition apps. Die Qualität von Ernährungs-Apps kann durch die Anwendung wissenschaftlich validierter Instrumente evaluiert werden. Ziel dieser Studie war es, eine detaillierte Qualitätsanalyse ernährungsbezogener Applikationen durchzuführen und Gemeinsamkeiten und Limitationen verschiedener Bewertungstools zu identifizieren. Basierend auf einer Schlagwortsuche zu „nutrition“ innerhalb des deutschen Google Play Stores wurden zehn ernährungsbezogene Apps ausgewählt und hinsichtlich ihrer Qualität bewertet. Hierzu wurden die App Quality Evaluation (AQEL), Mobile App Rating Scale (MARS) und “ENLIGHT” Instrumente eingesetzt. Die Analyse verdeutlicht die Diskrepanzen bezüglich der App Qualität hinsichtlich Performanz, Glaubwürdigkeit, Sicherheit und Nutzervorteile. Die hierzu verwendeten Evaluationsinstrumente fokussieren sich auf unterschiedliche Qualitätsaspekte und decken ein breites Spektrum an Qualitätskriterien ab. Überschneidungen existieren hinsichtlich der Evaluationskategorien Funktion und Funktionalität, Glaubwürdigkeit und Evidenzbasierung. Aufgrund der abweichenden Bewertungssysteme ist es nicht möglich gleiche Kategorien auszutauschen, welches eine allumfassende App-Qualitätsbewertung erschwert. Unsere Ergebnisse weisen darauf hin, dass AQEL, MARS und ENLIGHT individuell betrachtet, geeignete Instrumente zum Erfassen einzelner Qualitätsaspekte von Ernährungs-Apps darstellen, jedoch nicht allumfassend sind. Ergänzend wurden weitere wichtige Qualitätsaspekte identifiziert, die einen bedeutsamen Beitrag zur Entwicklung eines allumfassenden Qualitätsinstruments zur Bewertung von Ernährungs-Apps liefern könnten. Article visualizations: