Nutrition Outcomes Using a Randomized Intervention Via Smartphone on Dietary Habits

Participants will be assessed for eligibility. Those who are eligible will be randomly assigned to either intervention or control arm. The intervention group will be required to download the "Kalorist" application into their smartphones and will be guided about the activation of the application. The control group will only be observed. Both group will be requested to complete a baseline information survey form about their weight, waist circumference, eating habits (including mindful eating, self-regulation and food frequency questionnaire to measure dietary diversity and calorie intake) and nutrition related goals. After a period of 4 weeks both the groups will be re-assessed using the same survey instrument used previously, for endline information. Results will be compared both pre and post within the same group and intervention vs control group. The intervention group will additionally be requested to provide a user experience information for strength, weakness, opportunities and threat (SWOT) analysis for the application.

• Nutritional mobile phone application (Behavioral), also known as mhealth intervention, smartphone application: Kalorist is a nutrition-coaching platform built for South Asian population (desis) all over the world, delivering the kind of personalized, evidence-based support a client gets working one-on-one with a nutritionist, via a mobile app. It follows an assess-guide-monitor-adjust cycle: participant profile data (age, height, weight, gender) and goals set individualized calorie and macronutrient (carbohydrate, protein, fat) targets; participants log food by description, photo, or search, including local dishes and restaurants. Kal, an AI coach built inside, answers users' questions about their own patterns - why weight has plateaued or spiked, why cravings appear after skipping meals - using research-backed explanations rather than opinions, gives behavior- and habit-based guidance, and offers motivational support on request. Meal plans adapt to actual eating. KalLive gives an instant photo-based calorie/macro breakdown to save or share.

Primary outcomes

• Mindful Eating Score [4 weeks]: A validated tool named "Mindful Eating Questionnaire (MEQ)" will be used to obtain the mindful eating scores. 28-item questionnaire with subscales which includes Disinhibition, Awareness, External Cues, Emotional Response, Distraction. The minimum possible score is 1 while maximum score is 4. The higher score means more mindful eating.

Secondary outcomes

• Self-regulation for eating habits [4 weeks]: A validated tool "Self-regulation of Eating Behaviour Questionnaire (SREBQ)" for adults will be used to measure self-regulation scores. This is a 5 item and 5 point likert scale based questionnaire and the score ranges lies between 5 to 25 (min to max). Higher score signify better self regulation.
• Dietary diversity scores [4 weeks]: The dietary diversity scores (DDS) will be calculated from the food frequency questionnaire based on 24 food groups pre-defined by the Food and Agriculture organization of the United Nations. Among these the food groups classified as healthy are 10 in total therefore the score range lies between 0 to 10 with higher score meaning better dietary diversity.
• Calorie intake from the healthy vs unhealthy food groups. [4 weeks]: The calorie intake will be calculated from the food frequency questionnaire based on 24 food groups categorized as healthy, unhealthy or optional by the Food and Agriculture organization of the United Nations. Higher value = better (greater caloric contribution from healthy food groups). There is no fixed minimum or maximum cut off assigned as this is a continuous measure of dietary adequacy and varies from individual to individual.

Other outcomes

• SWOT analysis [4 weeks]: SWOT (Strengths, Weaknesses, Opportunities, Threats)

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Adults (>18 years old).
* Owns a smartphone with internet access.
* Can navigate the application in English.
* Is willing to improve dietary habits.

Exclusion Criteria:

* Pregnant women.
* Dietitians or nutrition professionals.
* Current use of the same or a similar calorie/diet-tracking application.
* Previous use of the same or a similar calorie/diet-tracking application.
* Current participation in a structured weight-loss or dietary program.
* Major medical conditions requiring a therapeutic diet.

• Kliemann N, Beeken RJ, Wardle J, Johnson F. Development and validation of the Self-Regulation of Eating Behaviour Questionnaire for adults. Int J Behav Nutr Phys Act. 2016 Aug 2;13:87. doi: 10.1186/s12966-016-0414-6. PMID 27484457
• Framson C, Kristal AR, Schenk JM, Littman AJ, Zeliadt S, Benitez D. Development and validation of the mindful eating questionnaire. J Am Diet Assoc. 2009 Aug;109(8):1439-44. doi: 10.1016/j.jada.2009.05.006. PMID 19631053

• Sanam I Soomro, PhD, Study director, Aga Khan University
• Syed Asad Ali, MBBS, MPH, DABP, DABPID, Principal investigator, Aga Khan University
• Mashaal Shakil, Study chair, Aga Khan University