Emotional strain of fitness and calorie counting apps

 Some users of popular fitness and calorie counting apps experience shame, disappointment and demotivation, potentially undermining their health and wellbeing, according to a new study led by researchers at UCL (University College London) and Loughborough University.

The study, published in the British Journal of Health Psychology, looked at 58,881 posts on Twitter (i.e., posted prior to the platform becoming X) relating to five popular fitness apps*.

The research team used AI models to filter out 13,799 posts judged to contain negative sentiment and then to group these posts into broad themes or topics.

They found users expressing shame at having to log “unhealthy” foods, irritation at notifications to log calories or to keep sugar consumption low, and disappointment at slow progress towards algorithm-generated targets. In some cases, these experiences led to demotivation, with users seemingly giving up on their goals, which is the opposite of what they are intended to be used for.

The researchers called for fitness apps to move away from “rigid” calorie counting and exercise quantification to a more holistic approach focusing on wellbeing.

Senior author Dr Paulina Bondaronek (UCL Institute of Health Informatics) said: “Few studies have looked at the potential detrimental effects of these apps. Social media provides a huge amount of data that could help us understand these effects. By using AI, we were able to analyse this data more quickly.

“In these posts, we found a lot of blame and shame, with people feeling they were not doing as well as they should be. These emotional effects may end up harming people’s motivation and their health.

“Instead of very narrow, rigid measures of success relating to amount of weight lost, health apps should prioritise overall wellbeing and focus on intrinsic motivation – i.e., the inherent enjoyment or satisfaction in activities.

“Many of these apps also ask users to do tasks individually. This misses out the great potential of social connectedness for improving our health and happiness.”

Dr Bondaronek added: “Self-monitoring and action planning are powerful behaviour change techniques. But we over-use them. We need to learn to be kinder to ourselves. We are good at blaming and shaming because we think it will help us to do better but actually it has the opposite effect.

“It is important to note, too, that we only looked at negative posts, so we cannot assess the overall effect of these apps in terms of our wellbeing. The apps may have a negative side, but they likely also provide benefits to many people.”

In their paper, the researchers grouped negative posts into several themes, chosen from a larger group of themes suggested by AI. These included frustration at the complexity of trying to track calories, technical faults and challenges leading to data loss, and the emotional impact of logging daily activity.

In terms of the complexity of tracking calories, the apps lacked the personalisation and tailoring needed to be fully accurate, with one user highlighting that they were unable to log breastfeeding within the app – an activity that can expend significant calories.

The researchers noted users’ surprise regarding the apps’ calorie recommendations, with one individual reporting being told that they needed to consume “−700 (negative 700) calories a day” to reach their goal. Another user said: “If you allow [MyFitnessPal] to prescribe your calories you’ll end up with a deficit that’s unachievable, unsustainable and very unhealthy. You could also starve to death ....”

Goals set by fitness apps were not based on public health recommendations (e.g. NHS recommendations for daily calorie intake), but were dictated by the user’s weight goals, which could lead to unrealistic or unsafe recommendations being given.

In terms of the emotional impact of logging daily activity, the researchers observed that some users felt “pestered” by app notifications, and that the difficulty of sticking to rigid goals led to loss of motivation.

They wrote: “Where individuals faced difficulties in keeping within the targets set by the app (e.g. losing a ‘streak’ or not meeting their daily goal) this appeared to contribute to avoidant behaviours (‘do NOT put Percy pigs into MyFitnessPal’) or complete disengagement (‘back to eating lotus biscoff spread out of jar’).”

The team found that some of the negative sentiment expressed in the posts were in line with previous research finding that measuring an activity might decrease the enjoyment of it. They cited a Strava user who had achieved their personal best for a half marathon but, in their Twitter post, had focused on the disappointment of this time not being recorded on the app.

Another user, they said, “expressed an intention to go to the gym in response to not meeting their calorie intake goals, describing themselves as ‘miserably’ stuffed, indicating that their decision to exercise was driven by negative emotions and the external prompt of the app’s feedback”, rather than by the inherent enjoyment of the exercise.

Co-author Dr Lucy Porter, from the UCL Division of Psychology & Language Sciences, said: “When we send behaviour change tools out into the world, it’s so important that we check if they have any unintended consequences. Listening to users’ reports on social media has shown that fitness apps can sometimes leave users feeling demoralised and ready to give up - which is the exact opposite of what these tools are supposed to do!

“We know from previous research that feeling ashamed and miserable about yourself is not going to support healthy, long-term behaviour change - what we need to know now is how pervasive these effects on morale and emotional wellbeing are, and whether there is anything that can be done to adapt fitness apps so that they better meet people's needs.”

Co-author Trisevgeni Papakonstantinou, also from UCL Psychology & Language Sciences, said: “Unsupervised machine learning (or we can say AI) lets us analyse insights from real-world social media data that would otherwise be inaccessible. By using these tools, we can turn naturalistic data into actionable insights for public benefit - and do so at scale, and at no cost.”

The study involved researchers at UCL, the University of Westminster, and Loughborough University. The lead author is funded by Wellcome to investigate large-scale textual data analysis using AI.

*The research team chose the five fitness apps that had the highest revenue. They were: MyFitnessPal, Strava, WW (formerly Weight Watchers), Workouts by Muscle Booster, Fitness Coach & Diet and FitCoach. However, most of the posts (8,464) related to MyFitnessPal, with Strava and WW also accounting for a large portion of the posts (2,264 and 2,902 respectively).

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Journal

British Journal of Health Psychology

Do fitness apps do more harm than good?

 A study published in the British Journal of Health Psychology reveals the negative behavioral and psychological consequences of commercial fitness apps reported by users on social media. These impacts may undermine the potential of apps to promote health and wellbeing.

When investigators used artificial intelligence (AI) using a method called Machine-Assisted Topic Analysis (MATA), which combines AI-powered topic modelling with human qualitative analysis, to help them analyze 58,881 X posts referring to the 5 most profitable fitness apps, they identified several negative themes—for example, challenges of quantifying diet and physical activity, the complexity of tracking calories and exercise through oversimplified algorithms, technical challenges and malfunctions, and aversive emotional responses to the apps’ notifications.

As a result, some users noted feelings of shame, disappointment and demotivation, and subsequent disengagement with apps and health behaviors.

The findings highlight the need for a more user-centered and psychologically informed app design that prioritizes wellbeing and intrinsic motivation over rigid, quantitative goals.

“Fitness apps remain some of the most profitable and widely downloaded health tools globally. While they can benefit health, there’s been far less attention to their potential downsides,” said corresponding author Paulina Bondaronek, PhD, of University College London. “When health is reduced to calorie counts and step goals, it can leave people feeling demotivated, ashamed, and disconnected from what truly drives lasting wellbeing. Using AI alongside human analysis, we were able to shed light on these often-overlooked impacts by centering the voices of real users.”

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/bjhp.70026

Restricted sugar intake during early life = lower risks of several heart conditions in adulthood

 Restricted sugar intake during early life is linked to lower risks of several heart conditions in adulthood, including heart attack, heart failure, and stroke, finds a study published by The BMJ today using data from the end of UK sugar rationing in 1953.

 

The greatest protection against the risk of developing heart problems - and the longest delay in disease onset - was seen in people whose sugar intake was restricted from conception (“in utero”) to around 2 years of age.

 

Evidence suggests that the first 1000 days of life (from conception to around 2 years of age) is a period when diet can have lasting health effects and leading health organisations recommend avoiding sugary drinks and ultra-processed foods (which often contain high amounts of sugar) as babies and toddlers are introduced to solids.

 

Researchers therefore wanted to examine whether restricting sugar during this time is associated with a reduced risk of cardiovascular outcomes in adulthood.

Using the end of UK sugar rationing in September 1953 as a natural experiment, they drew on data from 63,433 UK Biobank participants (average age 55 years) born between October 1951 and March 1956 with no history of heart disease. 

In total, the study included 40,063 participants exposed to sugar rationing and 23,370 who were not.

Linked health records were then used to track rates of cardiovascular disease (CVD), heart attack, heart failure, irregular heart rhythm (atrial fibrillation), stroke, and cardiovascular death, adjusting for a range of genetic, environmental, and lifestyle factors.

An external control group of non-UK born adults who did not experience sugar rationing or similar policy changes around 1953 were also assessed for more reliable comparisons.

The results show that longer exposure to sugar rationing was associated with progressively lower cardiovascular risks in adulthood, partly due to reduced risks of diabetes and high blood pressure.

Compared with people never exposed to rationing, those exposed in utero plus 1–2 years had a 20% reduced risk of CVD, as well as reduced risks of heart attack (25%), heart failure (26%), atrial fibrillation (24%), stroke (31%), and cardiovascular death (27%).

People exposed to rationing in utero and during early life also showed progressively longer delays (up to two and a half years) in the age of onset of cardiovascular outcomes compared with those not exposed to rationing.

Sugar rationing was also associated with small yet meaningful increases in healthy heart function compared with those never rationed. 

The authors point out that during the rationing period, sugar allowances for everyone, including pregnant women and children, were limited to under 40 g per day - and no added sugars were permitted for infants under 2 years old - restrictions consistent with modern dietary recommendations.

This is an observational study so no firm conclusions can be drawn about cause and effect, and the authors acknowledge several limitations including a lack of detailed individual dietary data and potential recall bias that could have affected their results.

However, they say this large, well-designed study allowed them to separately assess the effects of different exposure periods and explore the potential pathways linking sugar rationing and cardiovascular outcomes.

As such, they conclude: “Our results underscore the cardiac benefit of early life policies focused on sugar rationing. Further studies should investigate individual level dietary exposures and consider the interplay between genetic, environmental, and lifestyle factors to develop more personalised prevention strategies.”

Longevity clinics: between promise and peril

 A new editorial was published in Aging-US on October 13, 2025, titled “Longevity clinics: between promise and peril.”

In this editorial, Marco Demaria, Editor-in-Chief of Aging-US, from the European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), reviews the rapid rise of longevity clinics worldwide. 

Longevity clinics have emerged globally in response to increasing demand for personalized, preventive healthcare. Located in countries such as the United States, Switzerland, and the United Arab Emirates, these centers offer advanced diagnostic services, including genomic testing, advanced imaging, and multi-omics profiling. Their goal is to extend healthspan—the number of years a person lives in good health—through customized lifestyle interventions, nutritional guidance, and, in some cases, experimental therapies.

“Longevity clinics embody an important vision: healthcare is personalized, preventive, and engaged.”

Although the concept of proactive aging care is attractive, the editorial raises serious concerns about the scientific and ethical foundations of these clinics. Many operate outside conventional medical systems and lack connections to academic geroscience. This disconnection allows them to market expensive interventions without sufficient clinical validation. 

Despite these challenges, Dr. Demaria notes that longevity clinics may contribute meaningfully to innovation. By collecting extensive, long-term health data from clients, these clinics have the potential to identify early biomarkers of aging and detect signs of age-related diseases. Unlike traditional clinical trials, which are limited in scope and duration, longevity clinics track a wide range of health data over time. When paired with artificial intelligence tools, this information could help advance the science of healthy aging.

However, several risks remain. Many clinics lack standardized protocols, and the tools they use, such as biological age calculators or hormone therapies, often lack accuracy or clear clinical value. Without proper guidelines, clients may receive advice that is confusing or not scientifically supported. This can reduce public trust in the broader field of longevity research.

To ensure these clinics contribute positively to health innovation, the editorial outlines different key steps: greater collaboration with academic researchers, the adoption of standardized protocols, increased transparency, and work toward regulatory clarity. Broader access must also be considered by developing scalable and more affordable models, possibly through partnerships with public health systems.

Ultimately, longevity clinics represent both a major opportunity and a serious concern. If integrated responsibly with science, policy, and public health, they could support a shift toward personalized, preventive healthcare. Without this alignment, however, they risk reinforcing inequality and weakening the credibility of the science behind aging.

Parental deficiency in omega-3 fatty acids may have direct negative effects on children’s health

• EPA and DHA are essential for heart, brain and immune health, can help prevent preterm birth
• Mothers who previously had a premature birth currently consumed lower amounts of omega-3s
• Findings are likely representative of the wider U.S. parent population

A new survey-based study from Northwestern University, which examined the diets of parents across every Chicago neighborhood, found that parental intake of omega-3 fatty acids falls below recommended levels, with women consuming even lower amounts of omega-3 fatty acids than men. This deficiency may have direct negative effects on children’s health. 

The study, which included over a thousand parents, found several factors were associated with lower omega-3 intake from food. These included lower household income, certain self-reported racial and ethnic backgrounds, and not taking supplements that contain DHA. Particularly relevant for children’s health, women who had previously experienced a premature birth reported consuming less omega-3 fatty acids than those who had not.

The findings were published Saturday in the journal Nutrients. Although this study included only Chicagoans, the authors said the findings were likely representative of the wider U.S. parent population.

Omega-3 fatty acids (specifically eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA) are found in high concentrations in seafoods and in lower concentrations in eggs, poultry and other foods. They support brain development, cognitive function and retina health, help regulate immunity and inflammatory responses in the body, and play a crucial role in adults’ cardiovascular health. 

On average, parents reported consuming significantly less than the 250 mg/day of EPA and DHA recommended by the Dietary Guidelines for Americans and other medical groups, an amount typically achieved through regular seafood consumption. The mothers in the survey consumed just over 130 mg/day, on average, and the fathers consumed just over 160 mg/day. The study did not assess children’s dietary intake.

“As our children grow from infancy to early childhood, they are developing their own dietary habits, and a lot of that comes from our parents and what’s happening in the household,” said corresponding author Dr. Daniel Robinson, associate professor of pediatrics at Northwestern University Feinberg School of Medicine and a physician in the division of neonatology at Ann & Robert H. Lurie Children’s Hospital of Chicago. 

“Later it becomes influenced by advertising and their peers, but our parents are an important early influence. So, if we have parents whose general eating habits are that they consume lower-than-recommended amounts of omega-3 fatty acids, I would expect that their child’s eating habits probably wouldn’t include higher amounts of seafood.”

EPA and DHA’s link to preterm birth

Previous research has shown that mothers with lower intakes of omega-3 fatty acids are at higher risk of delivering their babies prematurely. In this study, mothers who reported lower current intake of EPA and DHA were more likely to have had a preterm birth in a past pregnancy, even after accounting for other demographic factors.

“We didn’t measure this directly in our study, but if someone who has had a preterm birth in the past is now eating even less omega-3s, and they become pregnant again, they could be at increased risk of another preterm birth due to their diet,” Robinson said. “Has anyone ever said, ‘You’ve had a preterm birth before. One way to help prevent that might be to eat more seafood.’”

Strategies to improve EPA and DHA consumption

Helping parents consume more omega-3 fatty acids could have real public-health benefits, including lowering the risk of preterm birth, the study authors said. They noted that the most effective strategies will likely take into account the many personal, social and cultural factors that influence what families eat. These strategies could include tailored dietary guidelines at both national and local levels, as well as consistent support from health care providers who offer nutrition advice to families and pregnant people.

“Health care providers should think about this problem longitudinally and not in our own silos of expertise,” Robinson said. “The whole timeline — from before a woman becomes pregnant through when that child becomes an adult — needs to be considered.”

How the study worked

To participate in the study, individuals had to have at least one child living with them. The researchers used data from the Voices of Child Health in Chicago Panel Survey, which collects responses from parents three times a year on topics related to child and adolescent health, family well-being and parenting.

Between May and July 2022, 1,057 participants completed a seven-question food frequency questionnaire to estimate their current intake of EPA and DHA from food sources. Parents also responded to questions as to whether they used DHA-containing supplements. The scientists also linked participants’ residential information to the Childhood Opportunity Index, a measure of neighborhood resources and conditions that reflect health potential for the children living in that neighborhood. Also, women were asked whether they had ever experienced a preterm birth.

Which sources are best for omega-3 fatty acids?

Seafood, especially oily fish such as salmon, tuna, sardines, mackerel and trout, provides the “biggest bang for your buck,” Robinson said. While DHA supplements can help increase someone’s levels of DHA, Robinson said the best way to consume it is along with other nutrients, such as protein, vitamins and micronutrients that are found in the whole foods. 

The study is titled, “Parental intake of eicosapentaenoic and docosahexaenoic acids in a diverse, urban city in the United States is associated with indicators of children’s health potential.” Marie Heffernan, assistant professor of pediatrics at Feinberg, also is a study author.

Older women: 4,000 steps on just one or two days a week = reduced risk of heart disease, mortality

• Mass General Brigham researchers found that older women who took 4,000 steps on just one or two days a week had a 27% reduction in risk of cardiovascular disease and 26% reduction in risk of death compared to those who got less steps
• The study found that the number of steps taken rather than any daily pattern of stepping was tied to these risk reductions

Tracking daily steps has become a staple exercise metric as smart devices keep count with ease. This physical activity stimulates bodily repair and maintenance, which is especially important as we age. But how many steps do you need to reap health benefits? A new study by investigators from Mass General Brigham examined 13,547 older women, comparing their step counts over a one week period against their mortality and cardiovascular disease rates over the next decade. They found that achieving just 4,000 steps one or two days per week was associated with lower risk of mortality and cardiovascular disease—and with more steps came even greater benefits, up to a point when risk reductions leveled. Their results are published in The British Journal of Sports Medicine.

“In countries like the United States, advances in technology have made it such that we don’t really move very much, and older individuals are among those least active,” said senior author I-Min Lee, MBBS, ScD, an epidemiologist in the Mass General Brigham Department of Medicine and the Division of Preventive Medicine at Brigham and Women’s Hospital (BWH). “Because of today’s low step counts, it’s increasingly important to determine the minimum amount of physical activity required to improve health outcomes, so that we can offer realistic and feasible goals for the public.”

In this federally funded study, Mass General Brigham researchers conducted a prospective cohort study of 13,574 older women (71.8 years old on average) without cardiovascular disease or cancer from BWH’s Women’s Health Study. The women wore ActiGraph GT3X+ accelerometers to track their steps over seven days between 2011 and 2015. For the next 10 years, the researchers monitored mortality and cardiovascular disease incidence.

Participants were sorted by how many days per week they achieved step thresholds at or above 4,000, 5,000, 6,000, or 7,000. Those that got 4,000 steps one or two days per week had 26% lower mortality risk and 27% lower cardiovascular disease risk compared to those that never hit 4,000 on any day. What’s more, reaching 4,000 steps three or more days in a week decreased mortality risk further to 40%. As for women that reached the higher step thresholds, cardiovascular disease risk leveled out.

Interestingly, the health benefits seem to be associated with the total volume of steps taken, rather than how many days per week a particular threshold was achieved. This suggests that there isn’t a “better” way to get steps—women with similar total volume of steps, either achieved by consistent steps throughout the week or sporadic steps in just a few days, had similar health benefits.

Future research will need to explore whether these effects hold in populations beyond older, American, mostly white women. Additionally, the researchers are curious to analyze even lower step count thresholds to determine whether less than 4,000 steps can produce similar health benefits.

“I hope our findings encourage the addition of step count metrics to physical activity guidelines, including the upcoming 2028 U.S. Physical Activity Guidelines,” said lead and corresponding author Rikuta Hamaya, MD, of Mass General Brigham’s Department of Medicine and the Division of Preventive Medicine at BWH. “If we can promote taking at least 4,000 steps once per week in older women, we could reduce mortality and cardiovascular disease risk across the country.”

Small changes in alcohol intake linked to blood pressure shifts

 

Light-to-moderate alcohol consumption is associated with increases in blood pressure (BP) and stopping drinking – even drinking less – may lead to clinically meaningful BP reductions, according to a study published today in JACC, the flagship journal of the American College of Cardiology. Findings show that slight changes in alcohol consumption can affect BP and can be a strategy for BP management and improvement.

Alcohol consumption is a well-established contributor to elevated BP, a major risk factor for cardiovascular disease (CVD). The 2025 ACC/AHA High Blood Pressure Guideline recommends nonpharmacological management strategies for high BP, including abstinence or limiting alcohol intake to one or fewer drinks (12–14 g) daily for women and two or fewer drinks daily for men. However, the impact of changes in light-to-moderate drinking habits – particularly cessation – on BP has remained unclear, especially among women and different beverage types.

“Our study set out to determine whether stopping alcohol use is associate with improvement in BP levels among habitual drinkers and whether starting alcohol use affects BP among non-habitual drinkers,” said Takahiro Suzuki, MD, MPH, a lead author of the study from St. Luke’s International Hospital and the Institute of Science Tokyo. “We focused on understudied groups, particularly women, light-to-moderate drinkers and consumers of different beverage types, to better understand how even low levels of alcohol consumption influence BP management, a critical public health issue.”

In this longitudinal annual check-up analysis from Japan, researchers analyzed 359,717 annual health check-up visits from 58,943 adults (52.1% women; median age 50.5 years) from 2012 to 2024. Alcohol intake was self-reported and categorized by standard drinks per day. The study tracked changes in systolic and diastolic blood pressure between visits, using a statistical model that accounted for demographics, medical history and lifestyle factors.

Study participants were divided into two cohorts: 1) habitual drinkers at first visit and 2) non-drinkers at first visit. Cohort 1 was created to understand the association between BP changes and alcohol cessation or continued habitual drinking, and Cohort 2 was created to understand the association between BP changes and new onset drinking or no drinking at the following visit.

Among participants who stopped drinking, lower BP was observed based on drinking level. Women who stopped drinking one to two drinks per day saw a decrease of 0.78 mmHg in systolic BP and 1.14 mmHg in diastolic BP. Men who stopped drinking at similar levels experienced reductions of 1.03 mmHg and 1.62 mmHg, respectively. Conversely, participants who initiated alcohol consumption showed higher BP based on drinking level, with similar trends across sexes.

Beverage-specific analyses revealed that the type of alcohol (beer, wine or spirits) did not significantly alter the BP effects, suggesting that quantity of alcohol intake is the primary driver of BP changes rather than beverage-specific components.

“Our study shows that when it comes to BP, the less you drink, the better. The more alcohol you drink, the higher your BP goes. In the past, scientists thought that small amounts of alcohol might be okay, but our results suggest that no alcohol is actually best. This means that stopping drinking, even at low levels, could bring real heart health benefits for both women and men,” Suzuki said.

Harlan Krumholz, MD, FACC, JACC Editor-in-Chief and Harold H. Hines Jr Professor of Medicine, Yale University School of Medicine, noted that the results challenge long-standing assumptions that low levels of alcohol do not meaningfully affect blood pressure.

“These findings suggest that alcohol cessation, even from low levels, could prevent or treat hypertension,” Krumholz said. “This is especially important as treatment targets for BP have been lowered.”

Study limitations include its observational design, which prevents establishing definitive cause-and-effect relationships. While researchers adjusted for many lifestyle and health factors, unmeasured influences, like changing drinking habits or detailed sodium and potassium intake, may have affected results. Alcohol consumption was self-reported, which can introduce recall bias, though standardized questionnaires improved accuracy. Additionally, the study population was predominantly Japanese and urban, which may limit generalizability to other groups.