Researchers looked at 19 studies involving over 13,000 teenagers to see if nutrition apps and digital programs were designed fairly for everyone. They found that while most apps focused on making them affordable and easy to use, they often ignored other important factors like whether teens with disabilities could use them, if they worked for different cultures, or if they protected privacy well. The study shows that nutrition apps need to be designed better so that all teenagers—no matter their background or abilities—can benefit from them equally.

The Quick Take

  • What they studied: Whether digital nutrition programs for teenagers were designed to work fairly for everyone, including those with different abilities, backgrounds, and access to technology.
  • Who participated: Analysis of 19 research studies involving 13,246 teenagers aged 10-19 years old. Most studies were done in wealthy countries like the United States, Australia, and Europe.
  • Key finding: All the nutrition apps studied tried to be affordable and most made them easy to use, but none of them successfully addressed all the fairness factors that matter. For example, many didn’t consider whether the apps worked for people with disabilities or different languages.
  • What it means for you: If you’re a teenager using a nutrition app, it might not work well for you if you have a disability, speak a different language, or have limited internet access. App makers need to do better at including everyone. This is especially important for teens who are already facing health challenges.

The Research Details

Researchers searched 10 major databases for studies published since 2005 that tested nutrition apps or digital programs with teenagers. They looked for studies that measured whether these programs actually changed what teenagers ate or how they thought about food. Two researchers independently reviewed each study to make sure they picked the right ones.

The team created a checklist of nine important fairness factors (called ‘digital determinants of health’) that should be included in nutrition apps. These factors include things like: Can people afford it? Is it easy to use? Does it work for people with disabilities? Does it respect privacy? Does it work in different languages? They then checked each study to see which of these factors the app designers thought about.

The researchers organized all the information they found and looked for patterns across the studies. They couldn’t compare whether apps that addressed more fairness factors actually worked better because no app addressed all nine factors.

As more teenagers use apps and digital programs to learn about nutrition, it’s critical that these tools don’t accidentally leave out certain groups of teens. If an app only works for wealthy kids with new phones and good internet, or only in English, then it’s making health problems worse for kids who already struggle the most. This review helps app makers understand what they’re missing.

This is a high-quality systematic review because two researchers independently checked each study, reducing the chance of mistakes. The researchers used a clear, pre-planned checklist to evaluate fairness factors. However, the review found that most studies didn’t report enough information about fairness considerations, which made it hard to fully evaluate how well apps addressed these issues. Most studies were from wealthy countries, so the findings may not apply to teenagers in other parts of the world.

What the Results Show

Out of 19 studies reviewed, all of them tried to make their nutrition apps affordable (100%), but only about 4 out of 10 studies focused on making them easy to use (42%). This is a big gap. The researchers found that app makers were thinking about some fairness factors but completely missing others.

None of the 19 studies successfully addressed all nine fairness factors. This means every single app had blind spots—areas where certain teenagers might struggle to use them. For example, many apps didn’t consider whether they would work for teenagers who are blind or deaf, or whether they respected user privacy, or whether they worked in languages other than English.

The researchers couldn’t tell whether apps that addressed more fairness factors actually helped teenagers eat better, because no app was complete enough to study this question. This is an important limitation—we don’t know yet if making apps fairer actually improves results.

Most studies (84%) were conducted in high-income countries like the United States, Canada, and Australia. Very few tested apps in lower-income countries where access to technology is more limited. This means we don’t know if these findings apply to teenagers in other parts of the world. The studies mostly used smartphones and computers to deliver the nutrition programs, but didn’t explore whether these devices were actually accessible to all teenagers who might benefit.

This is one of the first reviews to specifically look at fairness and equity in digital nutrition programs for teenagers. Previous research has shown that health apps often don’t work equally well for everyone, but this study is the first to systematically check whether nutrition apps for teens are designed with fairness in mind. The findings align with broader concerns in digital health that technology can accidentally make health problems worse for vulnerable groups.

The biggest limitation is that most studies didn’t report enough details about how they designed their apps for fairness. This made it hard for researchers to fully evaluate what was considered. Additionally, because no app addressed all fairness factors, the researchers couldn’t compare whether more complete apps actually worked better. The studies were mostly from wealthy countries, so the results may not apply to teenagers in other regions. Finally, the review only looked at studies published in English, which may have missed important research from other countries.

The Bottom Line

If you’re developing a nutrition app for teenagers: Consider accessibility for people with disabilities, offer multiple languages, ensure it works on older phones with slower internet, protect user privacy clearly, and test it with teenagers from different backgrounds. Confidence level: Strong evidence that this matters, though we still need more research on whether it improves results. For teenagers using nutrition apps: Look for apps that offer accessibility features, privacy protection, and support for your language. If an app doesn’t work for you, it’s not your fault—it’s the app’s design.

App developers and health organizations creating nutrition programs should care most about this research. Teenagers with disabilities, those who speak languages other than English, and those with limited internet access should especially care because current apps may not work well for them. Parents and educators should care because they want to recommend tools that work for all teenagers. Policymakers should care because they can require fairness standards for health apps.

Changes to app design could be implemented within 6-12 months. Teenagers would likely notice improvements in usability immediately, but it may take 3-6 months of regular use to see changes in actual nutrition behaviors.

Want to Apply This Research?

  • Track which accessibility features matter most to you: Can you use the app with a screen reader? Does it work on your device? Is it in your language? Rate each feature weekly to help app makers understand what real teenagers need.
  • Start by using a nutrition app that has at least 5 of the 9 fairness features (accessibility, multiple languages, works on older phones, clear privacy policy, culturally relevant content). If it doesn’t work for you, switch to one that does rather than struggling with a poorly designed app.
  • Every month, check: Does this app still work on my phone? Can I understand all the content? Does it respect my privacy? Does it feel relevant to my life? If you answer ’no’ to any of these, look for a better option. Share your feedback with app makers so they improve.

This review summarizes research about how nutrition apps are designed, but it does not provide medical advice. Before using any nutrition app or making major changes to your diet, talk to a doctor, school nurse, or registered dietitian, especially if you have health conditions, allergies, or eating concerns. The findings show that current apps have gaps in fairness—this doesn’t mean the apps don’t work, but rather that they may not work equally well for everyone. Always prioritize professional medical guidance over app recommendations.