Director General, ICMR, Dr. Balram Bhargava released the “IBD NutriCare App” on World IBD Day which is a collaborative effort between ICMR and team of gastroenterologists, dieticians and app developers of AIIMS, New Delhi dedicated for IBD population in Indian scenario. This telenutrition tool is a pioneering initiative undertaken by ICMR’s Centre for Advanced Research & Excellence (CARE) in Intestinal Diseases with Dr Vineet Ahuja, Professor in Gastroenterology, AIIMS, New Delhi as Principal investigator, to transform India’s Intestinal disease research and clinical practices.
According to the Intestinal Disease Burden research paper published in 2017, the estimated disease burden in 2010 for India was 1.4 million patients with IBD, as compared to 1.6 million in the United States which is the highest in the world. The data depicts that the burden of Inflammatory bowel disease (IBD) has had an upward trajectory in recent years with disease rates paralleling the West. Inflammatory bowel disease (IBD) is characterized by non-infectious chronic inflammation of the gastrointestinal tract, and primarily includes Crohn’s disease (which can affect any segment of the gastrointestinal tract from the mouth to the anus), ulcerative colitis (which is limited to the colonic mucosa), and indeterminate colitis. Telenutrition using smartphone applications could potentially redefine nutritional management in IBD. It makes feasible multicentric longitudinal dietary intervention studies which could provide us with robust high-quality data which otherwise would be cumbersome with traditional dietary assessment methods.
ICMR had commissioned in 2019 a multidisciplinary CARE in Intestinal Diseases project with team of researchers from various fields including gastroenterologists, dieticians and app developers to develop a culturally, educationally and linguistically relevant digital health platform.
The validated IBD NutriCare App is available in eight Indian languages like Hindi, English, Marathi, Telugu, Gujarati, Tamil, Malayalam and Bengali languages covering major geographical regions across India.
This digital health platform (IBD NutriCare) for tele nutrition provides a potential tool for improving the patient care in IBD. The omnipresent threat of Covid-19 outbreaks accelerates the acceptance of such remote health care tools. It is cardinal that patients be made aware of the role played by nutrition in the pathogenesis of IBD. The consumption of processed foods and ready -to-eat consumables are becoming increasingly popular. ‘Fast food’ apps with assists from artificial intelligence (AI) inputs are now custom made to allure and entice the common man’s appetite. All of these carry a 3-4-fold risk of developing IBD.
Considering the enormous disease burden and the gaps in providing dietary interventions, this Android and iOS-based digital health platform in the form of a smartphone application (App) is developed and validated for real-time tracking of dietary details and recording the data on a large scale for patients with IBD. This app aims to provide a personalised patient response to database on their demographics, medications, daily dietary intake based, clinical symptoms, and disease course. It provides a recording of diet variables based on nearly 650 Indian food recipes.
IBD NutriCare app is available free of cost which can be downloaded from any android play store or iOS store. The registration requires entry of demographic parameters, height and weight for calculating recommended nutrient values.
The goals are primarily focussed on personalised telenutrition counselling and ease of large-scale data acquisition that would enhance the entire clinical practice of dietary management and nutrition in IBD in a resource limited setting like India.
IBD NutriCare app has been designed and subsequently validated for the Indian IBD population against the traditional 24-hour dietary recall for nutritional assessment with modest acceptability rates. It provides a recording of diet variables, parameters like subjective global assessment, medications and clinical activity scores.
This smart phone app provides real-time data which alerts the nutritionist or dietician regarding adherence issues, erroneous entries, incorrect information thus helping initiate early and timely dietary interventions and formulating individualised diet plans.IBD NutriCare app and similar apps offer the advantage of more quality time being spend with the participant in counselling and offering dietary adjustments which could have a great impact on the disease outcomes.
The clinicians and researchers will be encouraged to use the tool which will help in improving the performance of tool and coming up with its next version.