Exercise and nutrition smartphone apps for children do not use the top recommended behaviors and strategies that were developed to prevent pediatric obesity, according to a report published in Childhood Obesity.

Some of the expert-recommended behaviors that the report looked for included eating five fruits and vegetables per day, exercising for one hour every day, watching TV for no more than two hours every day, and limiting consumption of sugary beverages. Recommended strategies to encourage children to be fit included setting goals, providing positive reinforcement, telling kids to self-monitor their efforts, and highlighting success and partial-success so that kids do not develop negative cognitive patterns.

These recommendations came from a report published in the journal Pediatrics in 2007.

The researchers, from the University of Kansas, found 62 apps in the Apple App Store and sent them to two independent app raters who then coded the apps to check how well they agreed with the expert-recommended guidelines. The raters found that while 93 percent of the apps complied with the recommended behaviors in the guidelines, only 20 percent had the recommended strategies.

Physical activity was one of the more popular behaviors that the apps included, at 53 percent. Just under that was fruit and vegetable consumption, which was encouraged in 48 percent of the apps. Twenty-nine percent of apps used videos and other images to show children how to perform different exercises. Both limiting screen time to two hours and encouraging eating family meals were only addressed in 1 app.

Self-monitoring was the most popular strategy used -- 16 percent of apps had this strategy in place.

Studies that evaluate how apps compare to long-established behaviors and strategies are not new. MobiHealthNews covered one of the first, conducted in 2009. At the time, we pointed out that this kind of study, which only examines whether apps follow existing protocols to determine how effective their weight loss strategies are, does not actually testing efficacy.

In October 2013, another study, published in the American Journal of Preventive Medicine evaluated the behavioral strategies commonly included in evidence-based behavioral weight-loss interventions from the Diabetes Prevention Program (DPP) Lifestyle Intervention Protocol. The DPP Lifestyle Intervention Protocol is based on a study done between 1994 and 1995, which, of course, predates the smartphone and the widespread adoption of mobile devices in general.