Is a Russian Pregnancy App Offering Fake News to U.S. Moms?

Research suggests health apps help moms-to-be. But what if the advice is bad?

Posted Apr 24, 2019

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new meta-analysis published in the open access Journal of Medical Internet Research suggests that pregnancy apps can have a big impact on the mental health and well-being of moms-to-be. The meta-analysis looked at 15 randomized controlled trials of apps aimed at helping moms manage weight, gestational diabetes, asthma, and other conditions and found that these apps improved maternal mental and physical health outcomes. 

That's the effect a good pregnancy app can have. But what about a bad one?

 Used with permission
Screenshot of the Hello Belly fasting advice.
Source: Used with permission

Fasting while pregnant

A couple of days ago, my friend Ellie was scrolling through her Hello Belly app—a pregnancy app that has been recommended in online articles by some pretty major women's magazines. She was looking forward to the adorable illustrations the app is best known for, but it was the day's health tip that grabbed her attention:

"Week 29: In the third trimester, fasting days can and must be done, especially if you have excess weight gain." 

Wait, what? Fasting while pregnant?  Apparently, yes. The tip went on to say that women in this stage of pregnancy "should take a fasting day once a week...of 1000 calories a day," and offered a decidedly unappetizing menu of boiled meat, potatoes, and baked apples. This advice runs contrary to that of the major nutrition and pregnancy associations. What's more, studies suggest fasting may be linked to low birthweight babies, and some research estimates that 11 percent of pregnant women have eating disorders which can be exacerbated by "dieting" advice.

Although the "fasting" tip may seem like a throwaway bit of advice that smart users would easily skip, the JMIR study suggests we can't ignore the effect it may have on women who are already in a vulnerable state (pregnancy). 

What does "expert" advice really mean?

Hello Belly is listed under "Medical" apps in both Apple iTunes and the Google Play stores, and the marketing info tells users they will "get professional tips every day of your pregnancy, written by the top experts." But according to the app's website, the experts are a Russian pop singer, a Russian mommy blogger, a "pregnancy psychologist," and a "medical sciences candidate" (equivalent to a Ph.D.) in ob/gyn. All of the experts hail from Russia, as does the app itself (though the founders are now in Silicon Valley). It's hard not to draw parallels between this terrible nutrition advice and the scourge of Russian "fake news." 

A marketing person from Hello Belly told me that they recommended this advice because the stomach gets smaller. (While that explains the day's advice to eat five or six meals a day, it doesn't explain the calorie restriction.) She promised they would update the advice to make it clear that women should check with their doctor first, and that the World Health Organization suggests women eat more calories in their third trimester (452 extra per day) not less. They did so

How to choose a solid health app

The mobile world is a little like the Wild West right now. Anyone can create an app, and Google Play and iTunes don't vet for content or snake-oil salesmanship. Just because a health app has made it into the app store doesn't mean the info within it is reliable.

So it falls to consumers to do due diligence, especially when it comes to downloading and using health apps. Here's how: 

  1. Always read the negative user reviews, don't just look at the overall number of stars the app has. Hello Belly has a total of 3 stars on iTunes and 4 on Google Play, but potential users may find some key and compelling information from the 1-star reviews. (I did.)
  2. Always click through to the app's actual website to check it out further. Who are the founders? Is there a major health association, hospital, or medical expert behind the app? If not, where is the app getting its medical information?
  3. If the app claims to have expert input or oversight, see if they list who those experts are on their website. If not, why not? If experts are listed by name, Google them or click through to their social media or professional websites to confirm that they are degreed, trustworthy experts in their fields.
  4. Finally, if something doesn't sit right with you—like this "fasting" tip didn't for my friend Ellie—listen to your gut and delete it.

References

Chan KL, Chen M. Effects of Social Media and Mobile Health Apps on Pregnancy Care: Meta-Analysis: JMIR Mhealth Uhealth 2019

Larsson, G. and Andersson‐Ellström, A. Experiences of pregnancy‐related body shape changes and of breast‐feeding in women with a history of eating disorders: Eur. Eat. Disorders 2003