{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:02:01Z","timestamp":1790344921176,"version":"4.1.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Defense Medical University, Taiwan"},{"DOI":"10.13039\/501100006705","name":"National Taipei University of Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006705","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Manual dietary self-monitoring can impose a burden on university students, limiting sustained engagement with digital nutrition tools. AbSound was developed as a wearable abdominal-acoustic biofeedback system that converts candidate gastrointestinal sound events into uncertainty-aware reflective prompts, rather than validated diagnoses of hunger, satiety, dietary intake, diet quality, or eating speed. This exploratory, randomized pilot study assessed feasibility, acceptability, user experience, preliminary self-reported behavioral signals, and agreement in acoustic event detection among Taiwanese university students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Sixty first- and second-year university students in Taipei were randomized 1:1 to AbSound plus a companion app or to an active app-based dietary-tracking comparator for 4\u202fweeks. Primary feasibility outcomes included retention, daily wear time, days worn, prompt exposure, prompt acknowledgment, reported burden, and adverse events. Exploratory behavioral outcomes included self-reported late-night eating, perceived eating speed, a brief dietary-quality score, self-regulation of eating behavior, weight, and waist circumference. TAM ratings, Kano feature classifications, brief interviews, and descriptive acceptance-path analyses characterized adoption and design priorities. Acoustic performance was evaluated\n                      <jats:italic>post hoc<\/jats:italic>\n                      against selected manually reviewed event segments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All participants completed follow-up. AbSound users wore the device for 9.2\u202f\u00b1 2.2\u202fh per day on 25.7\u202f\u00b1\u202f2.0 of 28 study days, corresponding to approximately 91.8% of possible study days. Prompt acknowledgment averaged 78%\u202f\u00b1\u202f9%. Selected, manually reviewed segments showed approximately 88% agreement in event detection, but this estimate does not establish physiological-state validation. Compared with the active comparator, AbSound users showed larger exploratory reductions in self-reported late-night eating. They reported lower perceived eating-speed scores, higher brief dietary-quality scores, and a marginally greater increase in eating self-regulation. Weight and waist circumference showed no clinically interpretable between-group differences. Acceptance ratings were high; comfort and privacy emerged as must-be design attributes, while feedback agreement and timeliness were performance attributes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AbSound demonstrated short-term feasibility and acceptability as a reflective abdominal-acoustic biofeedback tool for non-clinical Taiwanese university students. The findings support further user-centered development but do not establish clinical efficacy or validated detection of nutritional or physiological states. Larger preregistered trials require independent acoustic validation, objective or repeated dietary reference measures, longer follow-up, and explicit psychological-safety monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1799873","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:24:16Z","timestamp":1790342656000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Wearable abdominal acoustic biofeedback for dietary self-regulation among Taiwanese university students: an exploratory randomized pilot study"],"prefix":"10.3389","volume":"13","author":[{"given":"Chen","family":"Han","sequence":"first","affiliation":[{"name":"Doctoral Program in Design, College of Design, National Taipei University of Technology","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Interaction Design, National Taipei University of Technology","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Chia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, National Taipei University of Technology","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jwo-Shiun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, National Taipei University of Technology","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung-Jing","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, National Taipei University of Technology","place":["Taipei, Taiwan"]},{"name":"Department of Physiology and Biophysics, Graduate Institute of Physiology, College of Medicine, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e574","DOI":"10.1093\/nutrit\/nuae035","article-title":"Digital applications for diet monitoring, planning, and precision nutrition for citizens and professionals: a state of the art","volume":"83","author":"Abeltino","year":"2025","journal-title":"Nutr Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.jada.2010.10.008","article-title":"Self-monitoring in weight loss: a systematic review of the literature","volume":"111","author":"Burke","year":"2011","journal-title":"J Am Diet Assoc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e32","DOI":"10.2196\/jmir.2283","article-title":"Adherence to a smartphone application for weight loss compared with a website and a paper diary: pilot randomized controlled trial","volume":"15","author":"Carter","year":"2013","journal-title":"J Med Internet Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3390\/jpm9020031","article-title":"A scientific overview of smartphone applications and electronic devices for weight management in adults","volume":"9","author":"Holzmann","year":"2019","journal-title":"J Pers Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"7425","DOI":"10.3390\/ijerph110707425","article-title":"Prevalence of overweight\/obesity and its associated factors among university students from 22 countries","volume":"11","author":"Peltzer","year":"2014","journal-title":"Int J Environ Res Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1080\/07448480903221392","article-title":"The freshman 5: a meta-analysis of weight gain in the first year of college","volume":"58","author":"Vella-Zarb","year":"2009","journal-title":"J Am Coll Heal"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1038\/s41746-020-0246-2","article-title":"Automatic, wearable-based, in-field eating detection approaches for public health research: a scoping review","volume":"3","author":"Bell","year":"2020","journal-title":"NPJ Digit Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2966","DOI":"10.3390\/s25102966","article-title":"A systematic review of sensor-based methods for measurement of eating behavior","volume":"25","author":"Hossain","year":"2025","journal-title":"Sensors"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1109\/TBME.2016.2631246","article-title":"Unobtrusive and wearable systems for automatic dietary monitoring","volume":"64","author":"Prioleau","year":"2017","journal-title":"IEEE Trans Biomed Eng"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4735","DOI":"10.3390\/s25154735","article-title":"A novel you only listen once (YOLO) deep learning model for automatic prominent bowel sounds detection: feasibility study in healthy subjects","volume":"25","author":"Kalahasty","year":"2025","journal-title":"Sensors"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s40313-021-00727-8","article-title":"Development of optimal feature selection and deep learning toward hungry stomach detection using audio signals","volume":"32","author":"Maria","year":"2021","journal-title":"J Control Autom Electr Syst"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1037\/0033-2909.92.1.111","article-title":"Control theory: a useful conceptual framework for personality-social, clinical, and health psychology","volume":"92","author":"Carver","year":"1982","journal-title":"Psychol Bull"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.appet.2013.03.011","article-title":"Intuitive eating is associated with interoceptive sensitivity","volume":"67","author":"Herbert","year":"2013","journal-title":"Appetite"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e48230","DOI":"10.1371\/journal.pone.0048230","article-title":"The multidimensional assessment of interoceptive awareness (MAIA)","volume":"7","author":"Mehling","year":"2012","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1002\/eat.22924","article-title":"Just-in-time adaptive interventions: a novel approach for enhancing skill utilization and acquisition in cognitive behavioral therapy for eating disorders","volume":"51","author":"Juarascio","year":"2018","journal-title":"Int J Eat Disord"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e47098","DOI":"10.2196\/47098","article-title":"Using wearable passive sensing to predict binge eating in response to negative affect among individuals with transdiagnostic binge eating: protocol for an observational study","volume":"12","author":"Presseller","year":"2023","journal-title":"JMIR Res Protoc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s10484-014-9246-9","article-title":"Biofeedback for psychiatric disorders: a systematic review","volume":"39","author":"Schoenberg","year":"2014","journal-title":"Appl Psychophysiol Biofeedback"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1108\/YC-04-2020-1123","article-title":"Driving the adoption of healthcare wearable technology among generation Z consumers in Hong Kong","volume":"22","author":"Cheung","year":"2021","journal-title":"Young Consum"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e30960","DOI":"10.2196\/30960","article-title":"Impact of the moderating effect of national culture on adoption intention in wearable health care devices: meta-analysis","volume":"10","author":"Zhang","year":"2022","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1145\/3166.3170","article-title":"Designing for usability: key principles and what designers think","volume":"28","author":"Gould","year":"1985","journal-title":"Commun ACM"},{"key":"ref21","first-page":"39","article-title":"Attractive quality and must-be quality","volume":"14","author":"Kano","year":"1984","journal-title":"J Jpn Soc Qual Control"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e30","DOI":"10.2196\/jmir.4055","article-title":"The person-based approach to intervention development: application to digital health-related behavior change interventions","volume":"17","author":"Yardley","year":"2015","journal-title":"J Med Internet Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2307\/249008","article-title":"Perceived usefulness, perceived ease of use, and user acceptance of information technology","volume":"13","author":"Davis","year":"1989","journal-title":"MIS Q"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1518\/hfes.46.1.50_30392","article-title":"Trust in automation: designing for appropriate reliance","volume":"46","author":"Lee","year":"2004","journal-title":"Hum Factors"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1287\/mnsc.46.2.186.11926","article-title":"A theoretical extension of the technology acceptance model: four longitudinal field studies","volume":"46","author":"Venkatesh","year":"2000","journal-title":"Manag Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s12160-013-9486-6","article-title":"The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions","volume":"46","author":"Michie","year":"2013","journal-title":"Ann Behav Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"i5239","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomized pilot and feasibility trials","volume":"355","author":"Eldridge","year":"2016","journal-title":"BMJ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2288-10-1","article-title":"A tutorial on pilot studies: the what, why, and how","volume":"10","author":"Thabane","year":"2010","journal-title":"BMC Med Res Methodol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1145\/230538.230561","article-title":"Bias in computer systems","volume":"14","author":"Friedman","year":"1996","journal-title":"ACM Trans Inf Syst"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1057\/sth.2013.10","article-title":"The digitally engaged patient: self-monitoring and self-care in the digital health era","volume":"11","author":"Lupton","year":"2013","journal-title":"Soc Theory Health"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e1001953","DOI":"10.1371\/journal.pmed.1001953","article-title":"The rise of consumer health wearables: promises and barriers","volume":"13","author":"Piwek","year":"2016","journal-title":"PLoS Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1007\/s11948-016-9771-4","article-title":"Do-it-yourself healthcare? Quality of health and healthcare through wearable sensors","volume":"24","author":"Vesnic-Alujevic","year":"2018","journal-title":"Sci Eng Ethics"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.amepre.2016.06.015","article-title":"Understanding and promoting effective engagement with digital behavior change interventions","volume":"51","author":"Yardley","year":"2016","journal-title":"Am J Prev Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/BF02310555","article-title":"Coefficient alpha and the internal structure of tests","volume":"16","author":"Cronbach","year":"1951","journal-title":"Psychometrika"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.2196\/jmir.8.2.e9","article-title":"eHealth literacy: essential skills for consumer health in a networked world","volume":"8","author":"Norman","year":"2006","journal-title":"J Med Internet Res"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e126","DOI":"10.2196\/jmir.1923","article-title":"CONSORT-EHEALTH: improving and standardizing evaluation reports of web-based and mobile health interventions","volume":"13","author":"Eysenbach","year":"2011","journal-title":"J Med Internet Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"g1687","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e7586","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 statement: defining standard protocol items for clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An empirical evaluation of the system usability scale","volume":"24","author":"Bangor","year":"2008","journal-title":"Int J Hum Comput Interact"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.2196\/mhealth.3422","article-title":"Mobile app rating scale: a new tool for assessing the quality of health mobile apps","volume":"3","author":"Stoyanov","year":"2015","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref44","first-page":"189","volume-title":"Usability Evaluation in Industry","author":"Brooke","year":"1996"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1007\/s12160-016-9830-8","article-title":"Just-in-time adaptive interventions (JITAIs) in mobile health: key components and design principles for ongoing health behavior support","volume":"52","author":"Nahum-Shani","year":"2018","journal-title":"Ann Behav Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"a1655","DOI":"10.1136\/bmj.a1655","article-title":"Developing and evaluating complex interventions: the new Medical Research Council guidance","volume":"337","author":"Craig","year":"2008","journal-title":"BMJ"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington","year":"2021","journal-title":"BMJ"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1093\/tbm\/ibz080","article-title":"Randomized controlled trial of OnTrack, a just-in-time adaptive intervention designed to enhance weight loss","volume":"9","author":"Forman","year":"2019","journal-title":"Transl Behav Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e76625","DOI":"10.2196\/76625","article-title":"Just-in-time adaptive interventions for weight management among adults with excess body weight: scoping review","volume":"27","author":"Koh","year":"2025","journal-title":"J Med Internet Res"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"c869","DOI":"10.1136\/bmj.c869","article-title":"CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomized trials","volume":"340","author":"Moher","year":"2010","journal-title":"BMJ"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1799873\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:24:18Z","timestamp":1790342658000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1799873\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":51,"alternative-id":["10.3389\/fnut.2026.1799873"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1799873","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"article-number":"1799873"}}