Exploring the Zoe App Program - the pros and cons
In the era of digital health, the ZOE App Program, co-founded by Tim Spector, has emerged as a prominent player in personalized nutrition.
With nearly cult-like status among its 130,000 subscribers, this nutrition service offers a tailored approach to optimizing health through its innovative app-based platform.
In this comprehensive review Abby Olu-Sholanke one of our specialist Associate Dietitians, delves into the intricacies of the ZOE Programme, its product offerings, effectiveness, pros and cons, and compare it with the services provided by specialist dietitians.
What exactly is Zoe?
Zoe analyses your blood and faecal samples to provide insights about your gut microbiome, such as the diversity of gut and bowel bacteria and your ability to digest fats and sugars.
Zoe App sounds interesting - what Next?
The ZOE membership:
There are three membership tiers, which automatically renew unless you request a cancellation. You have to buy the test and the monthly membership as a package they are not available to purchase seperately.
The Membership categories are:
- £24.99 per month for a 12-month membership, plus £299.99 for testing. Membership paid in one payment of £299.88, billed when you can see your ZOE Scores in the app = £599
- £39.99 per month for a four-month membership, plus £299.99 for testing. Membership paid in one payment of £159.96, billed when you can see your ZOE Scores in the app =£439
- £59.99 per month for a rolling monthly membership, plus £299.99 for testing = £899.
What's in the Zoe App Kit?
The ZOE test kit:
- Gut health kit: A kit to collect a stool sample at home, to send off for analysis. The stool is examined to see the diversity of the gut microbiome – essentially the good and not so good microbes living in the stools. This is linked with health issues such as digestive system, immune response and mental health.
- Blood fat test: A small sample of blood collected via finger prick is sent for blood fat analysis. This measures how quickly fat is cleared from the blood after a meal. This is a risk factor indicator of developing heart disease and chronic inflammation.
- Blood sugar sensor: A round yellow disk that the user sticks to their arm and wears for 14 days. There is a tiny needle that measures the glucose from the fluid beneath the skin. This allows the app to gain real-time insights of how blood sugar levels fluctuate, per food eaten.
- Breakfast and lunch cookies to be consumed on a specific test day – these test out the blood sugar and blood fat results, as well as measuring the speed of users’ digestion and gastric emptying. (the diagram below illustrates the process and used from the zoe website)
Zoe Cookies??
So what are these cookies??
As we can see from the Zoe kit content, cookies are consumed….
According to the information on their website, the test cookies were specifically designed by scientists to enable users to test their biological responses. The purpose of the cookies is to challenge the metabolism with high doses of fat and sugar over 6 hours. To be able to package the necessary amounts of nutrients in the challenge in a standardised way, they used cookies.
Breakfast Test Cookie Ingredients:
- White chocolate chips (cocoa butter, cane sugar, tapioca starch, rice syrup solids, rice maltodextrin, organic vanilla and salt)
- Flour blend (brown rice flour, sweet rice flour, tapioca starch, cornstarch, potato starch, stabiliser (xanthan gum))
- Palm oil
- Brown sugar
- Chickpea flour
- Tapioca starch
- Tapioca syrup
- Less than 2% of: water, vanilla bean extractives, salt
Lunch Test Cookie Ingredients:
- Flour blend (brown rice flour, sweet rice flour, tapioca starch, cornstarch, potato starch, stabiliser (xanthan gum))
- Brown sugar
- Chickpea flour
- Tapioca starch
- Less than 2% of:
- water
- tapioca syrup
- vanilla bean extractives
- salt
- Colour: FD&C Blue #1 (Brilliant Blue FCF)
- Raising agent: Baking powder (sodium acid pyrophosphate, sodium bicarbonate, cornstarch, monocalcium phosphate))
Allergens in Zoe cookies -free from
- Gluten
- Milk
- Egg
- Fish and shellfish
- Peanut and tree nut
- Soy
- Wheat
Made in a facility handles the following : not suitable
- Tree Nuts
- Peanuts
- Wheat
- Eggs
Zoe App Diet Test Day
When it comes to eating the cookies on test day, testers need to fast the morning of the test – that means nothing to eat or drink, except water, black tea or coffee.
The specific breakfast cookies need to be eaten within 15 minutes, and then a four hour fast follows, before consuming the lunch cookies.
This can have implications for people who are on medications or diabetic.
Effectiveness
- According to reviews on the ZOE website, users said they feel the changes in their energy levels after around 4 weeks.
- A statistic on the website states 84% of users feel healthier after 12 weeks.
- Another article in Forbes, says 70 percent of ZOE members report having more energy.
- Good Food website states that there is so much information on the ZOE app as well as useful tricks to optimise what you eat, that you’re bound to gain tips that you can stick to in the long term.
Interestingly when you look at the stats for changing your diet to healthier choices this outcome is not unique to ZOE diet and achievable with guidance from a Dietitian.
The Pros and Cons of ZOE app
Pros
- ZOE is based on advice around monitoring blood sugar, blood fat and gut health.
- Provides helpful tips on minimising bad foods and useful tricks you can stick to long term.
- Contains a kit that has a blood sugar monitor, blood fat test, stool sample test and some food to test your gut transit time in the comfort of your home.
- The programme prides itself on helping users make healthy food choices and knowing how certain foods can impact their blood sugars and gut health. The ZOE app produces a score from 0-100, based on food choices.
- The program offers several articles and information of healthy eating
- It is a novel way of testing that is engaging and entertaining due to its game-like approach.
Cons
- The program lacks personalised coaching required for lasting behavioural changes.
- The test day relies on willpower, strict timings and rules. These components can become barriers to implementation and trigger negative emotions like frustration or guilt.
- The program appears to require a significant investment of time such as logging in food, weighing foods etc. This may be overwhelming especially for individuals with hectic schedules.
- The reviews provided by some users showed that the healthy food recommendations are the foods generally considered to be healthy. Essentially, it lacked a touch of personalisation in terms of their cultural preferences, personal preferences and geographical locations.
- The program is elitist. It may not be suitable for people with scientific or socio-economic challenges, making healthy eating inaccessible to such groups.
- Program does not project the importance of other factors such as epigenetics, epigenome, sleep, exercise, environment etc.
- There is a lot of emphasis on the traffic light system of rating foods, which can be negative for some and be viewed as another restrictive diet.
- The diet requests people eat 30 different plants a week, this can be costly, and possibly focus people to fixate on one area and if not guided overlooking other essential nutrients.
- According to an article, a ZOE tester described the test cookies as ‘sweet polystyrene’ – and are a struggle to get down during the requisite time limit.
Seeing a Specialist Gut Dietitian versus ZOE app
Working with a Specialist registered GUT dietitian before or alongside using the ZOE programme can be a more sustainable and holistic way to manage your health and wellbeing.
Here are reasons why:
- Individualised recommendations on all aspects of nutrition
A registered specialist dietitian will take time to complete a full assessment of your health history, dietary habits, lifestyle choices, health goals, facilitators and barriers. This personal support doesn’t provide prescriptive or numerical data that ZOE does, but it is more holistic in the overall approach and takes into account your specific needs. Plans are created and tailored to your lifestyle, routines, challenges, work and home environment, whilst considering cultural and personal preferences, other health concerns and relationship with food.
- Individualised recommendations on all aspects of nutrition
- Nutrition counselling, motivational interviewing and behavioural coaching
Seeing a dietitian who is experienced in behaviour change is beneficial to support those who struggle with disordered eating. Changing eating habits and patterns require accountability, motivation, consistency and connectivity for long term success. Reviews ensure you are on the right path.
- Nutrition counselling, motivational interviewing and behavioural coaching
- Your dietitian considers psychological and socio-economic factors and how they influence your food choices, habits, appetite, intake etc. The ZOE app is unable to provide this.
- Opportunity for more varied tests apart from testing for blood sugar, blood fats and gut health, there is a huge variety of other tests that an expert Dietitian will order such as vitamins and minerals, hormone testing, DNA testing, coeliac, helicobacter pylori, Gut Health testing and many more which are not available on the ZOE programme
By working with a dietitian, you can assess and discuss health concerns, leading to recommendations of specific tests that can be recommended to deepen understanding of challenges you may face with the symptoms you have.
- Opportunity for more varied tests apart from testing for blood sugar, blood fats and gut health, there is a huge variety of other tests that an expert Dietitian will order such as vitamins and minerals, hormone testing, DNA testing, coeliac, helicobacter pylori, Gut Health testing and many more which are not available on the ZOE programme
- A dietitian is able to support you with a referral or recommendation of a reliable place to get your tests done and help you interpret the results to create a nutrition plan with personalised goals.
- Developing a solid relationship with your healthcare provider Working with a dietitian encourages building solid relationships that are based on mutual trust, respect and genuine care. A personalised support is an important component that works with how a patient best develops new habits, how they learn best, their preferred means of communication etc. It is a patient-centred way to achieve the desired outcome.
Value for Money
Is the ZOE diet worth it?
Although several users and reviews show that the ZOE programme is a great opportunity to learn more about health and wellbeing, we think it is just an initial ignition point to kick off a person’s health journey.
The charity Guts UK warns that commercial tests are not “a direct way to find out why you’re not feeling well or how to improve your health”.
Shivani Misra, a diabetes expert and lecturer at Imperial College London, critiqued that ZOE attends to those who don’t really need it: the health-conscious, well-off members who are at lower risks of heart diseases, obesity etc.
According to a Financial Times article, some doctors are concerned that there is potential harm with the usage of ZOE app which may create anxiety for otherwise healthy people- “worried well”
In a Nutshell!
Most people know what a healthy diet looks like. So, the issue isn’t knowledge but implementation.
At 121 Dietitian, we believe that sole reliance on an app for nutritional guidance lacks personalised support, tracking and evaluation that a specialist Dietitian provides for sustainable nutrition and health outcomes to get the best bang for your buck.
The high emphasis on the traffic light system of rating foods can also be negative and restrictive for some individuals. This is why Dietitians, based on professional discretion and assessment, may decide to liberalise nutrition plans for some patients.
Taking care of your health is a personal journey and finding the right support that you connect with and enjoy, is important.
Please get in touch with us today at 121 Dietitian, to find out how Gillian and our team of Specialist Dietitian’s can support you on your health journey!
Abby x
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