A Pilot Study on Sensemaking of Consumer Micronutrient Tests: Sufficiencies, Deficiencies, and Barriers to Improvement

Abstract

Vitamins and minerals are essential for human health, yet deficiencies are prevalent. Recent advances in consumer health technology have led to the rise of at-home nutritional health test services, offering an affordable and accessible way to measure nutrient levels. This pilot study explores how young people interpret their results from a mail-in urine micronutrient test. The findings revealed that none of the 13 participants met the target levels for all micronutrients, with high sodium levels and deficiencies in vitamin B, calcium, and magnesium being particularly common. Despite consuming nutrient-rich foods or supplements, some participants still experienced deficiencies, highlighting the complexity of nutrient absorption. Although participants appreciated the food recommendations, barriers such as personal food preferences, resource constraints (i.e., limited time, space, and budget), and lack of cooking skills hindered their ability to follow through the recommendations. Based on these findings, we propose two design recommendations to enhance the utility of consumer nutritional tests.

Full text

A Pilot Study on Sensemaking of Consumer Micronutrient Tests:
Suiciencies, Deficiencies, and Barriers to Improvement
Zilu Liang
liang.zilu@kuas.ac.jp
Kyoto University of Advanced Science
Kyoto, Japan
Nhung Huyen Hoang
2023md05@kuas.ac.jp
Kyoto University of Advanced Science
Kyoto, Japan
Thilini Savindya Karunarathna
2021m647@kuas.ac.jp
Kyoto University of Advanced Science
Kyoto, Japan
Figure 1: Nutritional test results from the VitaNote app for one participant. Left: The overall nutrition score was 78 out of 100.
This participant demonstrated sucient levels in 7 nutrients (vitamin D, vitamin B1, vitamin B6, phosphorus, zinc, selenium,
and molybdenum), deciencies were noted in 9 nutrients (protein, vitamin B2, niacin, folic acid, pantothenic acid, biotin,
potassium, calcium, and magnesium), and sodium level was high. Middle: Recommended foods to address deciencies in folic
acid, calcium and biotin, including jute leaves, mustard spinach, sunower seeds, and hot cake. Right: This participant’s score
is benchmarked at the 42nd percentile compared to others.
Abstract
Vitamins and minerals are essential for human health, yet decien-
cies are prevalent. Recent advances in consumer health technology
have led to the rise of at-home nutritional health test services, of-
fering an aordable and accessible way to measure nutrient levels.
This pilot study explores how young people interpret their results
from a mail-in urine micronutrient test. The ndings revealed that
none of the 13 participants met the target levels for all micronutri-
ents, with high sodium levels and deciencies in vitamin B, calcium,
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and magnesium being particularly common. Despite consuming
nutrient-rich foods or supplements, some participants still experi-
enced deciencies, highlighting the complexity of nutrient absorp-
tion. Although participants appreciated the food recommendations,
barriers such as personal food preferences, resource constraints (i.e.,
limited time, space, and budget), and lack of cooking skills hindered
their ability to follow through the recommendations. Based on these
ndings, we propose two design recommendations to enhance the
utility of consumer nutritional tests.
CCS Concepts
•Human-centered computing
→
Empirical studies in HCI;•
Applied computing →Consumer health.
Keywords
Personal informatics, Consumer informatics, Sensemaking, Nutri-
tional health tests, Micronutrients, Minerals, Vitamins

CHI’25, April 26–May 01, 2025, Yokohama, Japan Liang et al.
ACM Reference Format:
Zilu Liang, Nhung Huyen Hoang, and Thilini Savindya Karunarathna. 2025.
A Pilot Study on Sensemaking of Consumer Micronutrient Tests: Sucien-
cies, Deciencies, and Barriers to Improvement. In Proceedings of Envisioning
the Future of Interactive Health Workshop (HCI+Health) at (CHI’25). ACM,
New York, NY, USA, 4 pages. https://doi.org/XXXXXXX.XXXXXXX
1 Introduction
Micronutrients, including vitamins and minerals, play important
roles in various functions of the human body, from immune support
to energy production [
11
]. Despite their importance, micronutrient
deciencies are common, particularly among young people who
may face dietary challenges due to factors like busy schedules,
limited food options, and academic stress [
1
], which may potentially
impact their short-term and long-term health [12].
Traditionally, assessing micronutrient levels through laboratory-
based testing has been complicated and costly, limiting its acces-
sibility for the average person [
6
]. However, recent developments
in consumer health technology have led to the emergence of at-
home nutritional health test services. These services oer a more
accessible and aordable way for individuals to measure the levels
of key nutrients by simply submitting a urine sample [
7
]. While
these services seem to provide valuable information, little is known
about how individuals users interpret and apply the results they
receive. It is important to understanding how users make sense of
their micronutrient test results , as it can inuence their health-
related decisions and behaviors. This study aims to take the rst
step in exploring how young people interpret their mail-in urine
nutrient test results. By examining their perceptions and responses,
this research seeks to contribute to a fundational understanding
of how consumer nutritional tests may inuence personal health
management in daily life.
2 Related Work
In personal health informatics, users often struggle to make sense
of large volumes of self-tracking data about their diet, activity, sleep,
or medical conditions [
4
,
8
]. The challenge of sensemaking is further
exacerbated in clinical settings, where deep domain knowledge is
required to understand the medical test reports [9].
A related aspect of personal health management is food jour-
naling, which involves tracking macronutrients such as proteins,
fats, and carbohydrates. While users can gain useful insights into
their dietary habits by tracking these macronutrients, a noticeable
gap exists in tools designed to help users understand their micronu-
trient intake. Unlike macronutrients, which can often be tracked
using basic food journaling apps, micronutrients—such as vitamins
and minerals—are more challenging to monitor and interpret. Lahti-
ranta [
5
] explores how sensemaking in personal health typically
focuses on high-level factors like diet and exercise but often over-
looks the more complex issues surrounding micronutrient intake
and its role in long-term health. These knowledge gaps are one of
the driving forces behind our study, which aims to explore how
individuals interpret and make sense of their micronutrient proles.
3 Method
To explore how young people interpret their micronutrient proles,
we recruited 13 university students (10 male, 3 female) aged 19-34
from Kyoto University of Advanced Science (KUAS). The study
began with a one-on-one kicko meeting where the research team
explained the study’s purpose and process and obtained written
informed consent. Participants were provided with a VitaNote nu-
trition kit, along with instructions on how to perform the test. They
collected urine samples the following morning and mailed them
to the VitaNote testing center. The test results were then made
available to the research team via the VitaNote smartphone app. A
screenshot of the VitaNote app is shown in Figure 1.
A second meeting was held after the research team conrmed the
test results. During this meeting, semi-structured interviews were
conducted where participants were shown their test results, asked
to interpret their nutrient levels and the app’s recommendations,
and inquired about any actions they planned to take based on the
results. All interviews were recorded, transcribed verbatim, and
uploaded to DoveTail software for further analysis.
We employed thematic analysis as described in [
3
]. The rst
author reviewed all transcripts to get familiar with the content and
identify preliminary themes. Initial coding was done manually by
marking relevant data segments that appeared to capture partic-
ipants’ perceptions, actions, and interpretations of their nutrient
test results in DoveTail. After the rst round of coding, the research
team gathered to discuss and rene the codes, ensuring consistency
and resolving discrepancies. Codes were then grouped into broader
themes that reected recurring patterns in participants’ responses.
These themes were iteratively reviewed and rened, with some
codes being merged or split based on deeper analysis.
4 Results
4.1 Popularity of Nutrients
As the test results indicate, none of the participants were free of
nutrient deciencies. Many participants asked questions about the
functions of the elements they were lacking, inquired about symp-
toms of deciency, and tried to identify potential causes based on
their lifestyles, particularly their diets. However, not all nutrients
received the same level of attention.
Sodium stood out as the most discussed nutrient, with more
than 50% (7 out of 13) of the participants immediately expressing
concerns about their sodium intake and attempting to identify
reasons for this. A common theme was the consumption of fast
food, instant noodles, and lunch boxes, which were frequently cited
as major contributors to their high sodium levels. As P004 noted: "I
do eat fast food, and that contains a lot of sodium, yeah, like I go to
McDonald’s maybe twice a week."
Calcium followed as the second most commonly discussed mi-
cronutrient, with 4 participants actively expressing thoughts on
their calcium intake. P007 noted that "The calcium level seems about
right because I don’t really consume many calcium-rich products right
now." P012, on the other hand, thought his calcium intake aligned
with his milk consumption but was unaware of the recommended
daily intake: "I think the calcium level matches my milk consumption,
but I didn’t know the recommended daily intake was this high." (019)

A Pilot Study on Sensemaking of Consumer Micronutrient Tests: Suiciencies, Deficiencies, and Barriers to Improvement CHI’25, April 26–May 01, 2025, Yokohama, Japan
Other nutrients, such as folic acid, Vitamin D, Vitamin B group,
potassium, and zinc, also received attention. Participants attributed
their deciencies to a lack of certain foods in their diet–such as
spinach for folic acid, bananas for potassium, and liver for zinc–or
to insucient sunlight exposure for Vitamin D. Health conditions,
such as polycystic ovary syndrome (PCOS), were also mentioned
as potential factors contributing to Vitamin B deciency. In con-
trast, selenium and molybdenum were the least discussed nutrients,
because participants were unfamiliar with these minerals.
4.2 Results Conrming Expectations
In some cases, the results of the nutritional test matched partici-
pants’ expectations. For instance, some participants believed they
were getting enough of certain nutrients, and the test results re-
assured them that they had no deciencies in those areas. As one
participant shared his thoughts on his calcium level: "I used to take
a lot of calcium supplements when I was a child. That may explain
why my calcium level is better than others. " (P011)
On the other hand, some participants were already aware that
their diet was not ideal, so they were not surprised by the abnormal
levels. As P009 explained: "I do eat snacks, you know, the nori I eat a
lot. Instant noodles or chips, I eat a lot. So I’m not surprised that my
sodium level was o the chart."
4.3 Results Contradicting Expectations
However, more often than not, participants found that the results
contradicted their expectations. In some cases, the levels of certain
nutrients were much lower than anticipated, revealing decien-
cies despite consuming foods that were considered rich in those
nutrients. In other instances, the levels were better than expected.
4.3.1 Unexpected Suiciency. Some participants were pleasantly
surprised by the results, discovering higher-than-expected levels
of certain nutrients. P009 noted: "I’m more curious about the stu
that I’m already fullling. It’s weird that I’m doing great on minerals.
Where are these from? Or maybe, you know, in the supermarkets,
there’s this small salad...maybe that’s where I got the minerals from. I
do eat the salad because it tastes really good." Similarly, P010 was sur-
prised by his sucient levels of magnesium and phosphorus, stating
that "I was not aware I had enough magnesium and phosphorus. Are
those rich in natural products?”"
4.3.2 Unexpected Deficiency. On the other hand, some participants
were shocked to nd deciencies in nutrients they had assumed
they were getting enough of, especially considering their diet or
supplement intake. For example, P011 and P012 were puzzled by
their low levels of vitamin D and calcium, despite regularly taking
vitamin D supplements or drinking a lot of milk. Similarly, P003 and
P006 were shocked to nd their calcium levels were low, despite
consuming calcium-rich sh: “I’m surprised that my calcium level
was low. I was eating spreads a lot.” (P006)
Some participants, like P003, were especially puzzled because
they had no perceivable symptoms to back up the deciencies they
were experiencing: "And another thing, especially for the performance
of the brain, magnesium and calcium... magnesium, yeah, it’s very low,
but I think I’m doing well. So, still, I’m thinking that the magnesium
level should be higher." (P003)
Surprises did not just stem from deciencies; high nutrient lev-
els were also a cause for shock, particularly with sodium. Some
participants were surprised to learn that their sodium levels were
two or three times higher than the recommended daily intake: "I
don’t really consume that much salt. Only on certain meals, I would
consume a little bit more sodium, but that’s on the rarer side." (P008)
4.4 Planning for Action
After discussing the nutrient levels in the test results, participants
were asked what they planned to do based on their ndings. Their
solutions included increasing the consumption of certain foods rich
in the nutrients they were lacking and considering supplements.
4.4.1 Improve Diet. All participants mentioned adjusting their diet
as the rst step towards improving their nutritional prole, as
they preferred natural solutions and some participants expressed a
reluctance towards supplements: "I mean, rst I would try changing
my diet because I know it’s not the greatest. And if it doesn’t work,
then I would consider buying supplements." (P007) or "Oh, maybe not
supplements. Honestly, I don’t mind the price of supplements, but if
possible, I’ll try to eat from natural sources rst. " (P005)
Participants outlined specic dietary changes they planned to
implement, including eating more whole food (1 participant), con-
suming more meat and organ meats like liver (5), vegatables (3),
diary products (3), fruits (2), and nuts (2).
"I think chicken liver gives you zinc and magnesium...also, I need
more meat, dierent types of meat." (P011)
"Like incorporate a lot more variety of food groups. For example, I
said dairy products such as milk, yogurts... I’ve stopped eating them
for some time. I’ll pick them up again, and nuts as we mentioned. I’m
already eating beef, so I’ll be adding other things too, like vegetables.
I will try liver, now that I know it’s packed with vitamins." (P007)
A few also expressed a desire to cut down on sodium sources,
such as bread: "I think I should have less sodium in general. I think I
should eat less bread; it has a lot of salt." (P010)
Diet changes also involved adjusting meal portions and sched-
ules. P001 expressed a desire to work on meal consistency: "Two
more consistent meals, like a very good breakfast, lunch, and din-
ner. Currently, it’s good but not great because it’s in the university
cafeteria. I want better quality and larger portions."
4.4.2 Take Supplements. Interestingly, while some participants
showed reluctance toward supplements, 4 participants viewed them
as a necessary complement to a healthy diet. P009 found it hard to
make signicant changes to his diet and stated "it’s easy to just take
pills." P011 further explained that “I need more supplements. Maybe
because I can’t get enough fruits in Japan, so supplements are easier.”
P001 highlighted the importance of dose control when taking
supplements: "Yes, in the week I didn’t eat too much, and I just take
the pill. That supplements me for a while, not every day. For me, I
don’t feel well taking a pill every day...just twice a week."
4.5 Barriers to Change
Although the VitaNote app provides food recommendations for
addressing micronutrient deciencies, some participants were re-
luctant to try certain foods due to personal preferences. Green leafy
vegetables like spinach and fermented foods such as natto were

CHI’25, April 26–May 01, 2025, Yokohama, Japan Liang et al.
commonly disliked. One participant shared, "I don’t know if this is
doable. I hate spinach so much. And natto... one time in the cafeteria
they had natto. I took it as my side dish. I opened the pack, and I
was like, oh my God..." (P009). Similarly, reducing salt intake proved
dicult for some, with one participant commenting, "If I cut down
on salt or salty food, it wouldn’t have much avor." (P013).
Time and budget constraints were also common issues. One par-
ticipant remarked, "It’s hard to nd time, and I prioritize school over
my health. I don’t think that will change." (P004), while another
noted the high cost of certain foods: "Nuts are very expensive here.
I’m okay with deciency." (P007). The challenge of balancing meal
planning with busy schedules was also mentioned, with P008 stat-
ing, "It would depend on if I can adjust my schedule to make it more
manageable to plan my meals more mindfully." In addition, space
and practicality issues were mentioned, particularly in relation to
cooking. P009 explained, "It’s really impractical to cook meat at my
place. If it’s just chicken breast, I guess it’s ne because it’s easy. But
preparing more complicated meals is dicult because I don’t have the
space to do that."
Finally, some participants noted that a lack of cooking skills
prevented them from preparing nutritious meals. For instance, P007
stated, "I don’t know how to cook spinach in a way that I would enjoy
it." and P012 mentioned, "Fish is hard to cook." Several participants
also noted that they were unfamiliar with cooking organ meats like
liver, despite recognizing their nutritional benets.
5 Discussions
5.1 Prevalence of Micronutrient Deciency
While the sample size was small, our results reveal a concerning
trend that no participant was able to meet the target levels for all
micronutrients measured in the test. Deciencies in vitamin B, folic
acid, calcium, and magnesium were more prevalent than initially
expected, with many participants unaware of these deciencies. In
contrast, the majority of the participants had high sodium levels,
with some reaching 2-3 times the recommended daily intake.
A key observation was that participants did not prioritize nutri-
ents equally when interpreting their test results. Nutrients such as
sodium and calcium, which are commonly highlighted in the media,
received the most attention. The level of concern often correlated
with participants’ familiarity with these nutrients.
An intriguing nding was that several participants experienced
deciencies in specic minerals despite consuming foods rich in
those nutrients or taking supplements. This underscores the com-
plexity of nutrient absorption, which cannot simply be assumed
based on dietary intake. The discrepancies between food consump-
tion and nutrient levels may be due to factors such as nutrient
bioavailability, which is inuenced by genetics [
2
], lifestyle [
13
],
and food combinations [
10
]. This suggests that tracking dietary
intake alone may not provide a complete picture of an individual’s
nutritional status. To address the gap between the two, we propose
the following design recommendation:
Design Recommendation 1. Integrate food logs with nutritional
test data to assess whether nutrient consumption aligns with the
levels derived from metabolites. Any discrepancies should be high-
lighted to alert users, encouraging them to consider more bioavail-
able food options that may better support their nutritional needs.
5.2 Utility of Consumer Nutritional Tests
Participants found the VitaNote test useful, especially as it high-
lighted deciencies they were previously unaware of and prompted
reection on their lifestyles and diets. However, many struggled to
fully understand their results due to limited nutritional knowledge.
This points to the need for educational support in interpreting test
results to bridge this knowledge gap.
Despite these challenges, the intuitive nature of the test results,
coupled with food recommendations, provided participants with
actionable insights. Still, this does not guarantee that users will
follow through on the recommendations. Many participants ex-
pressed concerns about food preferences, and the practicality of
incorporating the recommended foods into their daily routines.
This highlights a design opportunity for consumer nutritional test
services: the need to ensure that recommendations are not only
tailored but also feasible within users’ specic contexts. Based on
these ndings, we propose the following design recommendation:
Design Recommendation 2. Food recommendations should be
personalized not only based on test results but also considering in-
dividual contexts such as food preferences and resource constraints.
Oering recipes that incorporate the recommended foods, as well
as reminders to purchase these items while grocery shopping, may
help users more easily integrate these foods into their daily meals.
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Received 13 February 2025