New mobile methods for dietary assessment: review of image-assisted and image-based dietary assessment methods

For nutrition practitioners and researchers, assessing dietary intake of children and adults with a high level of accuracy continues to be a challenge. Developments in mobile technologies have created a role for images in the assessment of dietary intake. The objective of this review was to examine peer-reviewed published papers covering development, evaluation and/or validation of image-assisted or image-based dietary assessment methods from December 2013 to January 2016. Images taken with handheld devices or wearable cameras have been used to assist traditional dietary assessment methods for portion size estimations made by dietitians (image-assisted methods). Image-assisted approaches can supplement either dietary records or 24-h dietary recalls. In recent years, image-based approaches integrating application technology for mobile devices have been developed (image-based methods). Image-based approaches aim at capturing all eating occasions by images as the primary record of dietary intake, and therefore follow the methodology of food records. The present paper reviews several image-assisted and image-based methods, their benefits and challenges; followed by details on an image-based mobile food record. Mobile technology offers a wide range of feasible options for dietary assessment, which are easier to incorporate into daily routines. The presented studies illustrate that image-assisted methods can improve the accuracy of conventional dietary assessment methods by adding eating occasion detail via pictures captured by an individual (dynamic images). All of the studies reduced underreporting with the help of images compared with results with traditional assessment methods. Studies with larger sample sizes are needed to better delineate attributes with regards to age of user, degree of error and cost.

Download Full-text

A Novel Food Record App for Dietary Assessments Among Older Adults With Type 2 Diabetes: Development and Usability Study

JMIR Formative Research ◽

10.2196/14760 ◽

2021 ◽

Vol 5 (2) ◽

pp. e14760

Author(s):

Hyunggu Jung ◽

George Demiris ◽

Peter Tarczy-Hornoch ◽

Mark Zachry

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Qualitative Data ◽

Dietary Assessment ◽

Assessment Methods ◽

Smartphone App ◽

Food Record ◽

Food Items ◽

Dietary Assessment Methods

Background More than 1 in 4 people in the United States aged 65 years and older have type 2 diabetes. For diabetes care, medical nutrition therapy is recommended as a clinically effective intervention. Previous researchers have developed and validated dietary assessment methods using images of food items to improve the accuracy of self-reporting over traditional methods. Nevertheless, little is known about the usability of image-assisted dietary assessment methods for older adults with diabetes. Objective The aims of this study were (1) to create a food record app for dietary assessments (FRADA) that would support image-assisted dietary assessments, and (2) to evaluate the usability of FRADA for older adults with diabetes. Methods For the development of FRADA, we identified design principles that address the needs of older adults and implemented three fundamental tasks required for image-assisted dietary assessments: capturing, viewing, and transmitting images of food based on the design principles. For the usability assessment of FRADA, older adults aged 65 to 80 years (11 females and 3 males) were assigned to interact with FRADA in a lab-based setting. Participants’ opinions of FRADA and its usability were determined by a follow-up survey and interview. As an evaluation indicator of usability, the responses to the survey, including an after-scenario questionnaire, were analyzed. Qualitative data from the interviews confirmed the responses to the survey. Results We developed a smartphone app that enables older adults with diabetes to capture, view, and transmit images of food items they consumed. The findings of this study showed that FRADA and its instructions for capturing, viewing, and transmitting images of food items were usable for older adults with diabetes. The survey showed that participants found FRADA easy to use and would consider using FRADA daily. The analysis of the qualitative data from interviews revealed multiple categories, such as the usability of FRADA, potential benefits of using FRADA, potential features to be added to FRADA, and concerns of older adults with diabetes regarding interactions with FRADA. Conclusions This study demonstrates in a lab-based setting not only the usability of FRADA by older adults with diabetes but also potential opportunities using FRADA in real-world settings. The findings suggest implications for creating a smartphone app for an image-assisted dietary assessment. Future work still remains to evaluate the feasibility and validity of FRADA with multiple stakeholders, including older adults with diabetes and dietitians.

Download Full-text

Development and Usability Assessment of a Food Record App for Dietary Assessments among Older Adults with Type 2 Diabetes (Preprint)

10.2196/preprints.14760 ◽

2019 ◽

Author(s):

Hyunggu Jung ◽

George Demiris ◽

Peter Tarczy-Hornoch ◽

Mark Zachry

Keyword(s):

Older Adults ◽

Qualitative Data ◽

Dietary Assessment ◽

Smartphone Application ◽

Design Principles ◽

Assessment Methods ◽

Food Record ◽

Food Items ◽

Usability Assessment ◽

Dietary Assessment Methods

BACKGROUND More than one in four people in the United States aged 65 years and older have diabetes. For diabetes care, medical nutrition therapy (MNT) is recommended as a clinically effective intervention. Prior researchers have developed and validated dietary assessment methods using images of food items for improving the accuracy of self-reporting over traditional methods. Nevertheless, little is known about the usability of image-assisted dietary assessment methods for older adults with diabetes. OBJECTIVE The aims of this study were: a) to create a food record app for dietary assessments (FRADA) that would support image-assisted dietary assessments, and b) to evaluate the usability of FRADA for older adults with diabetes. METHODS For the development of FRADA, we identified design principles that address the needs of older adults and implemented three fundamental tasks required for image-assisted dietary assessments: capturing, viewing, and transmitting images of food based on the design principles. For the usability assessment of FRADA, older adults aged 65 to 80 (11 females and 3 males) were assigned to interact with FRADA in a lab-based setting. Participants’ opinions of FRADA and its usability were determined by a follow-up survey and interview. As an evaluation indicator of usability, the responses to the survey including an After-Scenario Questionnaire were analyzed. Qualitative data from the interviews confirmed the responses to the survey. RESULTS We developed a smartphone application that enables older adults with diabetes to capture, view, and transmit images of food items they consumed. The findings of this study showed that FRADA and its instructions for capturing, viewing, and transmitting images of food items were usable for older adults with diabetes. The survey showed that FRADA was easy to use, and study participants would consider using FRADA daily. The analysis of the qualitative data from interviews revealed multiple themes, such as the usability of FRADA, potential benefits and features of FRADA, and concerns of older adults with diabetes when interacting with FRADA. CONCLUSIONS This study demonstrates in a lab-based setting, not only the usability of FRADA with older adults who have diabetes, but it also demonstrates potential opportunities using FRADA in real-life settings. The findings suggest implications for creating a smartphone application for an image-assisted dietary assessment. Future work still remains to evaluate the feasibility and validity of FRADA with multiple stakeholders involving older adults with diabetes and dietitians.

Download Full-text

Validation of a FFQ to estimate the intake of PUFA using plasma phospholipid fatty acids and weighed foods records

British Journal Of Nutrition ◽

10.1017/s0007114507381385 ◽

2007 ◽

Vol 97 (3) ◽

pp. 561-568 ◽

Cited By ~ 60

Author(s):

S. A. McNaughton ◽

M. C. Hughes ◽

G. C. Marks

Keyword(s):

Fatty Acids ◽

Dietary Intake ◽

Controlled Trial ◽

Dietary Assessment ◽

Plasma Phospholipid ◽

Docosapentaenoic Acid ◽

Phospholipid Fatty Acids ◽

Food Record ◽

Dietary Assessment Methods ◽

Randomised Controlled

Due to the growing knowledge about the role of specific fatty acids in health and disease, dietary intake measurements of individual fatty acids or classes of fatty acids are becoming increasingly important. The objective of this study was to evaluate the ability of the Nambour FFQ to estimate intakes of specific fatty acids, particularly PUFA. The study population was a sub-sample of adult participants in a randomised controlled trial of β-carotene and sunscreen in the prevention of skin cancer (n43). Dietary intake was assessed by a self-administered FFQ and a weighed food record (WFR). Non-fasting blood samples were collected and analysed for plasma phospholipid fatty acids. Median intakes on the FFQ were generally higher than the WFR except for then-3 PUFA groups, where the FFQ estimated higher intakes. Correlations between the FFQ and WFR were moderate (r0·32–0·59) except fortransfatty acids (r0·03). Correlations between each of the dietary assessment methods and the plasma phospholipids were poor for all fatty acids other than the PUFA. Using the methods of triads approach, the FFQ validity coefficients for totaln-3 fatty acids, total long chainn-3 fatty acids, EPA, arachidonic acid, docosapentaenoic acid and DHA were 0·50, 0·63, 0·45 and 0·62 and 0·62, respectively. For most fatty acids, the FFQ adequately estimates group mean fatty acid intakes and can adequately rank individuals; however, the ability of this FFQ to estimatetransfatty acids was poor.

Download Full-text

Dietary assessment methods for micronutrient intake: a systematic review on vitamins

British Journal Of Nutrition ◽

10.1017/s0007114509993126 ◽

2009 ◽

Vol 102 (S1) ◽

pp. S10-S37 ◽

Cited By ~ 59

Author(s):

Patricia Henríquez-Sánchez ◽

Almudena Sánchez-Villegas ◽

Jorge Doreste-Alonso ◽

Adriana Ortiz-Andrellucchi ◽

Karina Pfrimer ◽

...

Keyword(s):

Dietary Intake ◽

Quality Index ◽

Dietary Assessment ◽

Correlation Coefficients ◽

Reference Method ◽

Assessment Methods ◽

Vitamin B ◽

Vitamin Supplement ◽

Supplement Use ◽

Dietary Assessment Methods

The EURRECA Network of Excellence is working towards the development of aligned micronutrient recommendations across Europe. The purpose of the present study was to define how to identify dietary intake validation studies in adults pertaining to vitamins. After establishing a search strategy, we conducted a MEDLINE and EMBASE literature review. A scoring system was developed to rate the quality of each validation study according to sample size, statistical methods, data collection procedure, seasonality and vitamin supplement use. This produced a quality index with possible scores obtained ranging from 0·5 to 7. Five thousand four-hundred and seventy-six papers were identified. The numbers meeting the inclusion criteria were: for vitamin A, 76; vitamin C, 108; vitamin D, 21; vitamin E, 75; folic acid, 47; vitamin B12, 19; vitamin B6, 21; thiamine, 49; riboflavin, 49; and niacin, 32. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24-h recalls were the most used reference methods. The correlation coefficients (CC) between vitamin intakes estimated by FFQ and the reference method were weighted according to the study's quality index and ranged from 0·41 to 0·53 when the reference method was the DR and from 0·43 to 0·67 when the reference was 24-h recalls. A minority of studies (n33) used biomarkers for validation and in these the CC ranged from 0·26 to 0·38. The FFQ is an acceptable method of assessing vitamin intake. The present review provides new insights regarding the characteristics that assessment methods for dietary intake should fulfil.

Download Full-text

Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records

British Journal Of Nutrition ◽

10.1079/bjn19940064 ◽

1994 ◽

Vol 72 (4) ◽

pp. 619-643 ◽

Cited By ~ 479

Author(s):

S. A. Bingham ◽

C. Gill ◽

A. Welch ◽

K. Day ◽

A. Cassidy ◽

...

Keyword(s):

Dietary Assessment ◽

Assessment Methods ◽

Portion Size ◽

Nutritional Epidemiology ◽

Food Diary ◽

Individual Values ◽

Food Frequency ◽

Dietary Assessment Methods ◽

Diet Records ◽

Habitual Diet

Women (n 160) aged 50 to 65 years were asked to weigh their food for 4 d on four occasions over the period of 1 year, using the PETRA (Portable Electronic Tape Recorded Automatic) scales. Throughout the year, they were asked to complete seven other dietary assessment methods: a simple 24 h recall, a structured 24 h recall with portion size assessments using photographs, two food-frequency questionnaires, a 7 d estimated record or open-ended food diary, a structured food-frequency (menu) record, and a structured food-frequency (menu) record with portion sizes assessed using photographs. Comparisons between the average of the 16 d weighed records and the first presentation of each method indicated that food-frequency questionnaires were not appreciably better at placing individuals in the distribution of habitual diet than 24 h recalls, due partly to inaccuracies in the estimation of frequency of food consumption. With a 7 d estimated record or open-ended food diary, however, individual values of nutrients were most closely associated with those obtained from 16 d weighed records, and there were no significant differences in average food or nutrient intakes.

Download Full-text

Evaluating the quality of dietary intake validation studies

British Journal Of Nutrition ◽

10.1017/s0007114509993114 ◽

2009 ◽

Vol 102 (S1) ◽

pp. S3-S9 ◽

Cited By ~ 83

Author(s):

Lluis Serra-Majem ◽

Lene Frost Andersen ◽

Patricia Henríque-Sánchez ◽

Jorge Doreste-Alonso ◽

Almudena Sánchez-Villegas ◽

...

Keyword(s):

Dietary Intake ◽

Validation Studies ◽

Scoring System ◽

Dietary Assessment ◽

Quality Score ◽

Assessment Methods ◽

Nutritional Epidemiology ◽

Supplement Use ◽

Dietary Assessment Methods

Within the EURopean micronutrient RECommendations Aligned Network of Excellence (EURRECA), a scoring system was developed to assess the quality of dietary intake validation studies. The scoring system included three steps. The first step was to give each study a quality score, which included five components: sample size, statistics used, data collection procedure, consideration of seasonality and supplement use. Scores ranged from 0 to 7, and validation studies classified as very good ( ≥ 5), good (5–3·5), acceptable/reasonable (3·5–2·5) and poor ( < 2·5). The second and third steps included an adjustment/weighting of the correlation coefficient according to the quality score and moreover a rating of the adjusted/weighted correlation. The scoring system was tested in 124 validation studies that included at least one vitamin. Only 5·6 % of the 124 studies were judged to be of very good quality according to the quality score, 41·9 % of good quality and 16·9 % had a poor rating. When adjusting for the study quality scores, crude and adjusted mean correlations of vitamins A, C, D and E intakes were similar, but the percentage of correlation values classified as poor or very good was higher after adjustment. These results show the importance of considering the quality of studies validating dietary assessment methods and the correlations obtained for the micronutrient of interest when interpreting effects observed in epidemiological studies using dietary assessment methods. Without a doubt, this subject constitutes a key topic for research in nutritional epidemiology.

Download Full-text

Accuracy and Cost-effectiveness of Technology-Assisted Dietary Assessment Comparing the Automated Self-administered Dietary Assessment Tool, Intake24, and an Image-Assisted Mobile Food Record 24-Hour Recall Relative to Observed Intake: Protocol for a Randomized Crossover Feeding Study (Preprint)

10.2196/preprints.32891 ◽

2021 ◽

Author(s):

Clare Whitton ◽

Janelle D Healy ◽

Clare E Collins ◽

Barbara Mullan ◽

Megan E Rollo ◽

...

Keyword(s):

Cost Effectiveness ◽

Assessment Tool ◽

Dietary Assessment ◽

Assessment Methods ◽

Food Record ◽

Chi Square ◽

Feeding Study ◽

Dietary Assessment Methods ◽

24 Hour Recall ◽

Chi Square Tests

BACKGROUND The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. OBJECTIVE The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. METHODS Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. RESULTS Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. CONCLUSIONS This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s INTERNATIONAL REGISTERED REPORT DERR1-10.2196/32891

Download Full-text

BMI was found to be a consistent determinant related to misreporting of energy, protein and potassium intake using self-report and duplicate portion methods

Public Health Nutrition ◽

10.1017/s1368980016002743 ◽

2016 ◽

Vol 20 (4) ◽

pp. 598-607 ◽

Cited By ~ 23

Author(s):

Laura Trijsburg ◽

Anouk Geelen ◽

Peter CH Hollman ◽

Paul JM Hulshof ◽

Edith JM Feskens ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Dietary Intake ◽

Dietary Assessment ◽

Linear Regression Analysis ◽

Assessment Methods ◽

Self Report ◽

Doubly Labelled Water ◽

Dietary Assessment Methods ◽

Duplicate Portion

AbstractObjectiveAs misreporting, mostly under-reporting, of dietary intake is a generally known problem in nutritional research, we aimed to analyse the association between selected determinants and the extent of misreporting by the duplicate portion method (DP), 24 h recall (24hR) and FFQ by linear regression analysis using the biomarker values as unbiased estimates.DesignFor each individual, two DP, two 24hR, two FFQ and two 24 h urinary biomarkers were collected within 1·5 years. Also, for sixty-nine individuals one or two doubly labelled water measurements were obtained. The associations of basic determinants (BMI, gender, age and level of education) with misreporting of energy, protein and K intake of the DP, 24hR and FFQ were evaluated using linear regression analysis. Additionally, associations between other determinants, such as physical activity and smoking habits, and misreporting were investigated.SettingThe Netherlands.SubjectsOne hundred and ninety-seven individuals aged 20–70 years.ResultsHigher BMI was associated with under-reporting of dietary intake assessed by the different dietary assessment methods for energy, protein and K, except for K by DP. Men tended to under-report protein by the DP, FFQ and 24hR, and persons of older age under-reported K but only by the 24hR and FFQ. When adjusted for the basic determinants, the other determinants did not show a consistent association with misreporting of energy or nutrients and by the different dietary assessment methods.ConclusionsAs BMI was the only consistent determinant of misreporting, we conclude that BMI should always be taken into account when assessing and correcting dietary intake.

Download Full-text

Dietary assessment methods for intakes of iron, calcium, selenium, zinc and iodine

British Journal Of Nutrition ◽

10.1017/s0007114509993138 ◽

2009 ◽

Vol 102 (S1) ◽

pp. S38-S55 ◽

Cited By ~ 41

Author(s):

Lluis Serra-Majem ◽

Karina Pfrimer ◽

Jorge Doreste-Alonso ◽

Lourdes Ribas-Barba ◽

Almudena Sánchez-Villegas ◽

...

Keyword(s):

Dietary Intake ◽

Validation Studies ◽

Quality Index ◽

Dietary Assessment ◽

Correlation Coefficients ◽

Reference Method ◽

Assessment Methods ◽

Inclusion Criteria ◽

Dietary Assessment Methods ◽

Dietary Records

The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is working towards developing aligned micronutrient recommendations across Europe. The purpose of the present study was to conduct a review of methods used in validation studies carried out in adults assessing dietary intake of EURRECA priority minerals. A search strategy and inclusion criteria were defined and a scoring system was developed to rate the quality of each validation study that produced a quality index with possible scores obtained ranging from 0·5 to 7. A MEDLINE and EMBASE literature review was conducted. Articles/validation studies meeting the inclusion criteria included: 79/88 for Fe; 95/104 for Ca; 13/15 for Se; 29/30 for Zn; 7/9 for iodine. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24 h recalls were the most used reference methods. The correlation coefficients (CC) between study mineral intakes estimated by FFQ and the reference method were weighted according to the study's quality index and obtained acceptable to good ratings, ranging from 0·36 to 0·60 when the reference method was DR and from 0·41 to 0·58 when the reference was 24 h recalls. A minority of studies (n9) used biomarkers for validation and among these, five included iodine obtaining a CC of 0·47. The FFQ was seen as a valid method for assessing mineral intake, particularly for Ca and, to a lower extent, for iodine and Zn. Se and Fe showed only acceptable correlations. The present review provides new insights regarding the characteristics that assessment methods for dietary mineral intakes should fulfil.

Download Full-text

Validation and reproducibility of dietary assessment methods in adolescents: a systematic literature review

Public Health Nutrition ◽

10.1017/s1368980013003157 ◽

2013 ◽

Vol 17 (12) ◽

pp. 2700-2714 ◽

Cited By ~ 31

Author(s):

Garden Tabacchi ◽

Emanuele Amodio ◽

Maria Di Pasquale ◽

Antonino Bianco ◽

Monèm Jemni ◽

...

Keyword(s):

Literature Review ◽

Dietary Assessment ◽

Scoring Systems ◽

Assessment Method ◽

Assessment Methods ◽

Portion Size ◽

Present Review ◽

Food Groups ◽

Size Estimation ◽

Dietary Assessment Methods

AbstractObjectiveThe aim of the present work was to determine what dietary assessment method can provide a valid and accurate estimate of nutrient intake by comparison with the gold standard.DesignA MEDLINE, EMBASE, ISI Web of Science, Cochrane and related references literature review was conducted on dietary assessment methods for adolescents reporting the validity and/or reproducibility values. A study quality assessment on the retrieved FFQ was carried out according to two different scoring systems, judging respectively the quality of FFQ nutrition information and of FFQ validation and calibration.SettingThe present review considered adolescents attending high schools and recruited in hospitals or at home.SubjectsThe target of the review was the healthy adolescent population in the age range 13–17 years.ResultsThirty-two eligible papers were included and analysed separately as ‘original articles’ (n20) and ‘reviews’ (n12). The majority (n17) assessed the validation and reproducibility of FFQ. Almost all studies found the questionnaires to be valid and reproducible (r> 0·4), except for some food groups and nutrients. Different design and validation issues were highlighted, such as portion-size estimation, number of food items and statistics used.ConclusionsThe present review offers new insights in relation to the characteristics of assessment methods for dietary intake in adolescents. Further meta-analysis is required although the current review provides important indications on the development of a new FFQ, addressing the need for a valid, reproducible, user-friendly, cost-effective method of accurately assessing nutrient intakes in adolescents.

Download Full-text