Usual intake modelling is essential in assessing nutritional adequacy in populations

AbstractUsing short-term assessment methods to study diet provide too wide population intake distributions leading to overestimation of tail probabilities. Usual intake modelling reduces the variation in the distribution. The objective of this study was to evaluate the amount of bias in proportions of population under average requirement (AR) or recommended intake (RI) using the mean intake of two days compared to usual intake distribution. The FinDiet 2017 Survey was carried out in a nationally representative sample from the population register including adults aged 18–74 years. The data included two non-consecutive 24-hour dietary recalls from 1 655 participants (response rate 53%). Weighing factors were used to correct for non-participation bias. Usual intake was estimated using statistical program SPADE (RIVM, The Netherlands). The proportions of the population below AR or RI (when AR is not available) according to NNR 2012 were evaluated using two days mean intake and the usual intake distribution. These were further compared to evaluate the bias in two days mean intake. The bias associated with two days mean intakes was substantial in some of the nutrients. For example, for vitamin C and D intakes the difference between the proportions using two days mean and usual intake was over 10 percentage points. For vitamin C intake from food the proportions below AR (60 mg/day for men, 50 mg/day for women) were 38% for men and 20% for women using two days mean but 13 percentage points smaller for both sexes based on usual intake. The proportions below AR (7.5 μg/day) for vitamin D from food were 25% for men and 40% for women using two days mean and 14% for men and 30% for women using usual intake. When taking the intake from supplements into account, the proportions for vitamin D intake were 16% for men and 21 % for women based on two days mean but only 7% for both sexes using usual intake. For calcium intake from food the proportion below AR (500 mg/day) was small (7% for men and 8% for women) using two days mean but more than 50% smaller using usual intake (3% for both sexes). Using two days mean intake to estimate nutritional adequacy can lead to considerable biased results due to extraneous day-to-day variation in the intake distribution. Therefore, usual intake modelling should always be applied to intakes derived from short-term dietary assessment methods when evaluating nutritional adequacy.

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Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers

International Journal of Epidemiology ◽

10.1093/ije/26.suppl_1.s137 ◽

1997 ◽

Vol 26 (90001) ◽

pp. 137S-151 ◽

Cited By ~ 409

Author(s):

S. Bingham

Keyword(s):

Vitamin C ◽

Dietary Assessment ◽

Serum Vitamin ◽

Assessment Methods ◽

Dietary Assessment Methods ◽

The Uk ◽

Urinary Nitrogen

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Faculty Opinions recommendation of Dietary assessment methods in epidemiologic studies.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726711683.793532919 ◽

2017 ◽

Author(s):

Pagona Lagiou

Keyword(s):

Dietary Assessment ◽

Epidemiologic Studies ◽

Assessment Methods ◽

Dietary Assessment Methods

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Dietary assessment methods in epidemiological research: current state of the art and future prospects

F1000Research ◽

10.12688/f1000research.10703.1 ◽

2017 ◽

Vol 6 ◽

pp. 926 ◽

Cited By ~ 98

Author(s):

Androniki Naska ◽

Areti Lagiou ◽

Pagona Lagiou

Keyword(s):

Dietary Assessment ◽

Smart Phone ◽

Food Composition ◽

Individual Variability ◽

Assessment Methods ◽

Nutrient Intakes ◽

Dietary Biomarkers ◽

Novel Technologies ◽

Sources Of Error ◽

Dietary Assessment Methods

Self-reported dietary intake is assessed by methods of real-time recording (food diaries and the duplicate portion method) and methods of recall (dietary histories, food frequency questionnaires, and 24-hour dietary recalls). Being less labor intensive, recall methods are more frequently employed in nutritional epidemiological investigations. However, sources of error, which include the participants’ inability to fully and accurately recall their intakes as well as limitations inherent in the food composition databases applied to convert the reported food consumption to energy and nutrient intakes, may limit the validity of the generated information. The use of dietary biomarkers is often recommended to overcome such errors and better capture intra-individual variability in intake; nevertheless, it has its own challenges. To address measurement error associated with dietary questionnaires, large epidemiological investigations often integrate sub-studies for the validation and calibration of the questionnaires and/or administer a combination of different assessment methods (e.g. administration of different questionnaires and assessment of biomarker levels). Recent advances in the omics field could enrich the list of reliable nutrition biomarkers, whereas new approaches employing web-based and smart phone applications could reduce respondent burden and, possibly, reporting bias. Novel technologies are increasingly integrated with traditional methods, but some sources of error still remain. In the analyses, food and nutrient intakes always need to be adjusted for total daily energy intake to account for errors related to reporting.

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Comparison dietary assessment methods in Sri Lankan adults: use of 24-hour dietary recall and 7-day weighed intake

BMC Nutrition ◽

10.1186/s40795-016-0059-5 ◽

2016 ◽

Vol 2 (1) ◽

Cited By ~ 5

Author(s):

Ranil Jayawardena

Keyword(s):

Dietary Assessment ◽

Assessment Methods ◽

Sri Lankan ◽

Dietary Recall ◽

Dietary Assessment Methods

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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.

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A Comparison of Two Dietary Assessment Methods in a Mediterranean Lebanese Adults Population: A Food Frequency Questionnaire and a Dietary Recall

Universal Journal of Public Health ◽

10.13189/ujph.2018.060505 ◽

2018 ◽

Vol 6 (5) ◽

pp. 262-273

Author(s):

Maya Tueni ◽

Afifee Mounayar ◽

Ines Birlouez-Aragon

Keyword(s):

Food Frequency Questionnaire ◽

Dietary Assessment ◽

Assessment Methods ◽

Food Frequency ◽

Dietary Recall ◽

Dietary Assessment Methods

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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.

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