Evaluating Mobile Apps For Dietary and Food Timing Assessment For Use in Research and Clinical Assessment (Preprint)

2021 ◽  
Author(s):  
Siena Gioia ◽  
Irma M Vlassac ◽  
Demsina Babazadeh ◽  
Noah L Fryou ◽  
Elizabeth Do ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Keyword Search ◽  
Mobile Apps ◽  
Dietary Assessment ◽  
Registered Dietitian ◽  
Food Record ◽  
User Privacy ◽  
Privacy Policies ◽  
Dietary Record ◽  
System Usability Scale

UNSTRUCTURED Abstract: Over the last decade, health apps have become an increasingly popular tool utilized by clinicians and researchers to track food consumption and exercise. However, as consumer apps have primarily focused on tracking dietary intake and exercise, many lack technological features to facilitate the capture of critical food timing details. To determine a viable app that recorded both dietary intake and food timing for use in our clinical study, we evaluated the timestamp data, usability, privacy policies, accuracy of nutrient estimates, and general features of 11 mobile apps for dietary assessment. Apps were selected using a keyword search of related terms and the following apps were reviewed: Bitesnap, Cronometer, DiaryNutrition, DietDiary, FoodDiary, FoodView, Macros, MealLogger, myCircadianClock, MyFitnessPal, and MyPlate. Our primary goal was identifying apps that record food timestamps, which 8 of the reviewed apps did (73%). Of those, only 4/11 (36%) allowed users to edit the timestamps, an important feature. Next, we sought to evaluate the usability of the apps, using the System Usability Scale (SUS) across 2 days, with 82% of the apps receiving favorable scores for usability (9/11 apps). To enable use in research and clinic settings, the privacy policies of each app were systematically reviewed using common criteria with 1 Health Insurance Portability and Accountability Act (HIPAA) compliant app (Cronometer). Furthermore, protected health information is collected by 9/11 (81%) of the apps. Lastly, to assess the accuracy of nutrient estimates generated by these apps, we selected 4 sample food items and one researcher’s 3-day dietary record to input into each app. The caloric and macronutrient estimates of the apps were compared to nutrient estimates provided by a registered dietitian using the Nutrition Data System for Research (NDSR). Compared to the 3-day food record, the apps were found to consistently underestimate calories and macronutrients compared to NDSR. Overall, we find the Bitesnap app to provide flexible dietary and food timing functionality capable for research or clinical use with the majority of apps lacking in necessary food timing functionality or user privacy.

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

2007 ◽  
Vol 97 (3) ◽  
pp. 561-568 ◽  
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.

scholarly journals Exploring the Feasibility of Use of An Online Dietary Assessment Tool (myfood24) in Women with Gestational Diabetes

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1147 ◽  
Author(s):  
Carla Gianfrancesco ◽  
Zoe Darwin ◽  
Linda McGowan ◽  
Debbie Smith ◽  
Roz Haddrill ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Assessment Tool ◽  
Dietary Assessment ◽  
Structured Interview ◽  
Clinical Population ◽  
Management Tool ◽  
Food Record ◽  
Dietary Recall ◽  
Lower Socioeconomic ◽  
System Usability Scale

myfood24 is an online 24 hr dietary recall tool developed for nutritional epidemiological research. Its clinical application has been unexplored. This mixed methods study explores the feasibility and usability of myfood24 as a food record in a clinical population, women with gestational diabetes (GDM). Women were asked to complete five myfood24 food records, followed by a user questionnaire (including the System Usability Scale (SUS), a measure of usability), and were invited to participate in a semi-structured interview. Of the 199 participants, the mean age was 33 years, mean booking body mass index (BMI) 29.7 kg/m2, 36% primiparous, 57% White, 33% Asian. Of these, 121 (61%) completed myfood24 at least once and 73 (37%) completed the user questionnaire; 15 were interviewed. The SUS was found to be good (mean 70.9, 95% CI 67.1, 74.6). Interviews identified areas for improvement, including optimisation for mobile devices, and as a clinical management tool. This study demonstrates that myfood24 can be used as an online food record in a clinical population, and has the potential to support self-management in women with GDM. However, results should be interpreted cautiously given the responders’ demographic characteristics. Further research to explore the barriers and facilitators of uptake in people from ethnic minority and lower socioeconomic backgrounds is recommended.

scholarly journals Applying a meal coding system to 16-d weighed dietary record data in the Japanese context: towards the development of simple meal-based dietary assessment tools

2018 ◽  
Vol 7 ◽  
Author(s):  
Kentaro Murakami ◽  
M. Barbara E. Livingstone ◽  
Satoshi Sasaki ◽  
Naoko Hirota ◽  
Akiko Notsu ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Dietary Assessment ◽  
Food Group ◽  
Scientific Basis ◽  
Food Composition ◽  
Assessment Tools ◽  
Coding System ◽  
Nutrient Intakes ◽  
Dietary Record ◽  
Eating Occasions

AbstractData on the combination of foods consumed simultaneously at specific eating occasions are scarce, primarily due to a lack of assessment tools. We applied a recently developed meal coding system to multiple-day dietary intake data for assessing its ability to estimate food and nutrient intakes and characterise meal-based dietary patterns in the Japanese context. A total of 242 Japanese adults completed sixteen non-consecutive-day weighed dietary records, including 14 734 eating occasions (3788 breakfasts, 3823 lunches, 3856 dinners and 3267 snacks). Common food group combinations were identified by meal type to identify a range of generic meals. Dietary intake was calculated on the basis of not only the standard food composition database but also the substituted generic meal database. In total, eighty generic meals (twenty-three breakfasts, twenty-one lunches, twenty-four dinners and twelve snacks) were identified. The Spearman correlation coefficients between food group intakes calculated based on the standard food composition database and the substituted generic meal database ranged from 0·26 to 0·85 (median 0·69). The corresponding correlations for nutrient intakes ranged from 0·17 to 0·82 (median 0·61). A total of eleven meal patterns were established using principal components analysis, and these accounted for 39·1 % of total meal variance. Considerable variation in patterns was seen in meal type inclusion and choice of staple foods (bread, rice and noodles) and drinks, and also in meal constituents. In conclusion, this study demonstrated the usefulness of a meal coding system for assessing habitual diet, providing a scientific basis towards the development of simple meal-based dietary assessment tools.

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

2016 ◽  
Vol 76 (3) ◽  
pp. 283-294 ◽  
Author(s):  
C. J. Boushey ◽  
M. Spoden ◽  
F. M. Zhu ◽  
E. J. Delp ◽  
D. A. Kerr
Keyword(s):  
Dietary Intake ◽  
Dietary Assessment ◽  
Assessment Methods ◽  
Portion Size ◽  
Mobile Technologies ◽  
Handheld Devices ◽  
Food Record ◽  
Dietary Assessment Methods ◽  
Wide Range ◽  
High Level

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.

scholarly journals Validity and Usability of a Smartphone Image-Based Dietary Assessment App Compared to 3-Day Food Diaries in Assessing Dietary Intake Among Canadian Adults: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Yuwei Ji ◽  
Hugues Plourde ◽  
Valerie Bouzo ◽  
Robert D Kilgour ◽  
Tamara R Cohen
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Dietary Intake ◽  
Total Energy ◽  
Saturated Fatty Acids ◽  
Dietary Assessment ◽  
Misclassification Rate ◽  
Relative Validity ◽  
System Usability Scale ◽  
System Usability

BACKGROUND Accurate dietary assessment is needed in studies that include analysis of nutritional intake. Image-based dietary assessment apps have gained in popularity for assessing diet, which may ease researcher and participant burden compared to traditional pen-to-paper methods. However, few studies report the validity of these apps for use in research. Keenoa is a smartphone image-based dietary assessment app that recognizes and identifies food items using artificial intelligence and permits real-time editing of food journals. OBJECTIVE This study aimed to assess the relative validity of an image-based dietary assessment app — Keenoa — against a 3-day food diary (3DFD) and to test its usability in a sample of healthy Canadian adults. METHODS We recruited 102 participants to complete two 3-day food records. For 2 weeks, on 2 non-consecutive days and 1 weekend day, in random order, participants completed a traditional pen-to-paper 3DFD and the Keenoa app. At the end of the study, participants completed the System Usability Scale. The nutrient analyses of the 3DFD and Keenoa data before (Keenoa-participant) and after they were reviewed by dietitians (Keenoa-dietitian) were analyzed using analysis of variance. Multiple tests, including the Pearson coefficient, cross-classification, kappa score, % difference, paired t test, and Bland-Altman test, were performed to analyze the validity of Keenoa (Keenoa-dietitian). RESULTS The study was completed by 72 subjects. Most variables were significantly different between Keenoa-participant and Keenoa-dietitian (<i>P</i>&lt;.05) except for energy, protein, carbohydrates, fiber, vitamin B1, vitamin B12, vitamin C, vitamin D, and potassium. Significant differences in total energy, protein, carbohydrates, % fat, saturated fatty acids, iron, and potassium were found between the 3DFD and Keenoa-dietitian data (<i>P</i>&lt;.05). The Pearson correlation coefficients between the Keenoa-dietitian and 3DFD ranged from .04 to .51. Differences between the mean intakes assessed by the 3DFD and Keenoa-dietitian were within 10% except for vitamin D (misclassification rate=33.8%). The majority of nutrients were within an acceptable range of agreement in the Bland-Altman analysis; no agreements were seen for total energy, protein, carbohydrates, fat (%), saturated fatty acids, iron, potassium, and sodium (<i>P</i>&lt;.05). According to the System Usability Scale, 34.2% of the participants preferred using Keenoa, while 9.6% preferred the 3DFD. CONCLUSIONS The Keenoa app provides acceptable relative validity for some nutrients compared to the 3DFD. However, the average intake of some nutrients, including energy, protein, carbohydrates, % fat, saturated fatty acids, and iron, differed from the average obtained using the 3DFD. These findings highlight the importance of verifying data entries of participants before proceeding with nutrient analysis. Overall, Keenoa showed better validity at the group level than the individual level, suggesting it can be used when focusing on the dietary intake of the general population. Further research is recommended with larger sample sizes and objective dietary assessment approaches.

scholarly journals Validity and Usability of a Smartphone Image-Based Dietary Assessment App Compared to 3-Day Food Diaries in Assessing Dietary Intake Among Canadian Adults: Randomized Controlled Trial

10.2196/16953 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e16953 ◽  
Author(s):  
Yuwei Ji ◽  
Hugues Plourde ◽  
Valerie Bouzo ◽  
Robert D Kilgour ◽  
Tamara R Cohen
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Dietary Intake ◽  
Total Energy ◽  
Saturated Fatty Acids ◽  
Dietary Assessment ◽  
Misclassification Rate ◽  
Relative Validity ◽  
System Usability Scale ◽  
System Usability

Background Accurate dietary assessment is needed in studies that include analysis of nutritional intake. Image-based dietary assessment apps have gained in popularity for assessing diet, which may ease researcher and participant burden compared to traditional pen-to-paper methods. However, few studies report the validity of these apps for use in research. Keenoa is a smartphone image-based dietary assessment app that recognizes and identifies food items using artificial intelligence and permits real-time editing of food journals. Objective This study aimed to assess the relative validity of an image-based dietary assessment app — Keenoa — against a 3-day food diary (3DFD) and to test its usability in a sample of healthy Canadian adults. Methods We recruited 102 participants to complete two 3-day food records. For 2 weeks, on 2 non-consecutive days and 1 weekend day, in random order, participants completed a traditional pen-to-paper 3DFD and the Keenoa app. At the end of the study, participants completed the System Usability Scale. The nutrient analyses of the 3DFD and Keenoa data before (Keenoa-participant) and after they were reviewed by dietitians (Keenoa-dietitian) were analyzed using analysis of variance. Multiple tests, including the Pearson coefficient, cross-classification, kappa score, % difference, paired t test, and Bland-Altman test, were performed to analyze the validity of Keenoa (Keenoa-dietitian). Results The study was completed by 72 subjects. Most variables were significantly different between Keenoa-participant and Keenoa-dietitian (P<.05) except for energy, protein, carbohydrates, fiber, vitamin B1, vitamin B12, vitamin C, vitamin D, and potassium. Significant differences in total energy, protein, carbohydrates, % fat, saturated fatty acids, iron, and potassium were found between the 3DFD and Keenoa-dietitian data (P<.05). The Pearson correlation coefficients between the Keenoa-dietitian and 3DFD ranged from .04 to .51. Differences between the mean intakes assessed by the 3DFD and Keenoa-dietitian were within 10% except for vitamin D (misclassification rate=33.8%). The majority of nutrients were within an acceptable range of agreement in the Bland-Altman analysis; no agreements were seen for total energy, protein, carbohydrates, fat (%), saturated fatty acids, iron, potassium, and sodium (P<.05). According to the System Usability Scale, 34.2% of the participants preferred using Keenoa, while 9.6% preferred the 3DFD. Conclusions The Keenoa app provides acceptable relative validity for some nutrients compared to the 3DFD. However, the average intake of some nutrients, including energy, protein, carbohydrates, % fat, saturated fatty acids, and iron, differed from the average obtained using the 3DFD. These findings highlight the importance of verifying data entries of participants before proceeding with nutrient analysis. Overall, Keenoa showed better validity at the group level than the individual level, suggesting it can be used when focusing on the dietary intake of the general population. Further research is recommended with larger sample sizes and objective dietary assessment approaches.

scholarly journals Development and feasibility testing of the smartphone-based dietary record app NutriDiary (beta version)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Johanna Conrad ◽  
Mats Wiese ◽  
Ionut Andone ◽  
Stefanie Koch ◽  
Alexander Markowetz ◽  
...  
Keyword(s):  
Dietary Assessment ◽  
Food Products ◽  
Free Text ◽  
Technical Problems ◽  
Digital Version ◽  
Dietary Record ◽  
System Usability Scale ◽  
Free Text Search ◽  
Beta Version ◽  
Paper Method

AbstractSmartphone technology has the potential to facilitate dietary assessment in epidemiological studies. Measurement error might be reduced by real time recording being more feasible with mobile methods. Our aim was to develop NutriDiary, a smartphone app for conducting three-day weighed dietary records. It provides a digital version of the established pen-and-paper method in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, an open cohort study from infancy to adulthood. NutriDiary was developed as a text-based app including brand specific recording of food products. Usability of the beta version of NutriDiary was evaluated in the DONALD study. Participants or their parents were offered to test the app for the annual dietary record and were asked to fill in an app-integrated evaluation questionnaire. Usability was assessed by the System Usability Scale (SUS) and in-app behavior recordings. In the beta version of NutriDiary, a consumed food item is selected using a free-text search from the integrated in-house database LEBTAB. To ease the process of recording, NutriDiary offers some usability features such as a recipe editor, an integrated help mode and a photo function for collecting information on branded food products. In total, 32 mostly female participants (69%) used the app with 21 subjects recording their own dietary intake and 11 subjects conducting a record for their child. However, a relatively large proportion of DONALD participants also refused using the app because they preferred the traditional pen-and-paper method as being easier. Among participants of the feasibility study, subjective usability of NutriDiary was “good” but considerable differences in individual ratings were observed (median SUS = 80, IQR = 23.75, minimum = 45). Although 38% of participants reported technical issues, 88% stated they would use the app again. Technical problems included issues related to setting the time, editing of entered food items and the photo function. In-app behavior recordings showed that the help mode and recipe function were well-used (72% and 63%, respectively). Feedback from the study staff revealed that the post-processing of the dietary data obtained with NutriDiary was still time-consuming. Overall, the beta version of the NutriDiary app was well-received by most participants. Some aspects for improvement such as a barcode scanning function and extension of the database were identified. Moreover, NutriDiary will be further optimized by implementing an automated recipe simulation function.

scholarly journals Identification of psychological correlates of dietary misreporting under laboratory and free-living environments

2020 ◽  
pp. 1-12
Author(s):  
Mark Hopkins ◽  
Joanna Michalowska ◽  
Stephen Whybrow ◽  
Graham W. Horgan ◽  
R. James Stubbs
Keyword(s):  
Home Environment ◽  
Emotional Eating ◽  
Dietary Assessment ◽  
Eating Behaviour ◽  
Openness To Experience ◽  
Psychological Traits ◽  
Psychological Correlates ◽  
Dietary Record ◽  
Assessment Techniques ◽  
Diet History

Abstract Errors inherent in self-reported measures of energy intake (EI) are substantial and well documented, but correlates of misreporting remain unclear. Therefore, potential predictors of misreporting were examined. In Study One, fifty-nine individuals (BMI = 26·1 (sd 3·8) kg/m2, age = 42·7 (sd 13·6) years, females = 29) completed a 14-d stay in a residential feeding behaviour suite where eating behaviour was continuously monitored. In Study Two, 182 individuals (BMI = 25·7 (sd 3·9) kg/m2, age = 42·4 (sd 12·2) years, females = 96) completed two consecutive days in a residential feeding suite and five consecutive days at home. Misreporting was directly quantified by comparing covertly measured laboratory weighed intakes (LWI) with self-reported EI (weighed dietary record (WDR), 24-h recall, 7-d diet history, FFQ). Personal (age, sex and %body fat) and psychological traits (personality, social desirability, body image, intelligence quotient and eating behaviour) were used as predictors of misreporting. In Study One, those with lower psychoticism (P = 0·009), openness to experience (P = 0·006) and higher agreeableness (P = 0·038) reduced EI on days participants knew EI was being measured to a greater extent than on covert days. Isolated associations existed between personality traits (psychoticism and openness to experience), eating behaviour (emotional eating) and differences between the LWI and self-reported EI, but these were inconsistent between dietary assessment techniques and typically became non-significant after accounting for multiplicity of comparisons. In Study Two, sex was associated with differences between LWI and the WDR (P = 0·009), 24-h recall (P = 0·002) and diet history (P = 0·050) in the laboratory, but not home environment. Personal and psychological correlates of misreporting identified displayed no clear pattern across studies or dietary assessment techniques and had little utility in predicting misreporting.

A comparison of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for measuring full day dietary intake among school-aged children

2021 ◽  
pp. 1-26
Author(s):  
Traci A. Bekelman ◽  
Corby K. Martin ◽  
Susan L. Johnson ◽  
Deborah H. Glueck ◽  
Katherine A. Sauder ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Energy Intake ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Assessment Tool ◽  
Dietary Assessment ◽  
Ease Of Use ◽  
Self Report ◽  
Food Photography ◽  
Photography Method

Abstract The limitations of self-report measures of dietary intake are well known. Novel, technology-based measures of dietary intake may provide a more accurate, less burdensome alternative to existing tools. The first objective of this study was to compare participant burden for two technology-based measures of dietary intake among school-age children: the Automated-Self Administered 24-hour Dietary Assessment Tool-2018 (ASA24-2018) and the Remote Food Photography Method (RFPM). The second objective was to compare reported energy intake for each method to the Estimated Energy Requirement for each child, as a benchmark for actual intake. Forty parent-child dyads participated in 2, 3-day dietary assessments: a parent proxy-reported version of the ASA24 and the RFPM. A parent survey was subsequently administered to compare satisfaction, ease of use and burden with each method. A linear mixed model examined differences in total daily energy intake (TDEI) between assessments, and between each assessment method and the EER. Reported energy intake was 379 kcal higher with the ASA24 than the RFPM (p=0.0002). Reported energy intake with the ASA24 was 231 kcal higher than the EER (p = 0.008). Reported energy intake with the RFPM did not differ significantly from the EER (difference in predicted means = −148 kcal, p = 0.09). Median satisfaction and ease of use scores were 5 out of 6 for both methods. A higher proportion of parents reported that the ASA24 was more time consuming than the RFPM (74.4% vs. 25.6%, p = 0.002). Utilization of both methods is warranted given their high satisfaction among parents.

scholarly journals Using Wearable Cameras to Assess Foods and Beverages Omitted in 24 Hour Dietary Recalls and a Text Entry Food Record App

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1806
Author(s):  
Virginia Chan ◽  
Alyse Davies ◽  
Lyndal Wellard-Cole ◽  
Silvia Lu ◽  
Hoi Ng ◽  
...  
Keyword(s):  
Dietary Assessment ◽  
Fats And Oils ◽  
Point Of View ◽  
Self Report ◽  
Smartphone App ◽  
Food Record ◽  
Post Hoc Analysis ◽  
Significant Difference ◽  
Post Hoc ◽  
Paired T Test

Technology-enhanced methods of dietary assessment may still face common limitations of self-report. This study aimed to assess foods and beverages omitted when both a 24 h recall and a smartphone app were used to assess dietary intake compared with camera images. For three consecutive days, young adults (18–30 years) wore an Autographer camera that took point-of-view images every 30 seconds. Over the same period, participants reported their diet in the app and completed daily 24 h recalls. Camera images were reviewed for food and beverages, then matched to the items reported in the 24 h recall and app. ANOVA (with post hoc analysis using Tukey Honest Significant Difference) and paired t-test were conducted. Discretionary snacks were frequently omitted by both methods (p < 0.001). Water was omitted more frequently in the app than in the camera images (p < 0.001) and 24 h recall (p < 0.001). Dairy and alternatives (p = 0.001), sugar-based products (p = 0.007), savoury sauces and condiments (p < 0.001), fats and oils (p < 0.001) and alcohol (p = 0.002) were more frequently omitted in the app than in the 24 h recall. The use of traditional self-report methods of assessing diet remains problematic even with the addition of technology and finding new objective methods that are not intrusive and are of low burden to participants remains a challenge.

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