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Nature of the evidence base and frameworks underpinning dietary recommendations for prevention of non-communicable diseases: a position paper from the Academy of Nutrition Sciences. Br J Nutr 2021; 126:1076-1090. [PMID: 34515022 DOI: 10.1017/s0007114520005000] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This Position Paper from the Academy of Nutrition Sciences is the first in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This first paper focuses on evidence which underpins dietary recommendations for prevention of non-communicable diseases. It considers methodological advances made in nutritional epidemiology and frameworks used by expert groups to support objective, rigorous and transparent translation of the evidence into dietary recommendations. The flexibility of these processes allows updating of recommendations as new evidence becomes available. For CVD and some cancers, the paper has highlighted the long-term consistency of a number of recommendations. The innate challenges in this complex area of science include those relating to dietary assessment, misreporting and the confounding of dietary associations due to changes in exposures over time. A large body of experimental data is available that has the potential to support epidemiological findings, but many of the studies have not been designed to allow their extrapolation to dietary recommendations for humans. Systematic criteria that would allow objective selection of these data based on rigour and relevance to human nutrition would significantly add to the translational value of this area of nutrition science. The Academy makes three recommendations: (i) the development of methodologies and criteria for selection of relevant experimental data, (ii) further development of innovative approaches for measuring human dietary intake and reducing confounding in long-term cohort studies and (iii) retention of national nutrition surveillance programmes needed for extrapolating global research findings to UK populations.
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Abstract
FFQ, the primary method of dietary assessment in large-scale nutritional epidemiological studies, preclude an informed evaluation of the timing of dietary intake and meal-specific dietary intake. In this study, we developed the Meal-based Diet History Questionnaire (MDHQ), a self-administered questionnaire designed for estimating food and nutrient intakes for each meal type separately. The development was done based on a 16-d dietary record obtained from 242 Japanese adults. The MDHQ consisted of the three different parts, with a total of 196 items. Part 1 of the MDHQ asks about consumption frequency of generic food groups (n 24) for each meal type: breakfast, morning snack, lunch, afternoon snack, dinner and night snack. Part 2 of the MDHQ asks about relative consumption frequency of sub-food groups within one of the generic food groups which are asked in Part 1. Combining information derived from Parts 1 and 2 enables us to increase the number of foods we can estimate efficiently but within a limited number of questions. Part 3 of the MDHQ asks about general eating behaviours, which are intended to use in a variety of ways during dietary intake calculation. A series of calculation algorithms for food groups, energy and nutrients was also prepared. Given that the MDHQ was empirically developed based on comprehensive information on actual food consumption, this innovative tool may be promising for future epidemiological research on meal patterns and time of day of dietary intake, or chrono-nutrition research. A rigorous evaluation of validity of the MDHQ is warranted.
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Koch SAJ, Conrad J, Cade JE, Weinhold L, Alexy U, Nöthlings U. Validation of the web-based self-administered 24-h dietary recall myfood24-Germany: comparison with a weighed dietary record and biomarkers. Eur J Nutr 2021; 60:4069-4082. [PMID: 33974128 PMCID: PMC8437850 DOI: 10.1007/s00394-021-02547-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/22/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE We aimed to validate myfood24-Germany, a web-based 24-h dietary recall (24HDR), by comparing its performance with a weighed dietary record (WDR) and biomarkers. METHODS 97 adults (77% female) completed a 3-day WDR with a 24-h urine collection on day 3, followed by at least one 24HDR with myfood24-Germany (corresponding to day 3 of the WDR). Intake of energy and 32 nutrients assessed by myfood24-Germany and the WDR for the same day were compared (method comparison). Intakes of protein and potassium assessed by myfood24-Germany/WDR were compared with intake estimated from urinary biomarkers for protein and potassium (biomarker comparison). RESULTS In the method comparison, significant correlations were found for energy and all tested nutrients (range 0.45-0.87). There was no significant difference between both methods in the assessed mean energy and macronutrient intake. However, myfood24-Germany underestimated mean intake of 15 nutrients. In the biomarker comparison, protein intake reported by myfood24-Germany/WDR was on average 10%/8% lower than estimated by biomarker. There was no significant difference in mean potassium intake assessed by myfood24-Germany/WDR and biomarker. However, a shared bias in the assessment of potassium intake was observed for both instruments. Concordance correlation coefficients (pc) and weighted Kappa coefficients (κ) confirmed good agreement with the biomarker estimates for myfood24-Germany/WDR in case of protein (pc = 0.58/0.66, κ = 0.51/0.53) and moderate agreement in case of potassium (pc = 0.44/0.51; κ = 0.30/0.33). CONCLUSION Our results suggest that myfood24-Germany is of comparable validity to traditional dietary assessment methods.
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Affiliation(s)
- Stefanie A J Koch
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany.
| | - Johanna Conrad
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany.,Science Department, German Nutrition Society, Bonn, Germany
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Leonie Weinhold
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - Ute Alexy
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
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The utility of household Grocery Purchase Quality Index scores as an individual diet quality metric. Br J Nutr 2021; 126:933-941. [PMID: 33267922 DOI: 10.1017/s0007114520004833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Grocery Purchase Quality Index (GPQI) reflects concordance between household grocery purchases and US dietary recommendations. However, it is unclear whether GPQI scores calculated from partial purchasing records reflect individual-level diet quality. This secondary analysis of a 9-month randomised controlled trial examined concordance between the GPQI (range 0-75, scaled to 100) calculated from 3 months of loyalty-card linked partial (≥50 %) household grocery purchasing data and individual-level Healthy Eating Index (HEI) scores at baseline and 3 months calculated from FFQ (n 209). Concordance was assessed with overall and demographic-stratified partially adjusted correlations; covariate-adjusted percentage score differences, cross-classification and weighted κ coefficients assessed concordance across GPQI tertiles (T). Participants were middle aged (55·4 (13·9) years), female (90·3 %), from non-smoking households (96·4 %) and without children (70·7 %). Mean GPQI (54·8 (9·1) %) scores were lower than HEI scores (baseline: 73·2 (9·1) %, 3 months: 72·4 (9·4) %) and moderately correlated (baseline r 0·41 v. 3 months r 0·31, P < 0·001). Correlations were stronger among participants with ≤ bachelor's degree, obesity and children. Scores showed moderate agreement (κ = 0·25); concordance was highest in T3. Participants with high (T3) v. low (T1) GPQI scores had 7·3-10·6 higher odds of having HEI scores >80 % at both time points. Household-level GPQI was moderately correlated with self-reported intake, indicating their promise for evaluating diet quality. Partial purchasing data appear to moderately reflect individual diet quality and may be useful in interventions monitoring changes in diet quality.
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Development of an Arabic food composition database for use in an Arabic online dietary assessment tool (myfood24). J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.104047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Coleone JD, Bellei EA, Roman MK, Kirsten VR, De Marchi ACB. Dietary Intake and Health Status of Elderly Patients With Type 2 Diabetes Mellitus: Cross-sectional Study Using a Mobile App in Primary Care. JMIR Form Res 2021; 5:e27454. [PMID: 34448711 PMCID: PMC8433854 DOI: 10.2196/27454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/23/2021] [Accepted: 07/05/2021] [Indexed: 12/15/2022] Open
Abstract
Background Healthy dietary intake reduces the risk of complications of diabetes mellitus. Using assessment methods helps to understand these circumstances, and an electronic application may optimize this practice. Objective In this study, we aimed to (1) assess the dietary intake and health status of elderly patients with type 2 diabetes mellitus (T2DM) in primary care, (2) use a mobile app as a tool for data collection and analysis in the context of primary care, and (3) verify the perceptions of multidisciplinary health professionals regarding app use. Methods First, we developed a mobile app comprised of the questions of the Food and Nutrition Surveillance System (SISVAN) of Brazil, which includes a food frequency questionnaire of food categories with a recall of the previous 7 days. Thereafter, we used the app to collect data on the health status and dietary intake of 154 participants, aged 60-96 years, diagnosed with T2DM, and under treatment in primary care centers in the northern region of Rio Grande do Sul, Brazil. We also collected participants’ demographic, anthropometric, biochemical, and lifestyle variables. The associations between dietary intake and other variables were tested using chi-square tests with a 5% significance level. Regarding the app, we assessed usability and acceptance with 20 health professionals. Results Between August 2018 and December 2018, participants had an intake in line with recommended guidelines for raw salads (57.1%), fruits (76.6%), milk products (68.2%), fried foods (72.7%), savory biscuits (60.4%), cookies or sweets (72.1%), and sugary drinks (92.9%) Meanwhile, the consumption of beans (59.7%), pulses and cooked vegetables (73.4%), and processed meat products (59.7%) was not in line with the guidelines. There were statistically significant differences in meeting the recommended guidelines among participants of different genders (P=.006 and P=.035 for the intake of fried foods and sugary drinks, respectively), place of residence (P=.034 for the intake of cookies and sweets), family history of diabetes (P<.001 for the intake of beans), physical activity engagement (P=.003 for the intake fresh fruits), history of smoking (P=.001 for the intake of raw salads), and presence of coronary disease (P=.050 for the intake of pulses and cooked vegetables). The assessment of usability resulted in a mean score of 71.75 points. Similarly, the assessment of the 15 acceptance questions revealed high scores, and the qualitative questions revealed positive perceptions. Conclusions We identified that most participants complied with recommended intake guidelines for 7 of 10 categories in the SISVAN guidelines. However, most participants were overweight and had nutritional and clinical disorders, which justifies further investigations in this population. The app was well-rated by health professionals and considered a useful and promising tool for collecting and analyzing data in primary care settings.
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Affiliation(s)
- Joane Diomara Coleone
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Ericles Andrei Bellei
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Mateus Klein Roman
- Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Vanessa Ramos Kirsten
- Department of Foods and Nutrition, Federal University of Santa Maria, Palmeira das Missões, RS, Brazil.,Graduate Program in Gerontology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Ana Carolina Bertoletti De Marchi
- School of Physical Education and Physiotherapy, University of Passo Fundo, Passo Fundo, RS, Brazil.,Institute of Exact Sciences and Geosciences, University of Passo Fundo, Passo Fundo, RS, Brazil
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Bzikowska-Jura A, Sobieraj P, Raciborski F. Low Comparability of Nutrition-Related Mobile Apps against the Polish Reference Method-A Validity Study. Nutrients 2021; 13:nu13082868. [PMID: 34445026 PMCID: PMC8398064 DOI: 10.3390/nu13082868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Nutrition-related mobile applications (apps) are commonly used to provide information about the user’s dietary intake, however, limited research has been carried out to assess to what extent their results agree with those from the reference method (RM). The main aim of this study was to evaluate the agreement of popular nutrition-related apps with the Polish RM (Dieta 6.0). The dietary data from two days of dietary records previously obtained from adults (60 males and 60 females) were compared with values calculated in five selected apps (FatSecret, YAZIO, Fitatu, MyFitnessPal, and Dine4Fit). The selection of apps was performed between January and February 2021 and based on developed criteria (e.g., availability in the Polish language, access to the food composition database, and the number of downloads). The data was entered by experienced clinical dietitians and checked by one more researcher. The mean age of study participants was 41.7 ± 14.8. We observed that all the apps tended to overestimate the energy intake, however, when considering the macronutrient intake, over- and underestimation were observed. According to our assumed criterion (±5% as perfect agreement, ±10% as sufficient agreement), none of the apps can be recommended as a replacement for the reference method both for scientific as well as clinical use. According to the Bland-Altman analysis, the smallest bias was observed in Dine4Fit in relation to energy, protein, and fat intake (respectively: −23 kcal; −0.7 g, 3 g), however, a wide range between the upper and lower limits of agreement were reported. According to the carbohydrate intake, the lowest bias was observed when FatSecret and Fitatu were used. These results indicate that the leading nutrition-related apps present a critical issue in the assessment of energy and macronutrient intake. Therefore, the implementation of validation studies for quality assessment is crucial to develop apps with satisfying quality.
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Affiliation(s)
- Agnieszka Bzikowska-Jura
- Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciolka Str. 27, 01-445 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-572-09-31
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Faculty of Medicine, Medical University of Warsaw, Banacha Str. 1a, 02-091 Warsaw, Poland;
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland;
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Potential of existing online 24-h dietary recall tools for national dietary surveys. Public Health Nutr 2021; 24:5361-5386. [PMID: 34392853 DOI: 10.1017/s1368980021003517] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe existing online, 24-h dietary recall (24-h DR) tools in terms of functionalities and ability to tackle challenges encountered during national dietary surveys, such as maximising response rates and collecting high-quality data from a representative sample of the population, while minimising the cost and response burden. DESIGN A search (from 2000 to 2019) was conducted in peer-reviewed and grey literature. For each tool, information on functionalities, validation and user usability studies, and potential adaptability for integration into a new context was collected. SETTING Not country-specific. PARTICIPANTS General population. RESULTS Eighteen online 24-h DR tools were identified. Most were developed in Europe, for children ≥10 years old and/or for adults. Eight followed the five multiple-pass steps but used various methodologies and features. Almost all tools (except three) validated their nutrient intake estimates, but with high heterogeneity in methodologies. User usability was not always assessed, and rarely by applying real-time methods. For researchers, eight tools developed a web platform to manage the survey and five appeared to be easily adaptable to a new context. CONCLUSIONS Among the eighteen online 24-h DR tools identified, the best candidates to be used in national dietary surveys should be those that were validated for their intake estimates, had confirmed user and researcher usability, and seemed sufficiently flexible to be adapted to new contexts. Regardless of the tool, adaptation to another context will still require time and funding, and this is probably the most challenging step.
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Development and Validation of a Mobile Phone Application Developed for Measuring Dietary Fiber Intake. Nutrients 2021; 13:nu13072133. [PMID: 34206639 PMCID: PMC8308258 DOI: 10.3390/nu13072133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/15/2021] [Accepted: 06/20/2021] [Indexed: 12/12/2022] Open
Abstract
We have developed a mobile phone application for measuring the intake of dietary fiber and validated the ability of the application to accurately capture this intake against measurements registered by a dietary record. We also investigated what food groups contributed most to the total, soluble, and insoluble dietary fiber intake. Twenty-six randomly selected Swedish women aged 35–85 years were included and randomized to either start to register dietary intake in the application or by a dietary record, during three consecutive days. After a washout period of at least two weeks, the participants used the other method. We found that the difference in measured mean fiber intake between the dietary record and the application was two grams independent of the total intake per day. A statistically significant correlation between fiber intake as measured by the two methods was found (rho = 0.65, p < 0.001). Vegetables and roots were the predominantly contributing foods to total and soluble fiber intake. Bread and crackers contributed most to insoluble fiber intake. In conclusion, the application may be considered as a useful and easy-to-use method to measure dietary fiber intake.
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Validation of the European Prospective Investigation into Cancer (EPIC) FFQ for use among adults in Lebanon. Public Health Nutr 2021; 24:4007-4016. [PMID: 33988118 DOI: 10.1017/s1368980021002123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To validate the European Prospective Investigation into Cancer (EPIC) FFQ in Lebanon. DESIGN Validation of the EPIC FFQ was done against three 24-h recalls (24-HR). Unadjusted and energy-adjusted correlations, Bland-Altman plots and weighed kappa statistics were used to assess the agreement between the two methods. SETTING Lebanon. PARTICIPANTS 119 adults (staff and students) at a Lebanese University. RESULTS Good unadjusted and energy-adjusted correlation coefficients were found between data from the two methods which ranged from -0·002 (vitamin A) to 0·337 (carbohydrates) and were all statistically significant except for vitamin D, vitamin E, vitamin A, Se and niacin. Slight/fair agreement was reported through weighed kappa estimates for unadjusted data ranging from -0·05 (vitamin C) to 0·248 (Mg) and for energy-adjusted data ranging from -0·034 (vitamin A) to 0·203 (P). Individuals were categorised into exact and adjacent quartiles with an average of 78 % for unadjusted data and 70 % for energy-adjusted data, indicating a very good agreement between the EPIC FFQ and the average of the 24-HR data. The visual inspection of the Bland-Altman plots revealed an overestimation of energy, carbohydrates, protein and fat intakes by the FFQ method. CONCLUSION Overall, when all tests were taken into consideration, the current study demonstrated an acceptable agreement of the EPIC FFQ with the 24-h dietary recall method and significantly good correlations between dietary intakes. Therefore, the EPIC FFQ can be considered a valid tool for assessing diet in epidemiological studies among Lebanese adults.
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Blanchard CM, Chin MK, Gilhooly CH, Barger K, Matuszek G, Miki AJ, Côté RG, Eldridge AL, Green H, Mainardi F, Mehers D, Ronga F, Steullet V, Das SK. Evaluation of PIQNIQ, a Novel Mobile Application for Capturing Dietary Intake. J Nutr 2021; 151:1347-1356. [PMID: 33693732 PMCID: PMC8112765 DOI: 10.1093/jn/nxab012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/31/2020] [Accepted: 01/13/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Accurate measurement of dietary intake is vital for providing nutrition interventions and understanding the complex role of diet in health. Traditional dietary assessment methods are very resource intensive and burdensome to participants. Technology may help mitigate these limitations and improve dietary data capture. OBJECTIVE Our objective was to evaluate the accuracy of a novel mobile application (PIQNIQ) in capturing dietary intake by self-report. Our secondary objective was to assess whether food capture using PIQNIQ was comparable with an interviewer-assisted 24-h recall (24HR). METHODS This study was a single-center randomized clinical trial enrolling 132 adults aged 18 to 65 y from the general population. Under a provided-food protocol with 3 menus designed to include a variety of foods, participants were randomly assigned to 1 of 3 food capture methods: simultaneous entry using PIQNIQ, photo-assisted recall using PIQNIQ, and 24HR. Primary outcomes were energy and nutrient content (calories, total fat, carbohydrates, protein, added sugars, calcium, dietary fiber, folate, iron, magnesium, potassium, saturated fat, sodium, and vitamins A, C, D, and E) captured by the 3 methods. RESULTS The majority of nutrients reported were within 30% of consumed intake in all 3 food capture methods (n = 129 completers). Reported intake was highly (>30%) overestimated for added sugars in both PIQNIQ groups and underestimated for calcium in the photo-assisted recall group only (P < 0.001 for all). However, in general, both PIQNIQ methods had similar levels of accuracy and were comparable to the 24HR except in their overestimation (>30%) of added sugars and total fat (P < 0.001 for both). CONCLUSIONS Our results suggest that intuitive, technology-based methods of dietary data capture are well suited to modern users and, with proper execution, can provide data that are comparable to data obtained with traditional methods. This trial was registered at clinicaltrials.gov as NCT03578458.
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Affiliation(s)
- Caroline M Blanchard
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Meghan K Chin
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Kathryn Barger
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Gregory Matuszek
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Akari J Miki
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Richard G Côté
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Alison L Eldridge
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Hilary Green
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Fabio Mainardi
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Damian Mehers
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Frédéric Ronga
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Vera Steullet
- Société des Produits Nestlé, Nestlé Research Center, Lausanne, Switzerland
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Landberg R. Does Simplified Estimation of Total Fruit and Vegetable Intake Pave the Way for Accurate Biomarkers of the Same? J Nutr 2021; 151:751-752. [PMID: 33693768 DOI: 10.1093/jn/nxab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rikard Landberg
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
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63
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Ergun-Longmire B, Clemente E, Vining-Maravolo P, Roberts C, Buth K, Greydanus DE. Diabetes education in pediatrics: How to survive diabetes. Dis Mon 2021; 67:101153. [PMID: 33541707 DOI: 10.1016/j.disamonth.2021.101153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus is the most common abnormal carbohydrate metabolism disorder affecting millions of people worldwide. It is characterized by hyperglycemia as a result of ß-cell destruction or dysfunction by both genetic and environmental factors. Over time chronic hyperglycemia leads to microvascular (i.e., retinopathy, nephropathy and neuropathy) and macrovascular (i.e., ischemic heart disease, peripheral vascular disease, and cerebrovascular disease) complications of diabetes. Diabetes complication trials showed the importance of achieving near-normal glycemic control to prevent and/or reduce diabetes-related morbidity and mortality. There is a staggering rate of increased incidence of diabetes in youth, raising concerns for future generations' health, quality of life and its enormous economic burden. Despite advancements in the technology, diabetes management remains cumbersome. Training individuals with diabetes to gain life-long survival skills requires a comprehensive and ongoing diabetes education by a multidisciplinary team. Diabetes education and training start at the time of diagnosis of diabetes and should be continuous throughout the course of disease. The goal is to empower the individuals and families to gain diabetes self-management skills. Diabetes education must be individualized depending on the individual's age, education, family dynamics, and support. In this article, we review the history of diabetes, etiopathogenesis and clinical presentation of both type 1 and type 2 diabetes in children as well as adolescents. We then focus on diabetes management with education methods and materials.
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Affiliation(s)
- Berrin Ergun-Longmire
- Associate Professor, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
| | - Ethel Clemente
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Patricia Vining-Maravolo
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Cheryl Roberts
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Koby Buth
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Donald E Greydanus
- Professor, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI United States
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Lewis JR, Voortman T, Ioannidis JP. Evaluating and Strengthening the Evidence for Nutritional Bone Research: Ready to Break New Ground? J Bone Miner Res 2021; 36:219-226. [PMID: 33503301 DOI: 10.1002/jbmr.4236] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 01/19/2023]
Abstract
A healthy diet is essential to attain genetically determined peak bone mass and maintain optimal skeletal health across the adult lifespan. Despite the importance of nutrition for bone health, many of the nutritional requirements of the skeleton across the lifespan remain underexplored, poorly understood, or controversial. With increasingly aging populations, combined with rapidly changing diets and lifestyles globally, one anticipates large increases in the prevalence of osteoporosis and incidence of osteoporotic fractures. Robust, transparent, and reproducible nutrition research is a cornerstone for developing reliable public health recommendations to prevent osteoporosis and osteoporotic fractures. However, nutrition research is often criticized or ignored by healthcare professionals due to the overemphasis of weak science, conflicting, confusing or implausible findings, industry interests, common misconceptions, and strong opinions. Conversely, spurious research findings are often overemphasized or misconstrued by the media or prominent figures especially via social media, potentially leading to confusion and a lack of trust by the general public. Recently, reforms of the broader discipline of nutrition science have been suggested and promoted, leading to new tools and recommendations to attempt to address these issues. In this perspective, we provide a brief overview of what has been achieved in the field on nutrition and bone health, focusing on osteoporosis and osteoporotic fractures. We discuss what we view as some of the challenges, including inherent difficulties in assessing diet and its change, disentangling complex interactions between dietary components and between diet and other factors, selection of bone-related outcomes for nutrition studies, obtaining evidence with more unbiased designs, and perhaps most importantly, ensuring the trust of the public and healthcare professionals. This perspective also provides specific recommendations and highlights new developments and future opportunities for scientists studying nutrition and bone health. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Joshua R Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, The University of Western Australia, Perth, WA, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - John Pa Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA.,Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.,Department of Statistics, Stanford University, Stanford, CA, USA.,Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
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65
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Development and evaluation of image-series for portion size estimation in dietary assessment among adults. J Nutr Sci 2021; 10:e3. [PMID: 33889386 PMCID: PMC8057404 DOI: 10.1017/jns.2020.58] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023] Open
Abstract
Portion size images are advantageous in dietary assessment. The aim of the present study was to develop and validate new culturally specific image-series for portion size estimation to be used in a new Norwegian version of a British web-based dietary assessment tool (myfood24). Twenty-three image-series of different foods, each containing seven portion size images, were created and validated in a group of adults (n 41, 58 % female) aged 19–44 (median 23), out of which 63 % had higher (tertiary) education. The participants compared 46 portions of pre-weighed foods to the portion size images (1886 comparisons in total). Portion size estimations were either classified as correct, adjacent or misclassified. The weight discrepancy in percentage between the chosen and the correct portion size image was also calculated. Mann–Whitney U tests were used to explore if portion size estimation accuracy differed across sample characteristics, or if it depended on how the foods were presented. For thirty-eight of the forty-six presented food items, the participants selected the correct or adjacent portion size image 98 % on average. The remaining eight food items were on average misclassified by 27 % of the participants. Overall, a mean weight discrepancy of 2⋅5 % was observed between the chosen and the correct portion size images. Females estimated portion size more accurately than males (P = 0⋅019). No other significant differences in estimation accuracy were observed. In conclusion, the new image-series performed satisfactorily, except for the image-series depicting bread, caviar spread and marzipan cake, which will be altered. The present study demonstrates the importance of validating portion size estimation tools.
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66
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Ho DKN, Chiu WC, Lee YC, Su HY, Chang CC, Yao CY, Hua KL, Chu HK, Hsu CY, Chang JS. Integration of an Image-Based Dietary Assessment Paradigm into Dietetic Training Improves Food Portion Estimates by Future Dietitians. Nutrients 2021; 13:nu13010175. [PMID: 33430147 PMCID: PMC7827495 DOI: 10.3390/nu13010175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
The use of image-based dietary assessments (IBDAs) has rapidly increased; however, there is no formalized training program to enhance the digital viewing skills of dieticians. An IBDA was integrated into a nutritional practicum course in the School of Nutrition and Health Sciences, Taipei Medical University Taiwan. An online IBDA platform was created as an off-campus remedial teaching tool to reinforce the conceptualization of food portion sizes. Dietetic students’ receptiveness and response to the IBDA, and their performance in food identification and quantification, were compared between the IBDA and real food visual estimations (RFVEs). No differences were found between the IBDA and RFVE in terms of food identification (67% vs. 71%) or quantification (±10% of estimated calories: 23% vs. 24%). A Spearman correlation analysis showed a moderate to high correlation for calorie estimates between the IBDA and RFVE (r ≥ 0.33~0.75, all p < 0.0001). Repeated IBDA training significantly improved students’ image-viewing skills [food identification: first semester: 67%; pretest: 77%; second semester: 84%) and quantification [±10%: first semester: 23%; pretest: 28%; second semester: 32%; and ±20%: first semester: 38%; pretest: 48%; second semester: 59%] and reduced absolute estimated errors from 27% (first semester) to 16% (second semester). Training also greatly improved the identification of omitted foods (e.g., condiments, sugar, cooking oil, and batter coatings) and the accuracy of food portion size estimates. The integration of an IBDA into dietetic courses has the potential to help students develop knowledge and skills related to “e-dietetics”.
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Affiliation(s)
- Dang Khanh Ngan Ho
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan; (D.K.N.H.); (W.-C.C.); (H.-Y.S.)
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan; (D.K.N.H.); (W.-C.C.); (H.-Y.S.)
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Chieh Lee
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 110, Taiwan;
| | - Hsiu-Yueh Su
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan; (D.K.N.H.); (W.-C.C.); (H.-Y.S.)
- Department of Dietetics, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chun-Chao Chang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110, Taiwan;
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chih-Yuan Yao
- Department of Computer Science and Information Engineering, National Taiwan University of Science and Technology, Taipei 110, Taiwan; (C.-Y.Y.); (K.-L.H.)
| | - Kai-Lung Hua
- Department of Computer Science and Information Engineering, National Taiwan University of Science and Technology, Taipei 110, Taiwan; (C.-Y.Y.); (K.-L.H.)
| | - Hung-Kuo Chu
- Department of Computer Science, National Tsing Hua University, Hsinchu 300, Taiwan;
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei 110, Taiwan;
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan; (D.K.N.H.); (W.-C.C.); (H.-Y.S.)
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-(2)-27361661 (ext. 6542); Fax: +886-(2)-2737-3112
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Cho PJ, Singh K, Dunn J. Roles of artificial intelligence in wellness, healthy living, and healthy status sensing. Artif Intell Med 2021. [DOI: 10.1016/b978-0-12-821259-2.00009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Evaluation of the Ability of Diet-Tracking Mobile Applications to Estimate Energy and Nutrient Intake in Japan. Nutrients 2020; 12:nu12113327. [PMID: 33138088 PMCID: PMC7694045 DOI: 10.3390/nu12113327] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
We evaluated the energy and nutrient intake estimates of popular Japanese diet-tracking mobile applications (apps). We identified five diet-tracking apps in the iTunes store during August 2020. A researcher entered the dietary data from a one-day paper-based dietary record (DR) previously obtained from apparently healthy free-living adults (15 males and 15 females; 22-65 years) into each app. The energy and nutrient intakes estimated by the apps were compared with those calculated using the Standard Tables of Food Composition in Japan based on the paper-based DR (reference method). The number of dietary variables available ranged from one (energy in Mogutan) to 17 (FiNC). Compared to the DR-based estimates, the median energy intake was significantly overestimated by MyFitnessPal, Asken, Calomiru, and Mogutan. Moreover, the intakes of many nutrients were overestimated by Asken and Calomiru and underestimated by MyFitnessPal. For energy intake, the Spearman correlation coefficient between the DR and the apps was lowest for Mogutan (0.76) and highest for FiNC (0.96). The median correlation coefficient for nutrient intakes was lower in MyFitnessPal (0.50) than in the other three apps (0.80 in Asken, 0.87 in FiNC, and 0.88 in Calomiru). These results suggest that intake calculations differ among apps. Further evaluation is needed in free-living settings, where users input their own food intake.
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Emerging trends of technology-based dietary assessment: a perspective study. Eur J Clin Nutr 2020; 75:582-587. [PMID: 33082535 DOI: 10.1038/s41430-020-00779-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 09/15/2020] [Accepted: 10/02/2020] [Indexed: 11/08/2022]
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Validity and reproducibility of a semi-quantitative food frequency questionnaire in Spanish preschoolers - The SENDO project. NUTR HOSP 2020; 37:672-684. [PMID: 32686450 DOI: 10.20960/nh.03003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: currently, it is important to determine whether food frequency questionnaires (FFQ) are valid tools to collect information on usual diet in children. Objective: we evaluated the reproducibility and validity of the semi-quantitative FFQ used in a Spanish cohort of children aged 4-7 years. Methods: to explore its reproducibility, parents filled a 138-item FFQ at baseline (FFQ-0) and then one year later (FFQ-1). To explore its validity, the FFQ-1 was compared with four weighed 3-day dietary records (DRs) that were used as standard of reference. To estimate associations we calculated deattenuated Pearson's correlation coefficients to correct for season-to-season variability, and the Bland-Altman index. We also calculated the weighted kappa index and assessed participant's gross misclassification across quintiles. We analyzed data from 67 (for reproducibility) and 37 (for validity) children aged 4-7 years old, recruited by the pilot study of the SENDO project. Results: regarding reproducibility, we found mean Bland-Altman indexes of 0-10.45 % for nutrients and 1.49 %-10.45 % for foods. The adjusted r ranged between 0.29 and 0.71, and between 0.27 and 0.74 for nutrients and foods, respectively. Regarding validity, we found mean Bland-Altman indexes of 0 %-16.22 % and 0 %-10.81 % for nutrients and for food groups, respectively. The deattenuated r ranged between 0.38 and 0.81 for nutrients, and between 0.53 and 0.68 for foods. The weighted kappa index for agreement across quintiles ranged from 54.1 to 85.1 for nutrients, and from 55.4 to 78.4 for food groups. Conclusions: our results showed acceptable levels of both reproducibility and validity, and that the ad-hoc developed FFQ is a valid tool for assessing usual diet in Spanish preschoolers.
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Chen YW, Wei J, Chen HL, Cheng CH, Hou IC. Developing a Heart Transplantation Self-Management Support Mobile Health App in Taiwan: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e18999. [PMID: 32812883 PMCID: PMC7468636 DOI: 10.2196/18999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/17/2020] [Accepted: 07/07/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Heart transplantation (HTx) is the most effective treatment for end-stage heart failure patients. After transplantation, patients face physiological, psychological, social, and other health care problems. Mobile health (mHealth) apps can change the delivery of conventional health care to ubiquitous care and improve health care quality. However, a dearth of mHealth apps exists for patients with HTx worldwide, including in Taiwan. OBJECTIVE The aim of this study was to investigate the information needed and to develop a preliminary framework for an mHealth app for post-HTx patients. METHODS A qualitative approach with individual in-depth interviews was conducted at a heart center in the regional hospital of northern Taiwan from June to November 2017. Patients that had undergone HTx and their health professionals were recruited for purposeful sampling. A semistructured interview guideline was used for individual interviews and transcribed. Thematic analysis was used for data analysis. RESULTS A total of 21 subjects, including 17 patients and 4 health professionals, were recruited for the study. The following five major themes were identified: reminding, querying, experience sharing, diet, and expert consulting. Minor themes included a desire to use the app with artificial intelligence and integration with professional management. CONCLUSIONS An intelligent mHealth app that addresses the five main themes and integrates the processes of using a mobile app could facilitate HTx self-management for Taiwanese patients.
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Affiliation(s)
- Yi-Wen Chen
- Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Jeng Wei
- Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Hwei-Ling Chen
- Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
| | | | - I-Ching Hou
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
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72
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Ladas EJ, Blonquist TM, Puligandla M, Orjuela M, Stevenson K, Cole PD, Athale UH, Clavell LA, Leclerc JM, Laverdiere C, Michon B, Schorin MA, Greene Welch J, Asselin BL, Sallan SE, Silverman LB, Kelly KM. Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia: A Report From the DALLT Cohort. J Clin Oncol 2020; 38:2151-2159. [DOI: 10.1200/jco.19.02555] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE The benefits and risks of supplementation with antioxidants during cancer therapy have been a controversial area. Few studies have systematically evaluated dietary intake of antioxidants with toxicity and survival in childhood cancer. We sought to determine the role of dietary intake of antioxidants on rates of infections, mucositis, relapse, and disease-free survival during induction and postinduction phases of therapy among children and adolescents with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS We enrolled 794 children in a prospective clinical trial for treatment of ALL. Dietary intake was prospectively evaluated by a food frequency questionnaire. The association between dietary intake of antioxidants and treatment-related toxicities and survival were evaluated with the Benjamini-Hochberg false discovery rate (q) and logistic regression and the Kaplan-Meier method, respectively. RESULTS Dietary surveys were available for analysis from 614 (77%), and 561 (71%) participants at diagnosis and at end of induction, respectively. Of 513 participants who completed the dietary surveys at both time points, 120 (23%) and 87 (16%) experienced a bacterial infection and 22 (4%) and 55 (10%) experienced mucositis during the induction or postinduction phases of treatment, respectively. Increased intake of dietary antioxidants was associated with significantly lower rates of infection and mucositis. No association with relapse or disease-free survival was observed. Supplementation was not associated with toxicity, relapse, or survival. CONCLUSION Consumption of antioxidants through dietary intake was associated with reduced rates of infection or mucositis, with no increased risk of relapse or reduced survival. Dietary counseling on a well-balanced diet that includes an array of antioxidants from food sources alone may confer a benefit from infections and mucositis during treatment of childhood ALL.
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Affiliation(s)
- Elena J. Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY
- Institute of Human Nutrition, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY
| | | | | | - Manuela Orjuela
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY
| | | | - Peter D. Cole
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Uma H. Athale
- Division of Hematology/Oncology, McMaster Children’s Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Jean-Marie Leclerc
- Hematology-Oncology Division, Charles Bruneau Cancer Center, Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada
| | | | - Bruno Michon
- Centre Hospitalier Universitaire de Quebec, Sainte-Foy, Quebec, Canada
| | | | - Jennifer Greene Welch
- Division of Pediatric Hematology/Oncology, Hasbro Children’s Hospital, Brown University, Providence, RI
| | - Barbara L. Asselin
- Department of Pediatrics, University of Rochester School of Medicine, Golisano Children’s Hospital at URMC, Rochester, NY
| | | | | | - Kara M. Kelly
- Department of Pediatrics, Roswell Park Comprehensive Cancer Center and University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY
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73
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Khazen W, Jeanne JF, Demaretz L, Schäfer F, Fagherazzi G. Rethinking the Use of Mobile Apps for Dietary Assessment in Medical Research. J Med Internet Res 2020; 22:e15619. [PMID: 32554383 PMCID: PMC7333076 DOI: 10.2196/15619] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 01/19/2023] Open
Abstract
Food intake and usual dietary intake are among the key determinants of health to be assessed in medical research and important confounding factors to be accounted for in clinical studies. Although various methods are available for gathering dietary data, those based on innovative technologies are particularly promising. With combined cost-effectiveness and ease of use, it is safe to assume that mobile technologies can now optimize tracking of eating occasions and dietary behaviors. Yet, choosing a dietary assessment tool that meets research objectives and data quality standards remains challenging. In this paper, we describe the purposes of collecting dietary data in medical research and outline the main considerations for using mobile dietary assessment tools based on participant and researcher expectations.
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Affiliation(s)
| | | | - Laëtitia Demaretz
- Innovation Science and Nutrition, Danone Nutricia Research, Palaiseau, France
| | - Florent Schäfer
- Innovation Science and Nutrition, Danone Nutricia Research, Palaiseau, France
| | - Guy Fagherazzi
- Digital Epidemiology Hub, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.,Center of Research in Epidemiology and Population Health, UMR 1018 Inserm, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, Villejuif, France
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74
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FoodFoto: A Systems Thinking Approach to Dietary Intake Collection, Storage and Analysis. Comput Inform Nurs 2020; 38:265-272. [PMID: 32511155 DOI: 10.1097/cin.0000000000000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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75
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Tay W, Kaur B, Quek R, Lim J, Henry CJ. Current Developments in Digital Quantitative Volume Estimation for the Optimisation of Dietary Assessment. Nutrients 2020; 12:E1167. [PMID: 32331262 PMCID: PMC7231293 DOI: 10.3390/nu12041167] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/23/2022] Open
Abstract
Obesity is a global health problem with wide-reaching economic and social implications. Nutrition surveillance systems are essential to understanding and addressing poor dietary practices. However, diets are incredibly diverse across populations and an accurate diagnosis of individualized nutritional issues is challenging. Current tools used in dietary assessment are cumbersome for users, and are only able to provide approximations of dietary information. Given the need for technological innovation, this paper reviews various novel digital methods for food volume estimation and explores the potential for adopting such technology in the Southeast Asian context. We discuss the current approaches to dietary assessment, as well as the potential opportunities that digital health can offer to the field. Recent advances in optics, computer vision and deep learning show promise in advancing the field of quantitative dietary assessment. The ease of access to the internet and the availability of smartphones with integrated cameras have expanded the toolsets available, and there is potential for automated food volume estimation to be developed and integrated as part of a digital dietary assessment tool. Such a tool may enable public health institutions to be able to gather an effective nutritional insight and combat the rising rates of obesity in the region.
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Affiliation(s)
- Wesley Tay
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Rina Quek
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Joseph Lim
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore; (W.T.); (B.K.); (R.Q.); (J.L.)
- Department of Biochemistry, Yong Loo Lin School of Medicine, Singapore 117596, Singapore
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76
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Zeisel SH. Precision (Personalized) Nutrition: Understanding Metabolic Heterogeneity. Annu Rev Food Sci Technol 2020; 11:71-92. [DOI: 10.1146/annurev-food-032519-051736] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
People differ in their requirements for and responses to nutrients and bioactive molecules in the diet. Many inputs contribute to metabolic heterogeneity (including variations in genetics, epigenetics, microbiome, lifestyle, diet intake, and environmental exposure). Precision nutrition is not about developing unique prescriptions for individual people but rather about stratifying people into different subgroups of the population on the basis of biomarkers of the above-listed sources of metabolic variation and then using this stratification to better estimate the different subgroups’ dietary requirements, thereby enabling better dietary recommendations and interventions. The hope is that we will be able to subcategorize people into ever-smaller groups that can be targeted in terms of recommendations, but we will never achieve this at the individual level, thus, the choice of precision nutrition rather than personalized nutrition to designate this new field. This review focuses mainly on genetically related sources of metabolic heterogeneity and identifies challenges that need to be overcome to achieve a full understanding of the complex interactions between the many sources of metabolic heterogeneity that make people differ from one another in their requirements for and responses to foods. It also discusses the commercial applications of precision nutrition.
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Affiliation(s)
- Steven H. Zeisel
- Nutrition Research Institute, Department of Nutrition, University of North Carolina, Kannapolis, North Carolina 28081, USA
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77
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How does a simplified recipe collection procedure in dietary assessment tools affect the food group and nutrient intake distributions of the population. Br J Nutr 2020; 124:189-198. [PMID: 32174294 DOI: 10.1017/s0007114520000999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Technology advancements have driven the use of self-administered dietary assessment methods in large-scale dietary surveys. Interviewer-assisted methods generally have a complicated recipe recording procedure enabling the adjustment from a standard recipe. In order to decide if this functionality can be omitted for self-administered dietary assessment, this study aimed to assess the extent of standard recipe modifications in the Dutch National Food Consumption Survey and measure the impact on the food group and nutrient intake distributions of the population when the modifications were disregarded. A two-scenario simulation analysis was conducted. Firstly, the individual recipe scenario omitted the full modifications to the standard recipes made by people who knew their recipes. Secondly, the modified recipe scenario omitted the modifications made by those who partially modified the standard recipe due to their limited knowledge. The weighted percentage differences for the nutrient and food group intake distributions between the scenarios and the original data set were calculated. The highest percentage of energy consumed through mixed dishes was 10 % for females aged 19-79 years. Comparing the combined scenario and the original data set, the average of the absolute percentage difference for the population mean intakes was 1·6 % across all food groups and 0·6 % for nutrients. The soup group (-6·6 %) and DHA (-2·3 %) showed the largest percentage difference. The recipe simplification caused a slight underestimation of the consumed amount of both foods (-0·2 %) and nutrients (-0·4 %). These results are promising for developing self-administered 24-hour recalls or food diary applications without complex recipe function.
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Promotion of Healthy Nutrition and Physical Activity Lifestyles for Teenagers: A Systematic Literature Review of The Current Methodologies. J Pers Med 2020; 10:jpm10010012. [PMID: 32121555 PMCID: PMC7151579 DOI: 10.3390/jpm10010012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/12/2020] [Accepted: 02/25/2020] [Indexed: 11/17/2022] Open
Abstract
Amid obesity problems in the young population and apparent trends of spending a significant amount of time in a stationary position, promoting healthy nutrition and physical activities to teenagers is becoming increasingly important. It can rely on different methodologies, including a paper diary and mobile applications. However, the widespread use of mobile applications by teenagers suggests that they could be a more suitable tool for this purpose. This paper reviews the methodologies for promoting physical activities to healthy teenagers explored in different studies, excluding the analysis of different diseases. We found only nine studies working with teenagers and mobile applications to promote active lifestyles, including the focus on nutrition and physical activity. Studies report using different techniques to captivate the teenagers, including questionnaires and gamification techniques. We identified the common features used in different studies, which are: paper diary, diet diary, exercise diary, notifications, diet plan, physical activity registration, gamification, smoking cessation, pictures, game, and SMS, among others.
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79
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Pires IM, Marques G, Garcia NM, Flórez-Revuelta F, Ponciano V, Oniani S. A Research on the Classification and Applicability of the Mobile Health Applications. J Pers Med 2020; 10:jpm10010011. [PMID: 32120849 PMCID: PMC7151562 DOI: 10.3390/jpm10010011] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022] Open
Abstract
Mobile health applications are applied for different purposes. Healthcare professionals and other users can use this type of mobile applications for specific tasks, such as diagnosis, information, prevention, treatment, and communication. This paper presents an analysis of mobile health applications used by healthcare professionals and their patients. A secondary objective of this article is to evaluate the scientific validation of these mobile health applications and to verify if the results provided by these applications have an underlying sound scientific foundation. This study also analyzed literature references and the use of mobile health applications available in online application stores. In general, a large part of these mobile health applications provides information about scientific validation. However, some mobile health applications are not validated. Therefore, the main contribution of this paper is to provide a comprehensive analysis of the usability and user-perceived quality of mobile health applications and the challenges related to scientific validation of these mobile applications.
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Affiliation(s)
- Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal; (G.M.); (N.M.G.)
- Computer Science Department, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal
- Correspondence: ; Tel.: +531-966-379-785
| | - Gonçalo Marques
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal; (G.M.); (N.M.G.)
| | - Nuno M. Garcia
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal; (G.M.); (N.M.G.)
| | | | - Vasco Ponciano
- R&D Unit in Digital Services, Applications, and Content, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal;
- Altranportugal, 1990-096 Lisbon, Portugal
| | - Salome Oniani
- Georgian Technical University, 0160 Tbilisi, Georgia;
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80
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Katz DL, Rhee LQ, Katz CS, Aronson DL, Frank GC, Gardner CD, Willett WC, Dansinger ML. Dietary assessment can be based on pattern recognition rather than recall. Med Hypotheses 2020; 140:109644. [PMID: 32131036 DOI: 10.1016/j.mehy.2020.109644] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
Abstract
Diet is the leading predictor of health status, including all-cause mortality, in the modern world, yet is rarely measured; whereas virtually every adult in a developed country knows their approximate blood pressure, hardly any knows their objective diet quality. Leading authorities have called for the inclusion of nutrition in every electronic health record as one of the many remedial steps required to give dietary quality the routine attention it warrants. Existing tools to capture dietary intake are based on either real-time journaling or recall. Journaling, or logging, is time and labor intensive. Recall is notoriously unreliable, as humans are notably bad at remembering detail. Even allowing for the challenge of recall, these dietary intake methods are labor and time intensive, and require analysis at the n-of-1 level. We hypothesize that dietary intake assessment can be "reverse engineered"-predicating assessment on the recognition of fully formed dietary patterns-rather than endeavoring to assemble such a representation one food, meal, dish, or day at a time. This pattern recognition-based method offers potential advantages over existing methods, including speed, efficiency, cost, and applicability. We have developed and provisionally tested such a system, and the results thus far support our hypothesis. We are convinced that leveraging pattern recognition to make dietary assessment quick, user-friendly, economical, and scalable can allow for the conversion of dietary quality into a universally measured and routinely managed vital sign. In this paper, we present the supporting case.
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Affiliation(s)
- D L Katz
- Diet ID, Inc, Detroit, MI, United States.
| | - L Q Rhee
- Diet ID, Inc, Detroit, MI, United States
| | - C S Katz
- Diet ID, Inc, Detroit, MI, United States
| | | | - G C Frank
- Department of Family and Consumer Sciences, California State University, Long Beach, United States
| | - C D Gardner
- Stanford Prevention Research Center, Department of Medicine, Stanford University Medical School, Stanford, CA, United States
| | - W C Willett
- Harvard T.H. Chan School of Public Health, Harvard Medical School, Boston, MA, United States
| | - M L Dansinger
- Boston Heart Diagnostics, Framingham, MA, United States
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81
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Lancaster R, Radd‐Vagenas S, Fiatarone Singh M, Noble Y, Daniel K, Mavros Y, Sachdev PS, Lautenschlager N, Cox K, Brodaty H, O'Leary F, Flood VM. Electronic food records among middle‐aged and older people: A comparison of self‐reported and dietitian‐assisted information. Nutr Diet 2020; 78:145-153. [DOI: 10.1111/1747-0080.12606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/11/2019] [Accepted: 12/08/2019] [Indexed: 12/22/2022]
Affiliation(s)
| | | | - Maria Fiatarone Singh
- The University of Sydney Sydney New South Wales Australia
- Hebrew Senior Life and Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston Massachusetts
| | - Yian Noble
- The University of Sydney Sydney New South Wales Australia
| | - Kenneth Daniel
- The University of Sydney Sydney New South Wales Australia
| | - Yorgi Mavros
- The University of Sydney Sydney New South Wales Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry University of New South Wales Sydney New South Wales Australia
| | - Nicola Lautenschlager
- Department of Psychiatry University of Melbourne Melbourne Victoria Australia
- North Western Mental Health Melbourne Health Melbourne Victoria Australia
| | - Kay Cox
- Medical School University of Western Australia Perth Western Australia Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry University of New South Wales Sydney New South Wales Australia
| | - Fiona O'Leary
- The University of Sydney Sydney New South Wales Australia
| | - Victoria M. Flood
- The University of Sydney Sydney New South Wales Australia
- Western Sydney Local Health District Westmead Hospital Sydney New South Wales Australia
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82
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Perazi FM, Kupek E, Assis MAAD, Pereira LJ, Cezimbra VG, Oliveira MTD, Vieira FGK, Pietro PFD, Hinnig PDF. Efeito do dia e do número de dias de aplicação na reprodutibilidade de um questionário de avaliação do consumo alimentar de escolares. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200084. [DOI: 10.1590/1980-549720200084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: O questionário de Consumo Alimentar e Atividade Física de Escolares (Web-CAAFE) foi desenvolvido para o monitoramento da dieta e atividade física de escolares brasileiros. Este estudo buscou avaliar o efeito do dia da semana e do número de aplicações na reprodutibilidade do Web-CAAFE. Metodologia: Escolares do 2º ao 5º ano (n = 197) de Florianópolis preencheram o Web-CAAFE por duas vezes no mesmo dia, dos quais 113 o fizeram em três dias não consecutivos. Avaliou-se a reprodutibilidade por meio da correlação intraclasse (CCI) e da regressão logística, para avaliação dos fatores associados à pior reprodutibilidade. Resultados: Observaram-se piores resultados de reprodutibilidade para o preenchimento do consumo nos finais de semana em relação àqueles que responderam em dias da semana (odds ratio - OR = 2,93; p = 0,045) e melhores resultados em meninas em relação aos meninos (OR = 0,29; p < 0,001). O preenchimento do consumo realizado nos segundo e terceiro dias apresentou melhor reprodutibilidade que o realizado no primeiro. Esses resultados são relevantes para o planejamento de futuros estudos que utilizem instrumentos de consumo alimentar em crianças, em especial sobre avaliação de sua validade e reprodutibilidade. Conclusões: Os resultados sugerem que pelo menos dois dias de aplicação do Web-CAAFE fornecem resultados aceitáveis de reprodutibilidade, e que o preenchimento referente ao fim de semana pode reduzi-la.
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Affiliation(s)
| | - Emil Kupek
- Universidade Federal de Santa Catarina, Brazil
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83
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Ahn JS, Kim DW, Kim J, Park H, Lee JE. Development of a Smartphone Application for Dietary Self-Monitoring. Front Nutr 2019; 6:149. [PMID: 31608283 PMCID: PMC6768016 DOI: 10.3389/fnut.2019.00149] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 08/27/2019] [Indexed: 11/21/2022] Open
Abstract
This article describes the key features of the Well-D, a mobile dietary self-monitoring application developed to assess and track dietary intake. To test the acceptability of the app, 102 adults aged 18 years or older were asked to use Well-D for 3 days or more. After using the app, they recorded their likes/dislikes and recommendations regarding ways to improve Well-D. A mobile application for dietary assessment and monitoring may have the potential to help individuals and groups to engage in healthy behaviors.
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Affiliation(s)
- Jeong Sun Ahn
- Department of Food and Nutrition, Seoul National University, Seoul, South Korea
| | - Dong Woo Kim
- Department of Home Economics, Korea National Open University, Seoul, South Korea
| | - Jiae Kim
- Platform Development Team, Bluecore, Seoul, South Korea
| | - Haemin Park
- Platform Development Team, Bluecore, Seoul, South Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, South Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea
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84
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85
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Wald JP, Asare E, Nakua EK, Nohr D, Lambert C, Riedel S, Gola U, Biesalski HK. Validation of a computer-based analysis tool for real-time dietary assessment within a Ghanaian region. NFS JOURNAL 2019. [DOI: 10.1016/j.nfs.2019.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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86
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Ward HA, McLellan H, Udeh-Momoh C, Giannakopoulou P, Robb C, Wark PA, Middleton L. Use of Online Dietary Recalls among Older UK Adults: A Feasibility Study of an Online Dietary Assessment Tool. Nutrients 2019; 11:nu11071451. [PMID: 31252526 PMCID: PMC6682978 DOI: 10.3390/nu11071451] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022] Open
Abstract
This study examined the feasibility of including myfood24, an online 24-hour dietary recall tool, in a cohort studies of older adults. Participants (n = 319) were recruited during follow-up visits for the CHARIOT-Pro Sub-study, a prospective study of cognitively healthy adults aged 60–85 years at baseline. Email invitations were sent over three consecutive months, with weekly reminders. Multivariable regression models were applied to examine the number of recalls completed in relation to technology readiness (TR) scores and demographic characteristics. Ninety-four percent of people agreed to participate. Among participants, 67% completed at least one recall, and 48% completed two or more. Participants who completed multiple recalls reported higher self-confidence with technology and received a higher TR score than those who did not complete any recalls. A one-point higher TR score was associated with higher odds of completing three recalls compared to zero recalls (OR 1.70, 95% CI 0.96–3.01); this association was further attenuated after adjustment for demographic and other TR-related covariates (OR 1.35, 95% CI 0.63–2.88). This study demonstrates reasonable participation rates for a single myfood24 recall among older adults participating in a cohort study but suggests that further support may be required to obtain multiple recalls in this population.
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Affiliation(s)
- Heather A Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Heather McLellan
- Department of Neuroepidemiology and Ageing, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Chi Udeh-Momoh
- Department of Neuroepidemiology and Ageing, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Parthenia Giannakopoulou
- Department of Neuroepidemiology and Ageing, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Catherine Robb
- Department of Neuroepidemiology and Ageing, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Petra A Wark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Lefkos Middleton
- Department of Neuroepidemiology and Ageing, School of Public Health, Imperial College London, London W6 8RP, UK
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87
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Taylor RM, Haslam RL, Burrows TL, Duncanson KR, Ashton LM, Rollo ME, Shrewsbury VA, Schumacher TL, Collins CE. Issues in Measuring and Interpreting Diet and Its Contribution to Obesity. Curr Obes Rep 2019; 8:53-65. [PMID: 30877574 DOI: 10.1007/s13679-019-00336-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review summarises the issues related to the measurement and interpretation of dietary intake in individuals with overweight and obesity, as well as identifies future research priorities. RECENT FINDINGS Some aspects of the assessment of dietary intake have improved through the application of technology-based methods and the use of dietary biomarkers. In populations with overweight and obesity, misreporting bias related to social desirability is a prominent issue. Future efforts should focus on combining technology-based dietary methods with the use of dietary biomarkers to help reduce and account for the impact of these biases. Future research will be important in terms of strengthening methods used in the assessment and interpretation of dietary intake data in the context of overweight and obesity.
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Affiliation(s)
- Rachael M Taylor
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Rebecca L Haslam
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Tracy L Burrows
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Kerith R Duncanson
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Lee M Ashton
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Megan E Rollo
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Vanessa A Shrewsbury
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
| | - Tracy L Schumacher
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia
- Faculty of Health and Medicine, Department of Rural Health, University of Newcastle, Tamworth, NSW, 2340, Australia
| | - Clare E Collins
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Level 3 ATC Building, Callaghan, NSW, 2308, Australia.
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88
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Herrán OF, Rojas MP. Lecciones aprendidas en un estudio de reproducibilidad y validez de cuestionarios para estimar la ingesta dietética en Colombia. 2010-2017. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.15446/revfacmed.v67n2.68187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La dieta es una exposición compleja de medir que se asocia al desarrollo de enfermedad crónica, por lo cual es necesario desarrollar y validar instrumentos simplificados para su medición.Objetivo. Establecer la reproducibilidad en la clasificación y la validez contra recordatorios de la ingesta dietética en las últimas 24 horas (R24H) de cuestionarios de frecuencia de consumo (CFC) desarrollados en Colombia.Materiales y métodos. Estudio de tecnología diagnóstica desarrollado durante 2010-2017. Se aplicaron dos R24H y dos CFC a 523 sujetos: 109 en Bogotá D.C., 107 en Medellín, 106 en Cali, 102 en Barranquilla y 99 en Bucaramanga y su área metropolitana. Los estudios de reproducibilidad y validez se realizaron con coeficientes de correlación r de Pearson crudos y ajustados por el método de energía residual.Resultados. La reproducibilidad de los recordatorios fue pobre-moderada (mínimo -0.00, máximo 0.72), al igual que la de los cuestionarios (mínimo -0.01, máximo 0.72). La validez de los cuestionarios fue pobre (mínimo -0.01, máximo, -0.59).Conclusión. Los CFC no son útiles en la investigación epidemiológica, lo que se explica en la alta variabilidad debida a pocas repeticiones en la estimación dietética al diseñar los cuestionarios y a fallas en la recolección de los datos.
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89
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Hooson Jzh J, Hutchinson Jyh J, Warthon-Medina M, Hancock N, Greathead K, Knowles B, Vargas-Garcia E, Gibson LE, Bush LA, Margetts B, Robinson S, Ness A, Alwan NA, Wark PA, Roe M, Finglas P, Steer T, Page P, Johnson L, Roberts K, Amoutzopoulos B, Burley VJ, Greenwood DC, Cade JE. A systematic review of reviews identifying UK validated dietary assessment tools for inclusion on an interactive guided website for researchers: www.nutritools.org. Crit Rev Food Sci Nutr 2019; 60:1265-1289. [PMID: 30882230 PMCID: PMC7114915 DOI: 10.1080/10408398.2019.1566207] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Health researchers may struggle to choose suitable validated dietary assessment tools (DATs) for their target population. The aim of this review was to identify and collate information on validated UK DATs and validation studies for inclusion on a website to support researchers to choose appropriate DATs.Design: A systematic review of reviews of DATs was undertaken. DATs validated in UK populations were extracted from the studies identified. A searchable website was designed to display these data. Additionally, mean differences and limits of agreement between test and comparison methods were summarized by a method, weighting by sample size.Results: Over 900 validation results covering 5 life stages, 18 nutrients, 6 dietary assessment methods, and 9 validation method types were extracted from 63 validated DATs which were identified from 68 reviews. These were incorporated into www.nutritools.org. Limits of agreement were determined for about half of validations. Thirty four DATs were FFQs. Only 17 DATs were validated against biomarkers, and only 19 DATs were validated in infant/children/adolescents.Conclusions: The interactive www.nutritools.org website holds extensive validation data identified from this review and can be used to guide researchers to critically compare and choose a suitable DAT for their research question, leading to improvement of nutritional epidemiology research.
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Affiliation(s)
- Jozef Hooson Jzh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Jayne Hutchinson Jyh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Marisol Warthon-Medina
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.,Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Neil Hancock
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Katharine Greathead
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Bethany Knowles
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Elisa Vargas-Garcia
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lauren E Gibson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Linda A Bush
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Barrie Margetts
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andy Ness
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Nisreen A Alwan
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.,Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Petra A Wark
- Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, UK.,Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Mark Roe
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK.,EuroFIR AISBL, Brussels, Belgium
| | - Paul Finglas
- Food Databanks National Capability, Quadram Institute Bioscience, Norwich, UK
| | - Toni Steer
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Polly Page
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Katharine Roberts
- Public Health Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.,Public Health England, London, UK
| | | | - Victoria J Burley
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Faculty of Medicine and Health Division of Biostatistics, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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90
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Spector AC, Kapoor N, Price RK, Pepino MY, Livingstone MBE, Le Roux CW. Proceedings from the 2018 Association for Chemoreception Annual Meeting Symposium: Bariatric Surgery and Its Effects on Taste and Food Selection. Chem Senses 2019; 44:155-163. [PMID: 30517609 PMCID: PMC6410396 DOI: 10.1093/chemse/bjy076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This article provides a summary of the topics discussed at the symposium titled "Bariatric Surgery and Its Effects on Taste and Food Selection," which was held at the Fortieth Annual Meeting of the Association for Chemoreception Sciences. Bariatric surgery such as Roux-en-Y gastric bypass (RYGB) is currently one of the most effective treatments available for weight loss and Type 2 diabetes. For this reason, it is of great interest to clinicians as well as to basic scientists studying the controls of feeding and energy balance. Despite the commonly held view by clinicians that RYGB patients change their food preferences away from fats and sugars in favor of less energy dense alternatives such as vegetables, the empirical support for this claim is equivocal. It is currently thought that the taste and palatability of fats and sugars are affected by the surgery. Some key preclinical and clinical findings addressing these issues were evaluated in this symposium.
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Affiliation(s)
- Alan C Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, USA
| | - Natasha Kapoor
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Ruth K Price
- The Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, College of ACES, University of Illinois at Urbana–Champaign, Urbana, IL, USA
| | - M Barbara E Livingstone
- The Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland
| | - Carel W Le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
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91
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Bredin C, Naimimohasses S, Norris S, Wright C, Hancock N, Hart K, Moore JB. Development and relative validation of a short food frequency questionnaire for assessing dietary intakes of non-alcoholic fatty liver disease patients. Eur J Nutr 2019; 59:571-580. [PMID: 30805696 PMCID: PMC7058564 DOI: 10.1007/s00394-019-01926-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 02/06/2019] [Indexed: 12/16/2022]
Abstract
Purpose This work aimed to design and validate a novel short food frequency questionnaire (SFFQ) to assess habitual intakes of food items related to non-alcoholic fatty liver disease (NAFLD) in a cohort of European patients. Methods A 48-item SFFQ was created, with questions from existing FFQs and expert knowledge, emphasizing foods and nutrients implicated in NAFLD pathogenesis. Consenting, fibroscan-diagnosed, NAFLD patients completed the SFFQ during a short interview and were asked to complete a 4-day diet diary (4DDD) at home for return by mail. Nutritional intakes were assessed utilizing the myfood24™ food composition dataset and estimated energy requirements (EER) were calculated using sex-, age- and weight-specific equations. Agreement between the dietary instruments was assessed by Spearman correlations and Bland Altman analysis. Results Fifty-five patients completed both the SFFQ and the 4DDD within 30 weeks; 42 (76%) were diagnosed with simple steatosis, whereas 13 (24%) had biopsy-proven steatohepatitis; the majority were overweight or obese, with a median (25th; 75th percentile) BMI of 33.2 kg/m2 (29.3; 36.0). Reported energy intakes were well below EER with a median intake of 73% of requirements, suggesting widespread under-reporting. Significant correlations were observed between sugar (r = 0.408, P = 0.002), fat (r = 0.44, P = 0.001), fruits (r = 0.51, P = 0.0001) and vegetables (r = 0.40, P = 0.0024) measurements by the SFFQ and 4DDD. Bland Altman plots with regression analysis demonstrated broad comparability with the 4DDD for intakes of fat (bias − 13.8 g/day) and sugar (bias + 12.9 g/day). Conclusions A novel SFFQ designed to be minimally burdensome to participants was effective at assessing dietary intakes in NAFLD patients. Electronic supplementary material The online version of this article (10.1007/s00394-019-01926-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carla Bredin
- Department of Nutritional Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Sara Naimimohasses
- Hepatology Department, St James' Hospital, Dublin, Ireland.,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Suzanne Norris
- Hepatology Department, St James' Hospital, Dublin, Ireland.,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Neil Hancock
- School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Kathryn Hart
- Department of Nutritional Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - J Bernadette Moore
- Department of Nutritional Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK. .,School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.
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92
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Evaluation of the Recipe Function in Popular Dietary Smartphone Applications, with Emphasize on Features Relevant for Nutrition Assessment in Large-Scale Studies. Nutrients 2019; 11:nu11010200. [PMID: 30669463 PMCID: PMC6356331 DOI: 10.3390/nu11010200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/05/2019] [Accepted: 01/17/2019] [Indexed: 12/21/2022] Open
Abstract
Nutrient estimations from mixed dishes require detailed information collection and should account for nutrient loss during cooking. This study aims to make an inventory of recipe creating features in popular food diary apps from a research perspective and to evaluate their nutrient calculation. A total of 12 out of 57 screened popular dietary assessment apps included a recipe function and were scored based on a pre-defined criteria list. Energy and nutrient content of three recipes calculated by the apps were compared with a reference procedure, which takes nutrient retention due to cooking into account. The quality of the recipe function varies across selected apps with a mean score of 3.0 (out of 5). More relevant differences (larger than 5% of the Daily Reference Intake) between apps and the reference were observed in micronutrients (49%) than in energy and macronutrients (20%). The primary source of these differences lies in the variation in food composition databases underlying each app. Applying retention factors decreased the micronutrient contents from 0% for calcium in all recipes to more than 45% for vitamins B6, B12, and folate in one recipe. Overall, recipe features and their ability to capture true nutrient intake are limited in current apps.
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93
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Eldridge AL, Piernas C, Illner AK, Gibney MJ, Gurinović MA, de Vries JHM, Cade JE. Evaluation of New Technology-Based Tools for Dietary Intake Assessment-An ILSI Europe Dietary Intake and Exposure Task Force Evaluation. Nutrients 2018; 11:E55. [PMID: 30597864 PMCID: PMC6356426 DOI: 10.3390/nu11010055] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/20/2018] [Accepted: 12/25/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND New technology-based dietary assessment tools, including Web-based programs, mobile applications, and wearable devices, may improve accuracy and reduce costs of dietary data collection and processing. The International Life Sciences Institute (ILSI) Europe Dietary Intake and Exposure Task Force launched this project to evaluate new tools in order to recommend general quality standards for future applications. METHODS A comprehensive literature search identified technology-based dietary assessment tools, including those published in English from 01/2011 to 09/2017, and providing details on tool features, functions and uses. Each of the 43 tools identified (33 for research and 10 designed for consumer use) was rated on 25 attributes. RESULTS Most of the tools identified (79%) relied on self-reported dietary intakes. Most (91%) used text entry and 33% used digital images to help identify foods. Only 65% had integrated databases for estimating energy or nutrients. Fewer than 50% contained any features of customization and about half generated automatic reports. Most tools reported on usability or reported validity compared with another assessment method (77%). A set of Best Practice Guidelines was developed for reporting dietary assessment tools using new technology. CONCLUSIONS Dietary assessment methods that utilize technology offer many advantages for research and are often preferable to consumers over more traditional methods. In order to meet general quality standards, new technology tools require detailed publications describing tool development, food identification and quantification, customization, outputs, food composition tables used, and usability/validity testing.
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Affiliation(s)
- Alison L Eldridge
- Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
| | - Anne-Kathrin Illner
- College of Health Sciences, Polytechnic Institute UniLaSalle Beauvais, 60026 Beauvais, France.
| | - Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin D04 V1W8, Ireland.
| | - Mirjana A Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade 11000, Serbia.
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University, 6708WE Wageningen, The Netherlands.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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94
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Price PH. Comment on: Five-year changes in dietary intake and body composition in adolescents with severe obesity undergoing laparoscopic Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis 2018; 15:69-70. [PMID: 30578014 DOI: 10.1016/j.soard.2018.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Paula Holland Price
- Division of Endocrinology, Metabolism & Diabetes, University of Colorado School of Medicine, Aurora, Colorado
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95
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Abstract
PURPOSE OF REVIEW A promising direction for improving dietary intake measurement in epidemiologic studies is the combination of short-term and long-term dietary assessment methods using statistical methods. Thereby, web-based instruments are particularly interesting as their application offers several potential advantages such as self-administration and a shorter completion time. The objective of this review is to provide an overview of new web-based short-term instruments and to describe their features. RECENT FINDINGS A number of web-based short-term dietary assessment tools for application in different countries and age-groups have been developed so far. Particular attention should be paid to the underlying database and the search function of the tool. Moreover, web-based instruments can improve the estimation of portion sizes by offering several options to the user. SUMMARY Web-based dietary assessment methods are associated with lower costs and reduced burden for participants and researchers, and show a comparable validity with traditional instruments. When there is a need for a web-based tool researcher should consider the adaptation of existing tools rather than developing new instruments. The combination of short-term and long-term instruments seems more feasible with the use of new technology.
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Affiliation(s)
- Johanna Conrad
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany
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96
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Roberts K, Cade J, Dawson J, Holdsworth M. Empirically Derived Dietary Patterns in UK Adults Are Associated with Sociodemographic Characteristics, Lifestyle, and Diet Quality. Nutrients 2018; 10:nu10020177. [PMID: 29415478 PMCID: PMC5852753 DOI: 10.3390/nu10020177] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 01/28/2018] [Accepted: 02/02/2018] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to examine empirical dietary patterns in UK adults and their association with sociodemographic characteristics, lifestyle factors, self-reported nutrient intake, nutrient biomarkers, and the Nutrient-based Diet Quality Score (NDQS) using National Diet and Nutrition Survey data 2008–2012 (n = 2083; mean age 49 years; 43.3% male). Four patterns explained 13.6% of the total variance: ‘Snacks, fast food, fizzy drinks’ (SFFFD), ‘Fruit, vegetables, oily fish’ (FVOF), ‘Meat, potatoes, beer’ (MPB), and ‘Sugary foods, dairy’ (SFD). ‘SFFFD’ was associated positively with: being male; smoking; body mass index (BMI); urinary sodium; intake of non-milk extrinsic sugars (NMES), fat and starch; and negatively with: age; plasma carotenoids; and NDQS. ‘FVOF’ was associated positively with: being non-white; age; income; socioeconomic classification (National Statistics Socio-economic Classifications; NSSEC); plasma carotenoids; intake of non-starch polysaccharides and polyunsaturated fatty acids. It was negatively associated with: being male, smoking, BMI, urinary sodium, intake of saturated fat; and NMES and NDQS. Whilst the patterns explained only 13.6% of the total variance, they were associated with self-reported nutrient intake, biomarkers of nutrient intake, sociodemographic and lifestyle variables, and the NDQS. These findings provide support for dietary patterns analyses as a means of exploring dietary intake in the UK population to inform public health nutrition policy and guidance.
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Affiliation(s)
- Katharine Roberts
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.
- Health Improvement Directorate, Public Health England, London SE1 6LH, UK.
| | - Janet Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jeremy Dawson
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.
| | - Michelle Holdsworth
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.
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97
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Savitz DA, Westreich D. Editorial: Innovations in Study Design-A Call for Creative Solutions. Am J Epidemiol 2017; 186:1024-1025. [PMID: 29040350 DOI: 10.1093/aje/kwx320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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98
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How Sensors Might Help Define the External Exposome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040434. [PMID: 28420222 PMCID: PMC5409635 DOI: 10.3390/ijerph14040434] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/14/2017] [Accepted: 03/23/2017] [Indexed: 01/23/2023]
Abstract
The advent of the exposome concept, the advancement of mobile technology, sensors, and the “internet of things” bring exciting opportunities to exposure science. Smartphone apps, wireless devices, the downsizing of monitoring technologies, along with lower costs for such equipment makes it possible for various aspects of exposure to be measured more easily and frequently. We discuss possibilities and lay out several criteria for using smart technologies for external exposome studies. Smart technologies are evolving quickly, and while they provide great promise for advancing exposure science, many are still in developmental stages and their use in epidemiology and risk studies must be carefully considered. The most useable technologies for exposure studies at this time relate to gathering exposure-factor data, such as location and activities. Development of some environmental sensors (e.g., for some air pollutants, noise, UV) is moving towards making the use of these more reliable and accessible to research studies. The possibility of accessing such an unprecedented amount of personal data also comes with various limitations and challenges, which are discussed. The advantage of improving the collection of long term exposure factor data is that this can be combined with more “traditional” measurement data to model exposures to numerous environmental factors.
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