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Diktas HE, Lozano CP, Saha S, Broyles ST, Martin CK, Apolzan JW. Evaluating the Validity of the PortionSize Smartphone Application for Estimating Dietary Intake in Free-Living Conditions: A Pilot Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00326-9. [PMID: 38888538 DOI: 10.1016/j.jneb.2024.05.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE Evaluate the validity of the PortionSize application. METHODS In this pilot study, 14 adults used PortionSize to record their free-living food intake over 3 consecutive days. Digital photography was the criterion measure, and the main outcomes were estimated intake of food (grams), energy (kilocalories), and food groups. Equivalence tests with ±25% equivalence bounds and Bland-Altman analysis were performed. RESULTS Estimated gram intake from PortionSize was equivalent (P < 0.001) to digital photography estimates. PortionSize and digital photography estimated energy intake, however, were not equivalent (P = 0.08), with larger estimates from PortionSize. In addition, PortionSize and digital photography were equivalent for vegetable intake (P = 0.01), but PortionSize had larger estimates of fruits, grains, dairy, and protein intake (P >0.07; error range 11% to 23%). CONCLUSIONS AND IMPLICATIONS Compared with digital photography, PortionSize accurately estimated food intake and had reasonable error rates for other nutrients; however, it overestimated energy intake, indicating further application improvements are needed for free-living conditions.
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Affiliation(s)
- Hanim E Diktas
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA
| | - Chloe P Lozano
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA; Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - Sanjoy Saha
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA; Agriculture, Food, and Nutrition Evidence Center, Texas A&M University, Fort Worth, TX
| | - Stephanie T Broyles
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA
| | - John W Apolzan
- Pennington Biomedical Research Center, Louisiana University System, Baton Rouge, LA.
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Schenk JM, Boynton A, Kulik P, Zyuzin A, Neuhouser ML, Kristal AR. The Use of Three-Dimensional Images and Food Descriptions from a Smartphone Device Is Feasible and Accurate for Dietary Assessment. Nutrients 2024; 16:828. [PMID: 38542739 PMCID: PMC10976213 DOI: 10.3390/nu16060828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 04/01/2024] Open
Abstract
Technology-assisted dietary assessment has the potential to improve the accuracy of self-reported dietary intake. This study evaluates MealScan3D (MS3D), a mobile device-based food recording system, which uses three-dimensional images to obtain food volumes and an application to capture algorithm-driven food intake data. Participants (n = 179) were randomly assigned and trained to record three meals using either MS3D or a written food record (WFR). Generous amounts of standardized meals were provided, and participants self-selected portions for each food. The weights of provided and uneaten/leftover foods were used to determine true intake. For total energy intake (three meals combined), validity (Pearson correlation) was significantly higher for MS3D vs. the WFR (p < 0.001); when interpreted as the percentage of variance in energy intake explained, MS3D explained 84.6% of true variance, a 25.3% absolute and 42.6% relative increase over the 59.3% explained by the WFR. For 9 of 15 individual foods, the Pearson correlations between true and reported portion size estimates were significantly larger for MS3D than the WFR. Bias was smaller (intercepts were closer to the means) for 9 of 15 foods and the regression coefficients for 10 of 15 foods were significantly closer to 1.0 in the MS3D arm. MS3D is feasible for dietary assessment and may provide improvements in accuracy compared to WFRs.
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Affiliation(s)
- Jeannette M. Schenk
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Alanna Boynton
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Pavel Kulik
- Allen Institute, Seattle, WA 98109, USA;
- Illionix Product Development, Seattle, WA 98125, USA;
| | - Alexei Zyuzin
- Illionix Product Development, Seattle, WA 98125, USA;
| | - Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Alan R. Kristal
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
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Saha S, Lozano CP, Broyles ST, Apolzan JW, Martin CK. Selecting foods from FNDDS when calculating food intake: Does the reference matter? J Food Compost Anal 2024; 125:105733. [PMID: 37954912 PMCID: PMC10634654 DOI: 10.1016/j.jfca.2023.105733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
To estimate food intake, the nutrient content of food must be known or inferred by matching it to a nutrient database. This study evaluated how different procedures for matching foods to the Food and Nutrient Database for Dietary Studies (FNDDS) affect food intake estimates. Adult participants estimated a meal with the PortionSize app, which contains a subset of FNDDS codes (PortionSize FNDDS). Meals were covertly weighed (weigh back), and intake was estimated by referencing the FNDDS dataset. Combination foods were evaluated by 1) a composite generated by summing the nutrient values (from FNDDS) from single food items and 2) using the single composite food code from FNDDS. Raters analyzed food images from the PortionSize app to estimate intake with the digital photography of foods (DPF) method. Raters estimated intake from: 1) PortionSize FNDDS and 2) full FNDDS. Using PortionSize's FNDDS database, participants' energy intake estimates were equivalent to rater estimated energy intake. Raters estimated almost identical energy intake when they used PortionSize vs. full FNDDS. Using the full FNDDS, the DPF's energy estimates were similar to weigh back. Estimation of energy intake with a single FNDDS code was not equivalent to estimations from summing the nutrient values for combination foods.
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Affiliation(s)
- Sanjoy Saha
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
- Agriculture, Food, and Nutrition Evidence Center, Texas A&M University, 801 Cherry Street, Suit 850, Fort Worth, TX 76102, USA
| | - Chloe P Lozano
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
- University of Hawaii at Manoa, 2500 Campus Road, Honolulu, HI 96822, USA
| | - Stephanie T Broyles
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
| | - John W Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA
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Kashef S, Bell LK, Brown V, Gardner C, Zarnowiecki D, Morgillo S, Arguelles JC, Cox DN, Golley RK. Evaluation of a menu box delivery service for Australian long-day care services to improve food provision and child intake: a cluster randomised controlled trial. Public Health Nutr 2023; 26:3122-3133. [PMID: 37830292 PMCID: PMC10755420 DOI: 10.1017/s1368980023002136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 08/06/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To evaluate the impact of a menu box delivery service tailored to the long-day care (LDC) setting on improving menu compliance with recommendations, children's diet quality and dietary intake while in care. DESIGN A cluster randomised controlled trial in LDC centres randomly assigned to an intervention (menu box delivery) or comparison (menu planning training) group. The primary outcome was child food provision and dietary intake. Secondary outcomes include menu compliance and process evaluation, including acceptability, fidelity and menu cost (per child, per day). SETTING South Australian LDC centres. PARTICIPANTS Eight LDC centres (n 224 children) provided data. RESULTS No differences were observed in serves/d between intervention and comparison centres, for provision (intervention, 0·9 inter-quartile range (IQR) 0·7-1·2; comparison, 0·8 IQR 0·5-1·3) or consumption (intervention, 0·5 IQR 0·2-0·8; comparison, 0·5 IQR 0·3-0·9) of vegetables. Child food provision and dietary intake were similar across both groups for all food groups (P < 0·05). At follow-up, all intervention centres met menu planning guidelines for vegetables, whereas only one comparison centre met guidelines. Intervention centre directors found the menu box delivery more acceptable than cooks. Cost of the intervention was AUD$2·34 greater than comparison centres (intervention, AUD$4·62 (95 % CI ($4·58, $4·67)); comparison, AUD$2·28 (95 % CI ($2·27, $2·30)) per child, per day). CONCLUSIONS Menu compliance can be improved via a menu delivery service, delivering equivalent impacts on child food provision and dietary intake compared with an online training programme. Further exploration of cooks acceptability and cost is essential before scaling up to implementation.
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Affiliation(s)
- Shabnam Kashef
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
| | - Lucinda K Bell
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
| | - Victoria Brown
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Claire Gardner
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
| | - Dorota Zarnowiecki
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
| | - Samantha Morgillo
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
| | | | - David N Cox
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity, Adelaide, SA, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park South Australia, GPO Box 2100, Adelaide, SA5001, Australia
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Richardson AS, Nugroho A, Dubowitz T, Schultz D, Martin CK. Students' consumption of high and low nutrition foods and reduced plate waste by schools' wellness-related policies and garden program participation. J Hum Nutr Diet 2023; 36:864-874. [PMID: 36890709 PMCID: PMC10853945 DOI: 10.1111/jhn.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Participation in school-based programs that may support children's nutritious dietary behaviours varies across schools. We examined school participation in wellness-related policies, school-based garden programs and students' dietary behaviours. METHODS Among matching schools who did and did not participate in school-based garden programs, we analysed the lunches of 80 Pittsburgh Public Schools (PPS) students in 1st, 2nd, 6th and 7th grades during Autumn 2019 using digital food photography. We also acquired school wellness policy data. Using cross-sectional linear regression, we estimated the association between school-based garden programming, wellness-related policies and dietary outcomes, adjusting for grade. RESULTS School's implementation of nutrition services policies was negatively associated with energy wasted from lunch (β = - 44.7 , p = 0.01 ${\rm{\beta }}=-44.7,{p}=0.01$ ). The number of semesters the students' school had participated in the garden program was positively associated with students' whole grain consumption (β = 0.07 , p < 0.001 ${\rm{\beta }}=0.07,{p}\lt 0.001$ ). CONCLUSIONS Cross-sectional associations suggest that schools that are more engaged in wellness policies and garden programs may provide environments that are more supportive of students' nutrition than in other schools.
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Affiliation(s)
- Andrea S Richardson
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Alvin Nugroho
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Tamara Dubowitz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Dana Schultz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
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Shonkoff ET, Hennessy E, Chui K, Gervis JE, Matthews E, Amin S, Bakun P, Roberts SB, Borges M, Martino J, Economos CD. Reliability and Validity of Digital Images to Assess Child Dietary Intake in a Quick-Service Restaurant Setting. J Acad Nutr Diet 2023; 123:427-437.e2. [PMID: 35963534 DOI: 10.1016/j.jand.2022.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Development of methods to accurately measure dietary intake in free-living situations-restaurants or otherwise-is critically needed to understand overall dietary patterns. OBJECTIVE This study aimed to develop and test reliability and validity of digital images (DI) for measuring children's dietary intake in quick-service restaurants (QSRs), validating against weighed plate waste (PW) and bomb calorimetry (BC). DESIGN In 2016, cross-sectional data were collected at two time points within a randomized controlled trial assessing children's leftovers in QSRs from parents of 4- to 12-year-old children. PARTICIPANTS/SETTING Parents (n = 640; mean age = 35.9 y; 70.8% female) consented and agreed to provide their child's PW for digital imaging, across 11 QSRs in Massachusetts in areas with low socioeconomic status and ethnically diverse populations. OUTCOME MEASURES Outcome measures were interrater reliability for DIs, correspondence between methods for energy consumed and left over, and correspondence between methods across varying quantities of PW. ANALYSES PERFORMED Intraclass correlations, percent agreement, Spearman correlations, Wilcoxon signed rank tests, and Bland-Altman plots were used. RESULTS Interrater reliability ratings for DIs had substantial intraclass correlations (ICC = 0.94) but not acceptable exact percent agreement (80.2%); DI and PW energy consumed were significantly correlated (r = 0.96, P < 0.001); DI slightly underestimated energy consumed compared with PW (Mdiff = -1.61 kcals, P < 0.001). Bland-Altman plots showed high DI-PW correspondence across various energy amounts and revealed few outliers. Energy left over by BC was highly correlated with DI (r = 0.87, P < 0.001) and PW (r = 0.90, P < 0.001); and mean differences were not significantly different from DI (Mdiff = 9.77 kcal, P = 0.06) or PW (Mdiff = -2.84 kcal, P = 0.20). CONCLUSIONS Correspondence was high between PW and DI assessments of energy consumed, and high with BC energy left over. Results demonstrate reliability and practical validity of digital images for assessing child meal consumption in QSR settings.
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Badrasawi M, Altamimi M, Zidan S, Illner AK, Aleksandrova K. Development and validation of a photographic food atlas of Middle Eastern Mediterranean diet: Toward improved understanding of traditional healthy and sustainable diets. Front Nutr 2023; 9:982420. [PMID: 36712511 PMCID: PMC9875072 DOI: 10.3389/fnut.2022.982420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023] Open
Abstract
Background Middle Eastern Mediterranean diet (MEMD) is a traditional plant-based diet that is commonly consumed and increasingly popular, but not well studied in nutrition research. To facilitate the dietary assessment of MEMD, we developed and validated a photographic food atlas depicting a variety of foods and dishes consumed in the MEM region. Methods The photographic food atlas included 1,002 photos of 400 types of foods and traditional dishes photographed characterizing MEMD. Foods and dishes were prepared by a professional cook and were subsequently photographed as a series of photos depicting portion size options. In a validation study, 45 individuals aged 20-50 years were recruited to assess portion size estimation of 25 representative food-photo series for each item. The validity of portion size estimation was assessed by comparing actual and reported estimates using Pearson or Spearman correlation tests. Sizes of the differences between estimated portions and the actual served portion sizes were calculate as mean differences and standard deviations. Results In the validation study, there was a strong correlation (r > 0.7) between estimated portion size of actual foods for 7 food items, such as pita bread, milk, labneh, and tomatoes, a moderate correlation (< 0.5 | r | < 0.7) for 12 items, such as meat, chicken, and grapes, and weak correlation (r < 0.3) for 6 items, such as seeds. Underestimation of portion sizes was more commonly observed for food items quantified when using "grams" or "milliliters" as a unit of measurement. In contrast, when household measurements were used, the participants tended to overestimate the portion sizes of respective foods and dishes. Conclusion We developed and validated a photographic food atlas depicting a wide variety of foods and dishes typical for the MEMD. The application of the photographic food atlas may facilitate the accurate assessment of adherence to MEMD and support the understanding of its health and sustainability aspects. Further methodological work is warranted to extend the list of food items and to evaluate the validity of the food atlas among larger and more heterogeneous groups of participants.
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Affiliation(s)
- Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine,*Correspondence: Manal Badrasawi, , orcid.org/0000-0003-4803-1052
| | - Mohammad Altamimi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | - Souzan Zidan
- Department of Nutrition and Food Technology, Faculty of Agriculture, Hebron University, Hebron, Palestine
| | - Anne-Kathrin Illner
- Institut Polytechnique UniLaSalle, Université d’Artois, ULR 7519, Equipe PANASH, Beauvais, France
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany,Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
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Bean MK, Raynor HA, Thornton LM, de Jonge L, Mazzeo SE. Design and rationale for evaluating the impact of salad bars on elementary school students' fruit, vegetable, and energy intake: a wait list control, cluster randomized controlled trial. BMC Public Health 2022; 22:2304. [PMID: 36494649 PMCID: PMC9733053 DOI: 10.1186/s12889-022-14744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Most children do not consume the recommended amount of fruit and vegetable (FV) servings. Changing the school food environment can be a cost-efficient, effective approach to improving children's dietary quality. There is great popular support for school salad bars as a means to increase children's FV intake within the National School Lunch Program (NSLP), yet empirical research is limited. Further, although FV consumption can facilitate healthy weight management if these foods replace high calorie items, there is a need to enhance understanding of salad bars' influence on children's diet quality and energy intake within the NSLP. This is particularly important to investigate in schools in communities characterized by high poverty, as students they serve are particularly likely to rely on school meals. METHODS This report describes the design and rationale of a federally-funded investigation that uses validated methods to evaluate school salad bars. This district plans to install salad bars into 141 elementary schools over 5-years, facilitating the conduct of a waitlist control, cluster randomized controlled trial. Specifically, 12 pairs of matched schools will be randomly selected: half receiving a salad bar (Intervention) and half serving pre-portioned FVs only, standard under the NSLP (Control). Thus, groups will have different FV presentation methods; however, all schools will operate under a policy requiring students to take at least one FV serving. Schools will be matched on Title I status and percent of racial/ethnic minoritized students. Intake will be objectively assessed at lunch in each school pair, prior to (baseline), and 4-6 weeks after salad bars are installed (post), yielding ~ 14,160 lunch observations throughout the study duration. Cafeteria sales and NSLP participation data will be obtained to determine how salad bars impact revenues. Finally, implementation factors and cafeteria personnel's perspectives will be assessed, to identify barriers and facilitators to salad bars use and inform sustainability efforts. Proposed methods and current status of this investigation due to COVID-19 are described. DISCUSSION Results will have great potential to inform school nutrition policies and programs designed to improve dietary quality and reduce obesity. TRIAL REGISTRATION Retrospectively registered (10/28/22) in clinicaltrials.gov (NCT05605483).
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Affiliation(s)
- Melanie K. Bean
- grid.224260.00000 0004 0458 8737Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Box 980140, Richmond, VA 23298 USA
| | - Hollie A. Raynor
- grid.411461.70000 0001 2315 1184Department of Nutrition, University of Tennessee, Knoxville, 1215 W. Cumberland Ave, Knoxville, TN 37996 USA
| | - Laura M. Thornton
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Lilian de Jonge
- Department of Nutrition and Food Studies, 10349 Democracy Ln, Suite 306, Fairfax, VA 22030 USA
| | - Suzanne E. Mazzeo
- grid.224260.00000 0004 0458 8737Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284 USA
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Wells NM, Todd LE, Henderson Jr. CR, Myers BM, Barale K, Gaolach B, Ferenz G, Aitken M, Hendrix L, Taylor C, Wilkins JL. The effects of school gardens on fruit and vegetable consumption at school: a randomized controlled trial with low-income elementary schools in four U.S. states. Prev Med Rep 2022; 31:102053. [DOI: 10.1016/j.pmedr.2022.102053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
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Identification of Factors Necessary for Enabling Technology-Based Dietary Record Surveys: A Qualitative Focus Group Interview with Japanese Dietitians. Nutrients 2022; 14:nu14204357. [PMID: 36297041 PMCID: PMC9609297 DOI: 10.3390/nu14204357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/20/2022] Open
Abstract
Weighed food records together with an in-person interview approach constitute the most basic methods used to estimate energy and nutrient intakes in dietary surveys. In the background of the coronavirus disease-2019 pandemic, the need for non-face-to-face dietary surveys using information and communication technology (ICT) is increasing. We aimed to evaluate ICT-based dietary record surveys and identify factors that may enable this survey method to become more widely used in the future. We conducted a non-face-to-face survey of dietary records of 44 Japanese individuals, maintained by dietitians using dietary photography and video conferencing services. We conducted a focus group interview with the six dietitians who conducted that survey. Their opinions on the factors necessary to popularize ICT-based dietary survey method were analyzed. In the focus group interview, dietitians highlighted fewer restrictions on time and place as positive aspects. Negative aspects included insufficient skills to operate computers, difficulty in hearing, and understanding facial expressions using ICT. We identified three main factors for enabling widespread use of ICT-based dietary record survey: individual skill, device and technology, and social environmental factors. This suggests that a comprehensive approach is necessary for popularizing the use of ICT in dietary surveys.
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Development of a Digital Photographic Food Atlas as a Portion Size Estimation Aid in Japan. Nutrients 2022; 14:nu14112218. [PMID: 35684017 PMCID: PMC9182677 DOI: 10.3390/nu14112218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to develop a digital photographic food atlas as a portion size estimation aid. Commonly consumed foods were identified from the 5512-day weighed dietary records of 644 Japanese adults. Portion sizes were determined based on the market research and distribution of food consumption in the dietary records. Each food item was classified into one of two photo types: a series of photographs showing gradually increasing portion sizes or guide photographs representing a range of portion sizes and food varieties in one photograph. Photographs of the food were taken at an angle of 42°, along with appropriate reference objects such as chopsticks. In total, 209 food and dish items were included in the food atlas. Series of photographs were taken for 105 items that are not usually served in predetermined amounts (e.g., rice and pasta), whereas guide photographs were taken for 104 items usually served in predetermined amounts (e.g., bananas and cookies). Moreover, photographs were taken for 12 kinds of household measurement items, such as cups and glasses. The food atlas could be a valuable tool for estimating the portion size in dietary surveys. Evaluating the validity of this food atlas for portion size estimation is warranted.
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Saha S, Lozano CP, Broyles S, Martin CK, Apolzan JW. Assessing initial validity of the PortionSize app to estimate dietary intake among adults: A pilot and feasibility study (Preprint). JMIR Form Res 2022; 6:e38283. [PMID: 35704355 PMCID: PMC9244674 DOI: 10.2196/38283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background Accurately assessing dietary intake can promote improved nutrition. The PortionSize app (Pennington Biomedical Research Center) was designed to quantify and provide real-time feedback on the intake of energy, food groups, saturated fat, and added sugar. Objective This study aimed to assess the preliminary feasibility and validity of estimating food intake via the PortionSize app among adults. Methods A total of 15 adults (aged 18-65 years) were recruited and trained to quantify the food intake from a simulated meal by using PortionSize. Trained personnel prepared 15 simulated meals and covertly weighed (weigh back) the amount of food provided to participants as well as food waste. Equivalence tests (±25% bounds) were performed to compare PortionSize to the weigh back method. Results Participants were aged a mean of 28 (SD 12) years, and 11 were female. The mean energy intake estimated with PortionSize was 742.9 (SD 328.2) kcal, and that estimated via weigh back was 659.3 (SD 190.7) kcal (energy intake difference: mean 83.5, SD 287.5 kcal). The methods were not equivalent in estimating energy intake (P=.18), and PortionSize overestimated energy intake by 83.5 kcal (12.7%) at the meal level. Estimates of portion sizes (gram weight; P=.01), total sugar (P=.049), fruit servings (P=.01), and dairy servings (P=.047) from PortionSize were equivalent to those estimated via weigh back. PortionSize was not equivalent to weigh back with regard to estimates for carbohydrate (P=.10), fat (P=.32), vegetable (P=.37), grain (P=.31), and protein servings (P=.87). Conclusions Due to power limitations, the equivalence tests had large equivalence bounds. Though preliminary, the results of this small pilot study warrant the further adaptation, development, and validation of PortionSize as a means to estimate energy intake and provide users with real-time and actionable dietary feedback.
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Affiliation(s)
- Sanjoy Saha
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Chloe Panizza Lozano
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Stephanie Broyles
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
| | - John W Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
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13
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Andueza N, Navas-Carretero S, Cuervo M. Effectiveness of Nutritional Strategies on Improving the Quality of Diet of Children from 6 to 12 Years Old: A Systematic Review. Nutrients 2022; 14:nu14020372. [PMID: 35057552 PMCID: PMC8781853 DOI: 10.3390/nu14020372] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Dietary habits, that are formed during childhood and consolidated in adulthood, are known to influence the development of future chronic diseases such as metabolic syndrome or type 2 diabetes. The aim of this review was to evaluate the effectiveness of nutritional interventions carried out in recent years focused on improving the quality of the diet of the child population. A systematic search of the PubMed and Scopus databases was performed from January 2011 until September 2021. A total of 910 articles were identified and screened based on their title, abstract and full text. Finally, 12 articles were included in the current systematic review. Of those, in six studies the intervention was based on the provision of healthy meals and in the other six studies the intervention focused on modifying the school environment. Six of the studies selected included other components in their intervention such as nutritional education sessions, physical activity and/or families. A wide variety of methods were used for diet assessments, from direct method to questionnaires. The results suggest that interventions that modify the school environment or provide different meals or snacks may be effective in improving children’s dietary patterns, both in the short and long term. Further research is necessary to evaluate the real effectiveness of strategies with multidisciplinary approach (nutritional sessions, physical activity and family’s involvement).
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Affiliation(s)
- Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948425600
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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14
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Food waste generation in a university and the handling efficiency of a university catering facility-scale automatic collection system. FACILITIES 2022. [DOI: 10.1108/f-01-2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to evaluate the generation of food waste in a university and the handling efficiency of an automatic waste collection system.
Design/methodology/approach
The quantity of food waste generated and collected from a university canteen was surveyed. The food waste handling efficiencies using manual collection strategy and automated food waste collection system were determined by the density of food waste. Life-cycle costing analysis was done to evaluate the economic impacts of various food waste collection methods.
Findings
As compared with the manual collection approach, the automatic system can improve the food waste handling efficiency by 30% (from 0.01 to 0.007 bin kg−1) and reduce the water use by 20% (from 0.512 to 0.406 L kg−1); however, it also consumes 4.4 times more energy (from 0.005 to 0.027 kWh kg−1). Under ideal system operation, the 10-year cost of food waste collection was significantly reduced from $3.45 kg−1 in the manual collection to $1.79 kg−1, and the payback period of the system collection was 1.9 years without discount.
Practical implications
The outcomes of this study show that an automatic food waste collection system is feasible, and it is recommended for small- and medium-sized catering facilities (e.g. canteens and food courts) to improve food waste handling efficiency. This study also provides useful reference data of automatic food waste collection systems for planning food waste management programs for catering facilities.
Originality/value
To the best of the authors’ knowledge, this is the first study to evaluate the waste handling efficiency, operational expenditure and life-cycle cost of a small-scale automatic food waste collection system.
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15
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Pfisterer KJ, Amelard R, Chung AG, Syrnyk B, MacLean A, Keller HH, Wong A. Automated food intake tracking requires depth-refined semantic segmentation to rectify visual-volume discordance in long-term care homes. Sci Rep 2022; 12:83. [PMID: 34997022 PMCID: PMC8742067 DOI: 10.1038/s41598-021-03972-8] [Citation(s) in RCA: 9] [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: 03/31/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022] Open
Abstract
Malnutrition is a multidomain problem affecting 54% of older adults in long-term care (LTC). Monitoring nutritional intake in LTC is laborious and subjective, limiting clinical inference capabilities. Recent advances in automatic image-based food estimation have not yet been evaluated in LTC settings. Here, we describe a fully automatic imaging system for quantifying food intake. We propose a novel deep convolutional encoder-decoder food network with depth-refinement (EDFN-D) using an RGB-D camera for quantifying a plate's remaining food volume relative to reference portions in whole and modified texture foods. We trained and validated the network on the pre-labelled UNIMIB2016 food dataset and tested on our two novel LTC-inspired plate datasets (689 plate images, 36 unique foods). EDFN-D performed comparably to depth-refined graph cut on IOU (0.879 vs. 0.887), with intake errors well below typical 50% (mean percent intake error: [Formula: see text]%). We identify how standard segmentation metrics are insufficient due to visual-volume discordance, and include volume disparity analysis to facilitate system trust. This system provides improved transparency, approximates human assessors with enhanced objectivity, accuracy, and precision while avoiding hefty semi-automatic method time requirements. This may help address short-comings currently limiting utility of automated early malnutrition detection in resource-constrained LTC and hospital settings.
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Affiliation(s)
- Kaylen J Pfisterer
- University of Waterloo, Waterloo, Systems Design Engineering, Waterloo, ON, N2L 3G1, Canada.
- Waterloo AI Institute, Waterloo, ON, N2L 3G1, Canada.
- Schlegel-UW Research Institute for Aging, Waterloo, N2J 0E2, Canada.
| | - Robert Amelard
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, M5G 2A2, Canada
| | - Audrey G Chung
- University of Waterloo, Waterloo, Systems Design Engineering, Waterloo, ON, N2L 3G1, Canada
- Waterloo AI Institute, Waterloo, ON, N2L 3G1, Canada
| | - Braeden Syrnyk
- University of Waterloo, Waterloo, Mechanical and Mechatronics Engineering, Waterloo, ON, N2L 3G1, Canada
| | - Alexander MacLean
- University of Waterloo, Waterloo, Systems Design Engineering, Waterloo, ON, N2L 3G1, Canada
- Waterloo AI Institute, Waterloo, ON, N2L 3G1, Canada
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, Waterloo, N2J 0E2, Canada
- University of Waterloo, Waterloo, Kinesiology and Health Studies, Waterloo, ON, N2L 3G1, Canada
| | - Alexander Wong
- University of Waterloo, Waterloo, Systems Design Engineering, Waterloo, ON, N2L 3G1, Canada
- Waterloo AI Institute, Waterloo, ON, N2L 3G1, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, N2J 0E2, Canada
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16
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Van Wymelbeke-Delannoy V, Juhel C, Bole H, Sow AK, Guyot C, Belbaghdadi F, Brousse O, Paindavoine M. A Cross-Sectional Reproducibility Study of a Standard Camera Sensor Using Artificial Intelligence to Assess Food Items: The FoodIntech Project. Nutrients 2022; 14:nu14010221. [PMID: 35011096 PMCID: PMC8747564 DOI: 10.3390/nu14010221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 12/18/2022] Open
Abstract
Having a system to measure food consumption is important to establish whether individual nutritional needs are being met in order to act quickly and to minimize the risk of undernutrition. Here, we tested a smartphone-based food consumption assessment system named FoodIntech. FoodIntech, which is based on AI using deep neural networks (DNN), automatically recognizes food items and dishes and calculates food leftovers using an image-based approach, i.e., it does not require human intervention to assess food consumption. This method uses one-input and one-output images by means of the detection and synchronization of a QRcode located on the meal tray. The DNN are then used to process the images and implement food detection, segmentation and recognition. Overall, 22,544 situations analyzed from 149 dishes were used to test the reliability of this method. The reliability of the AI results, based on the central intra-class correlation coefficient values, appeared to be excellent for 39% of the dishes (n = 58 dishes) and good for 19% (n = 28). The implementation of this method is an effective way to improve the recognition of dishes and it is possible, with a sufficient number of photos, to extend the capabilities of the tool to new dishes and foods.
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Affiliation(s)
- Virginie Van Wymelbeke-Delannoy
- Elderly Unit, University Hospital Center Dijon Bourgogne F Mitterrand, F-21000 Dijon, France; (C.G.); (F.B.)
- Centre des Sciences du Goût et de l’Alimentation, INRAE, Université de Bourgogne Franche-Comté, CNRS, Agrosup, F-21000 Dijon, France
- Correspondence: ; Tel.: +33-00-3-80-29-31-55
| | - Charles Juhel
- ATOL Conseils & Développements (AtolCD), ZAE les Terres d’Or, Route de Saint Philibert, F-21220 Gevrey-Chambertin, France; (C.J.); (H.B.)
| | - Hugo Bole
- ATOL Conseils & Développements (AtolCD), ZAE les Terres d’Or, Route de Saint Philibert, F-21220 Gevrey-Chambertin, France; (C.J.); (H.B.)
| | - Amadou-Khalilou Sow
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F-21000 Dijon, France;
| | - Charline Guyot
- Elderly Unit, University Hospital Center Dijon Bourgogne F Mitterrand, F-21000 Dijon, France; (C.G.); (F.B.)
| | - Farah Belbaghdadi
- Elderly Unit, University Hospital Center Dijon Bourgogne F Mitterrand, F-21000 Dijon, France; (C.G.); (F.B.)
| | - Olivier Brousse
- Yumain, 14 Rue Pierre de Coubertin, F-21000 Dijon, France; (O.B.); (M.P.)
| | - Michel Paindavoine
- Yumain, 14 Rue Pierre de Coubertin, F-21000 Dijon, France; (O.B.); (M.P.)
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17
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AMARAL YG, PENAFORTE FRDO, ARAÚJO LBD, JAPUR CC. Can hospitalized patients adequately estimate their own food intake? A cross-sectional pilot study. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To assess and identify factors linked to the accuracy of patients’ food intake estimations through a self-monitoring instrument filled in by the patient. Methods This cross-sectional study approached adult hospital patients subjected to regular or therapeutic diets. The actual food intake percentage was obtained by the ratio between the actual food intake and the amount of food served x 100. Patients had to complete a food chart including 9 circles representing plates of food in percentages (increasing scale of 12.5%) to represent their food intake at lunch and/or dinner. The Bland-Altman method assessed the agreement between the actual and the estimated values. The associations between variables (age, sex, hospitalization day, diet prescription, amount of food served and actual food intake percentage) and the accuracy of the food intake estimation (adequate ±10%, overestimated and underestimated) were evaluated through univariate multinomial logistic regression. Results Ninety-six patients were evaluated (51.0% male; 44.0±15.8 years of age). The Bland-Altman analysis showed good agreement between the actual and the estimated food intake. The actual food intake percentage was the only variable associated with the accuracy of the food intake estimation. Conclusion Most patients (~70%) adequately estimated their food intake using the 9-point food chart tested. Furthermore, the only factor linked to the accuracy of the food intake estimation was the actual food-intake percentage. These findings provide preliminary support for the usefulness of this instrument. However, it must be tested in a representative sample of hospitalized patients.
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18
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Accuracy of estimates of serving size using digitally displayed food photographs among Japanese adults. J Nutr Sci 2022; 11:e105. [PMID: 36452397 PMCID: PMC9705702 DOI: 10.1017/jns.2022.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
We evaluated the accuracy of the estimated serving size using digital photographs in a newly developed food atlas. From 209 food items in the food atlas, we selected 14 items with various appearances for evaluation. At the study site, fifty-four participants aged 18-33 years were served fourteen foods in the amount they usually ate. After they left, each food item was weighed by a researcher. The following day, the participants estimated the quantity of each food they served based on food photographs using a web-based questionnaire. We compared the weights of the foods the participants served (true serving sizes) and those determined based on the photographs (estimated serving sizes). For ten of the fourteen food items, significant differences were observed between the estimated and true serving sizes, ranging from a 29⋅8 % underestimation (curry sauce) to a 34⋅0 % overestimation (margarine). On average, the relative difference was 8⋅8 %. Overall, 51⋅6 % of the participants were within ±25 % of the true serving size, 81⋅9 % were within ±50 % and 93⋅4 % were within ±75 %. Bland-Altman plots showed wide limits of agreement and increased variances with larger serving sizes for most food items. Overall, no association was found between estimation errors and participant characteristics. The food atlas has shown potential for assessment of portion size estimation. Further development, refinement and testing are needed to improve the usefulness of the digital food photographic atlas as a portion size estimation aid.
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Tagi M, Tajiri M, Hamada Y, Wakata Y, Shan X, Ozaki K, Kubota M, Amano S, Sakaue H, Suzuki Y, Hirose J. Accuracy of an artificial intelligence-based model for estimating leftover liquid food in hospitals: validation study (Preprint). JMIR Form Res 2021; 6:e35991. [PMID: 35536638 PMCID: PMC9131145 DOI: 10.2196/35991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background An accurate evaluation of the nutritional status of malnourished hospitalized patients at a higher risk of complications, such as frailty or disability, is crucial. Visual methods of estimating food intake are popular for evaluating the nutritional status in clinical environments. However, from the perspective of accurate measurement, such methods are unreliable. Objective The accuracy of estimating leftover liquid food in hospitals using an artificial intelligence (AI)–based model was compared to that of visual estimation. Methods The accuracy of the AI-based model (AI estimation) was compared to that of the visual estimation method for thin rice gruel as staple food and fermented milk and peach juice as side dishes. A total of 576 images of liquid food (432 images of thin rice gruel, 72 of fermented milk, and 72 of peach juice) were used. The mean absolute error, root mean squared error, and coefficient of determination (R2) were used as metrics for determining the accuracy of the evaluation process. Welch t test and the confusion matrix were used to examine the difference of mean absolute error between AI and visual estimation. Results The mean absolute errors obtained through the AI estimation approach were 0.63 for fermented milk, 0.25 for peach juice, and 0.85 for the total. These were significantly smaller than those obtained using the visual estimation approach, which were 1.40 (P<.001) for fermented milk, 0.90 (P<.001) for peach juice, and 1.03 (P=.009) for the total. By contrast, the mean absolute error for thin rice gruel obtained using the AI estimation method (0.99) did not differ significantly from that obtained using visual estimation (0.99). The confusion matrix for thin rice gruel showed variation in the distribution of errors, indicating that the errors in the AI estimation were biased toward the case of many leftovers. The mean squared error for all liquid foods tended to be smaller for the AI estimation than for the visual estimation. Additionally, the coefficient of determination (R2) for fermented milk and peach juice tended to be larger for the AI estimation than for the visual estimation, and the R2 value for the total was equal in terms of accuracy between the AI and visual estimations. Conclusions The AI estimation approach achieved a smaller mean absolute error and root mean squared error and a larger coefficient of determination (R2) than the visual estimation approach for the side dishes. Additionally, the AI estimation approach achieved a smaller mean absolute error and root mean squared error compared to the visual estimation method, and the coefficient of determination (R2) was similar to that of the visual estimation method for the total. AI estimation measures liquid food intake in hospitals more precisely than visual estimation, but its accuracy in estimating staple food leftovers requires improvement.
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Affiliation(s)
- Masato Tagi
- Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mari Tajiri
- Division of Nutrition, Tokushima University Hospital, Tokushima, Japan
| | - Yasuhiro Hamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshifumi Wakata
- Health Information Management Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
- Medical Information Technology Center, Tokushima University Hospital, Tokushima, Japan
| | - Xiao Shan
- Medical Information Technology Center, Tokushima University Hospital, Tokushima, Japan
| | - Kazumi Ozaki
- Department of Oral Health Care Promotion, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | | | - Hiroshi Sakaue
- Division of Nutrition, Tokushima University Hospital, Tokushima, Japan
- Department of Nutrition and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshiko Suzuki
- Division of Nutrition, Tokushima University Hospital, Tokushima, Japan
| | - Jun Hirose
- Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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20
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Papathanail I, Brühlmann J, Vasiloglou MF, Stathopoulou T, Exadaktylos AK, Stanga Z, Münzer T, Mougiakakou S. Evaluation of a Novel Artificial Intelligence System to Monitor and Assess Energy and Macronutrient Intake in Hospitalised Older Patients. Nutrients 2021; 13:4539. [PMID: 34960091 PMCID: PMC8706142 DOI: 10.3390/nu13124539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 01/07/2023] Open
Abstract
Malnutrition is common, especially among older, hospitalised patients, and is associated with higher mortality, longer hospitalisation stays, infections, and loss of muscle mass. It is therefore of utmost importance to employ a proper method for dietary assessment that can be used for the identification and management of malnourished hospitalised patients. In this study, we propose an automated Artificial Intelligence (AI)-based system that receives input images of the meals before and after their consumption and is able to estimate the patient's energy, carbohydrate, protein, fat, and fatty acids intake. The system jointly segments the images into the different food components and plate types, estimates the volume of each component before and after consumption, and calculates the energy and macronutrient intake for every meal, based on the kitchen's menu database. Data acquired from an acute geriatric hospital as well as from our previous study were used for the fine-tuning and evaluation of the system. The results from both our system and the hospital's standard procedure were compared to the estimations of experts. Agreement was better with the system, suggesting that it has the potential to replace standard clinical procedures with a positive impact on time spent directly with the patients.
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Affiliation(s)
- Ioannis Papathanail
- ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland; (I.P.); (M.F.V.); (T.S.)
| | - Jana Brühlmann
- Geriatrische Klinik St. Gallen AG, Rorschacherstrasse 94, 9000 St. Gallen, Switzerland; (J.B.); (T.M.)
| | - Maria F. Vasiloglou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland; (I.P.); (M.F.V.); (T.S.)
| | - Thomai Stathopoulou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland; (I.P.); (M.F.V.); (T.S.)
| | | | - Zeno Stanga
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Thomas Münzer
- Geriatrische Klinik St. Gallen AG, Rorschacherstrasse 94, 9000 St. Gallen, Switzerland; (J.B.); (T.M.)
| | - Stavroula Mougiakakou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, 3008 Bern, Switzerland; (I.P.); (M.F.V.); (T.S.)
- Department of Emergency Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
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21
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Dietary Composition and Its Association with Newly Diagnosed Nonalcoholic Fatty Liver Disease and Insulin Resistance. Nutrients 2021; 13:nu13124438. [PMID: 34959990 PMCID: PMC8708546 DOI: 10.3390/nu13124438] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 12/13/2022] Open
Abstract
Dietary modification is essential for treating nonalcoholic fatty liver disease (NAFLD); however, the dietary components are less well defined. We enrolled 252 adults with no history of liver disease and excessive alcohol use to evaluate the relationship between macronutrients and NAFLD and insulin resistance. Participants took photographs of their meals and documented their food intake in a food diary for seven consecutive days. A dietitian estimated the type and portion size of food items and analyzed nutrients with INMUCAL-Nutrients software. Later, participants underwent transient elastography to diagnose NAFLD and blood tests to measure insulin resistance using the homeostasis model. Total energy intake and the proportion of carbohydrate, fat, and protein consumption did not differ between participants with NAFLD (n = 41) and those without NAFLD (n = 211). Using multiple logistic regression analysis, daily intake of protein < 1.0 g/kg (OR: 3.66, 95% CI: 1.41–9.52) and full-fat dairy product ≥ 50 g (OR: 0.42, 95% CI: 0.18–0.99) were associated with NAFLD. Insulin resistance was associated with a daily intake of protein < 1.0 g/kg (OR: 3.09, 95% CI: 1.59–6.05), full-fat dairy product ≥ 50 g (OR: 0.46, 95% CI: 0.25–0.82), and dietary fiber ≥ 8 g (OR: 0.41, 95% CI: 0.22–0.74). Our data show that a low protein intake increases the odds for NAFLD and insulin resistance. Contrarily, a high intake of full-fat dairy products and dietary fiber has been associated with a potential protective effect against NAFLD and insulin resistance.
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22
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Xu Y, Duan R, Feng P, Gao W, Xing D, Cheng G. Comparison of the Diet Photograph Record to Weighed Dietary Record and 24 h Dietary Recall for Estimating Energy and Nutrient Intakes Among Chinese Preschoolers. Front Nutr 2021; 8:755683. [PMID: 34859031 PMCID: PMC8631866 DOI: 10.3389/fnut.2021.755683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the relative validity of the diet photograph record (DP) for measuring the energy and nutrient intakes against the weighed dietary record (WD) and the 24 h dietary recall (HR) in the Chinese preschoolers. In this study, 40 preschool children aged 4–6 years and their parents were recruited from a kindergarten in southwest China. Dietary intake of the preschoolers on a same day, as estimated by the DP and the HR were compared with the WD. These three methods were administered by the three group of investigators independently. The mean differences, correlation coefficients, cross-classifications, and weighted κ, as well as the Bland–Altman plots were performed to assess the differences and agreements among the estimates from the DP, the HR, and the WD. For the DP and the HR, the estimates of energy and nutrient intakes were moderate to high correlated with the WD, with the higher coefficients ranging from 0.73 to 0.94 for the DP. Both the methods tended to underestimate the dietary intake, but the differences from the known weights using the DP were significantly smaller than those using the HR. The weighed κ values ranking the preschoolers ranged from 0.48 to 0.80 for the DP and ranged from 0.28 to 0.64 for the HR. Furthermore, the Bland–Altman plots indicated a better agreement between the DP and the WD for estimating energy and nutrient intakes. This DP is a valid tool for measuring energy and nutrient intakes among the preschoolers.
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Affiliation(s)
- Yujie Xu
- Department of Nutrition, Food Safety, and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ruonan Duan
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Feng
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Wanke Gao
- Department of Nutrition, Food Safety, and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dong Xing
- Department of Nutrition, Food Safety, and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
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23
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Bekelman TA, Johnson SL, Steinberg RI, Martin CK, Sauder KA, Luckett-Cole S, Glueck DH, Hsia DS, Dabelea D. A Qualitative Analysis of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for Assessing Children's Food Intake Reported by Parent Proxy. J Acad Nutr Diet 2021; 122:961-973. [PMID: 34767972 PMCID: PMC9038614 DOI: 10.1016/j.jand.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Accuracy and participant burden are two key considerations in the selection of a dietary assessment tool for assessing children's full-day dietary intake. OBJECTIVE The aim of this study was to identify barriers experienced by parents and burden when using two technology-based measures of dietary intake to report their child's intake: the Remote Food Photography Method (RFPM) and the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24). DESIGN Qualitative, semistructured, focus groups were conducted with parents who served as proxy reporters of their child's dietary intake using the two different dietary assessment methods (ie, RFPM and ASA24) 1 week apart. PARTICIPANTS/SETTING This study was conducted in 2019 and included 32 parents of children aged 7 to 8 years in Colorado and Louisiana. MAIN OUTCOME MEASURES Barriers adhering to the protocol and burden with the RFPM and ASA24. QUALITATIVE ANALYSES Qualitative content analysis and Atlas.ti software were used to analyze and interpret focus group data. RESULTS For the RFPM, parents described missing photos due to unobserved intake, forgetting to capture images, disruption of mealtimes, and child embarrassment when meals were photographed at school. For the ASA24, parents described the time commitment as the main source of burden and the need to expand the food database to include additional ethnic foods and restaurant items. The main strengths were ease of use for the RFPM and the consolidated workload for the ASA24. CONCLUSIONS The barriers experienced by parents and burden differed by method, highlighting the importance of considering the unique characteristics of each assessment tool when designing a pediatric dietary assessment study and interpreting findings.
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Affiliation(s)
- Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.
| | - Susan L Johnson
- Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz
| | - Rachel I Steinberg
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado
| | - Corby K Martin
- Ingestive Behavior, Weight Management & Health Promotion Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana; Human Phenotyping Core, Nutrition Obesity Research Center, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado; Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz
| | - Sophie Luckett-Cole
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado; Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz
| | - Daniel S Hsia
- Ingestive Behavior, Weight Management & Health Promotion Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, Colorado School of Public Health, Aurora, Colorado; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado; Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz
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Engler-Stringer R, Black J, Muhajarine N, Martin W, Gilliland J, McVittie J, Kirk S, Wittman H, Mousavi A, Elliott S, Tu S, Hills B, Androsoff G, Field D, Macdonald B, Belt C, Vatanparast H. The Good Food for Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol for a Two-Year Matched Control Pre-Post and Case Study. JMIR Res Protoc 2021; 10:e30899. [PMID: 34546171 PMCID: PMC8493466 DOI: 10.2196/30899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background Good nutrition affects children’s health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children’s eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous community-engaged academic research on the impact of school meal programs, especially universal ones. Objective The aim of this population health intervention research is to study the impact of a 2-year universal, curriculum-integrated healthy school lunch program in elementary schools in Saskatoon, Saskatchewan, Canada, on food consumption, dietary quality and food and nutrition-related knowledge, attitudes, and practices. Methods This population health intervention study will be conducted in 2 intervention elementary schools matched with 2 control schools. We will collect preintervention data, including objective measurements of food eaten at school and food-related knowledge, attitudes, and behaviors. This will be followed by the intervention itself, along with qualitative case studies of the intervention process in the 2 intervention schools. Then, we will collect postintervention data similar to the preintervention data. Finally, we will finish the data analysis and complete the ongoing sharing of learning from the project. Results This study was funded in April 2020 but because of the COVID-19 pandemic, data collection did not begin until May 2021. The intervention will begin in September 2021 and end in June 2023, with end point data collection occurring in May and June 2023. The case study research will begin in September 2021 and will be ongoing for the duration of the intervention. Conclusions The opportunity we have to systematically and comprehensively study a curriculum-integrated school lunch program, as well as the promising practices for school food programs across Canada, is without precedent. International Registered Report Identifier (IRRID) DERR1-10.2196/30899
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Affiliation(s)
- Rachel Engler-Stringer
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jennifer Black
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Wanda Martin
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Janet McVittie
- Department of Educational Foundations, College of Education, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Hannah Wittman
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
| | - Amin Mousavi
- Department of Educational Psychology and Special Education, College of Education, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sinikka Elliott
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Sylvana Tu
- Saskatchewan Population Health Evaluation and Research Unit, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brent Hills
- Saskatoon Public Schools Division, Saskatoon, SK, Canada
| | | | - Debbie Field
- Coalition for Healthy School Food, Food Secure Canada, Montreal, QC, Canada
| | - Brit Macdonald
- Little Green Thumbs Program, Agriculture in the Classroom, Saskatoon, SK, Canada
| | - Chelsea Belt
- Health Promotion Department, Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
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Evaluation of a Novel WeChat Applet for Image-Based Dietary Assessment among Pregnant Women in China. Nutrients 2021; 13:nu13093158. [PMID: 34579035 PMCID: PMC8470395 DOI: 10.3390/nu13093158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 12/12/2022] Open
Abstract
As an important part of antenatal care for pregnant women in China, dietary assessment plays a positive role in maternal and fetal health. Shortcomings in the associated methodologies require improvement. Our purpose was to develop a novel WeChat Applet for image-based dietary assessment (WAIDA) and evaluate its relative validity among pregnant women in China. Data on 251 lunch meals of pregnant women in their second trimester were analyzed. The differences in food weight, energy, and nutrient estimates by the dietary recall or WAIDA method with the weighing method were compared using paired t-tests. Pearson correlation coefficients were used to analyze the correlation between food weight, energy, and nutrient intake obtained from the recall or WAIDA method and those obtained from the weighing method. The Bland–Altman analysis was used to examine the agreement between the recall or WAIDA method and the weighing method for energy and nutrients. Compared with the weighing method, the variation range of food weight, energy and nutrients estimated by the WAIDA method was smaller and more stable than that estimated by the recall method. Compared with the recall method, the correlations suggested a better relationship between the energy and nutrient intakes from the weighing method and those estimated by the WAIDA method (0.752–0.970 vs. 0.480–0.887), which were similar to those of food weight (0.332–0.973 vs. −0.019–0.794). The Bland-Altman analysis showed that the mean differences of the energy and nutrients estimated from the recall method were further away from zero relative to the weighing method compared to the WAIDA method and with numerically wider 95% confidence intervals. The spans between the upper and lower 95% limit of agreement (LOAs) of the energy and nutrients obtained by the WAIDA method were narrower than those obtained by the recall method, and the majority of the data points obtained by the WAIDA method lay between the LOAs, closer to the middle horizontal line. Compared with the recall method, the WAIDA method is consistent with the weighing method, close to the real value of dietary data, and expected to be suitable for dietary assessment in antenatal care.
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Bean MK, Thornton LM, Mazzeo SE, Raynor HA. Salad bars and energy intake in Virginia elementary schools with free meals. Prev Med Rep 2021; 24:101515. [PMID: 34458079 PMCID: PMC8379484 DOI: 10.1016/j.pmedr.2021.101515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/29/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
School salad bars are widely promoted as a means to increase adherence to National School Lunch Program (NSLP) nutrition mandates. Yet it is unknown how salad bars or fruit and vegetable (F&V) intake relates to energy intake within the NSLP, or if F&Vs displace energy from other sources. This relation is particularly important to understand among children from minoritized backgrounds, who are at high risk of obesity and food insecurity, and the most likely to be impacted by school food policies, given their reliance on school meals. This study purpose was to evaluate if school salad bars and F&V intake are associated with lower lunch energy intake. Energy intake in Virginia elementary schools with and without salad bars, and associations between F&V energy and other energy sources, were examined. Cross-sectional plate waste assessments were conducted in matched school pairs (3 with, 3 without salad bars; N = 1,102 students; >90% Black and Latinx; 100% free meals). Two-level hierarchical models assessed group differences in energy intake and the proportion of energy from each meal component. Mean total lunch energy intake was 304 ± 157 kcal (salad bar); 269 ± 152 kcal (no salad bar). Students in salad bar schools consumed more energy from vegetables (+11 kcal; P < .001). Energy intake patterns were inconsistent across pairs. F&V energy was not associated with non-F&V energy (F = 1.04, P = .31). Findings do not suggest that salad bars were associated with lower energy intake. Evidence was inconsistent regarding F&V displacement of other lunch calories. Further research regarding F&V, salad bars, and energy intake is needed.
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Affiliation(s)
- Melanie K Bean
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, 2303 N. Parham Rd, Suite 1, Richmond, VA 23229, United States
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27599, United States
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St., Richmond, VA 23284, United States
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, 1215 W. Cumberland Ave., Knoxville, TN 37996, United States
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ALMASİ N, RAKICIOĞLU N. The Estimation of Standard Portion Sizes Using Food Photographic Booklet Among University Students in Turkey. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.886274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Matsushita Y, Takahashi T, Asahi K, Harashima E, Takahashi H, Tanaka H, Tsumuraya Y, Sarukura N, Furuta M, Tanaka H, Yokoyama T. Validation of improved 24-hour dietary recall using a portable camera among the Japanese population. Nutr J 2021; 20:68. [PMID: 34266425 PMCID: PMC8283912 DOI: 10.1186/s12937-021-00724-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The collection of weighed food records (WFR) is a gold standard for dietary assessment. We propose using the 24-h recall method combined with a portable camera and a food atlas (24hR-camera). This combination overcomes the disadvantages of the 24-h dietary recall method. Our study examined the validity of the 24hR-camera method against WFR by comparing the results. METHODS Study subjects were 30 Japanese males, aged 31-58 years, who rarely cook and reside in the Tokyo metropolitan area. For validation, we compared the estimated food intake (24hR-camera method) and weighed food intake (WFR method). The 24hR-camera method uses digital photographs of all food consumed during a day, taken by the subjects, and a 24-h recall questionnaire conducted by a registered dietitian, who estimates food intake by comparing the participant's photographs with food atlas photographs. The WFR method involves a registered dietitian weighing each food item prepared for the subject to consume and any leftovers. Food intake was calculated for each food group and nutrient using the 24hR-camera vs. weighed methods. RESULTS Correlation coefficients between the estimated vs. weighed food intake were 0.7 or higher in most food groups but were low in food groups, such as oils, fats, condiments, and spices. The estimated intake of vegetables was significantly lower for the 24hR-camera method compared to the WFR method. For other food groups, the percentages of the mean difference between estimated vs. weighed food intake were -22.1% to 5.5%, with no significant differences between the methods (except for algae, which had a very low estimated intake). The correlation coefficients between the two methods were 0.774 for energy, and 0.855, 0.769, and 0.763 for the macronutrients, proteins, lipids, and carbohydrates, respectively, demonstrating high correlation coefficients: greater than 0.75. The correlation coefficients between the estimated vs. weighed for salt equivalents and potassium intake were 0.583 and 0.560, respectively, but no significant differences in intake were observed. CONCLUSIONS The 24hR-camera method satisfactorily estimated the intake of energy and macronutrients (except salt equivalents and potassium) in Japanese males and was confirmed as a useful method for dietary assessment.
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Affiliation(s)
- Yumi Matsushita
- Department of Clinical Research, National Cen, ter for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Tosei Takahashi
- Department of Nutritional and Health Sciences, Faculty of Food and Nutritional Sciences, Toyo University, 1-1-1 Izumino, Itakura-machi, Ora-gun, Gunma, 374-0193, Japan
| | - Kumiko Asahi
- Department of Clinical Nutrition, Faculty of Health and Wellness Sciences, Hiroshima International University, 5-1-1 Hirokoshinkai, , Kure city, Hiroshima, 737-0112, Japan
| | - Emiko Harashima
- Department of Nutrition and Life Science, Faculty of Health and Medical, Sciences, Kanagawa Institute of Technology, 1030 Shimo-ogino, Atsugi-shi, Kanagawa, 243-0292, Japan
| | - Hiroko Takahashi
- The Japanese Society of Nutrition and Dietetics, 3-4-18-904 Mita Minato-ku, Tokyo, 108-0073, Japan
| | - Hiroyuki Tanaka
- Department of Human Nutrition Faculty of Human Nutrition, Tokyo Kasei Gakuin University, 22 Sanbant-cho Chiyoda-ku, Tokyo, 102-8341, Japan
| | - Yoshiko Tsumuraya
- Department of Nutritional Management, Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara-shi, Kanagawa, 252-0383, Japan
| | - Nobuko Sarukura
- Department of Nutrition and Health, Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara-shi, Kanagawa, 252-0383, Japan
| | - Masashi Furuta
- Department of Nutrition, Toho University Omori Medical Center, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Heizo Tanaka
- Professor Emeritus, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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A comparison of the remote food photography method and the automated self-administered 24-h dietary assessment tool for measuring full-day dietary intake among school-age children. Br J Nutr 2021; 127:1269-1278. [PMID: 34085613 DOI: 10.1017/s0007114521001951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The limitations of self-report measures of dietary intake are well-known. Novel, technology-based measures of dietary intake may provide a more accurate, less burdensome alternative to existing tools. The first objective of this study was to compare participant burden for two technology-based measures of dietary intake among school-age children: the Automated-Self-Administered 24-hour Dietary Assessment Tool-2018 (ASA24-2018) and the Remote Food Photography Method (RFPM). The second objective was to compare reported energy intake for each method to the Estimated Energy Requirement for each child, as a benchmark for actual intake. Forty parent-child dyads participated in two, 3-d dietary assessments: a parent proxy-reported version of the ASA24 and the RFPM. A parent survey was subsequently administered to compare satisfaction, ease of use and burden with each method. A linear mixed model examined differences in total daily energy intake between assessments, and between each assessment method and the Estimated Energy Requirement (EER). Reported energy intake was 379 kcal higher with the ASA24 than the RFPM (P = 0·0002). Reported energy intake with the ASA24 was 231 kcal higher than the EER (P = 0·008). Reported energy intake with the RFPM did not differ significantly from the EER (difference in predicted means = -148 kcal, P = 0·09). Median satisfaction and ease of use scores were five out of six for both methods. A higher proportion of parents reported that the ASA24 was more time-consuming than the RFPM (74·4 % v. 25·6 %, P = 0·002). Utilisation of both methods is warranted given their high satisfaction among parents.
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Adams EL, Raynor HA, Thornton LM, Mazzeo SE, Bean MK. Nutrient Intake During School Lunch in Title I Elementary Schools With Universal Free Meals. HEALTH EDUCATION & BEHAVIOR 2021; 49:118-127. [PMID: 34024168 DOI: 10.1177/10901981211011936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The National School Lunch Program (NSLP) provides >30 million meals to children daily; however, the specific nutrient composition of NSLP-selected and consumed meals for students from lower income and racial/ethnic minoritized backgrounds is unknown. AIMS To quantify the nutrients in school lunch selection and consumption among students participating in the NSLP and compare these values to nutrient recommendations. METHOD Students (1st-5th graders; 98.6% from racial/ethnic minoritized backgrounds; 92.5% NSLP participation) from six Title I elementary schools serving universal free meals participated. Digital images of students' lunch meal selection and consumption were obtained (n = 1,102 image pairs). Plate waste analyses quantified portions consumed. Nutrient composition of students' lunch selection and consumption were calculated and compared with the 2010 Healthy Hunger-Free Kids Act and 2009 Institute of Medicine recommendations. RESULTS Most lunches selected (59%-97%) met recommendations for all nutrients except for total calories (23%), vitamin C (46%), and dietary fiber (48%). Based on lunch consumption, most students' lunches met recommendations for sodium (98%), protein (55%), calories from fat (82%), and saturated fat (89%); however, few met recommendations for total calories (5%), calcium (8%), iron (11%), vitamin A (18%), vitamin C (16%), and fiber (7%). DISCUSSION Meals selected met most nutrient recommendations for the majority of children; yet overall consumption patterns reflect suboptimal nutrient intake. CONCLUSION Meals served under the NSLP policy mandates align with recommended nutrient patterns, highlighting the importance of maintaining these standards. Strategies to optimize children's intake of nutrient-rich portions of these meals are needed to optimize policy impact.
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Affiliation(s)
| | | | - Laura M Thornton
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Hasegawa Y, Yoshida M, Sato A, Fujimoto Y, Minematsu T, Sugama J, Sanada H. A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study. BMC Geriatr 2021; 21:182. [PMID: 33722195 PMCID: PMC7962248 DOI: 10.1186/s12877-021-02086-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Methods A prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged ≥65 years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris– Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson’s correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy< 75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy. Results Forty-eight patients were analyzed (mean age 84.4 ± 7.8 years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r = 0.733, p < 0.001). ROC analysis identified a percentage change in temporal muscle thickness of − 3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125–0.635). Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.
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Affiliation(s)
- Yoko Hasegawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Clinical Nutrition Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aoba-ku, Sendai city, Miyagi, 980-8575, Japan
| | - Aya Sato
- Department of Gerontological Nursing, Kawasaki City College of Nursing, 4-30-1 Ogura, Saiwai-ku, Kawasaki city, Kanagawa, 212-0054, Japan
| | - Yumiko Fujimoto
- Department of Gerontological Nursing, School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama city, Wakayama, 641-0011, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa city, Ishikawa, 920-0942, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Wiriyaphanich T, Guinard JX, Spang E, Amsler Challamel G, Valgenti RT, Sinclair D, Lubow S, Putnam-Farr E. Food Choice and Waste in University Dining Commons-A Menus of Change University Research Collaborative Study. Foods 2021; 10:foods10030577. [PMID: 33801876 PMCID: PMC8000212 DOI: 10.3390/foods10030577] [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: 01/30/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022] Open
Abstract
The purpose of this multi-campus research was to investigate the relationships of food type and personal factors with food choice, consumption, and waste behaviors of college students at all-you-care-to-eat dining facilities. The amount of food taken and wasted was indirectly measured in units relative to the plate size using before and after photos taken by the diners themselves. Animal protein and mixed dishes (e.g., stir fry, sandwich) took up more of diners’ plate space and these items were correlated to both greater hedonic appeal as well as a higher likelihood of the item being pre-plated. Greater confidence in liking an item before choosing it was correlated to a larger portion being taken. Finally, increased satisfaction with the meal and frequency of visiting the dining commons was correlated to less food waste. Understanding these potential food choice drivers can help dining facilities better target healthier meals to diners while reducing food waste.
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Affiliation(s)
- Tiffany Wiriyaphanich
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA; (T.W.); (E.S.)
| | - Jean-Xavier Guinard
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA; (T.W.); (E.S.)
- Correspondence:
| | - Edward Spang
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA; (T.W.); (E.S.)
| | | | - Robert T. Valgenti
- Department of Religion and Philosophy, Lebanon Valley College, Annville, PA 17003, USA;
| | - Danielle Sinclair
- Housing Dining & Auxiliary Enterprises—Campus Dining, University of California, Santa Barbara, CA 93106, USA;
| | - Samantha Lubow
- Cal Dining, University of California, Berkeley, CA 94720, USA;
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Gillingham MB, Li Z, Beck RW, Calhoun P, Castle JR, Clements M, Dassau E, Doyle FJ, Gal RL, Jacobs P, Patton SR, Rickels MR, Riddell M, Martin CK. Assessing Mealtime Macronutrient Content: Patient Perceptions Versus Expert Analyses via a Novel Phone App. Diabetes Technol Ther 2021; 23:85-94. [PMID: 32833544 PMCID: PMC7868577 DOI: 10.1089/dia.2020.0357] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: People with type 1 diabetes estimate meal carbohydrate content to accurately dose insulin, yet, protein and fat content of meals also influences postprandial glycemia. We examined accuracy of macronutrient content estimation via a novel phone app. Participant estimates were compared with expert nutrition analyses performed via the Remote Food Photography Method© (RFPM©). Methods: Data were collected through a novel phone app. Participants were asked to take photos of meals/snacks on the day of and day after scheduled exercise, enter carbohydrate estimates, and categorize meals as low, typical, or high protein and fat. Glycemia was measured via continuous glucose monitoring. Results: Participants (n = 48) were 15-68 years (34 ± 14 years); 40% were female. The phone app plus RFPM© analysis captured 88% ± 29% of participants' estimated total energy expenditure. The majority (70%) of both low-protein and low-fat meals were accurately classified. Only 22% of high-protein meals and 17% of high-fat meals were accurately classified. Forty-nine percent of meals with <30 g of carbohydrates were overestimated by an average of 25.7 ± 17.2 g. The majority (64%) of large carbohydrate meals (≥60 g) were underestimated by an average of 53.6 ± 33.8 g. Glycemic response to large carbohydrate meals was similar between participants who underestimated or overestimated carbohydrate content, suggesting that factors beyond carbohydrate counting may impact postprandial glycemic response. Conclusions: Accurate estimation of total macronutrients in meals could be leveraged to improve insulin decision support tools and closed loop insulin delivery systems; development of tools to improve macronutrient estimation skills should be considered.
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Affiliation(s)
- Melanie B. Gillingham
- Oregon Health and Sciences University, Portland, Oregon, USA
- Address correspondence to: Melanie B. Gillingham, PhD, RD, Department of Molecular and Medical Genetics, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode L103, Portland, OR 97239, USA
| | - Zoey Li
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - Roy W. Beck
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - Peter Calhoun
- Jaeb Center for Health Research, Tampa, Florida, USA
| | | | - Mark Clements
- Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Eyal Dassau
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - Francis J. Doyle
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - Robin L. Gal
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - Peter Jacobs
- Oregon Health and Sciences University, Portland, Oregon, USA
| | | | - Michael R. Rickels
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
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Students choosing fat-free chocolate milk during school lunch consume more calories, total sugar, protein, minerals and vitamins at lunch. Public Health Nutr 2021; 24:1818-1827. [PMID: 33441212 DOI: 10.1017/s1368980021000161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To examine how milk consumption varies by milk choice and measure the association of milk choice on the nutritional and energetic content of National School Lunch Program (NSLP) lunches. DESIGN An observational plate waste study using the Digital Photography of Foods Method. SETTING Data were collected from two suburban South Carolina schools in one district during February and March 2013. PARTICIPANTS Totally, 968 NSLP lunches selected by 619 kindergarten to fifth grade students. RESULTS Most students chose chocolate milk (75 %). A multinomial logit model indicated milk choice varied significantly by sociodemographic characteristics. An ordinary least square regression indicated that consumption rates of low-fat white milk were 8·5 % lower than fat-free chocolate milk (P = 0·039) and milk consumption rates varied statistically by sociodemographic characteristics. Ordinary least square regressions found that the consumption of energies and nutrients from NSLP lunches varied with sociodemographic characteristics and milk choice; students selecting chocolate milk consumed 58 more energies (P < 0·001) and 10 more grams of total sugar (P < 0·001) than students selecting low-fat white milk from their NSLP lunches. Students consumed statistically similar energies and nutrients from the non-milk components of their meals. CONCLUSIONS Students selecting chocolate milk consumed more energies and nutrients from their NSLP lunches with the increases in consumption attributed to the milk component of the meal. The findings have implications for recent changes to NSLP guidelines that allow schools to offer both low-fat and fat-free flavoured milk, reversing the previous ban on low-fat flavoured milk under the Healthy, Hunger-Free Kids Act.
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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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[Validation, reproducibility, and reliability of food photographic record for food intake assessment]. NUTR HOSP 2021; 38:790-796. [PMID: 34008995 DOI: 10.20960/nh.03502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: food intake records are a useful resource for diet assessment, as well as for self-evaluation, self-control, and self-motivation to change an eating behavior. New technologies based on mobile phones permit a different way of recording food intake. Objective: to validate and assess food photographic record (FPR) as a useful instrument in professional practice for assessing food intake. Methodology: forty nutrition professionals participated. In a first stage, food variables obtained through FPR were analyzed and correlated with data from the frequency of food consumption questionnaire (FFQ) and a 24-hour recall (24HR). In a second stage, FPR was applied again to evaluate temporal stability (FPR 1 versus FPR 2). Wilcoxon's test and Spearman's correlation test were applied. Results: a moderate and significant positive association was found for total caloric intake (TCI) and total fat between FPR and 24HR (r = 0.68, p = 0.0008, and r = 0.52, p = 0.01, respectively). In addition, a positive and moderate association was found for TCI, proteins and fats between FPR 1 and FPR 2 (r = 0.61, p = 0.0004; r = 0.60, p = 0.0005; r = 0.64, p = 0.0002, respectively). Conclusion: FPR is a valid method for professional practice to estimate dietary intake, with greater consistency with 24HR data than FFQ, and presents temporal stability for TCI, protein and fat recordings. In addition, FPR may facilitate the adoption of positive eating habits such as more conscious intakes, among other benefits.
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Adams EL, Raynor HA, Thornton LM, Mazzeo SE, Bean MK. Using digital imagery to quantify students' added sugar intake at lunch in Title I schools with universal free meals. Prev Med Rep 2020; 20:101253. [PMID: 33318885 PMCID: PMC7723792 DOI: 10.1016/j.pmedr.2020.101253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/09/2020] [Accepted: 11/08/2020] [Indexed: 11/16/2022] Open
Abstract
School meals are a major source of dietary intake for low-income students at high obesity risk. Associations between added sugar and obesity are well known, and the National School Lunch Program prohibits added sugar in fruit and juice; yet, no added sugar limits exist for other meal components. This study measured students' added sugar selection and consumption in school lunches and compared % of daily calories consumed from added sugar to the Dietary Guidelines for Americans (DGA) recommendations. In October 2016, this cross-sectional study was conducted in six Virginia Title I elementary schools (>90% racial/ethnic minorities; 100% free meals). Digital imagery plate waste methods assessed lunch consumption in N = 1155, 1st-5th graders. Added sugar (g, %kcal) in foods and beverages selected and consumed were quantified, and kcal of added sugar consumed was compared to DGA recommendations. Students consumed an average 6.6 g of added sugar from foods (grade differences; q = 0.0012), and 3.6 g of added sugar from beverages. Added sugar comprised ~10% of school lunch calories consumed from foods and ~35% of school lunch calories consumed from beverages. Added sugar in the total school lunch meal comprised ~2.5% of student's recommended daily calorie needs; thus, ~7.5% of daily calories from added sugar remained before students would have exceeded the DGA. Total added sugar consumption was within daily DGA recommendations. Findings contribute to previous reports that school-provided lunches are low in added sugar. Future research should examine added sugar consumed in school breakfast and lunch separately and combined.
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Affiliation(s)
- Elizabeth L. Adams
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, 2303 N. Parham Rd, Suite 1, Richmond, VA 23229, United States
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, 1215 W. Cumberland Ave., Knoxville, TN 37996, United States
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27599, United States
| | - Suzanne E. Mazzeo
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St., Richmond, VA, United States
| | - Melanie K. Bean
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, 2303 N. Parham Rd, Suite 1, Richmond, VA 23229, United States
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Assessment of Dietary Intake Using Food Photography and Video Recording in Free-Living Young Adults: A Comparative Study. J Acad Nutr Diet 2020; 121:749-761.e1. [PMID: 33187931 PMCID: PMC7975321 DOI: 10.1016/j.jand.2020.09.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/09/2020] [Accepted: 09/25/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Conventional methods of dietary assessment are prone to recall bias and place burden on participants. OBJECTIVE Our aim was to compare the performance of image-based dietary assessment (IBDA), including food photography (FP) and video recording (VR), with the criterion of weighed food records (WFR). DESIGN In this comparative study, participants captured meals using FP and VR before and after consumption, over 2 days. Food type and portion size were assessed using the images and videos. Energy and nutrient intakes (mean of 2 days) were compared against WFR. PARTICIPANTS/SETTINGS Eighty-four healthy adults (mean [standard deviation] age = 29 [8] years), recruited through advertisement in Glasgow, UK, between January and August 2016 were enrolled in the study. Eighty participants (95%) (mean [standard deviation] age = 28 [7] years) completed the study and were included in the analysis. MAIN OUTCOME MEASURES Agreement in estimated energy and nutrient intake between WFR and IBDA. The IBDA method feasibility was evaluated using a questionnaire. Inter-rater and intra-rater reliability were assessed. STATISTICAL ANALYSIS PERFORMED The performance of the IBDA methods against WFR and their inter and intra-rater reliability were tested with Bland-Altman plots and Spearman correlations. Intra-class agreement between methods was assessed using κ statistics. RESULTS Inter-rater reliability was strong for both IBDA methods in estimating energy intake (ρ-coefficients: FP = 0.80; VR = 0.81). There was no difference in the agreement between the 2 assessors. Intra-rater reliability was high. FP and VR underestimated energy intake by a mean (95% agreement limits) of -13.3% (-56.4% and 29.7%) and -4.5% (-45.5% and 36.4%), respectively. IBDA demonstrated moderate-to-strong correlations in nutrient intake ranking, median ρ-coefficients for all nutrients: FP = 0.73 (interquartile range, 0.09) and VR = 0.82 (interquartile range, 0.02). Inter-class agreement of IBDA methods was moderate compared with the WFR in energy intake estimation. IBDA was more practical and enjoyable than WFR. CONCLUSIONS IBDA and VR in particular demonstrated a moderate-to-strong ability to rank participants' dietary intake, and considerable group and inter-class agreement compared with the WFR. However, IBDA was found to be unsuitable for assessment in individuals.
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Höchsmann C, Martin CK. Review of the validity and feasibility of image-assisted methods for dietary assessment. Int J Obes (Lond) 2020; 44:2358-2371. [PMID: 33033394 DOI: 10.1038/s41366-020-00693-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/02/2020] [Accepted: 09/26/2020] [Indexed: 11/09/2022]
Abstract
Accurately quantifying dietary intake is essential to understanding the effect of diet on health and evaluating the efficacy of dietary interventions. Self-report methods (e.g., food records) are frequently utilized despite evident inaccuracy of these methods at assessing energy and nutrient intake. Methods that assess food intake via images of foods have overcome many of the limitations of traditional self-report. In cafeteria settings, digital photography has proven to be unobtrusive and accurate and is the method of choice for assessing food provision, plate waste, and food intake. In free-living conditions, image capture of food selection and plate waste via the user's smartphone, is promising and can produce accurate energy intake estimates, though accuracy is not guaranteed. These methods foster (near) real-time transfer of data and eliminate the need for portion size estimation by the user since the food images are analyzed by trained raters. A limitation that remains, similar to self-report methods where participants must truthfully record all consumed foods, is intentional and/or unintentional underreporting of foods due to social desirability or forgetfulness. Methods that rely on passive image capture via wearable cameras are promising and aim to reduce user burden; however, only pilot data with limited validity are currently available and these methods remain obtrusive and cumbersome. To reduce analysis-related staff burden and to allow real-time feedback to the user, recent approaches have aimed to automate the analysis of food images. The technology to support automatic food recognition and portion size estimation is, however, still in its infancy and fully automated food intake assessment with acceptable precision not yet a reality. This review further evaluates the benefits and challenges of current image-assisted methods of food intake assessment and concludes that less burdensome methods are less accurate and that no current method is adequate in all settings.
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Affiliation(s)
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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40
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Qualitative Research Study of the Calorie Count Process in Hospitalized Pediatric Patients and Identification of Opportunities for Quality Improvement. TOP CLIN NUTR 2020. [DOI: 10.1097/tin.0000000000000222] [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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Saeki K, Otaki N, Kitagawa M, Tone N, Takachi R, Ishizuka R, Kurumatani N, Obayashi K. Development and validation of nutrient estimates based on a food-photographic record in Japan. Nutr J 2020; 19:104. [PMID: 32948201 PMCID: PMC7501716 DOI: 10.1186/s12937-020-00615-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 08/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Previous studies have reported that estimates of portion size, energy, and macronutrients such as carbohydrates, proteins, and fat based on the food-photographic record closely correlate with directly weighed values. However, the correlation based on a large sample of the test meal with the evidence of many nutrients is yet to be determined. We conducted this study to assess the correlation and difference between the food-photographic record and weighed results for 44 nutrients based on a larger number of test meals than those in previous studies. Methods We assessed the nutrients of test meals using a food-photographic record and direct weighing and compared the results of the two methods. Twenty participants prepared a total of 1163 test meals. Each participant cooked 28–29 different kinds of dishes. Five participants cooked the same dish with their own recipes. For the most commonly consumed 41 dishes, 20 participants served a meal with their usual portion size. For the remaining 73 dishes, five participants served a meal with their usual portion size. An independent researcher weighed each ingredient and calculated the nutrients of the test meals. The participants took photographs of the test meals using a digital camera. Two independent, trained analysts measured the longitudinal and transverse diameters of the food area on the photographs of the test meals, compared the portion size with the reference photographs, and calculated the nutrients based on a database that contained reference photographs. Results Rank correlation coefficients between estimates from the food-photographic record of each test meal and weighed results were high for portion size (r = 0.93), energy (r = 0.93), protein (r = 0.90), fat (r = 0.92), and carbohydrate (r = 0.94), and those for the 44 nutrients ranged from 0.78 to 0.94. We found high reproducibility between the two analysts for all the nutrients (r > 0.90). Conclusions We found a high correlation and small difference between the food-photographic record method and weighed results of a large number of nutrients in many test meals.
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Affiliation(s)
- Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.
| | - Naoto Otaki
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Hyogo, Japan
| | - Maiko Kitagawa
- Otemae College of Nutrition, Osaka, Japan.,Oura clinic, Nara, Japan
| | - Nobuhiro Tone
- Center for Academic Industrial and Governmental Relations, Nara Medical University School of Medicine, Nara, Japan
| | - Ribeka Takachi
- Takatori corporation, Nara, Japan.,Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Rika Ishizuka
- Department of Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan.,Department of Food and Nutrition Faculty of Contemporary Human Life Science, Tezukayama University, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
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Roe BE, Qi D, Apolzan JW, Martin CK. Selection, intake, and plate waste patterns of leftover food items among U.S. consumers: A pilot study. PLoS One 2020; 15:e0238050. [PMID: 32903260 PMCID: PMC7480863 DOI: 10.1371/journal.pone.0238050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 08/08/2020] [Indexed: 11/18/2022] Open
Abstract
Many campaigns promote the preservation and consumption of leftover food items as a critical household strategy to accomplish national consumer food waste reduction goals. We fill a gap in knowledge about the consumption and creation of leftovers in the United States by analyzing data from a pilot study in which 18 subjects tracked food selection, intake, and plate waste across all eating occasions for about one week. Subjects noted which items selected for consumption were leftovers, i.e., previously prepared but uneaten items that were stored for future consumption, and which unfinished items were saved to become leftovers. We found that 12% of items selected for consumption were leftovers while 24% of selected items that were not fully consumed were kept to become a leftover. Leftovers were most frequently vegetables, cheeses, and meats, and most frequently selected on Mondays and for lunch. Regression analyses isolate significant dining patterns with respect to leftovers, including evidence that leftovers were less likely to be fully consumed than non-leftover items, and that larger meals led to more uneaten food. This suggests that strategies to reduce meal size may be most effective in reducing food waste by limiting the creation of leftovers in the first place. Strategies to make leftovers more attractive and appealing may also reduce food waste.
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Affiliation(s)
- Brian E. Roe
- Department of Agricultural, Environmental and Development Economics, Ohio State University, Columbus, OH, United States of America
| | - Danyi Qi
- Department of Agricultural Economics and Agribusiness, Louisiana State University, Baton Rouge, LA, United States of America
| | - John W. Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA United States of America
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA United States of America
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Ji Y, Plourde H, Bouzo V, Kilgour RD, Cohen TR. Validity and Usability of a Smartphone Image-Based Dietary Assessment App Compared to 3-Day Food Diaries in Assessing Dietary Intake Among Canadian Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16953. [PMID: 32902389 PMCID: PMC7511869 DOI: 10.2196/16953] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/06/2020] [Accepted: 06/13/2020] [Indexed: 01/19/2023] Open
Abstract
Background Accurate dietary assessment is needed in studies that include analysis of nutritional intake. Image-based dietary assessment apps have gained in popularity for assessing diet, which may ease researcher and participant burden compared to traditional pen-to-paper methods. However, few studies report the validity of these apps for use in research. Keenoa is a smartphone image-based dietary assessment app that recognizes and identifies food items using artificial intelligence and permits real-time editing of food journals. Objective This study aimed to assess the relative validity of an image-based dietary assessment app — Keenoa — against a 3-day food diary (3DFD) and to test its usability in a sample of healthy Canadian adults. Methods We recruited 102 participants to complete two 3-day food records. For 2 weeks, on 2 non-consecutive days and 1 weekend day, in random order, participants completed a traditional pen-to-paper 3DFD and the Keenoa app. At the end of the study, participants completed the System Usability Scale. The nutrient analyses of the 3DFD and Keenoa data before (Keenoa-participant) and after they were reviewed by dietitians (Keenoa-dietitian) were analyzed using analysis of variance. Multiple tests, including the Pearson coefficient, cross-classification, kappa score, % difference, paired t test, and Bland-Altman test, were performed to analyze the validity of Keenoa (Keenoa-dietitian). Results The study was completed by 72 subjects. Most variables were significantly different between Keenoa-participant and Keenoa-dietitian (P<.05) except for energy, protein, carbohydrates, fiber, vitamin B1, vitamin B12, vitamin C, vitamin D, and potassium. Significant differences in total energy, protein, carbohydrates, % fat, saturated fatty acids, iron, and potassium were found between the 3DFD and Keenoa-dietitian data (P<.05). The Pearson correlation coefficients between the Keenoa-dietitian and 3DFD ranged from .04 to .51. Differences between the mean intakes assessed by the 3DFD and Keenoa-dietitian were within 10% except for vitamin D (misclassification rate=33.8%). The majority of nutrients were within an acceptable range of agreement in the Bland-Altman analysis; no agreements were seen for total energy, protein, carbohydrates, fat (%), saturated fatty acids, iron, potassium, and sodium (P<.05). According to the System Usability Scale, 34.2% of the participants preferred using Keenoa, while 9.6% preferred the 3DFD. Conclusions The Keenoa app provides acceptable relative validity for some nutrients compared to the 3DFD. However, the average intake of some nutrients, including energy, protein, carbohydrates, % fat, saturated fatty acids, and iron, differed from the average obtained using the 3DFD. These findings highlight the importance of verifying data entries of participants before proceeding with nutrient analysis. Overall, Keenoa showed better validity at the group level than the individual level, suggesting it can be used when focusing on the dietary intake of the general population. Further research is recommended with larger sample sizes and objective dietary assessment approaches.
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Affiliation(s)
- Yuwei Ji
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Hugues Plourde
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Valerie Bouzo
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Robert D Kilgour
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada.,PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Tamara R Cohen
- PERFORM Centre, Concordia University, Montreal, QC, Canada.,Faculty of Land and Food Systems, Food, Nutrition and Health, University of British Columbia, Vancouver, BC, Canada
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Roe BE, Qi D, Beyl RA, Neubig KE, Martin CK, Apolzan JW. The Validity, Time Burden, and User Satisfaction of the FoodImage™ Smartphone App for Food Waste Measurement Versus Diaries: A Randomized Crossover Trial. RESOURCES, CONSERVATION, AND RECYCLING 2020; 160:104858. [PMID: 32773964 PMCID: PMC7409719 DOI: 10.1016/j.resconrec.2020.104858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The FoodImage™ smartphone app transmits to researchers users' photographs of food selection and food waste, and includes user-tagged information about waste reasons and destination. Twenty-four participants were trained to record food waste using FoodImage, food waste diaries requiring visual estimation of waste quantities, and diaries requiring scale weights. Participants used each method during three staged food-waste scenarios (food preparation, eating, and clean-out) in a randomized crossover trial. Two participants had extreme values for the weighed diary method; therefore, accuracy results are reported with and without these two participants' data. Error was calculated as waste estimated with the experimental method minus directly weighed waste. Mean absolute error from FoodImage was significantly smaller than or equal to the error from both diary methods in each scenario. Furthermore, the mean values from FoodImage were equivalent to directly weighed values in two out of the three tasks; while weighed diaries were equivalent in two tasks only when the two participants with extreme values were removed. Visually estimated diaries were equivalent for only one task. All 24 participants preferred FoodImage to diaries and all rated FoodImage as less time consuming. Over one week, FoodImage would require ~24 fewer minutes of users' time to record all data. Unlike food waste diaries, FoodImage also transmits data to researchers in real-time and provides detailed data on food selection and intake. ClinicalTrials.gov Identifier: NCT03309306.
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Affiliation(s)
- Brian E. Roe
- Department of Agricultural, Environmental and Development Economics, Ohio State Univesity, 2120 Fyffe Road, Columbus, OH 43210 USA
- Corresponding Author: Department of Agricultural, Environmental and Development Economics, Ohio State University, 2120 Fyffe Road, Columbus, OH 43210 USA ()
| | - Danyi Qi
- Department of Agricultural Economics and Agribusiness, Louisiana State University, Martin D. Woodin Hall, Baton Rouge, LA 70802 USA
| | - Robbie A. Beyl
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808 USA
| | - Karissa E. Neubig
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808 USA
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808 USA
| | - John W. Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808 USA
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Improvement in Healthy Meal Index, Lunch Quality, and Diversity Scores Following an Integrated Nutritional Intervention in a Communal Dining Room: The NEKST Study. Nutrients 2020; 12:nu12061741. [PMID: 32532098 PMCID: PMC7353002 DOI: 10.3390/nu12061741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 01/09/2023] Open
Abstract
The objective of the NEKST (Nutrition Environmental Kibbutzim Study), a nonrandomized interventional study, was to evaluate the effect of an integrated intervention program on participants’ lunch quality and diversity in two communal dining rooms (intervention n = 58 vs. control n = 54). The intervention included recipe modification, environmental changes, and an education program. The outcomes included simple healthy meal index (SHMI), lunch quality (LQS), and diversity scores (LDS) calculated based on photographs of lunch trays. A nutrition questionnaire assessed the changes in fruit and vegetable intake at baseline and 3 months following the intervention. The mean SHMI, LQS, and LDS increased in the intervention group (0.51, p < 0.001; 0.27, p = 0.045; 0.95, p < 0.001, respectively) but not in the control group (p = 0.865; p = 0.339; p = 0.354, respectively). Multivariable linear models demonstrate an increase in the SHMI (β = 0.26, 95% CI [0.12–0.76], p = 0.015), LQS (β = 0.23, 95% CI [0.06–0.83], p = 0.024), and LDS (β = 0.34, 95% CI [0.41–1.39], p < 0.001) of the participants in the intervention group. More participants in the intervention group raised their daily fruit intake compared with the control. We conclude that this integrated intervention program was effective in improving lunch healthy meal index, quality, and diversity in a communal dining room, with a modest halo effect of the intervention throughout the day.
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Everitt T, Engler-Stringer R, Martin W, Vatanparast H. Comparing Diet Quality of School Meals versus Food Brought from Home. CAN J DIET PRACT RES 2020; 81:179-185. [PMID: 32495636 DOI: 10.3148/cjdpr-2020-013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Consuming nutritious food is essential to learning. The purpose of this research was to determine the diet quality of elementary school lunches, both those in meal programs and those bringing food from home, in urban and rural locations in Saskatchewan.Methods: Using a School Food Checklist and digital photography we compared food group servings and diet quality in 3 school types: urban schools with a meal program and urban and rural schools without a meal program. The total sample was 773 students.Results: Only 55% of students brought the minimum number of servings for grain products and meat and alternatives, with fewer bringing the minimum for vegetables and fruit (25.6%-34.9%), whole grains (24.1%), and milk and alternatives (14.1%). Students bringing food from home had significantly more calories in their lunches from minimally nutritious foods. Students in meal programs had the highest diet quality scores using the Healthy Eating Index adapted for school hours.Conclusions: The diet quality of elementary students' lunches needs improvement, although students in meal programs have healthier diets. Interventions targeting what children eat at school should focus on increasing the number of students meeting recommendations for healthy foods while decreasing minimally nutritious foods brought to school.
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Affiliation(s)
- Tracy Everitt
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
| | - Rachel Engler-Stringer
- Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK
| | - Wanda Martin
- College of Nursing, University of Saskatchewan, Saskatoon, SK
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Al-Ozairi E, AlAwadhi MM, Al Kandari J, Taghadom E, Abdullah M, Le Roux CW. Photo-Assisted Dietary Method Improves Estimates of Dietary Intake Among People with Sleeve Gastrectomy. Obes Surg 2020; 29:1602-1606. [PMID: 30756296 DOI: 10.1007/s11695-019-03736-4] [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: 12/22/2022]
Abstract
INTRODUCTION Bariatric operations are effective obesity treatments because of the significant reductions in food intake after surgery, but weight regain remains a problem in a small group of patients after surgery. Estimating food intake is difficult due to dieting status, weight, gender, and challenges with estimating portion size. We aimed to evaluate the use of digital food photography in comparison to conventional methods among patients after sleeve gastrectomy. METHODS Participants used a mobile device (mHealth) to photo-document their dietary intake of all food and beverages consumed before and after eating. They also completed a 24 h food recall interview with a dietician. RESULTS Data from 383 eating occasions were analyzed. Food intake using 24 h recall was reported as 972.5 ± 77 kcal and estimates from photographs were 802.9 ± 63.4 kcal, with a difference of 169.6 ± 451.4 kcal (95% confidence interval (CI) of 41.4 to 297.9 kcal, p = 0.005). There was no difference for protein intake, but carbohydrate intake reported during the 24 h recall was 541.2 ± 298 kcal and estimates from photographs were 395.2 ± 219.6 kcal, with a difference of 145.8 ± 256.3 kcal (95% CI of 73.2 to 218.8 kcal, p = 0.0001). CONCLUSION After sleeve gastrectomy, patients reported eating more total calories and calories from carbohydrates compared to estimations using photographs. The implication for patients are that tools such as mHealth might be useful to optimize food intake and calories after sleeve gastrectomy, especially for those patients that may struggle with weight regain after surgery.
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Affiliation(s)
- Ebaa Al-Ozairi
- Dasman Diabetes Institute, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Kuwait City, Kuwait. .,Faculty of Medicine, Department of Medicine, Kuwait University, Jabriya, Kuwait.
| | - Manar M AlAwadhi
- Faculty of Public Health, Department of Public Health Practice, Kuwait University, Jabriya, Kuwait
| | - Jumana Al Kandari
- Dasman Diabetes Institute, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Kuwait City, Kuwait.,Ministry of Health Kuwait, Kuwait City, Kuwait
| | - Etab Taghadom
- Dasman Diabetes Institute, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Kuwait City, Kuwait.,Ministry of Health Kuwait, Kuwait City, Kuwait
| | | | - Carel W Le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
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Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children's Eating Traits. Nutrients 2019; 11:nu11123020. [PMID: 31835571 PMCID: PMC6950396 DOI: 10.3390/nu11123020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child′s energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver′s own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver′s own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child′s age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children.
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Bekelman TA, Bellows LL, McCloskey ML, Martin CK, Johnson SL. Assessing dinner meals offered at home among preschoolers from low-income families with the Remote Food Photography Method. Pediatr Obes 2019; 14:e12558. [PMID: 31347302 PMCID: PMC6991120 DOI: 10.1111/ijpo.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/18/2019] [Accepted: 05/29/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND The high prevalence of obesity among preschoolers may be partially explained by the type and quantity of foods offered by parents and left unconsumed by preschoolers. OBJECTIVES (a) To compare foods offered and consumed at dinner to the Dietary Guidelines for Americans (DGAs) and the Child and Adult Care Food Program (CACFP) standards and (b) to examine the types, quantities, and nutrient composition of foods offered to and consumed by preschoolers and their plate waste. METHODS Participants were recruited from six Head Start/preschool centres. The Remote Food Photography Method was used to document dinner meals over 1 week (n = 153 meals). Energy and nutrients for foods offered, consumed, and plate waste were calculated. Foods offered and consumed were compared with the DGAs and CACFP standards. RESULTS Foods and beverages offered at dinner equaled 506 kcal, which is 36% of the DGA-recommended total daily energy intake. Meals offered and consumed were high in fat and sodium and low in fibre. Adherence to CACFP standards was low for fruits (25%) and milk (2%) and moderate for vegetables (63%). Mean plate waste (29%) was similar across food types. CONCLUSIONS Opportunities exist to improve preschoolers' adherence to the DGAs and CACFP standards by enhancing the quality of dinner meals offered to them.
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Affiliation(s)
- Traci A. Bekelman
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Laura L. Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Morgan L. McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Corby K. Martin
- Pennington Biomedical Research Center, Ingestive Behavior, Weight Management & Health Promotion Laboratory, Baton Rouge, Louisiana
| | - Susan L. Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Wang JS, Hsieh RH, Tung YT, Chen YH, Yang C, Chen YC. Evaluation of a Technological Image-Based Dietary Assessment Tool for Children during Pubertal Growth: A Pilot Study. Nutrients 2019; 11:nu11102527. [PMID: 31635141 PMCID: PMC6835909 DOI: 10.3390/nu11102527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 12/19/2022] Open
Abstract
We designed an image-based dietary assessment tool called COFIT, which means “fit together” and pilot-tested it in the Taipei Puberty Longitudinal Study (TPLS). Children aged 6–17 years were invited to use COFIT over three days for recording all instances of eating in addition to maintaining written food records (FR). Spearman’s correlation and Bland–Altman analysis were used to compare the intake of macronutrients and micronutrients estimated using the image-based dietary assessment and the FR method. Intra-class correlation coefficients were used to estimate reliability between dietitians. In the final analysis, 23 children (mean age: 10.47 ± 0.47 years) with complete data obtained using two dietary assessment methods were included. Reliability among dietitians was high. Most assessments of macronutrients and micronutrients revealed moderate correlations between the two methods (range: 0.27–0.94); moreover, no significant differences in nutrients assessments were observed between the two methods, except for energy and fat. The average difference in energy intake between the methods was 194 kcal/day. Most limits of agreement were within an acceptable range. The Bland–Altman plots showed robust agreement with minimum bias. The limitation was the small sample size and not dividing the population into children and teenagers since the two groups may have different food consumption habits. Overall, the results showed that the image-based assessment tool is suitable for assessing children’s dietary intake of macronutrients and micronutrients during pubertal growth.
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Affiliation(s)
- Jiao-Syuan Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
| | - Rong-Hong Hsieh
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
| | - Yu-Tang Tung
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
| | - Yue-Hwa Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
| | - Chen Yang
- Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei 110, Taiwan.
| | - Yang Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
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