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Maugeri A, Magnano San Lio R, Favara G, La Rosa MC, La Mastra C, Riela PM, Guarnera L, Battiato S, Barchitta M, Agodi A. Impact of Eating Context on Dietary Choices of College Students: Evidence from the HEALTHY-UNICT Project. Nutrients 2022; 14:nu14204418. [PMID: 36297101 PMCID: PMC9609717 DOI: 10.3390/nu14204418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022] Open
Abstract
While personal characteristics have been evaluated as determinants of dietary choices over the years, only recently studies have looked at the impact of eating context. Examining eating context, however, can be challenging. Here, we propose the use of a web-app for the Ecological Momentary Assessment of dietary habits among 138 college students from Catania (Italy) and therefore for examining the impact of eating context on dietary choices. Eating away from home was associated with lower odds of consuming vegetables, fruits, and legumes and higher odds of consuming processed meat, salty snacks, and alcoholic drinks compared with eating at home. Eating in the company of other people was associated with higher odds of consuming vegetables, red meat, fish, legumes, milk, and sugar-sweetened beverages and lower odds of consuming nuts than eating alone. This study proposed a new way to capture and assess how eating environment might affect dietary habits. Based on our results, meal location and social context have significant effects on the dietary choices of college students, pointing to the need to incorporate these aspects into further epidemiological studies.
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Affiliation(s)
- Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - Roberta Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - Giuliana Favara
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - Maria Clara La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - Claudia La Mastra
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy
| | - Luca Guarnera
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy
| | - Sebastiano Battiato
- Department of Mathematics and Informatics, University of Catania, 95123 Catania, Italy
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
- Correspondence:
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
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Potter T, Vieira R, de Roos B. Perspective: Application of N-of-1 Methods in Personalized Nutrition Research. Adv Nutr 2021; 12:579-589. [PMID: 33460438 PMCID: PMC8166550 DOI: 10.1093/advances/nmaa173] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/20/2020] [Accepted: 12/11/2020] [Indexed: 01/19/2023] Open
Abstract
Personalized and precision nutrition aim to examine and improve health on an individual level, and this requires reconsideration of traditional dietary interventions or behavioral study designs. The limited frequency of measurements in group-level human nutrition trials cannot be used to infer individual responses to interventions, while in behavioral studies, retrospective data collection does not provide an accurate measure of how everyday behaviors affect individual health. This review introduces the concept of N-of-1 study designs, which involve the repeated measurement of a health outcome or behavior on an individual level. Observational designs can be used to monitor a participant's usual health or behavior in a naturalistic setting, with repeated measurements conducted in real time using an Ecological Momentary Assessment. Interventional designs can introduce a dietary or behavioral intervention with predictors and outcomes of interest measured repeatedly either during or after 1 or more intervention and control periods. Due to their flexibility, N-of-1 designs can be applied to both short-term physiological studies and longer-term studies of eating behaviors. As a growing number of disease markers can be measured outside of the clinic, with self-reported data delivered via electronic devices, it is now easier than ever to generate large amounts of data on an individual level. Statistical techniques can be utilized to analyze changes in an individual or to aggregate data from sets of N-of-1 trials, enabling hypotheses to be tested on a small number of heterogeneous individuals. Although their designs necessitate extra methodological and statistical considerations, N-of-1 studies could be used to investigate complex research questions and to study underrepresented groups. This may help to reveal novel associations between participant characteristics and health outcomes, with repeated measures providing power and precision to accurately determine an individual's health status.
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Affiliation(s)
- Tilly Potter
- Rowett Institute, University of Aberdeen, United Kingdom
| | - Rute Vieira
- Institute of Applied Health Sciences, University of Aberdeen, United Kingdom
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Maugeri A, Barchitta M. A Systematic Review of Ecological Momentary Assessment of Diet: Implications and Perspectives for Nutritional Epidemiology. Nutrients 2019; 11:nu11112696. [PMID: 31703374 PMCID: PMC6893429 DOI: 10.3390/nu11112696] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/18/2022] Open
Abstract
The ecological momentary assessment (EMA) of eating behaviors represents an innovative, detailed and valid approach to capture the complexity of food intake and to overcome limitations of traditional dietary assessment methods. Moreover, EMA studies might generate a large variety of data (e.g., dietary, behavioral, physical, sociopsychological, and contextual information), thereby enabling to examine concurrent exposures and events. Due to the increasing number of studies in this field of research, here we systematically reviewed EMA methods for the assessment of dietary intake in epidemiological studies, and discussed implications and perspectives for future research. Our study summarized several protocols and platforms that may be applied to assess diet in terms of eating frequency, choices, and habits. Nearly 38% of studies used an event-contingent strategy by asking participants to report foods and beverages consumed in real-time at each eating occasion. Instead, approximately 55% of studies used a signal-contingent prompting approach that notified the participants to record their dietary consumption. The remaining studies used a combination of event- and signal-contingent protocols to compare their accuracy or to improve the assessment of dietary data. Although both approaches might improve the accuracy and ecological validity of dietary assessment—also reducing the burden for participants—some limitations should nevertheless be considered. Despite these limitations, our systematic review pointed out that EMA can be applied in various fields of nutritional epidemiology, from the identification of determinants of dietary habits in healthy people to the management of patients with eating or metabolic disorders. However, more efforts should be encouraged to improve the validity and the reliability of EMA and to provide further technological innovations for public health research and interventions.
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Allan J, McMinn D, Powell D. Tracking snacking in real time: Time to look at individualised patterns of behaviour. Nutr Health 2019; 25:179-184. [PMID: 31347450 DOI: 10.1177/0260106019866099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Identifying when and where people overeat is important for intervention design, yet little is known about how unhealthy behaviours unfold in real life. AIM To track the activities, social contexts and locations that co-occur with unhealthy snacking. METHODS Sixty-four adults (49F, mean age = 38.6 years) used electronic diaries to record snacking, location, social context and current activity every waking hour over 7 days. The proportion of snacking episodes that co-occurred with each location/activity/context was calculated by group and individual. RESULTS Over the group, snacking was most frequent whilst socialising (19.9% of hours spent socialising) or using the TV/computer (19.7%), when with friends (16.7%) and when at home (15.3%). All intra-class correlation statistics for cued behaviour were low, indicating the importance of within-person variability. There were marked individual differences between people in what constituted a 'typical' context for snacking. CONCLUSIONS People show substantial differences in the contexts in which they snack. Tailoring interventions to these individual patterns of behaviour may improve intervention efficacy.
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Affiliation(s)
- Julia Allan
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK
| | - David McMinn
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK
- Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK
| | - Daniel Powell
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK
- Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK
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Schembre SM, Liao Y, O'Connor SG, Hingle MD, Shen SE, Hamoy KG, Huh J, Dunton GF, Weiss R, Thomson CA, Boushey CJ. Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review. JMIR Mhealth Uhealth 2018; 6:e11170. [PMID: 30459148 PMCID: PMC6280032 DOI: 10.2196/11170] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/03/2018] [Accepted: 10/10/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND New methods for assessing diet in research are being developed to address the limitations of traditional dietary assessment methods. Mobile device-assisted ecological momentary diet assessment (mEMDA) is a new dietary assessment method that has not yet been optimized and has the potential to minimize recall biases and participant burden while maximizing ecological validity. There have been limited efforts to characterize the use of mEMDA in behavioral research settings. OBJECTIVE The aims of this study were to summarize mEMDA protocols used in research to date, to characterize key aspects of these assessment approaches, and to discuss the advantages and disadvantages of mEMDA compared with the traditional dietary assessment methods as well as implications for future mEMDA research. METHODS Studies that used mobile devices and described mEMDA protocols to assess dietary intake were included. Data were extracted according to Preferred Reporting of Systematic Reviews and Meta-Analyses and Cochrane guidelines and then synthesized narratively. RESULTS The review included 20 studies with unique mEMDA protocols. Of these, 50% (10/20) used participant-initiated reports of intake at eating events (event-contingent mEMDA), and 50% (10/20) used researcher-initiated prompts requesting that participants report recent dietary intake (signal-contingent mEMDA). A majority of the study protocols (60%, 12/20) enabled participants to use mobile phones to report dietary data. Event-contingent mEMDA protocols most commonly assessed diet in real time, used dietary records for data collection (60%, 6/10), and provided estimates of energy and nutrient intake (60%, 6/10). All signal-contingent mEMDA protocols used a near real-time recall approach with unannounced (ie, random) abbreviated diet surveys. Most signal-contingent protocols (70%, 7/10) assessed the frequency with which (targeted) foods or food groups were consumed. Relatively few (30%, 6/20) studies compared mEMDA with the traditional dietary assessment methods. CONCLUSIONS This review demonstrates that mEMDA has the potential to reduce participant burden and recall bias, thus advancing the field beyond current dietary assessment methods while maximizing ecological validity.
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Affiliation(s)
- Susan M Schembre
- Department of Behavioral Science, Division of Cancer Control and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, United States
| | - Yue Liao
- Department of Behavioral Science, Division of Cancer Control and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sydney G O'Connor
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Shu-En Shen
- Department of Kinesiology, Wiess School of Natural Sciences, Rice University, Houston, TX, United States
| | - Katarina G Hamoy
- Department of Health and Human Performance, College of Liberal Arts and Social Sciences, University of Houston, Houston, TX, United States
| | - Jimi Huh
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Genevieve F Dunton
- Institute for Health Promotion & Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Rick Weiss
- Viocare, Inc, Princeton, NJ, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
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