A novel online Food Recall Checklist for use in an undergraduate student population: a comparison with diet diaries

Body mass index and nutritional intake following Elexacaftor/Tezacaftor/Ivacaftor modulator therapy in adults with cystic fibrosis

BACKGROUND

Elexacaftor/Tezacaftor/Ivacaftor (ETI) modulator therapy is often associated with increased body mass index (BMI) in people with cystic fibrosis (CF). This is thought to reflect improved clinical stability and increased appetite and nutritional intake. We explored the change in BMI and nutritional intake following ETI modulator therapy in adults with CF.

METHODS

Dietary intake, measured with myfood24®, and BMI were collected from adults with CF at baseline and follow-up as part of an observational study. Changes in BMI and nutritional intake in participants who commenced ETI therapy between time points were assessed. To contextualize findings, we also assessed changes in BMI and nutritional intake between study points in a group on no modulators.

RESULTS

In the pre and post ETI threapy group (n = 40), BMI significantly increased from 23.0 kg/m2 (IQR 21.4, 25.3) at baseline to 24.6 kg/m2 (IQR 23.0, 26.7) at follow-up (p<0.001), with a median of 68 weeks between time points (range 20-94 weeks) and median duration of ETI therapy was 23 weeks (range 7-72 weeks). There was a significant decrease in energy intake from 2551 kcal/day (IQR 2107, 3115) to 2153 kcal/day (IQR 1648, 2606), p<0.001. In the no modulator group (n = 10), BMI and energy intake did not significantly change between time points (p>0.05), a median of 28 weeks apart (range 20-76 weeks).

CONCLUSIONS

These findings tentatively suggest that the increase in BMI with ETI therapy may not simply be attributable to an increase in oral intake. Further exploration into the underlying aetiology of weight gain with ETI therapy is needed.

Validation of Dietary Intake Estimated by Web-Based Dietary Assessment Methods and Usability Using Dietary Records or 24-h Dietary Recalls: A Scoping Review

The goal was to summarize studies comparing the accuracy of web-based dietary assessments with those of conventional face-to-face or paper-based assessments using 24-h dietary recall or dietary record methods in the general population. Using two databases, mean differences and correlation coefficients (CCs) for intakes of energy, macronutrients, sodium, vegetables, and fruits were extracted from each study independently by the authors. We also collected information regarding usability from articles reporting this. From 17 articles included in this review, the mean dietary intake differences in the web-based dietary assessment compared to conventional methods, were -11.5-16.1% for energy, -12.1-14.9% for protein, -16.7-17.6% for fat, -10.8-8.0% for carbohydrates, -11.2-9.6% for sodium, -27.4-3.9% for vegetables, and -5.1-47.6% for fruits. The CC was 0.17-0.88 for energy, protein, fat, carbohydrates, and sodium, and 0.23-0.85 for vegetables and fruits. In three out of four studies reporting usability, more than half of the participants preferred the web-based dietary assessment. In conclusion, % difference and CC of dietary intake were acceptable in both web-based dietary records and 24-h dietary recalls. The findings from this review highlight the possibility of wide-spread application of the web-based dietary assessment in the future.

Self-reported Resistance Training Is Associated With Better HR-pQCT-derived Bone Microarchitecture in Vegan People

CONTEXT

A plant-based lifestyle is a global trend; lower bone mineral density and increased fracture risk in vegan people are reported.

OBJECTIVE

The primary objective was to assess trabecular and cortical bone microarchitecture in vegans and omnivores. Secondary objectives were to evaluate relationships between bone microarchitecture, nutrition parameters, and physical activity.

METHODS

This was an observational study at the Medical Department II, St. Vincent Hospital (tertiary referral center for gastrointestinal, metabolic, and bone diseases, and teaching hospital of the Medical University of Vienna), including 43 healthy nonobese female and male subjects on a plant-based diet for at least 5 years, and 45 healthy nonobese female and male subjects on an omnivore diet for at least 5 years. The main outcome measures were the parameters of trabecular and cortical bone microarchitecture (high-resolution peripheral quantitative computed tomography), serum markers of bone turnover, nutrient intake (nutrition protocol), and self-reported resistance training (physical activity questionnaires).

RESULTS

In the vegan group, trabecular and cortical structure were altered compared with omnivores. Vegans not reporting resistance training had diminished bone microarchitecture compared with omnivores not reporting resistance training. In vegans and omnivores reporting resistance training, bone structure was similar. In both vegan subgroups (resistance training and not resistance training), a small number of correlations between nutrient intake and bone microarchitecture were observed without a conclusive pattern.

CONCLUSION

Bone microarchitecture in vegans differed from matched omnivores but could not be explained solely by nutrient uptake. These differences were attenuated between the subgroups reporting resistance training. In addition to a well-planned diet, progressive resistance training on a regular basis should be part of the vegan lifestyle.

Potential of existing online 24-h dietary recall tools for national dietary surveys

OBJECTIVE

To describe existing online, 24-h dietary recall (24-h DR) tools in terms of functionalities and ability to tackle challenges encountered during national dietary surveys, such as maximising response rates and collecting high-quality data from a representative sample of the population, while minimising the cost and response burden.

DESIGN

A search (from 2000 to 2019) was conducted in peer-reviewed and grey literature. For each tool, information on functionalities, validation and user usability studies, and potential adaptability for integration into a new context was collected.

SETTING

Not country-specific.

PARTICIPANTS

General population.

RESULTS

Eighteen online 24-h DR tools were identified. Most were developed in Europe, for children ≥10 years old and/or for adults. Eight followed the five multiple-pass steps but used various methodologies and features. Almost all tools (except three) validated their nutrient intake estimates, but with high heterogeneity in methodologies. User usability was not always assessed, and rarely by applying real-time methods. For researchers, eight tools developed a web platform to manage the survey and five appeared to be easily adaptable to a new context.

CONCLUSIONS

Among the eighteen online 24-h DR tools identified, the best candidates to be used in national dietary surveys should be those that were validated for their intake estimates, had confirmed user and researcher usability, and seemed sufficiently flexible to be adapted to new contexts. Regardless of the tool, adaptation to another context will still require time and funding, and this is probably the most challenging step.

A systematic review of reviews identifying UK validated dietary assessment tools for inclusion on an interactive guided website for researchers: www.nutritools.org

Background: Health researchers may struggle to choose suitable validated dietary assessment tools (DATs) for their target population. The aim of this review was to identify and collate information on validated UK DATs and validation studies for inclusion on a website to support researchers to choose appropriate DATs.Design: A systematic review of reviews of DATs was undertaken. DATs validated in UK populations were extracted from the studies identified. A searchable website was designed to display these data. Additionally, mean differences and limits of agreement between test and comparison methods were summarized by a method, weighting by sample size.Results: Over 900 validation results covering 5 life stages, 18 nutrients, 6 dietary assessment methods, and 9 validation method types were extracted from 63 validated DATs which were identified from 68 reviews. These were incorporated into www.nutritools.org. Limits of agreement were determined for about half of validations. Thirty four DATs were FFQs. Only 17 DATs were validated against biomarkers, and only 19 DATs were validated in infant/children/adolescents.Conclusions: The interactive www.nutritools.org website holds extensive validation data identified from this review and can be used to guide researchers to critically compare and choose a suitable DAT for their research question, leading to improvement of nutritional epidemiology research.

Assessing the relative validity of a new, web-based, self-administered 24 h dietary recall in a French-Canadian population

OBJECTIVE

To assess the relative validity of a new, web-based, self-administered 24 h dietary recall, the R24W, for assessment of energy and nutrient intakes among French Canadians.

DESIGN

Each participant completed a 3d food record (FR) and the R24W on three occasions over a 4-week period. Intakes of energy and of twenty-four selected nutrients assessed by both methods were compared.

SETTING

Québec City metropolitan area.

SUBJECTS

Fifty-seven women and fifty men (mean (sd) age: 47·2 (13·3) years).

RESULTS

Equivalent proportions of under-reporters were found with the R24W (15·0%) and the FR (23·4%). Mean (sd) energy intake from the R24W was 7·2% higher than that from the FR (10 857 (3184) kJ/d (2595 (761) kcal/d) v. 10 075 (2971) kJ/d (2408 (710) kcal/d); P<0·01). Significant differences in mean nutrient intakes between the R24W and the FR ranged from -54·8% (i.e. lower value with R24W) for niacin to +40·0% (i.e. higher value with R24W) for alcohol. Sex- and energy-adjusted deattenuated correlations between the two methods were significant for all nutrients except Zn (range: 0·35-0·72; P<0·01). Cross-classification demonstrated that 40·0% of participants were classified in the same quartile with both methods, while 40·0% were classified in the adjacent quartile and only 3·6% were grossly misclassified (1st v. 4th quartile). Analysis of Bland-Altman plots revealed proportional bias between the two assessment methods for 8/24 nutrients.

CONCLUSIONS

These data suggest that the R24W presents an acceptable relative validity as compared with the FR for estimating usual dietary intakes in a cohort of French Canadians.

Validation of a self-administered web-based 24-hour dietary recall among pregnant women

Background

The use of valid dietary assessment methods is crucial to analyse adherence to dietary recommendations among pregnant women. This study aims to assess the relative validity of a self-administered Web-based 24-h dietary recall, the R24W, against a pen-paper 3-day food record (FR) among pregnant women.

Methods

Sixty (60) pregnant women recruited at 9.3 ± 0.7 weeks of pregnancy in Quebec City completed, at each trimester, 3 R24W and a 3-day FR. Mean energy and nutrient intakes reported by both tools were compared using paired Student T-Tests. Pearson correlations were used to analyze the association between both methods. Agreement between the two methods was evaluated using cross-classification analyses, weighted kappa coefficients and Bland-Altman analyses.

Results

Pearson correlation coefficients were all significant, except for vitamin B₁₂ (r = 0.03; p = 0.83) and ranged from 0.27 to 0.76 (p < 0.05). Differences between mean intakes assessed by the R24W and the FR did not exceed 10% in 19 variables and were not significant for 16 out of 26 variables. In cross-classification analyses, the R24W ranked, on average, 79.1% of participants in the same or adjacent quartiles as the FR.

Conclusions

Compared to a 3-day FR, the R24W is a valid method to assess intakes of energy and most nutrients but may be less accurate in the evaluation of intakes of fat (as a proportion of energy intake), vitamin D, zinc and folic acid. During pregnancy, the R24W was a more accurate tool at a group-level than at an individual-level and should, therefore, be used in an epidemiological rather than a clinical setting. The R24W may be particularly valuable as a tool used in cohort studies to provide valid information on pregnant women’s dietary intakes and facilitate evaluation of associations between diet and adverse pregnancy outcomes.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1741-1) contains supplementary material, which is available to authorized users.

The Development, Validation, and User Evaluation of Foodbook24: A Web-Based Dietary Assessment Tool Developed for the Irish Adult Population

BACKGROUND

The application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often specifically designed for a particular country or region.

OBJECTIVE

The aim of this study was to describe the development, validation, and user evaluation of a Web-based dietary assessment tool "Foodbook24."

METHODS

Foodbook24 is a Web-based, dietary assessment tool consisting of a 24-hour dietary recall (24HDR) and food frequency questionnaire (FFQ) alongside supplementary questionnaires. Validity of the 24HDR component was assessed by 40 participants, who completed 3 nonconsecutive, self-administered 24HDR using Foodbook24 and a 4-day semi-weighed food diary at separate time points. Participants also provided fasted blood samples and 24-hour urine collections for the identification of biomarkers of nutrient and food group intake during each recording period. Statistical analyses on the nutrient and food group intake data derived from each method were performed in SPSS version 20.0 (SPSS Inc). Mean nutrient intakes (and standard deviations) recorded using each method of dietary assessment were calculated. Spearman and Pearson correlations, Wilcoxon Signed Rank and Paired t test were used to investigate the agreement and differences between the nutritional output from Foodbook24 (test method) and the 4-day semi-weighed food diary (reference method). Urinary and plasma biomarkers of nutrient intake were used as an objective validation of Foodbook24. To investigate the user acceptability of Foodbook24, participants from different studies involved with Foodbook24 were asked to complete an evaluation questionnaire.

RESULTS

For nutrient intake, correlations between the dietary assessment methods were acceptable to very good in strength and statistically significant (range r=.32 to .75). There were some significant differences between reported mean intakes of micronutrients recorded by both methods; however, with the exception of protein (P=.03), there were no significant differences in the reporting of energy or macronutrient intake. Of the 19 food groups investigated in this analysis, there were significant differences between 6 food groups reported by both methods. Spearman correlations for biomarkers of nutrient and food group intake and reported intake were similar for both methods. A total of 118 participants evaluated the acceptability of Foodbook24. The tool was well-received and the majority, 67.8% (80/118), opted for Foodbook24 as the preferred method for future dietary intake assessment when compared against a traditional interviewer led recall and semi-weighed food diary.

CONCLUSIONS

The results of this study demonstrate the validity and user acceptability of Foodbook24. The results also highlight the potential of Foodbook24, a Web-based dietary assessment method, and present a viable alternative to nutritional surveillance in Ireland.

Development and Evaluation of e-CA, an Electronic Mobile-Based Food Record

Measures that capture diet as validly and reliably as possible are cornerstones of nutritional research, and mobile-based devices offer new opportunities to improve and simplify data collection. The balance between precision and acceptability of these data collection tools remains debated, and rigorous validations are warranted. Our objective was to develop and evaluate an electronic mobile-based food record for a research setting. We developed e-CA, which includes almost 900 foods and beverages classified in 14 categories and 60 subcategories. e-CA was evaluated using three different methods: (1) usability and acceptability through a logbook and qualitative interviews; (2) dietary intake accuracy through comparison with 2 unannounced 24-h phone recalls on overlapping days; and (3) reliability and process comparison with a paper-based food record in a laboratory setting with a randomized design. e-CA proved to be intuitive and practical and was perceived as modern, trendy, and fun. Comparisons of e-CA with 24-h telephone recalls or paper-based food records in a laboratory setting with two small convenient samples showed good agreement but highlighted the well-known difficulty of estimating portion sizes and a necessary learning time to use the app. e-CA is a functional tool that has the potential to facilitate food intake measurement for research by increasing the pleasure of using the food record tool and reducing the perceived burden for the participants. It also decreases the workload, costs and the risk of transcription errors for researchers.

A review of the design and validation of web- and computer-based 24-h dietary recall tools

Technology-based dietary assessment offers solutions to many of the limitations of traditional dietary assessment methodologies including cost, participation rates and the accuracy of data collected. The 24-h dietary recall (24HDR) method is currently the most utilised method for the collection of dietary intake data at a national level. Recently there have been many developments using web-based platforms to collect food intake data using the principles of the 24HDR method. This review identifies web- and computer-based 24HDR tools that have been developed for both children and adult population groups, and examines common design features and the methods used to investigate the performance and validity of these tools. Overall, there is generally good to strong agreement between web-based 24HDR and respective reference measures for intakes of macro- and micronutrients.

Assessment tools in obesity - psychological measures, diet, activity, and body composition

The global increase in the prevalence of obesity has led to an increased need for measurement tools for research, management and treatment of the obese person. The physical size limitations imposed by obesity, variations in body composition from that of normal weight, and a complex psychopathology all pose tremendous challenges to the assessment of an obese person. There is little published research regarding what tools can be used with confidence. This review is designed to provide researchers and clinicians with a guide to the current and emerging measurement tools specifically associated with obesity research and practice. Section 1 addresses psychological measures of well being. Sections 2, 3, and 4 focus on the assessment of food intake, activity, and body composition. All sections address basic challenges involved in the study and management of obesity, and highlight methodological issues associated with the use of common assessment tools. The best available methods for use in the obese both in research and clinical practice are recommended.

Feasibility of innovative dietary assessment in epidemiological studies using the approach of combining different assessment instruments

Objective

To assess the feasibility of combining short-term and long-term dietary assessment instruments as new concept for improving usual dietary intake assessment on the individual level.

Design

Feasibility study of completing three 24 h dietary recalls (24-HDR) and a self-administered food propensity questionnaire (FPQ). The 24-HDR was conducted by monthly telephone interviews, using EPIC-SOFT software. The FPQ was completely standardized across cohorts and offered either as a web-based tool or in paper format.

Setting

Random sample derived from five ongoing European cohort studies (EPIC-San Sebastian, EPIC-Florence, EPIC-Potsdam, Estonia Genome Center (EGC) and Norwegian Women and Cancer study (NOWAC)).

Subjects

A total of 400 participants.

Results

Overall, the total participation rate for the present study was 65·3 % (n 261). On average, completion of the 24-HDR was highest for the first 24-HDR (63·0 %) and decreased slightly for the second (60·3 %) and third 24-HDR (56·3 %). The proportions of selecting the web-based FPQ varied among the study centres, with the highest in EGC (92·9 %) and NOWAC (70·0 %) and the lowest in EPIC-San Sebastian (25·5 %) and EPIC-Potsdam (33·9 %). Web users rarely requested support and were younger and more highly educated than those who completed the paper format.

Conclusions

The present study supports the feasibility of a combined application of three 24-HDR and an FPQ in culturally different populations. The varying acceptance of the web-based instrument across populations requires a flexible application of assessment instruments.