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da Silva ADS, Brito FDSB, dos Santos DM, Adegboye ARA. Use of Digital Tools for the Assessment of Food Consumption in Brazil: A Scoping Review. Nutrients 2024; 16:1399. [PMID: 38732645 PMCID: PMC11085537 DOI: 10.3390/nu16091399] [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: 03/25/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
This is a scoping review on mapping the use of digital tools to assess food consumption in Brazil. Searches were carried out in nine electronic databases (Medline, Lilacs, Scopus, Embase, Web of Science, Science Direct, Ovid, Free Medical Journal and Crossref) to select studies published from October 2020 to December 2023. This review identified forty-eight digital tools in the 94 publications analyzed, the most frequent being web-based technologies (60%) and mobile devices (40%). Among these studies, 55% (n = 52) adopted a population-based approach, while 45% (n = 42) focused on specific regions. The predominant study design observed was cross-sectional (n = 63). A notable trend observed was the increasing frequency of validation studies in recent years. Although the use of digital tools in the assessment of food consumption in Brazil has grown in recent years, studies did not describe the process of creating and validating the tools, which would contribute to the improvement of data quality. Investments that allow the expansion of the use of the internet and mobile devices; the improvement of digital literacy; and the development of open-access tools, especially in the North and Northeast regions, are challenges that require a concerted effort towards providing equal opportunities, fostering encouragement, and delving deeper into the potential of digital tools within studies pertaining to food consumption in Brazil.
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Affiliation(s)
- Adriane dos Santos da Silva
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (A.d.S.d.S.); (D.M.d.S.)
| | - Flávia dos Santos Barbosa Brito
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (A.d.S.d.S.); (D.M.d.S.)
| | - Debora Martins dos Santos
- Nutrition Institute, Rio de Janeiro State University, São Francisco Xavier Street, 524, Rio de Janeiro 20550-900, Brazil; (A.d.S.d.S.); (D.M.d.S.)
| | - Amanda Rodrigues Amorim Adegboye
- Centre for Agroecology, Water and Resilience (CAWR), Coventry University, Coventry CV8 3LG, UK
- Centre for Healthcare Research, Coventry University, Coventry CV1 5FB, UK
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Murai U, Tajima R, Matsumoto M, Sato Y, Horie S, Fujiwara A, Koshida E, Okada E, Sumikura T, Yokoyama T, Ishikawa M, Kurotani K, Takimoto H. Validation of Dietary Intake Estimated by Web-Based Dietary Assessment Methods and Usability Using Dietary Records or 24-h Dietary Recalls: A Scoping Review. Nutrients 2023; 15:nu15081816. [PMID: 37111035 PMCID: PMC10141001 DOI: 10.3390/nu15081816] [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] [Received: 03/02/2023] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
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.
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Affiliation(s)
- Utako Murai
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Yoko Sato
- Department of the Science of Living, Kyoritsu Women's Junior College, Tokyo 101-8437, Japan
| | - Saki Horie
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Emiko Koshida
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Emiko Okada
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tomoko Sumikura
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Midori Ishikawa
- Department of Health Promotion, National Institute of Public Health, Wako 351-0197, Japan
| | - Kayo Kurotani
- Faculty of Food and Health Sciences, Showa Women's University, Tokyo 154-8533, Japan
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Kento Innovation Park NK Building, 3-17 Shinmachi, Settsu City, Osaka 566-0002, Japan
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König LM, Van Emmenis M, Nurmi J, Kassavou A, Sutton S. Characteristics of smartphone-based dietary assessment tools: a systematic review. Health Psychol Rev 2022; 16:526-550. [PMID: 34875978 DOI: 10.1080/17437199.2021.2016066] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.
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Affiliation(s)
- Laura M König
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.,Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Miranda Van Emmenis
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Johanna Nurmi
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aikaterini Kassavou
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Moyen A, Rappaport AI, Fleurent-Grégoire C, Tessier AJ, Brazeau AS, Chevalier S. Relative Validation of an Artificial Intelligence–Enhanced, Image-Assisted Mobile App for Dietary Assessment in Adults: Randomized Crossover Study. J Med Internet Res 2022; 24:e40449. [DOI: 10.2196/40449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 10/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background
Thorough dietary assessment is essential to obtain accurate food and nutrient intake data yet challenging because of the limitations of current methods. Image-based methods may decrease energy underreporting and increase the validity of self-reported dietary intake. Keenoa is an image-assisted food diary that integrates artificial intelligence food recognition. We hypothesized that Keenoa is as valid for dietary assessment as the automated self-administered 24-hour recall (ASA24)–Canada and better appreciated by users.
Objective
We aimed to evaluate the relative validity of Keenoa against a 24-hour validated web-based food recall platform (ASA24) in both healthy individuals and those living with diabetes. Secondary objectives were to compare the proportion of under- and overreporters between tools and to assess the user’s appreciation of the tools.
Methods
We used a randomized crossover design, and participants completed 4 days of Keenoa food tracking and 4 days of ASA24 food recalls. The System Usability Scale was used to assess perceived ease of use. Differences in reported intakes were analyzed using 2-tailed paired t tests or Wilcoxon signed-rank test and deattenuated correlations by Spearman coefficient. Agreement and bias were determined using the Bland-Altman test. Weighted Cohen κ was used for cross-classification analysis. Energy underreporting was defined as a ratio of reported energy intake to estimated resting energy expenditure <0.9.
Results
A total of 136 participants were included (mean 46.1, SD 14.6 years; 49/136, 36% men; 31/136, 22.8% with diabetes). The average reported energy intakes (kcal/d) were 2171 (SD 553) in men with Keenoa and 2118 (SD 566) in men with ASA24 (P=.38) and, in women, 1804 (SD 404) with Keenoa and 1784 (SD 389) with ASA24 (P=.61). The overall mean difference (kcal/d) was −32 (95% CI −97 to 33), with limits of agreement of −789 to 725, indicating acceptable agreement between tools without bias. Mean reported macronutrient, calcium, potassium, and folate intakes did not significantly differ between tools. Reported fiber and iron intakes were higher, and sodium intake lower, with Keenoa than ASA24. Intakes in all macronutrients (r=0.48-0.73) and micronutrients analyzed (r=0.40-0.74) were correlated (all P<.05) between tools. Weighted Cohen κ scores ranged from 0.30 to 0.52 (all P<.001). The underreporting rate was 8.8% (12/136) with both tools. Mean System Usability Scale scores were higher for Keenoa than ASA24 (77/100, 77% vs 53/100, 53%; P<.001); 74.8% (101/135) of participants preferred Keenoa.
Conclusions
The Keenoa app showed moderate to strong relative validity against ASA24 for energy, macronutrient, and most micronutrient intakes analyzed in healthy adults and those with diabetes. Keenoa is a new, alternative tool that may facilitate the work of dietitians and nutrition researchers. The perceived ease of use may improve food-tracking adherence over longer periods.
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Long Z, Huang S, Zhang J, Zhang D, Yin J, He C, Zhang Q, Xu H, He H, Sun HC, Xie K. A Digital Smartphone-Based Self-administered Tool (R+ Dietitian) for Nutritional Risk Screening and Dietary Assessment in Hospitalized Patients With Cancer: Evaluation and Diagnostic Accuracy Study. JMIR Form Res 2022; 6:e40316. [PMID: 36287601 PMCID: PMC9647468 DOI: 10.2196/40316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Malnutrition is a common and severe problem in patients with cancer that directly increases the incidence of complications and significantly deteriorates quality of life. Nutritional risk screening and dietary assessment are critical because they are the basis for providing personalized nutritional support. No digital smartphone-based self-administered tool for nutritional risk screening and dietary assessment among hospitalized patients with cancer has been developed and evaluated. OBJECTIVE This study aims to develop a digital smartphone-based self-administered mini program for nutritional risk screening and dietary assessment for hospitalized patients with cancer and to evaluate the validity of the mini program. METHODS We have developed the R+ Dietitian mini program, which consists of 3 parts: (1) collection of basic information of patients, (2) nutritional risk screening, and (3) dietary energy and protein assessment. The face-to-face paper-based Nutritional Risk Screening (NRS-2002), the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and 3 days of 24-hour dietary recall (3d-24HRs) questionnaires were administered according to standard procedure by 2 trained dietitians as the reference methods. Sensitivity, specificity, positive predictive value, negative predictive value, κ value, and correlation coefficients (CCs) of nutritional risk screened in R+ Dietitian against the reference methods, as well as the difference and CCs of estimated dietary energy and protein intakes between R+ Dietitian and 3d-24HRs were calculated to evaluate the validity of R+ Dietitian. RESULTS A total of 244 hospitalized patients with cancer were recruited to evaluate the validity of R+ Dietitian. The NRS-2002 and PG-SGA-SF tools in R+ Dietitian showed high accuracy, sensitivity, and specificity (77.5%, 81.0%, and 76.7% and 69.3%, 84.5%, and 64.5%, respectively), and fair agreement (κ=0.42 and 0.37, respectively; CC 0.62 and 0.56, respectively) with the NRS-2002 and PG-SGA-SF tools administered by dietitians. The estimated intakes of dietary energy and protein were significantly higher (P<.001 for both) in R+ Dietitian (mean difference of energy intake: 144.2 kcal, SD 454.8; median difference of protein intake: 10.7 g, IQR 9.5-39.8), and showed fair agreement (CC 0.59 and 0.47, respectively), compared with 3d-24HRs performed by dietitians. CONCLUSIONS The identified nutritional risk and assessment of dietary intakes of energy and protein in R+ Dietitian displayed a fair agreement with the screening and assessment conducted by dietitians. R+ Dietitian has the potential to be a tool for nutritional risk screening and dietary intake assessment among hospitalized patients with cancer. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900026324; https://www.chictr.org.cn/showprojen.aspx?proj=41528.
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Affiliation(s)
| | - Shan Huang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jie Zhang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Deng Zhang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Jun Yin
- Recovery Plus Clinic, Chengdu, China
| | | | - Qinqiu Zhang
- Recovery Plus Clinic, Chengdu, China
- College of Food Science, Sichuan Agricultural University, Ya'an, China
| | - Huilin Xu
- Recovery Plus Clinic, Chengdu, China
| | - Huimin He
- Recovery Plus Clinic, Chengdu, China
| | | | - Ke Xie
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Zhang L, Misir A, Boshuizen H, Ocké M. A Systematic Review and Meta-Analysis of Validation Studies Performed on Dietary Record Apps. Adv Nutr 2021; 12:2321-2332. [PMID: 34019624 PMCID: PMC8634532 DOI: 10.1093/advances/nmab058] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Mobile dietary record apps have been increasingly validated by studies with various study designs. This review aims to evaluate the overall accuracy of dietary record apps in measuring the intake of energy, macro- and micronutrients, and food groups in real-life settings and the designs of validation studies. We systematically searched mobile dietary record validation studies published during the period from 2013 to 2019. We identified 14 studies for the systematic review, of which 11 studies were suitable for meta-analyses on energy intake and 8 studies on macronutrient intake. Mean differences and SDs of nutrient estimations between the app and the reference method from studies were pooled using a random-effects model. All apps underestimated energy intake when compared with their reference methods, with a pooled effect of -202 kcal/d (95% CI: -319, -85 kcal/d); the heterogeneity of studies was 72%. After stratification, studies that used the same food-composition table for both the app and the reference method had a lower level of heterogeneity (0%) and a pooled effect of -57 kcal/d (95% CI: -116, 2 kcal/d). The heterogeneity of studies in the differences in carbohydrate, fat, and protein intake was 54%, 73%, and 80%, with the pooled effect of -18.8 g/d, -12.7 g/d, and -12.2 g/d, respectively, after excluding outliers. The intakes of micronutrients and food groups were statistically nonsignificantly underestimated by the apps in most cases. In conclusion, dietary record apps underestimated food consumption compared with traditional dietary assessment methods. Moreover, varying study designs have been found across studies. Recommended practices for conducting validation studies were formulated including considering biomarkers as the reference, testing in a larger and more representative study population for a longer period, avoiding the learning effect of each method, and comparing food group or food item consumption in addition to comparing energy and nutrient intakes.
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Affiliation(s)
- Liangzi Zhang
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands,Division of Human Nutrition, Wageningen University and Research, Wageningen, The Netherlands
| | - Andreja Misir
- Division of Human Nutrition, Wageningen University and Research, Wageningen, The Netherlands
| | - Hendriek Boshuizen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands,Division of Human Nutrition, Wageningen University and Research, Wageningen, The Netherlands
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Abstract
PURPOSE OF REVIEW This review describes the state-of-the-art for dietary assessment using smartphone apps and digital technology and provides an update on the efficacy of technology-mediated interventions for dietary change. RECENT FINDINGS Technology has progressed from apps requiring entry of foods consumed, to digital imaging to provide food intake data. However, these methods rely on patients being active in data collection. The automated estimation of the volume and composition of every meal consumed globally is years away. The use of text messaging, apps, social media, and combinations of these for interventions is growing and proving effective for type 2 diabetes mellitus (T2DM). Effectiveness of text messaging for obesity management is improving and multicomponent interventions show promise. A stand-alone app is less likely to produce positive outcomes and social media is relatively unexplored. A concentrated effort will be needed to progress digital dietary assessment. Researcher-designed technology programs are producing positive outcomes for T2DM but further research is needed in the area of weight management.
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Affiliation(s)
- Margaret Allman-Farinelli
- University of Sydney, School of Life and Environmental Science, Level E 4 East, Charles Perkins Centre D17, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Luke Gemming
- University of Sydney, School of Life and Environmental Science, Level E 4 East, Charles Perkins Centre D17, University of Sydney, Sydney, NSW, 2006, Australia
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