1
|
Folson GK, Bannerman B, Atadze V, Ador G, Kolt B, McCloskey P, Gangupantulu R, Arrieta A, Braga BC, Arsenault J, Kehs A, Doyle F, Tran LM, Hoang NT, Hughes D, Nguyen PH, Gelli A. Validation of Mobile Artificial Intelligence Technology-Assisted Dietary Assessment Tool Against Weighed Records and 24-Hour Recall in Adolescent Females in Ghana. J Nutr 2023; 153:2328-2338. [PMID: 37276939 DOI: 10.1016/j.tjnut.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Important gaps exist in the dietary intake of adolescents in low- and middle-income countries (LMICs), partly due to expensive assessment methods and inaccuracy in portion-size estimation. Dietary assessment tools leveraging mobile technologies exist but only a few have been validated in LMICs. OBJECTIVE We validated Food Recognition Assistance and Nudging Insights (FRANI), a mobile artificial intelligence (AI) dietary assessment application in adolescent females aged 12-18 y (n = 36) in Ghana, against weighed records (WR), and multipass 24-hour recalls (24HR). METHODS Dietary intake was assessed during 3 nonconsecutive days using FRANI, WRs, and 24HRs. Equivalence of nutrient intake was tested using mixed-effect models adjusted for repeated measures, by comparing ratios (FRANI/WR and 24HR/WR) with equivalence margins at 10%, 15%, and 20% error bounds. Agreement between methods was assessed using the concordance correlation coefficient (CCC). RESULTS Equivalence for FRANI and WR was determined at the 10% bound for energy intake, 15% for 5 nutrients (iron, zinc, folate, niacin, and vitamin B6), and 20% for protein, calcium, riboflavin, and thiamine intakes. Comparisons between 24HR and WR estimated equivalence at the 20% bound for energy, carbohydrate, fiber, calcium, thiamine, and vitamin A intakes. The CCCs by nutrient between FRANI and WR ranged between 0.30 and 0.68, which was similar for CCC between 24HR and WR (ranging between 0.38 and 0.67). Comparisons of food consumption episodes from FRANI and WR found 31% omission and 16% intrusion errors. Omission and intrusion errors were lower when comparing 24HR with WR (21% and 13%, respectively). CONCLUSIONS FRANI AI-assisted dietary assessment could accurately estimate nutrient intake in adolescent females compared with WR in urban Ghana. FRANI estimates were at least as accurate as those provided through 24HR. Further improvements in food recognition and portion estimation in FRANI could reduce errors and improve overall nutrient intake estimations.
Collapse
Affiliation(s)
- Gloria K Folson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - Boateng Bannerman
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Vicentia Atadze
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gabriel Ador
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bastien Kolt
- International Food Policy Research Institute, Washington, DC, United States
| | | | | | - Alejandra Arrieta
- International Food Policy Research Institute, Washington, DC, United States
| | - Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Medford, MA, United States
| | - Joanne Arsenault
- Intake - Center for Dietary Assessment, FHI Solutions, Washington, DC, United States
| | - Annalyse Kehs
- Penn State University, State College, PA, United States
| | - Frank Doyle
- Penn State University, State College, PA, United States
| | | | | | - David Hughes
- Penn State University, State College, PA, United States
| | - Phuong Hong Nguyen
- International Food Policy Research Institute, Washington, DC, United States; Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Aulo Gelli
- International Food Policy Research Institute, Washington, DC, United States
| |
Collapse
|
2
|
Braga BC, Arrieta A, Bannerman B, Doyle F, Folson G, Gangupantulu R, Hoang NT, Huynh PN, Koch B, McCloskey P, Tran LM, Tran THT, Truong DTT, Nguyen PH, Hughes D, Gelli A. Measuring adherence, acceptability and likability of an artificial-intelligence-based, gamified phone application to improve the quality of dietary choices of adolescents in Ghana and Vietnam: Protocol of a randomized controlled pilot test. Front Digit Health 2022; 4:961604. [PMID: 36561922 PMCID: PMC9763447 DOI: 10.3389/fdgth.2022.961604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022] Open
Abstract
Unhealthy diets are a critical global concern while dietary measure methods are time consuming and expensive. There is limited evidence that phone-based interventions can improve nutrition data collection and dietary quality, especially for adolescents in developing countries. We developed an artificial-intelligence-based phone application called Food Recognition Assistance and Nudging Insights (FRANI) to address these problems. FRANI can recognize foods in images, track food consumption, display statistics and use gamified nudges to give positive feedback on healthy food choice. This study protocol describes the design of new pilot studies aimed at measuring the feasibility (acceptability, adherence, and usability) of FRANI and its effects on the quality of food choice of adolescents in Ghana and Vietnam. In each country, 36 adolescents (12-18 years) will be randomly allocated into two groups: The intervention group with the full version of FRANI and the control group with the functionality limited to image recognition and dietary assessment. Participants in both groups will have their food choices tracked for four weeks. The control groups will then switch to the full version of FRANI and both groups will be tracked for a further 2 weeks to assess acceptability, adherence, and usability. Analysis of outcomes will be by intent to treat and differences in outcomes between intervention and control group will use Poisson and odds ratio regression models, accounting for repeated measures at individual levels. If deemed feasible, acceptable and usable, FRANI will address gaps in the literature and advance the nutrition field by potentially improving the quality of food choices of adolescent girls in developing countries. This pilot study will also provide insights on the design of a large randomized controlled trial. The functioning and dissemination of FRANI can be an important step towards highly scalable nutrition data collection and healthier food choices for a population at risk of malnutrition. The study protocol and the methods and materials were approved by the Institutional Review Board (IRB) of the IFPRI on April 29th, 2020 (registration number #00007490), the Thai Nguyen National Hospital on April 14th, 2020 (protocol code 274/ĐĐĐ-BVTWTN) and the University of Ghana on August 10th, 2020 (Federalwide Assurance FWA 00001824; NMIMR-IRB CPN 078-19/20). The study protocol was registered in the International Standard Randomized Controlled Trial Number (ISRCTN 10681553; https://doi.org/10.1186/ISRCTN10681553) on November 12, 2021.
Collapse
Affiliation(s)
- Bianca C. Braga
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States,Correspondence: Bianca C. Braga
| | - Alejandra Arrieta
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, United States,Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
| | - Boateng Bannerman
- Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Frank Doyle
- Department of Entomology, Pennsylvania State University, University Park, PA, United States
| | - Gloria Folson
- Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Rohit Gangupantulu
- Department of Entomology, Pennsylvania State University, University Park, PA, United States
| | | | | | - Bastien Koch
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
| | - Peter McCloskey
- Department of Entomology, Pennsylvania State University, University Park, PA, United States
| | - Lan Mai Tran
- Hubert Department of Global Health, Rolling School of Public Health, Emory University, Atlanta, GA, United States
| | | | | | - Phuong H. Nguyen
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States,Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - David Hughes
- Department of Entomology, Pennsylvania State University, University Park, PA, United States,Department of Biology, Pennsylvania State University, University Park, PA, United States
| | - Aulo Gelli
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
| |
Collapse
|
3
|
Nguyen PH, Tran LM, Hoang NT, Trương DTT, Tran THT, Huynh PN, Koch B, McCloskey P, Gangupantulu R, Folson G, Bannerman B, Arrieta A, Braga BC, Arsenault J, Kehs A, Doyle F, Hughes D, Gelli A. Relative validity of a mobile AI-technology-assisted dietary assessment in adolescent females in Vietnam. Am J Clin Nutr 2022; 116:992-1001. [PMID: 35945309 PMCID: PMC9535545 DOI: 10.1093/ajcn/nqac216] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 08/04/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND There is a gap in data on dietary intake of adolescents in low- and middle-income countries (LMICs). Traditional methods for dietary assessment are resource intensive and lack accuracy with regard to portion-size estimation. Technology-assisted dietary assessment tools have been proposed but few have been validated for feasibility of use in LMICs. OBJECTIVES We assessed the relative validity of FRANI (Food Recognition Assistance and Nudging Insights), a mobile artificial intelligence (AI) application for dietary assessment in adolescent females (n = 36) aged 12-18 y in Vietnam, against a weighed records (WR) standard and compared FRANI performance with a multi-pass 24-h recall (24HR). METHODS Dietary intake was assessed using 3 methods: FRANI, WR, and 24HRs undertaken on 3 nonconsecutive days. Equivalence of nutrient intakes was tested using mixed-effects models adjusting for repeated measures, using 10%, 15%, and 20% bounds. The concordance correlation coefficient (CCC) was used to assess the agreement between methods. Sources of errors were identified for memory and portion-size estimation bias. RESULTS Equivalence between the FRANI app and WR was determined at the 10% bound for energy, protein, and fat and 4 nutrients (iron, riboflavin, vitamin B-6, and zinc), and at 15% and 20% bounds for carbohydrate, calcium, vitamin C, thiamin, niacin, and folate. Similar results were observed for differences between 24HRs and WR with a 20% equivalent bound for all nutrients except for vitamin A. The CCCs between FRANI and WR (0.60, 0.81) were slightly lower between 24HRs and WR (0.70, 0.89) for energy and most nutrients. Memory error (food omissions or intrusions) was ∼21%, with no clear pattern apparent on portion-size estimation bias for foods. CONCLUSIONS AI-assisted dietary assessment and 24HRs accurately estimate nutrient intake in adolescent females when compared with WR. Errors could be reduced with further improvements in AI-assisted food recognition and portion estimation.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Bastien Koch
- International Food Policy Research Institute, Washington, DC, USA
| | | | | | | | | | | | - Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Boston, MA, USA
| | - Joanne Arsenault
- Intake–Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | | | - Frank Doyle
- Penn State University, State College, PA, USA
| | | | - Aulo Gelli
- International Food Policy Research Institute, Washington, DC, USA
| |
Collapse
|