BackgroundThere is a great necessity for new methods of evaluation of dietary intake that overcome the limitations of traditional self-reporting methods.ObjectiveThe objective of this study was to develop a new method, based on an app for mobile phones called e-EPIDEMIOLOGY, which was designed to collect individual consumption data for a series of foods/drinks, and to compare this app with a previously validated paper food frequency questionnaire (FFQ).MethodsUniversity students >18 years of age recorded the consumption of certain foods/drinks using e-EPIDEMIOLOGY during 28 consecutive days and then filled out a paper FFQ at the end of the study period. To evaluate the agreement between the categories of habitual consumption for each of the foods/drinks included in the study, cross-classification analysis and a weighted kappa statistic were used.ResultsA total of 119 participants completed the study (71% female, 85/119; 29% male, 34/119). Cross-classification analysis showed that 79.8% of the participants were correctly classified into the same category and just 1.1% were misclassified into opposite categories. The average weighted kappa statistic was good (κ=.64).ConclusionsThe results indicate that e-EPIDEMIOLOGY generated ranks of dietary intakes that were highly comparable with the previously validated paper FFQ. However, it was noted that further testing of e-EPIDEMIOLOGY is required to establish its wider utility.

Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: ‘feedback’ e-12HR (IG) and ‘non-feedback’ e-12HR (CG). Only the ‘feedback’ e-12HR had two specific automatic functions: 1. Evaluation of the user’s AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.

BackgroundOne of the greatest challenges in nutritional epidemiology is improving upon traditional self-reporting methods for the assessment of habitual dietary intake.ObjectiveThe aim of this study was to evaluate the relative validity of a new method known as the current-day dietary recall (or current-day recall), based on a smartphone app called 12-hour dietary recall, for determining the habitual intake of a series of key food and drink groups using a food frequency questionnaire (FFQ) and four dietary records as reference methods.MethodsUniversity students over the age of 18 years recorded their consumption of certain groups of food and drink using 12-hour dietary recall for 28 consecutive days. During this 28-day period, they also completed four dietary records on randomly selected days. Once the monitoring period was over, subjects then completed an FFQ. The two methods were compared using the Spearman correlation coefficient (SCC), a cross-classification analysis, and weighted kappa.ResultsA total of 87 participants completed the study (64% women, 56/87; 36% men, 31/87).For e-12HR versus FFQ, for all food and drink groups, the average SCC was 0.70. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 51.5%; exact agreement + adjacent was 91.8%, and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.51.For e-12HR versus the four dietary records, for all food and drink groups, the average SCC was 0.63. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 47.1%; exact agreement + adjacent was 89.2%; and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.47.ConclusionsCurrent-day recall, based on the 12-hour dietary recall app, was found to be in good agreement with the two reference methods (FFQ & four dietary records), demonstrating its potential usefulness for categorizing individuals according to their habitual dietary intake of certain food and drink groups.

Background Accurate dietary assessment is key to understanding nutrition-related outcomes and for estimating the dietary change in nutrition-based interventions. When researching the habitual consumption of selected food groups, it is essential to be aware of factors that could possibly affect reporting accuracy. Objective This study aimed to evaluate the relative validity of the current-day dietary recall, a method based on a smartphone app called electronic 12-hour dietary recall (e-12HR), to categorize individuals according to habitual intake, in the whole sample of adults and in different strata thereof. Methods University students and employees over 18 years recorded the consumption of 10 selected groups of food using e-12HR during 28 consecutive days. During this period, they also completed 4 dietary records. Once the period was finished, the subjects then completed a food frequency questionnaire (FFQ) and a usability-rating questionnaire for e-12HR. The food group intakes estimated by the e-12HR app, the dietary records, and the FFQ were categorized into sextiles: less than once a week, once or twice a week, 3-4 times a week, 5-6 times a week, once or twice a day, and 3 or more times a day . The 10 selected groups with e-12HR were compared with 4 dietary records and an FFQ reference method, in the whole sample and in different strata thereof: age (years): <25 and ≥25; gender: females and males; occupation: students and employees; smoking: no and yes; physical activity (minutes/week): ≥150 and <150; and body mass index (kg/m 2 ): <25 and ≥25. The association between the different methods was assessed using Spearman correlation coefficient (SCC). Cross-classification and kappa statistic were used as a measure of agreement between the different methods. Results In total, 203 participants completed the study (56.7% [115/203] women, and 43.3% [88/203] men). For all food groups and all participants, the mean SCC for e-12HR versus FFQ was 0.67 (≥0.62 for all strata). On average, 50.7% of participants were classified into the same category (≥47.0% for all strata) and 90.2% within the nearest category (≥88.6% for all strata). Mean weighted kappa was 0.49 (≥0.44 for all strata). For e-12HR versus RDs, mean SCC was 0.65 (≥0.57 for all strata). On average, 50.0% of participants were classified into the same category (≥47.0% for all strata) and 88.2% within the nearest category (≥86.1% for all strata). Mean weighted kappa was 0.50 (≥0.44 for all strata). Conclusions The results indicate that e-12HR generated categories of dietary intake highly comparable with the 2 reference methods in the whole sample and in different strata thereof. The inclusion of photographs to facilitate estimation of the servings consumed generated correlation/agreement data between e-12HR and the FFQ that we...

There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).