Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

Abstract

Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77–0.99) was lower when compared with the 3-day WFR (ICC = 0.82–0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

“…These image-based records were of similar accuracy to written estimated or weighed food records as a method for quantifying intake among older adults with T2DM and were considered to have high usability and acceptability 53,54. Computer vision, a form of automated image analysis, has further expanded the capabilities of these types of dietary records for DSM 50,55,56.…”

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

“…In recent years there have been many advances in the application of technology in the area of dietary assessment (2) . Innovative dietary assessment technologies using devices such as mobile telephones (3)(4)(5)(6)(7)(8) , sensors, wearable cameras (9)(10)(11) and web-based platforms are common ways of collecting dietary intake data and have become increasingly popular alternatives to traditional pen-and-paper versions of dietary assessment (12) . Web-based methodologies facilitate the collection of dietary intake across many geographic locations (13)(14)(15)(16) and in some cases are preferred by participants compared with the traditional pen-and-paper alternatives (3,17) .…”

Feasibility study of an Online 24-hr Dietary Assessment Tool: myfood24, in a clinical population

“…In the same way it could be advantageous to complete online dietary assessments between clinic visits for review by the user and health professional. Using self-administered dietary assessment technologies has been shown to be a more engaging and accurate way of capturing a diet history [5,14] and preferred to traditional methods in people with diabetes [30]. Women in our study commented that they began to consider changes in their food intake from performing the recalls and receiving the feedback; this has been observed in other populations [13,15] and has been shown to improve uptake of self- professional to advise on dietary changes and increasing knowledge and skills has been shown to increase an individual's sense of control.…”