Four-Day Multimedia Diet Records Underestimate Energy Needs in Middle-Aged and Elderly Women as Determined by Doubly-Labeled Water

Abstract

Systematic problems exist in the quantification of food intake in populations using traditional self-reported measures. The objective of this study was to determine the effectiveness of an innovative multimedia diet record (MMDR) for dietary energy intake assessment. Dietary intake was estimated by combining the use of a microcassette tape recorder and 35-mm camera in 53 women whose ages ranged from 50 to 93 y (64.9 +/- 11.3 y), with body weights of 62.4 +/- 12.2 kg and body mass indexes (BMI) of 24.4 +/- 4.0 kg/m(2). Using household measures, subjects voice-recorded and photographed all food and beverages consumed for four consecutive days. A two-point doubly-labeled water (DLW) method was used over 13 d to calculate carbon dioxide production, total body water, and subsequently, total energy expenditure (TEE) through the use of a food quotient. Mean body weight did not change between d 1 and 14. TEE and reported energy intake were compared using MMDR. Mean reported energy intakes 7.5 +/- 1.9 MJ/d (1774 +/- 476 kcal/d) were lower (P < 0.01) than TEE by 10.4 +/- 3.1 MJ/d (2477 +/- 736 kcal/d), indicating underreporting of food intake. Reporting accuracy (reported energy intake/TEE' 100%) was 76.0 +/- 22.9%. Mean energy expenditure (MJ/d), as determined by doubly-labeled water, was higher (P < 0.01) in each stratified age range when compared to reported energy intake by MMDR. There were no significant differences in reporting accuracy among the stratified age groups. Using the MMDR method, this population of weight-stable women underreported their food intakes compared to their determined energy expenditure estimated by DLW.

Validation of photographic food records in children: are pictures really worth a thousand words?

“…However, the participants in this adult study were all college-aged nutrition students who, due to their age and education level, would be expected to follow the study instructions more closely than a broad population of school-aged children and who, due to their specific nutrition training, would also be more capable of keeping an accurate food diary than our study population. The second adult study that employed photographic food records in adults observed a greater extent of underreporting than was observed in the current pediatric cohort (Kaczkowski et al, 2000).…”

“…However, those subjects that forgot to carry their cameras at all times also forgot to carry their diet diaries so both methods suffer from this drawback. The advantage of the diet diary is that foods can be recorded in retrospect which, although not ideal due to increases in misreporting under these circumstances (Dwyer et al, 1987;Kaczkowski et al, 2000;Black and Cole, 2001;Goris et al, 2001), is not possible with the photographic method. Therefore, it would be advantageous to issue instruction on portion sizes and standard recording methods when beginning a photographic food record so that foods could be recorded on paper or later in the day if subjects forget to take photographs.…”

“…Selfreporting is riddled with limitations, including the timeconsuming nature of the task, inaccuracies stemming from the fact that the person is not objective, error in estimates of portion size and the fact that the more days of intake a subject records, the less accurate the data become (Dwyer et al, 1987;Medlin and Skinner, 1988;Thompson and Byers, 1994). Studies using doubly labeled water have shown that underreporting of food intake is a common problem for all self-report methods (Aronoff et al, 2000;Kaczkowski et al, 2000;Black and Cole, 2001;Goris et al, 2001). Estimates from these studies show that subjects routinely underreport their caloric intake by 20-50% (Haraldsdottir and Hermansen, 1995;Kroke et al, 1999;Kaczkowski et al, 2000;Livingstone and Robson, 2000).…”

“…Two studies have attempted to validate the use of photographic recording as a method of assessing dietary intake in adults (Kaczkowski et al, 2000;Wang et al, 2002). This method seems well suited for pediatric studies as it would considerably decrease the reporting burden for children and their parents and may increase the accuracy of collected data.…”

Computer Vision for Lifelogging

“…Professional researchers can also benefit in performing diet intake studies with the help of lifelog browsing and annotation tools. Both audio recorders and cameras are combined in [25]. According to [26], individuals self-reported energy intake frequently and substantially underestimates true energy intake, while Microsoft SenseCam wearable camera can help more accurately report dietary intake within various sporting populations.…”