Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review

Abstract

BackgroundNew methods for assessing diet in research are being developed to address the limitations of traditional dietary assessment methods. Mobile device–assisted ecological momentary diet assessment (mEMDA) is a new dietary assessment method that has not yet been optimized and has the potential to minimize recall biases and participant burden while maximizing ecological validity. There have been limited efforts to characterize the use of mEMDA in behavioral research settings.ObjectiveThe aims of this study were to summarize mEMDA protocols used in research to date, to characterize key aspects of these assessment approaches, and to discuss the advantages and disadvantages of mEMDA compared with the traditional dietary assessment methods as well as implications for future mEMDA research.MethodsStudies that used mobile devices and described mEMDA protocols to assess dietary intake were included. Data were extracted according to Preferred Reporting of Systematic Reviews and Meta-Analyses and Cochrane guidelines and then synthesized narratively.ResultsThe review included 20 studies with unique mEMDA protocols. Of these, 50% (10/20) used participant-initiated reports of intake at eating events (event-contingent mEMDA), and 50% (10/20) used researcher-initiated prompts requesting that participants report recent dietary intake (signal-contingent mEMDA). A majority of the study protocols (60%, 12/20) enabled participants to use mobile phones to report dietary data. Event-contingent mEMDA protocols most commonly assessed diet in real time, used dietary records for data collection (60%, 6/10), and provided estimates of energy and nutrient intake (60%, 6/10). All signal-contingent mEMDA protocols used a near real-time recall approach with unannounced (ie, random) abbreviated diet surveys. Most signal-contingent protocols (70%, 7/10) assessed the frequency with which (targeted) foods or food groups were consumed. Relatively few (30%, 6/20) studies compared mEMDA with the traditional dietary assessment methods.ConclusionsThis review demonstrates that mEMDA has the potential to reduce participant burden and recall bias, thus advancing the field beyond current dietary assessment methods while maximizing ecological validity.

Automatic, wearable-based, in-field eating detection approaches for public health research: a scoping review

“…Mobile device-assisted ecological momentary assessment (mEMA), repeated sampling of one's behavior in real-time and in-context 24 , has been suggested as a promising tool for eating assessment 72 , and may also serve as a novel tool to evaluate the performance of wearable sensors in the field. In a recent review, Schembre and colleagues 73 summarize the existing literature on mEMA methods for the measurement of dietary intake in research studies. They conclude that mobile ecological momentary dietary assessment methods may be interchangeable with existing methods, in addition to reducing participant burden, recall biases, and technological barriers while maximizing ecological validity 73 .…”

“…In a recent review, Schembre and colleagues 73 summarize the existing literature on mEMA methods for the measurement of dietary intake in research studies. They conclude that mobile ecological momentary dietary assessment methods may be interchangeable with existing methods, in addition to reducing participant burden, recall biases, and technological barriers while maximizing ecological validity 73 .…”

Moving beyond self‐report data collection in the natural environment: A review of the past and future directions for ambulatory assessment in eating disorders

“…Mobile assessment of nutrition and diet is still emerging but may provide more valid and reliable data beyond traditional assessments (e.g., 24-hour recalls, food frequency questionnaires; Schembre et al, 2018). EMA has successfully been used to study diet (Schembre et al, 2018), although data on portion size and specific nutrient intake has proved difficult to capture. In order to collect more detailed information about food intake that is difficult to collect via self-report EMA, researchers have had participants take photos of their food consumed throughout the day (e.g., Costello, Deighton, Dyson, Mckenna, & Jones, 2017).…”

Lifestyle medicine and use of technology in current healthcare

“…( b) Nutritio n assessment apps — Mobile device-assisted ecological momentary diet assessment (mEMDA) is a recently introduced dietary assessment procedure that is yet to optimised but holds the potential to reduce the recall biases as well as the burden on participants while increasing the ecological validity. ‘As of yet, limited efforts have been put to begin the use of mEMDA in behavioral research settings’ 4. Calorie counter/Daily Dozen/Habit/myfitnesspal/Hapicoach.…”

“…These apps help to assess the nutritional intake of users using a 24 hours, 3 days, 7 days or even a monthly or three monthly intake. They not only help to record but also to suggest the dietary changes that can be incorporated in the lifestyle modifications 4 5. ( c ) Ment al health tracking apps —Phone based and web-based applications have been shown to reduce burnout, depression, stress and suicidal ideation among several populations world-wide and may help to deal with these barriers 6 7.…”