Validation of a self-administered web-based 24-hour dietary recall among pregnant women

Abstract

BackgroundThe use of valid dietary assessment methods is crucial to analyse adherence to dietary recommendations among pregnant women. This study aims to assess the relative validity of a self-administered Web-based 24-h dietary recall, the R24W, against a pen-paper 3-day food record (FR) among pregnant women.MethodsSixty (60) pregnant women recruited at 9.3 ± 0.7 weeks of pregnancy in Quebec City completed, at each trimester, 3 R24W and a 3-day FR. Mean energy and nutrient intakes reported by both tools were compared using paired Student T-Tests. Pearson correlations were used to analyze the association between both methods. Agreement between the two methods was evaluated using cross-classification analyses, weighted kappa coefficients and Bland-Altman analyses.ResultsPearson correlation coefficients were all significant, except for vitamin B12 (r = 0.03; p = 0.83) and ranged from 0.27 to 0.76 (p < 0.05). Differences between mean intakes assessed by the R24W and the FR did not exceed 10% in 19 variables and were not significant for 16 out of 26 variables. In cross-classification analyses, the R24W ranked, on average, 79.1% of participants in the same or adjacent quartiles as the FR.ConclusionsCompared to a 3-day FR, the R24W is a valid method to assess intakes of energy and most nutrients but may be less accurate in the evaluation of intakes of fat (as a proportion of energy intake), vitamin D, zinc and folic acid. During pregnancy, the R24W was a more accurate tool at a group-level than at an individual-level and should, therefore, be used in an epidemiological rather than a clinical setting. The R24W may be particularly valuable as a tool used in cohort studies to provide valid information on pregnant women’s dietary intakes and facilitate evaluation of associations between diet and adverse pregnancy outcomes.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1741-1) contains supplementary material, which is available to authorized users.

Validity and Usability of a Smartphone Image-Based Dietary Assessment App Compared to 3-Day Food Diaries in Assessing Dietary Intake Among Canadian Adults: Randomized Controlled Trial

“…This study assessed the use of an image-based app for assessment of dietary intake in healthy adults. Similar to other studies [ 8 , 16 - 20 ], the results from Keenoa-dietitian produced similar mean nutrient profiles for more than half of nutrients when compared to the 3DFD method. However, this study included relative validation; therefore, it is impossible to conclude that one method is closer to “true dietary intake” than the other, as true dietary intake is not known.…”

“…Nevertheless, in this study, the majority of the tests (4/7) scored poorly on 10 of the 22 nutrients when comparing the 3DFD and Keenoa-dietitian, including energy, protein, carbohydrates, % fat, saturated fatty acids, and iron. To our knowledge, only a few research groups have performed such an in-depth analysis as seen with the Keenoa-dietitian data, and although our findings cannot speak to reliability, the average number of poor outcomes is similar but slightly higher than those found by Savard et al [ 20 ] and Lafrenière et al [ 22 ].…”

“…However, a relatively better association of energy and macronutrients between the two methods was observed with coefficient values closer to .5. Similarly, others have shown correlation coefficients between the 3DFD and web-based 24-h recall ranging from .03 to .76 [ 20 ]. A comparable trend was found in another study comparing a 4-day food record to two web-based 24-h recalls among 93 university-affiliated adults; the correlation coefficients varied between .06 and .76 [ 26 ].…”

“…These results are similar to that of other studies. In pregnant women (n=60), Savard et al [ 20 ] found an average 12.2% difference when comparing 3DFD with another web-based dietary assessment tool (24-h recall for 3 days). Similar to their study, we also compared a traditional dietary record method to a new app-based method; therefore, a relatively higher % difference is acceptable [ 16 ].…”

Trimester-Specific Dietary Intakes in a Sample of French-Canadian Pregnant Women in Comparison with National Nutritional Guidelines

“…In addition, systematic questions are asked about frequently forgotten food items including toppings, condiments, fats, snacks, and drinks. The R24W was previously validated in pregnant women for each trimester [ 24 ]. All food items were automatically coded using the 2015 version of the Canadian Nutrient File [ 23 ] and data for energy and 22 nutrients were analyzed.…”