Validation of a Smartphone Image-Based Dietary Assessment Method for Pregnant Women

Abstract

Image-based dietary records could lower participant burden associated with traditional prospective methods of dietary assessment. They have been used in children, adolescents and adults, but have not been evaluated in pregnant women. The current study evaluated relative validity of the DietBytes image-based dietary assessment method for assessing energy and nutrient intakes. Pregnant women collected image-based dietary records (via a smartphone application) of all food, drinks and supplements consumed over three non-consecutive days. Intakes from the image-based method were compared to intakes collected from three 24-h recalls, taken on random days; once per week, in the weeks following the image-based record. Data were analyzed using nutrient analysis software. Agreement between methods was ascertained using Pearson correlations and Bland-Altman plots. Twenty-five women (27 recruited, one withdrew, one incomplete), median age 29 years, 15 primiparas, eight Aboriginal Australians, completed image-based records for analysis. Significant correlations between the two methods were observed for energy, macronutrients and fiber (r = 0.58–0.84, all p < 0.05), and for micronutrients both including (r = 0.47–0.94, all p < 0.05) and excluding (r = 0.40–0.85, all p < 0.05) supplements in the analysis. Bland-Altman plots confirmed acceptable agreement with no systematic bias. The DietBytes method demonstrated acceptable relative validity for assessment of nutrient intakes of pregnant women.

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

“…One study used a note-taking app with image capture (52). Others had study participants record the consumption of pre-defined food types or food groups [54-56, 58, 60].…”

“…In Seto and colleagues' [59] 6-day study, 72 food items were reported via video per participant. Participants on average reported 7 food entries via dietary record per day in Ashman and colleagues' 3-day study [52]. Two studies used alternative methods to capture missed meals (ie, pen-and-pencil or voice recording).…”

“…A total of 10 studies described event-contingent mEMDA methods used in nutrition-related research [52][53][54][55][56][57][58][59][60][61]. Additional approach details were extracted from other related journal articles [43,[62][63][64][65][66][67][68][69][70][71][72][73].…”

“…The remaining 5 studies used a PDA device with customized software [55,60], an Internet-based app [52,54], or social media (Twitter) [56]. All studies assessed dietary intake continuously throughout each day.…”

“…analyze the data based on a nutrient database or software [52,53,57,59]; 3 studies downloaded data from the mobile device to perform further data analysis without the use of a nutrient database or software [55,58,60]; 2 utilized output generated by non-nutrient-related software or app [54,56], and 1 automated the nutrient analysis within the study app [61]. With respect to the primary outcomes assessed, 5 studies estimated energy intake [52,53,57,58,61].…”