Insight into dietary trends is important for the development and evaluation of dietary policies. The aim of this study is to describe changes in dietary intakes of Dutch adults and to evaluate these changes by age, gender, and education. In 2007–2010 and 2012–2016, two national food consumption surveys were conducted including 2106 and 1540 adults, respectively. Data collection included two non-consecutive 24 h dietary recalls. Mean habitual intakes of foods and nutrients relevant for a healthy diet of both surveys were estimated. Between the two periods the mean consumption of red or processed meat, dairy, sodium and alcohol and the ratio of whole-grain to cereal products decreased by 4–30% and the consumption of fibre and unsaturated fatty acids increased by about 3% and 6%, respectively. For most food groups, changes in consumption were comparable for both sexes and in all age groups. A healthier consumption pattern and several favorable changes were observed among higher-educated people. Most, but not all, changes in food consumption are favorable from a public health point of view. However, there is still a large potential for further improvements. A healthier consumption pattern was observed in adults with a higher educational level which calls for attention to social disparities when developing dietary policies.
This study aimed to evaluate the relative validity of intake of energy, nutrients and food groups assessed with MijnEetmeter food diary as compared to 24-h dietary recalls, and if this differed between experienced and new users. One hundred men and women aged 18–70 y participated, of whom 47 had prior experience with the tool. Participants kept MijnEetmeter on three days. Trained dietitians called them three times for a 24-h dietary recall interview, once recalling food consumption on the same day as the food recording in MijnEetmeter. Systematic differences and correlations were assessed, and Bland–Altman plots were created; both for 3-day mean intakes and for intakes on the same day. Relative to 24-h dietary recalls, MijnEetmeter underestimated consumption of drinks, added fat, cereal products, and potatoes. Relative underestimation was observed for energy intake (6%) and about half of the nutrients. Experienced MijnEetmeter users underestimated intake the least. For intake of energy and six key nutrients, correlations between 3-day mean intakes were above 0.7 except for sodium intake. In conclusion, MijnEetmeter moderately underestimates intakes of energy and some nutrients and food groups. To improve the self-monitoring of dietary intake, it is recommended that the users record food consumption for several days and that the apps probes for easily forgotten foods and drinks.
BACKGROUND In the Dutch national food consumption surveys, dietary intake has been assessed since 2003 through 24-h dietary recalls using the GloboDiet software. A new self-administered smartphone food record application called DitEetIk! was developed for potential use in future surveys. OBJECTIVE This study aimed to evaluate the data collected with the DitEetIk!-app and its relative validity of food group, energy, and nutrient intake as compared to GloboDiet 24-h dietary recalls. METHODS 300 men and women aged 18–79 y were recruited from a consumer panel. Participants were asked to keep a record of their consumptions using the DitEetIk!-app on three non-consecutive days. Trained dietitians conducted a 24-h dietary recall interview by telephone using GloboDiet software and recalled one of three DitEetIk! recording days. The nutrient intake was calculated with NEVO version 2021/7.0. Participants with implausible records, defined as days with energy intake less than 0.6 BMR or more than 3.0 BMR, were excluded from the analyses. For 19 food groups and 29 nutrients, differences in median intakes were assessed using the Wilcoxon signed-rank test and Spearman rank correlation coefficients were calculated. Bland–Altman plots with mean differences and 95% limits of agreement were made for energy intake and the contribution to energy intake from fat, carbohydrates, and protein. RESULTS A total of 227 participants completed a combination of an app recording day and a 24-h dietary recall interview referring to the same day. Of this group, 211 participants, 104 men and 107 women, had a plausible recording day. Of all recorded foods, 13% were scanned and 19% text searched at the brand level. For 5 of the 16 food groups, the median intake assessed with the app was >10% lower than the median intake assessed with 24-h dietary recall (P<.05). This was also the case for 4 of the 29 nutrients (P<.05). For mean intakes differences were generally smaller. For energy intake, the mean difference and 95% limits of agreement was 14 (-1096 - 1124) kcal. Compared to expected energy intake, at group level, the mean percentage of underreporting with the app was 19.8% versus 20.1% with the 24-h dietary recall. Spearman correlation coefficients between intakes assessed with the DitEetIk!-app and the 24-h dietary recall ranged from 0.48 to 0.88 (median 0.78) for food groups and from 0.58 to 0.90 (median 0.72) for nutrients. CONCLUSIONS Compared to GloboDiet 24-h dietary recalls, the DitEetIk!-app assessed similar mean levels of energy intake, but somewhat lower median levels of intake for several food groups and nutrients. It is recommended to add functionalities to the app that stimulate a more complete food recording before applying it in the national food consumption surveys. In addition, more detailed information about consumed foods can be derived by encouraging the use of barcode scanning.
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