The aim of the present study was to report the first reliability and validity tests of the remote food photography method (RFPM), which consists of camera-enabled cell phones with data transfer capability. Participants take and transmit photographs of food selection and plate waste to researchers/clinicians for analysis. Following two pilot studies, adult participants (n 52; BMI 20 -35 kg/m 2 inclusive) were randomly assigned to the dine-in or take-out group. Energy intake (EI) was measured for 3 d. The dine-in group ate lunch and dinner in the laboratory. The take-out group ate lunch in the laboratory and dinner in free-living conditions (participants received a cooler with pre-weighed food that they returned the following morning). EI was measured with the RFPM and by directly weighing foods. The RFPM was tested in laboratory and free-living conditions. Reliability was tested over 3 d and validity was tested by comparing directly weighed EI to EI estimated with the RFPM using Bland -Altman analysis. The RFPM produced reliable EI estimates over 3 d in laboratory (r 0·62; P,0·0001) and free-living (r 0·68; P, 0·0001) conditions. Weighed EI correlated highly with EI estimated with the RFPM in laboratory and free-living conditions (r . 0·93; P, 0·0001). In two laboratory-based validity tests, the RFPM underestimated EI by 24·7 % (P¼ 0·046) and 25·5 % (P¼ 0·076). In free-living conditions, the RFPM underestimated EI by 26·6 % (P¼ 0·017). Bias did not differ by body weight or age. The RFPM is a promising new method for accurately measuring the EI of free-living individuals. Error associated with the method is small compared with self-report methods.Digital photography: Food intake: Energy intake: Measurement: Self-reportThe gold standard for measuring food or energy intake (EI) in free-living humans is the doubly labelled water (DLW) method. DLW provides an accurate measure of total daily energy expenditure and, during a period of energy balance, total daily energy expenditure is equal to EI (1,2) . When a large energy deficit is present during the DLW period, however, it is difficult to obtain an accurate (valid) estimate of an individual's short-term EI using DLW, even if changes in energy stores are considered (3) . This limitation is noteworthy, since researchers and clinicians frequently require an estimate of EI during diets or periods of energy restriction. Additional limitations of the DLW method include: (1) cost; (2) availability; (3) its inability to provide important information about the type and micro-and macronutrient composition of foods ingested. Nevertheless, seemingly few valid and reliable alternatives for estimating EI are available.Self-report methods are frequently used to collect EI data, including 24 h food recall and pen-and-paper food records. When estimating EI with 24 h food recall, a trained individual interviews the participant about his/her food and beverage consumption over the previous 24 h. This method relies on the ability of the participant to accurately recall the types and amou...
Consumption of sugar-sweetened beverages may be one of the dietary causes of metabolic disorders, such as obesity. Therefore, substituting sugar with low-calorie sweeteners may be an efficacious weight management strategy. We tested the effect of preloads containing stevia, aspartame, or sucrose on food intake, satiety, and postprandial glucose and insulin levels. Design: 19 healthy lean (BMI = 20.0 -24.9) and 12 obese (BMI = 30.0 -39.9) individuals 18 to 50 years old completed three separate food test days during which they received preloads containing stevia (290 kcal), aspartame (290 kcal), or sucrose (493 kcal) before the lunch and dinner meal. The preload order was balanced, and food intake (kcal) was directly calculated. Hunger and satiety levels were reported before and after meals, and every hour throughout the afternoon. Participants provided blood samples immediately before and 20 minutes after the lunch preload. Despite the caloric difference in preloads (290 vs. 493 kcals), participants did not compensate by eating more at their lunch and dinner meals when they consumed stevia and aspartame versus sucrose in preloads (mean differences in food intake over entire day between sucrose and stevia = 301 kcal, p < .01; aspartame = 330 kcal, p < .01). Selfreported hunger and satiety levels did not differ by condition. Stevia preloads significantly lowered postprandial glucose levels compared to sucrose preloads (p < .01), and postprandial insulin levels compared to both aspartame and sucrose preloads (p < .05). When consuming stevia and aspartame preloads, participants did not compensate by eating more at either their lunch or dinner meal and reported similar levels of satiety compared to when they consumed the higher calorie sucrose preload.
Background The “Positive Action for Today’s Health” (PATH) trial tested an environmental intervention to increase walking in underserved communities. Methods Three matched communities were randomized to a police-patrolled walking plus social marketing, a police-patrolled walking-only, or a no-walking intervention. The 24-month intervention addressed safety and access for physical activity (PA) and utilized social marketing to enhance environmental supports for PA. African-Americans (N=434; 62 % females; aged 51±16 years) provided accelerometry and psychosocial measures at baseline and 12, 18, and 24 months. Walking attendance and trail use were obtained over 24 months. Results There were no significant differences across communities over 24 months for moderate-to-vigorous PA. Walking attendance in the social marketing community showed an increase from 40 to 400 walkers per month at 9 months and sustained ~200 walkers per month through 24 months. No change in attendance was observed in the walking-only community. Conclusions Findings support integrating social marketing strategies to increase walking in underserved African-Americans (ClinicalTrials.gov #NCT01025726).
Background Ethnic minorities and lower-income adults have among the highest rates of obesity and lowest levels of regular physical activity (PA). The Positive Action for Today's Health (PATH) trial compares three communities that are randomly assigned to different levels of an environmental intervention to improve safety and access for walking in low income communities. Design and setting Three communities matched on census tract information (crime, PA, ethnic minorities, and income) were randomized to receive either: an intervention that combines a police-patrolled-walking program with social marketing strategies to promote PA, a police-patrolled-walking only intervention, or no-walking intervention (general health education only). Measures include PA (7-day accelerometer estimates), body composition, blood pressure, psychosocial measures, and perceptions of safety and access for PA at baseline, 6, 12, 18, and 24 months. Intervention The police-patrolled walking plus social marketing intervention targets increasing safety (training community leaders as walking captains, hiring off-duty police officers to patrol the walking trail, and containing stray dogs), increasing access for PA (marking a walking route), and utilizes a social marketing campaign that targets psychosocial and environmental mediators for increasing PA. Main hypotheses/outcomes It is hypothesized that the police-patrolled walking plus social marketing intervention will result in greater increases in moderate-to-vigorous PA as compared to the police-patrolled-walking only or the general health intervention after 12 months and that this effect will be maintained at 18 and 24 months. Conclusions Implications of this community-based trial are discussed.
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