Development and validation of a photographic food atlas for portion size assessment in the southern plains of Nepal

Abstract

Objective: To develop and validate a photographic food atlas of common foods for dietary assessment in southern Nepal. Design: We created a life-sized photographic atlas of forty locally prepared foods. Between March and June 2014, data collectors weighed portion sizes that respondents consumed during one mealtime and then a different data collector revisited the household the next day to record respondents' estimations of their previous day's intakes using the atlas. Validity was assessed by percentage error, Cohen's weighted kappa (κ w ) and Bland-Altman limits of agreement. Setting: Dhanusha and Mahottari districts in southern Nepal. Subjects: A random sample of ninety-five adults in forty-eight rural households with a pregnant woman. Results: Overall, respondents underestimated their intakes (mean error = − 4·5 %). Rice and dal (spiced lentil soup) intakes were underestimated (−14·1 % and −34·5 %, respectively), but vegetable curry intake was overestimated (+20·8 %). Rice and vegetable curry portion size images were significantly reliably selected (Cohen's κ w (SE): rice = 0·391 (0·105); vegetable curry = 0·430 (0·139)), whereas dal images were not. Energy intake over one mealtime was under-reported by an average of 569 kJ (136 kcal; 4·5 % error) using recall compared with the weighing method. Conclusions: The photographic atlas is a useful tool for field estimation of dietary intake. Average errors were low, and there was 'modest' agreement between weighed and recalled portion size image selection of rice and vegetable curry food items. Error in energy estimation was low but with wide limits of agreement, suggesting that there is scope for future work to reduce error further.

Evaluation of a photographic food atlas as a tool for quantifying food portion size in the United Arab Emirates

“…These traditional habits may lead to additional challenges for the participants in this study to estimate food portions. In populations where measuring foods is not commonly practiced, accurate conceptualization of food portions might be lower leading to higher portion size estimation errors [ 26 ].…”

The Adherence of Singaporean Students in Different Educational Institutions to National Food-Based Dietary Guidelines

“…A novel food atlas was developed for culturally-relevant food items in Singapore and used to support the collection of dietary recall data [ 41 ]. While similar tools have been used in other populations effectively [ 67 , 68 ], it must be noted that the current tool has not been validated. Nonetheless, the authors believe that this approach helped to ensure better estimation of food portion sizes by respondents, thereby benefitting the overarching study outcomes.…”

Development and validation of a food photography manual, as a tool for estimation of food portion size in epidemiological dietary surveys in Tunisia

“…The three portion sizes considered to be representative of the range of portion sizes actually consumed (22–24) were placed on a white dining plate (26 cm in diameter) in a colored background contrast. All photographs were taken at approximately the same angle of 45° and from a distance of 50 cm above the plate, which was considered the best compromise between showing the depth and height of the food (25). This technique, sitting at a table, is necessary to show the differences between the size of the portions depending on the height of the food on a plate and depth in a soup bowl (15).…”