Electronic 12-Hour Dietary Recall (e-12HR): Comparison of a Mobile Phone App for Dietary Intake Assessment With a Food Frequency Questionnaire and Four Dietary Records

Abstract

BackgroundOne of the greatest challenges in nutritional epidemiology is improving upon traditional self-reporting methods for the assessment of habitual dietary intake.ObjectiveThe aim of this study was to evaluate the relative validity of a new method known as the current-day dietary recall (or current-day recall), based on a smartphone app called 12-hour dietary recall, for determining the habitual intake of a series of key food and drink groups using a food frequency questionnaire (FFQ) and four dietary records as reference methods.MethodsUniversity students over the age of 18 years recorded their consumption of certain groups of food and drink using 12-hour dietary recall for 28 consecutive days. During this 28-day period, they also completed four dietary records on randomly selected days. Once the monitoring period was over, subjects then completed an FFQ. The two methods were compared using the Spearman correlation coefficient (SCC), a cross-classification analysis, and weighted kappa.ResultsA total of 87 participants completed the study (64% women, 56/87; 36% men, 31/87).For e-12HR versus FFQ, for all food and drink groups, the average SCC was 0.70. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 51.5%; exact agreement + adjacent was 91.8%, and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.51.For e-12HR versus the four dietary records, for all food and drink groups, the average SCC was 0.63. Cross-classification analysis revealed that the average percentage of individuals classified in the exact agreement category was 47.1%; exact agreement + adjacent was 89.2%; and no participant (0%) was classified in the extreme disagreement category. The average weighted kappa was 0.47.ConclusionsCurrent-day recall, based on the 12-hour dietary recall app, was found to be in good agreement with the two reference methods (FFQ & four dietary records), demonstrating its potential usefulness for categorizing individuals according to their habitual dietary intake of certain food and drink groups.

Relative Validity of a Method Based on a Smartphone App (Electronic 12-Hour Dietary Recall) to Estimate Habitual Dietary Intake in Adults

“…The investigation protocol has been published previously elsewhere [32]. In brief, the study was carried out in 2 centers: the Schools of Medicine and Pharmacy at the University of Seville (Andalusia, Spain, South of Europe).…”

“…Other food groups such as dairy and derivatives, eggs, nuts, potatoes, pasta, rice, or bread have not been included. In any case, the food groups included can be modified to meet the needs of each study [32]. The list could not be too long to minimize the workload of the participants as well as the research costs [21].…”

“…As an example, 1 participant registered an average daily consumption of 0.76 standard servings of vegetables over 28 days using the app. This average consumption represents 5.32 standard servings per week (0.76×7=5.32), which would be classified as 5 to 6 times a week [32,44,45]. As for the 4 DRs, the information they contained also needed to be converted [9].…”

“…This study is an extension of the study previously published in JMIR mHealth and uHealth titled Electronic 12-Hour Dietary Recall (e-12HR): Comparison of a Mobile Phone App for Dietary Intake Assessment With a Food Frequency Questionnaire and Four Dietary Records [32]. This study, with regard to the previous one, compares e-12HR against an FFQ and 4 DRs in a whole sample of adults (students and employees of the Schools of Medicine or Pharmacy, University of Seville), and in different strata thereof (sociodemographic characteristics, lifestyle factors and weight category), and not only a sample of the university students.…”

Underreporting of Dietary Intake: Key Issues for Weight Management Clinicians

“…The majority of mobile apps on the market for dietary tracking have not been tested for accuracy or validity and vary widely in format and content; research, where it exists, often focuses on usability and acceptability, rather than validity [47]. Apps may be limited in the number and types of foods included in order to reduce length, but researchers speculate that including visual representations of items and sample sizes and allowing users to simply tap on an image rather than typing in information on amounts or serving sizes has the potential to remove some literacy barriers and improve usability [48].…”