Novel Technologies for Assessing Dietary Intake: Evaluating the Usability of a Mobile Telephone Food Record Among Adults and Adolescents

Abstract

BackgroundThe development of a mobile telephone food record has the potential to ameliorate much of the burden associated with current methods of dietary assessment. When using the mobile telephone food record, respondents capture an image of their foods and beverages before and after eating. Methods of image analysis and volume estimation allow for automatic identification and volume estimation of foods. To obtain a suitable image, all foods and beverages and a fiducial marker must be included in the image.ObjectiveTo evaluate a defined set of skills among adolescents and adults when using the mobile telephone food record to capture images and to compare the perceptions and preferences between adults and adolescents regarding their use of the mobile telephone food record.MethodsWe recruited 135 volunteers (78 adolescents, 57 adults) to use the mobile telephone food record for one or two meals under controlled conditions. Volunteers received instruction for using the mobile telephone food record prior to their first meal, captured images of foods and beverages before and after eating, and participated in a feedback session. We used chi-square for comparisons of the set of skills, preferences, and perceptions between the adults and adolescents, and McNemar test for comparisons within the adolescents and adults.ResultsAdults were more likely than adolescents to include all foods and beverages in the before and after images, but both age groups had difficulty including the entire fiducial marker. Compared with adolescents, significantly more adults had to capture more than one image before (38% vs 58%, P = .03) and after (25% vs 50%, P = .008) meal session 1 to obtain a suitable image. Despite being less efficient when using the mobile telephone food record, adults were more likely than adolescents to perceive remembering to capture images as easy (P < .001).ConclusionsA majority of both age groups were able to follow the defined set of skills; however, adults were less efficient when using the mobile telephone food record. Additional interactive training will likely be necessary for all users to provide extra practice in capturing images before entering a free-living situation. These results will inform age-specific development of the mobile telephone food record that may translate to a more accurate method of dietary assessment.

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 (Preprint)

“…For each food group, the participant would choose the most appropriate image (or images) from a series of color photographs with 2-4 possible options, shown simultaneously [14,27], that illustrated the different serving sizes to assist with selecting the number of standard servings consumed [10,12,14,20,27]. To further assist with estimating serving sizes, each photograph was accompanied by an explanatory text and three objects of known/predictable size for the students [30,31] (fiducial markers): a commonly used pencil, pen and a marker. For example, on the first screen of the app, the following would appear: How many pieces of fruit have you eaten today?, with the Rations button and Next button and a box with the value set to 0 by default.…”

“…To assist with estimating serving sizes, each photograph was accompanied by an explanatory text and three reference objects of known/predictable size for the students [30,31] (fiducial markers): a commonly used pencil, pen and a marker.…”

“…The same research team member who performed the first interview then explained to each participant, in this second interview, the process for completing the semi-quantitative FFQ, and provided them with an explanatory pamphlet to estimate what was considered a standard serving for each food group. This pamphlet contained a photograph of a standard serving for each food group along with an explanatory text and three reference objects of a known/predictable size for the students [30,31] (fiducial markers): a commonly used pencil, pen and marker. The time period considered by the FFQ corresponded to the 28 days of the app.…”

“…On top of this, the information on the paper questionnaires must be later converted to digital format for analysis, which increases the workload and costs for the research team [17,40]. Online FFQs and DRs, or even Smartphone apps, offer direct solutions to these limitations [10,13,20,[30][31][32]40,[49][50][51][52][53], by reducing paper waste and mailing costs, and removing the need for secure storage space and organization inherent with paper documents [50]. Additionally, online administrative methods can be used to gain access to specific population groups that would otherwise be difficult to study due to geography, for example, as they can be used remotely [32].…”

Is there any alternative to traditional food frequency questionnaire for evaluating habitual dietary intake?

“…In these studies, the participants completed electronic food records or 24-hour recalls based on applications for mobile phones, which allowed digital recording of all foods/drinks consumed for 1-7 days. The objective of these short-term instruments was to assess the whole diet (14)(15)(16)(17)(18). However, until now, no electronic long-term tools had been developed for evaluating habitual dietary intake of selected food/drink groups, benefitting from mobile technologies and serving as an alternative to traditional short FFQs (19).…”