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Portion size estimation in dietary assessment: a systematic review of existing tools, their strengths and limitations
Birdem Amoutzopoulos1,2, Polly Page1,2, Caireen Roberts1,2
1MRC Elsie Widdowson Laboratory, Cambridge, UK.
Context:
Overestimation or underestimation of portion size leads to measurement error during dietary assessment.
Objective:
To identify portion size estimation elements (PSEEs) and evaluate their relative efficacy in relation to dietary assessment, and assess the quality of studies validating PSEEs.
Data Selection And Extraction:
Electronic databases, internet sites, and cross-references of published records were searched, generating 16 801 initial records, from which 334 records were reviewed and 542 PSEEs were identified, comprising 5% 1-dimensional tools (eg, food guides), 46% 2-dimensional tools (eg, photographic atlases), and 49% 3-dimensional tools (eg, household utensils). Out of 334 studies, 21 validated a PSEE (compared PSEE to actual food amounts) and 13 compared PSEEs with other PSEEs.
Conclusion:
Quality assessment showed that only a few validation studies were of high quality. According to the findings of validation and comparison studies, food image-based PSEEs were more accurate than food models and household utensils. Key factors to consider when selecting a PSEE include efficiency of the PSEE and its applicability to targeted settings and populations.
