Validation of computer software to estimate dietary intake among patients with type 2 diabetes

Tailored nutritional guidance by a registered dietitian is necessary for feasible, practical application of nutrition therapy. In order to reduce the requirement for estimation by a dietitian and to increase the time available for practical advice, we developed and validated computer software for estimating dietary intake among patients with type 2 diabetes. The study enrolled 46 patients with type 2 diabetes, recruited from an outpatient clinic in 2015. We used the computer software "Syokuseikatsu Shindan System" (SSS; Nissha, Kyoto, Japan). SSS allows the user to choose pictures of dishes and the portions he/she has consumed for each meal. The one-day dietary intake estimations for SSS were validated against a reference estimation of 24-h dietary recall by a registered dietitian. The mean carbohydrate intake as assessed by SSS and 24-h recall was 210.6 ± 55.1 and 215.5 ± 52.9 g/day, with a positive correlation (r = 0.53, p<0.001). Bland-Altman analysis showed that limits of agreement in carbohydrates between the methods were -107.4 to 97.5 g/day. Even though the limits of agreement were wide and non-negligible at the individual level for clinical use, SSS appears to have potential as a dietary estimation tool under registered dietitian supervision.