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Validity of an AI-Assisted Dietary Recording Application for Family-Based Nutritional Management in Young Patients
Nao Shiraishi1, Rieko Kawase2, Haruka Ogawa1
1Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Insights
An AI-assisted app for digital dietary recording shows acceptable accuracy in estimating energy and nutrient intake for adolescents with anorexia nervosa (AN). This tool supports family-based nutritional management of AN.
Area of Science:
- Nutritional Science
- Pediatric Psychology
- Digital Health
Background:
- Limited evidence exists on digital dietary recording validity for family-based anorexia nervosa (AN) treatment.
- AI-assisted apps may aid parents in nutritional management of AN.
- This study assesses an AI app's validity for dietary intake recording in AN patients.
Purpose of the Study:
- To evaluate the validity of an AI-assisted app for digital dietary recording.
- To compare app-estimated energy and nutrient intake with a dietitian's assessment.
- To assess the app's utility in family-based nutritional management of AN.
Main Methods:
- Parents of 30 female AN inpatients recorded one day of dietary intake using an AI app (meal photographs).
- App-estimated intake was compared to a registered dietitian's visual estimation.
- Statistical analyses included Wilcoxon signed-rank test, Spearman correlation, and Bland-Altman analysis.
Main Results:
- No significant difference in total energy intake between the app and dietitian (2462 vs. 2439 kcal/day).
- Moderate to high correlations observed for total energy and major nutrients (e.g., ρ = 0.62 for energy).
- App showed acceptable agreement, with no systematic bias, and improved correlations after outlier exclusion (ρ = 0.74).
Conclusions:
- The AI-assisted app demonstrates acceptable validity for estimating energy and nutrient intake in AN treatment.
- The app can support family-based nutritional management of anorexia nervosa.
- Attention to dish type and portion size is recommended for optimal clinical use.
Abstract:
Background: Evidence regarding the validity of digital dietary recordings in the family-based nutritional management of anorexia nervosa (AN) remains limited. This study evaluated the validity of an AI-assisted dietary recording application (app) used by the parents of young patients with AN, with total energy intake as the primary outcome and major nutrient intake as the secondary outcome. Methods: During hospital leave prior to discharge, one day of dietary intake was recorded by parents using the app based on meal photographs. The energy and nutrient intakes estimated by the app were compared with a registered dietitian using visual estimation of the photographs. Differences were examined using the Wilcoxon signed-rank test, associations were assessed using Spearman's correlation coefficients, and agreement was evaluated using Bland-Altman analysis. Sensitivity analyses excluding extreme outliers were performed. Results: Thirty female inpatients with AN (mean age: 14.8 ± 2.9 years) and their mothers participated. The median total energy intake did not differ significantly between the app and reference method (2462 vs. 2439 kcal/day). Moderate to high correlations were observed for total energy (ρ = 0.62) and major nutrient intakes. The app tended to overestimate these intakes; however, Bland-Altman analyses indicated no systematic bias. Exclusion of two outliers strengthened correlations for total energy intake (ρ = 0.74) and narrowed the limits of agreement. Conclusions: The app demonstrated an acceptable agreement for estimating energy and major nutrient intake in the therapeutic context of AN. Careful attention to dish type and portion size may further support its clinical use.
