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The Validity of Measuring Energy and Nutrient Intake with the Remote Food Photography Method (RFPM) in Adolescents
Christoph Höchsmann1, Hanim E Diktas2, Candice A Myers2
1Pennington Biomedical Research Center, Baton Rouge, LA; Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
The American Journal of Clinical Nutrition
|July 25, 2026
Summary
The Remote Food Photography Method (RFPM) accurately estimates adolescent energy intake (EI) in controlled settings but underestimates it in free-living situations. Higher BMI percentile correlated with greater EI underestimation by the RFPM.
Area of Science:
- Nutrition Science
- Adolescent Health
- Dietary Assessment Methods
Background:
- The Remote Food Photography Method (RFPM) shows accuracy in adult energy intake (EI) estimation.
- Adolescent self-reported dietary intake often lacks accuracy.
- Validating the RFPM for adolescents in various settings is crucial.
Purpose of the Study:
- To assess the validity of the RFPM for estimating adolescent energy intake (EI).
- To compare RFPM accuracy in controlled versus free-living environments.
- To identify factors influencing RFPM accuracy in adolescents.
Main Methods:
- Two studies involving adolescents (n=45 and n=22) utilized the RFPM/SmartIntake app.
- EI estimations were compared against criterion measures like weighed food intake and doubly labeled water.
- Equivalence testing and linear mixed models analyzed RFPM accuracy and error predictors.
Main Results:
- RFPM achieved equivalent EI estimates in controlled settings (cafeteria, lab meal) in Study 1 and controlled settings in Study 2.
- Significant underestimation of EI by RFPM was observed in free-living settings across both studies.
- Higher BMI percentile was associated with increased EI underestimation by the RFPM.
Conclusions:
- The RFPM is a valid tool for estimating adolescent energy intake in controlled settings.
- The RFPM demonstrates significant underestimation of EI in free-living conditions for adolescents.
- Findings align with previous research on the challenges of assessing adolescent free-living dietary intake.
