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'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake
Published on: September 18, 2018
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, United States; Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Background:
The remote food photography method (RFPM) accurately estimates energy intake (EI) in adults, but its validity in adolescents has yet to be tested. Given the low accuracy of self-reported dietary intake in adolescents, evaluating the validity of the RFPM in both controlled and free-living settings is crucial.
Objectives:
To examine the validity of the RFPM in estimating adolescents' EI in controlled and free-living settings.
Methods:
In Study 1, adolescents (n = 45) used the RFPM/SmartIntake application during 1) a laboratory test meal, 2) a cafeteria meal, and 3) 7 d of free-living intake, with EI estimations validated against weighed food intake, digital photography of foods method, and doubly labeled water, respectively. EI was measured under the same 3 settings with pen-and-paper food records. After refining the application and training, Study 2 (n = 22) repeated the protocol with a 3-d free-living period. For both studies, equivalence was evaluated using two one-sided t-tests (±10% bounds), and linear mixed models assessed RFPM error by participant characteristics.
Results:
In Study 1, RFPM estimates of EI were equivalent to the criterion measure during cafeteria meals [mean standard deviation (SD) error: 4.1 (120.8) kcal; P = 0.005] but were not equivalent for the laboratory test meal [mean (SD) error: 61.1 (112.7) kcal; P = 0.675] and 7 d of free-living intake [mean (SD) error: -887.9 (554.8) kcal/d; P > 0.99]. In Study 2, RFPM EI estimates were equivalent to the criterion measure in the controlled setting [mean (SD) error: -2.2 (86.5) kcal; P = 0.007], but not in free-living settings [mean (SD) error: -782.8 (947.0) kcal/d; P = 0.99]. In both studies, a higher body mass index (in kg/m2) percentile was associated with greater underestimation of EI (both R2 > 0.19 and P < 0.05).
Conclusions:
The RFPM can accurately estimate the meal-level EI of adolescents in controlled settings; however, significant underestimation occurred in free-living settings in both studies. Previous studies demonstrated the inability to accurately assess adolescents' free-living intake, and the current results extend these findings to the RFPM. This trial was registered at clinicaltrials.gov as Study 1: NCT01719445 (https://clinicaltrials.gov/study/NCT01719445) and Study 2: NCT04148560 (https://clinicaltrials.gov/study/NCT04148560).
