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Research Original Research| Volume 118, ISSUE 2, P252-260, February 2018

Validity of a Digital Diet Estimation Method for Use with Preschool Children

Published:June 19, 2017DOI:https://doi.org/10.1016/j.jand.2017.05.005
Validity of a Digital Diet Estimation Method for Use with Preschool Children
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      Abstract

      Background

      The validity of using the Remote Food Photography Method (RFPM) for measuring food intake of minority preschool children’s intake is not well documented.

      Objective

      Our aim was to determine the validity of intake estimations made by human raters using the RFPM compared with those obtained by weighing all foods and beverages consumed by 3- to 5-year-old children (weighed method).

      Design

      We conducted a cross-sectional observational study.

      Participants/settings

      A convenience sample of 54 3- to 5-year-old Hispanic and African-American children were observed during a 12-hour period at Baylor Metabolic Research Unit between June 2013 and January 2014.

      Main outcome measures

      All foods/beverages consumed by the children were provided by Baylor research coordinators who took and wirelessly transmitted before-and-after pictures of the trays to trained human raters at the Pennington Biomedical Research Center who estimated grams consumed. Energy and macronutrients were calculated using the Food and Nutrient Database for Dietary Studies or food facts data provided by manufacturers.

      Statistical analyses

      Paired t test, mean differences, and Bland-Altman limits of agreement were performed.

      Results

      Compared to the weighed method, the rater method significantly overestimated total intake by 34±71 g (P<0.0001), with a mean percent error of 2.9% (root mean square error=7.1%), and total energy intake by 75±102 kcal (P<0.0001), with a mean percent error of 7.5% (root mean square error=12.3%). The standard error for the macronutrient intakes ranged from 11.0% to 20.2%. The Bland-Altman approach demonstrated a positive slope for the rater method relative to the weighed method for total intake in grams (P=0.006), carbohydrate (P=0.01), and protein (P=0.01) (ie, magnitude of the bias increased with increasing intakes).

      Conclusions

      The rater method overestimated total intake in grams and energy in kilocalories in minority preschool children in a well-controlled condition and needs to be further tested in a free-living environment.

      Keywords

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      Biography

      T. Nicklas is a professor, US Department of Agriculture, Agriculture Research Services, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX.

      Biography

      N. G. Islam is a senior research coordinator, US Department of Agriculture, Agriculture Research Services, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX.

      Biography

      R. Saab is a research coordinator, US Department of Agriculture, Agriculture Research Services, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX.

      Biography

      Y. Liu is a statistician, US Department of Agriculture, Agriculture Research Services, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX.

      Biography

      N. F. Butte is a professor, US Department of Agriculture, Agriculture Research Services, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX.

      Biography

      R. Schulin is a pediatric clinical dietitian, Texas Children's Hospital, Houston, TX; at the time of the study, she was a research dietitian, Pennington Biomedical Research Center, Baton Rouge, LA.

      Biography

      J. W. Apolzan is an assistant professor, Pennington Biomedical Research Center, Baton Rouge, LA.

      Biography

      C. A. Myers is a post-doctoral fellow, Pennington Biomedical Research Center, Baton Rouge, LA.

      Biography

      C. K. Martin is an associate professor, Pennington Biomedical Research Center, Baton Rouge, LA.

      Article info

      Publication history

      Published online: June 19, 2017
      Accepted: May 4, 2017
      Received: June 9, 2016

      Footnotes

      STATEMENT OF POTENTIAL CONFLICT OF INTEREST Pennington Biomedical Research Center/Louisiana State University System has an interest in the intellectual property surrounding the Smart Intake app and Corby Martin is listed as an inventor of the approach.

      FUNDING/SUPPORT This work was funded by National Institutes of Health. Partial support was received from the US Department of Agriculture/Agricultural Research Service through specific cooperative agreement 58-3092-5-001, partial support was received from the National Institute of General Medical Sciences (National Institutes of Health) grant number U54 GM104940, which funds the Louisiana Clinical and Translational Science Center. Also partial support received from the Nutrition Obesity Research Center; grant P30DK072476 from the National Institute of Diabetes and Digestive and Kidney Diseases, grant 1R01CA142919-01A1 from the National Cancer Institute, and grant F32 HL123242 from the National Heart, Lung, and Blood Institute. The funding agencies had no input into the study design, data analytical plan, results, or interpretation of the data. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

      ClinicalTrials.gov Identifier: NCT01725347.

      Identification

      DOI: https://doi.org/10.1016/j.jand.2017.05.005

      Copyright

      © 2018 by the Academy of Nutrition and Dietetics.

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