Accuracy of energy and nutrient intake estimation versus observed intake using 4 technology-assisted dietary assessment methods: a randomized crossover feeding study

Clare Whitton; Clare E Collins; Barbara A Mullan; Megan E Rollo; Satvinder S Dhaliwal; Richard Norman; Carol J Boushey; Edward J Delp; Fengqing Zhu; Tracy A McCaffrey; Sharon I Kirkpatrick; Christina M Pollard; Janelle D Healy; Amira Hassan; Shivangi Garg; Paul Atyeo; Syed Aqif Mukhtar; Deborah A Kerr

doi:10.1016/j.ajcnut.2024.04.030

Accuracy of energy and nutrient intake estimation versus observed intake using 4 technology-assisted dietary assessment methods: a randomized crossover feeding study

Am J Clin Nutr. 2024 May 6:S0002-9165(24)00456-8. doi: 10.1016/j.ajcnut.2024.04.030. Online ahead of print.

Authors

Clare Whitton¹, Clare E Collins², Barbara A Mullan³, Megan E Rollo⁴, Satvinder S Dhaliwal⁵, Richard Norman⁶, Carol J Boushey⁷, Edward J Delp⁸, Fengqing Zhu⁹, Tracy A McCaffrey¹⁰, Sharon I Kirkpatrick¹¹, Christina M Pollard¹², Janelle D Healy¹³, Amira Hassan¹⁴, Shivangi Garg¹⁵, Paul Atyeo¹⁶, Syed Aqif Mukhtar¹⁷, Deborah A Kerr¹⁸

Affiliations

¹ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia; School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia. Electronic address: clare.whitton@curtin.edu.au.
² School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia. Electronic address: clare.collins@newcastle.edu.au.
³ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Enable Institute, Curtin University, Perth, Australia. Electronic address: barbara.mullan@curtin.edu.au.
⁴ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia. Electronic address: megan.rollo@curtin.edu.au.
⁵ Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia; Obstetrics & Gynaecology Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, 8 College Rd, 169857, Singapore; Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia; Singapore University of Social Sciences, 463 Clementi Road, 599494, Singapore. Electronic address: S.Dhaliwal@curtin.edu.au.
⁶ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Enable Institute, Curtin University, Perth, Australia. Electronic address: richard.norman@curtin.edu.au.
⁷ Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA. Electronic address: cjboushey@cc.hawaii.edu.
⁸ School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States. Electronic address: ace@ecn.purdue.edu.
⁹ School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States. Electronic address: zhu0@purdue.edu.
¹⁰ Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia. Electronic address: tracy.mccaffrey@monash.edu.
¹¹ School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada. Electronic address: sharon.kirkpatrick@uwaterloo.ca.
¹² Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia; Enable Institute, Curtin University, Perth, Australia. Electronic address: C.Pollard@curtin.edu.au.
¹³ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia. Electronic address: janelle.healy@curtin.edu.au.
¹⁴ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia. Electronic address: amira.hassan@curtin.edu.au.
¹⁵ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia. Electronic address: shivangi.garg@curtin.edu.au.
¹⁶ Health Section, Health and Disability Branch, Australian Bureau of Statistics, Canberra, Australia. Electronic address: paul.atyeo@abs.gov.au.
¹⁷ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia. Electronic address: Aqif.Mukhtar@curtin.edu.au.
¹⁸ Curtin School of Population Health, Curtin University, Kent Street, GPO Box U1987, Perth 6845, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Kent Street, GPO Box U1987, Perth 6845, Australia. Electronic address: d.kerr@curtin.edu.au.

PMID: 38710447
DOI: 10.1016/j.ajcnut.2024.04.030

Abstract

Background: Technology-assisted 24-h dietary recalls (24HRs) have been widely adopted in population nutrition surveillance. Evaluations of 24HRs inform improvements, but direct comparisons of 24HR methods for accuracy in reference to a measure of true intake are rarely undertaken in a single study population.

Objectives: To compare the accuracy of energy and nutrient intake estimation of 4 technology-assisted dietary assessment methods relative to true intake across breakfast, lunch, and dinner.

Methods: In a controlled feeding study with a crossover design, 152 participants [55% women; mean age 32 y, standard deviation (SD) 11; mean body mass index 26 kg/m², SD 5] were randomized to 1 of 3 separate feeding days to consume breakfast, lunch, and dinner, with unobtrusive weighing of foods and beverages consumed. Participants undertook a 24HR the following day [Automated Self-Administered Dietary Assessment Tool-Australia (ASA24); Intake24-Australia; mobile Food Record-Trained Analyst (mFR-TA); or Image-Assisted Interviewer-Administered 24-hour recall (IA-24HR)]. When assigned to IA-24HR, participants referred to images captured of their meals using the mobile Food Record (mFR) app. True and estimated energy and nutrient intakes were compared, and differences among methods were assessed using linear mixed models.

Results: The mean difference between true and estimated energy intake as a percentage of true intake was 5.4% (95% CI: 0.6, 10.2%) using ASA24, 1.7% (95% CI: -2.9, 6.3%) using Intake24, 1.3% (95% CI: -1.1, 3.8%) using mFR-TA, and 15.0% (95% CI: 11.6, 18.3%) using IA-24HR. The variances of estimated and true energy intakes were statistically significantly different for all methods (P < 0.01) except Intake24 (P = 0.1). Differential accuracy in nutrient estimation was present among the methods.

Conclusions: Under controlled conditions, Intake24, ASA24, and mFR-TA estimated average energy and nutrient intakes with reasonable validity, but intake distributions were estimated accurately by Intake24 only (energy and protein). This study may inform considerations regarding instruments of choice in future population surveillance. This trial was registered at Australian New Zealand Clinical Trials Registry as ACTRN12621000209897.

Keywords: Automated Self-Administered Dietary Assessment Tool; Intake24; controlled feeding; dietary assessment; dietary measurement error; image-assisted; interview-administered dietary recall; mobile food record; mobile technology; validation.