New and Innovative Dietary Assessment Methods German Institute for Human Nutrition, Potsdam-...
Transcript of New and Innovative Dietary Assessment Methods German Institute for Human Nutrition, Potsdam-...
New and Innovative Dietary Assessment Methods
German Institute for Human Nutrition, Potsdam-Rehbruecke
Dr. Karen Wagner/Anne-Kathrin Illner
Literature search
• Criteria for inclusion
– Studies published in English between 2002 and later
– Studies using an instrument to assess foods
– Studies with target populations relevant to the characteristics of
cohorts of IDAMES partners
– Studies identified in Pubmed
Overview
New Method Number of Studies
Validation Studies Feasibility Studies and other
PDA 7 5 2
Picture-sort FFQ
2 2
Smart-card 3 3Bar code scanner
2 2
Computer-tools 3 3
Web-FFQ 5 2 3
Web-24 HDR 2 2
Statistical
method2 2
PDA (1)
Wellnavi
handheld personal digital assistant with camera and mobile phone card
• real time dietary data assessment possible
• digital photos of foods and drinks consumed
• display to specify the ingredients of the meal
• electronic data transfer to a dietician
Fig. 1: „Wellnavi“-Instrument
Wang, D.H., et al., Validity and reliability of a dietary assessment method: the application of a digital camera with a mobile phone card attachment. J Nutr Sci
Vitaminol (Tokyo), 2002. 48(6): p. 498-504.
“Wellnavi” – Studies
Author Methods Subjects Results for nutrient intake
Wang et al, 2006
Wellnavi vs. 1d-WFR1
28 ♀
19.3 ± 0.5 y
r = 0.21-0.81
+ less burden & time consuming (57%)
Kikunaga et al, 2007
Wellnavi vs.
5d-WFR1
75 ♂ & ♀
48.8 ± 10.2 y
r = 0.34-0.78
+ underestimation
Wang, D.H., M. Kogashiwa, and S. Kira, Development of a new instrument for evaluating individuals' dietary intakes. J Am Diet Assoc, 2006. 106(10): p. 1588-93.
Kikunaga, S., et al., The application of a handheld personal digital assistant with camera and mobile phone card (Wellnavi) to the general population in a dietary
survey. J Nutr Sci Vitaminol (Tokyo), 2007. 53(2): p. 109-16.
1WFR: weighted food record
Beasley, J., W.T. Riley, and J. Jean-Mary, Accuracy of a PDA-based dietary assessment program. Nutrition, 2005. 21(6): p. 672-7.
DietMatePro
PDA with integrated Web-based technology
• real time dietary assessment possible • selection of foods from the USDA-database and specification of portion sizes
• immediate web-based transfer form dietary data, date and time of consumption
• individualization of database
PDA (2)
Fig. 2: „DietMatePro“-Display
„DietMatePro“ – Studies
Beasley, J., W.T. Riley, and J. Jean-Mary, Accuracy of a PDA-based dietary assessment program. Nutrition, 2005. 21(6): p. 672-7.
Beasley JM, Riley WT, Davis A, Singh J. Evaluation of a PDA-based dietary assessment and intervention program: a randomized controlled trial. J Am Coll Nutr.
2008 Apr;27(2):280-6.
Author Methods Subjects Results for nutrient intake
Beasley et al, 2005
DietMatePro vs:
1) 24HDR1
2) Weighed meal
39 ♂ & ♀
53 ± 1,7 y
1) r = 0.51-0.80
2) r = 0.42-0.79
+ training essential
Beasley et al, 2008
DietMatePro vs:
1) 24HDR1
2) Paper-diary
174 ♂ & ♀
1) r = 0.41-0.71
2) r = 0.63-0.83
+ training essential
1HDR: 24 Hour dietary recall
Weaknesses Benefits
• high technical and staff
requirements → expensive
• training required
• inaccurate estimation of portion
size
• low correlation coefficient
• usefully measure of
individual dietary intake for a
variety of nutrients
• immediate data transfer
• facilitated data coding
• useful to reach low-literacy
groups, e.g. children, elderly
PDAs
Alternatives to measure self-reported food
intake in large-scale studies?
Web-based FFQs
Author Methods Subjects Results
Beasley et al, 2008
Web-DHQ1 vs:
1) PDHQ2
2) 24 HDR3
3) 4d-FR4
218 ♂ & ♀
54.9 ± 14.4 y
1) r = 0.82
2) r = 0.31
3) r = 0.41(for nutrient intake)
Matthys et al, 2007
Web-based FFQ
vs 3d-WFR5
104 ♂ & ♀ r = 0.20 to 0.64 (for food intake)
Beasley, J. M., Davis, A., and Riley, W. T. Evaluation of a web-based, pictorial diet history questionnaire. Public Health Nutr: 1-9, 2008.
Matthys, C., Pynaert, I., De Keyzer, W., and De Henauw, S. Validity and reproducibility of an adolescent web-based food frequency questionnaire. J Am Diet Assoc, 107: 605-10, 2007
1DHQ: Diet History Questionnaire 2PDHQ: Paper-Diet History Questionnaire3HDR: 24 Hour dietary recall4FR: food record5WFR: weighted food record
Weaknesses Benefits
• finite food list with often closed
ended response categories
• measurement error (no
quantification)
• burden & selection bias - cognitive difficult
- computer literacy
• higher data quality - immediate data check
• less costs - no costs for printing, postage
• less organisational constraints - no manual checks of incomplete or
implausible answers, no transfer of data to
an electronic format
• higher compliance of participants - completion any time & location, reminder
messages, personalized feed-
back, interactive help features
Hanning, R. M., Woodruff, S. J., Lambraki, I., Jessup, L., Driezen, P., and Murphy, C. C. Nutrient intakes and food consumption patterns among Ontario students in grades six, seven, and eight. Can J Public Health, 98: 12-6, 2007;
Bälter, K., Bälter, O., Fondell, E. and Lagerros, Y. Web-based and mailed questionnaires: a comparison of response rates and compliance. Epidemiology, 16:4 S577-590, 2005.
Web-based FFQs
• More specific contributions of new methods to epidemiologic approaches have to be evaluated in feasibility research.
• Some are of high interest large-scale epidemiologic studies, web-based FFQs, 24 HDR today preferred
• High potential for a historically new period of research?
Outlook
Thank you for your attention!
Wellnavi – Validity I
Wang, D.H., et al., Validity and reliability of a dietary assessment method: the application of a digital camera with a mobile
phone card attachment. J Nutr Sci Vitaminol (Tokyo), 2002. 48(6): p. 498-504.
Wellnavi vs. 1-d weighed record
Subjects: College students (n = 20)
Results: r = 0.46 to 0.93 (median r = 0.77).
Conclusion:
Wellnavi can usefully measure individual dietary intakes for a variety of nutrients
in an epidemiologic study
Wellnavi – Validation II
Wang, D.H., M. Kogashiwa, and S. Kira, Development of a new instrument for evaluating individuals' dietary intakes. J Am Diet
Assoc, 2006. 106(10): p. 1588-93.
Wellnavi vs. 1-d weighed record and 24 hr recall
Design: cross-sectional study design
Subjects: College students (n = 28)
Results: no significant differences between the methods
Practicability evaluations participants burden by using a questionnaire
• least burdensome (57% participants)
Conclusion: • may be a valid and convenient instrument for evaluating dietary intake.
New / innovative methods
• Personal Digital Assistant (PDA)– Wellnavi (Wang 2002, Wang 2006, Kikunaga 2007)
– DietMatePro (Beasley 2005 and 2008)
• Web-based and computer based tools
• New statistical analysis
Application Wellnavi
Kikunaga, S., et al., The application of a handheld personal digital assistant with camera and mobile phone card (Wellnavi) to the
general population in a dietary survey. J Nutr Sci Vitaminol (Tokyo), 2007. 53(2): p. 109-16.
Wellnavi vs. 1-d weighed record
Subjects: healthy adults n = 75
Results: significant correlation for energy intake [kcal]:
r = 0.602; p < 0,001
significant lower values for the Energy intake [kcal]:
Wellnavi: 1718 ± 361 vs record: 1977 ± 405
Conclusion:
• could become a useful new dietary assessment method to get accurate
dietary information from people of a wide range of age and occupation
DietMatePro – Validation
Validated in two on-site studies:
(1) 39-person trial with weighed intake of a meal
(2) 174 person randomized, controlled trial comparing
DietMatePro vs 24 hr recall
Beasley, J., W.T. Riley, and J. Jean-Mary, Accuracy of a PDA-based dietary assessment program. Nutrition, 2005. 21(6): p.
672-7.
DietMatePro – Validation
Beasley, J., W.T. Riley, and J. Jean-Mary, Accuracy of a PDA-based dietary assessment program. Nutrition, 2005. 21(6): p.
672-7.
(1) DietMatePro vs. 24 hr recall and weighed meal
Design: Randomized controlled trial
Subjects: 39 participants
Results: r = 0.51 to 0.80 for DietMatePro vs. 24 hr recall
r = 0.42 to 0.79 for DietMatePro vs weighed meal
Conclusion: • provides a method of assessing energy and macronutrient intakes comparable
to the 24-h recall
DietMatePro – Validation
(2) DieMatePro or paper food diary vs 24 hr recall
Design: Randomized controlled trial
Subjects: 174 overweight/obese participants (BMI 25 – 40 kg/m²)
Results: r = 0.41 to 0.71 for the DietMatePro vs 24 hr recall
r = 0.63 to 0.83 for the paper-based diary vs 24 hr recall
Conclusion:
• does not produce more valid data than paper-based approaches
• may improve adherence compared to paper-based methods
Beasley JM, Riley WT, Davis A, Singh J. Evaluation of a PDA-based dietary assessment and intervention program: a
randomized controlled trial. J Am Coll Nutr. 2008 Apr;27(2):280-6.
Web-based version of the NCI diet history questionnaire(web-PDHQ) – Beasley et al, 2008
Design: comparing web-PDHQ vs original paper DHQ
4day food record and 24 hr recall as reference
Subjects: 218 subjects
Results: r = 0.82 between web-PDHQ/original paper DHQ
web-based questionnaires
Beasley, J. M., Davis, A., and Riley, W. T. Evaluation of a web-based, pictorial diet history questionnaire. Public Health Nutr : 1-9, 2008.
Web-based food frequency questionnaire (web-FFQ)Mathyss et al, 2007
Design: comparing web-FFQ vs diary
Subjects: 104 adolescents (12 to 18 years)
Results: r = 0. 20 to 0.64
acceptable validity only for:
water , fruit, bread, and fish/eggs/meat
web-based questionnaires
Matthys, C., Pynaert, I., De Keyzer, W., and De Henauw, S. Validity and reproducibility of an adolescent web-based food frequency questionnaire. J Am Diet Assoc, 107: 605-10, 2007
MyPyramid Tracker, Juan et al, 2006
Design: comparing web-FFQ vs diary
Subjects: 104 adolescents (12 to 18 years)
Results: r = 0. 20 to 0.64
acceptable validity only for:
water , fruit, bread, and fish/eggs/meat
Web-based tool
Juan, W., Gerrior, S., and Hiza, H. MyPyramid Tracker assesses food consumption, physical activity, and energy balance status interactively. J Nutr Educ Behav, 38: S155-7, 2006.
Advanced metods
Lu et al, 2006; Moore et al, 2007; Hanning et al, 2007;
Edwards et al, 2007, Subar et al, 2007
Application:
• web-based questionnaires, web-based software, computer-based recalls
Experiences in application:
• Time-saving, accurate, low burden, cost-effective, well-accepted
• Publicly available