Evaluating Mobile Apps For Dietary and Food Timing Assessment For Use in Research and Clinical Assessment (Preprint)

UNSTRUCTURED Abstract: Over the last decade, health apps have become an increasingly popular tool utilized by clinicians and researchers to track food consumption and exercise. However, as consumer apps have primarily focused on tracking dietary intake and exercise, many lack technological features to facilitate the capture of critical food timing details. To determine a viable app that recorded both dietary intake and food timing for use in our clinical study, we evaluated the timestamp data, usability, privacy policies, accuracy of nutrient estimates, and general features of 11 mobile apps for dietary assessment. Apps were selected using a keyword search of related terms and the following apps were reviewed: Bitesnap, Cronometer, DiaryNutrition, DietDiary, FoodDiary, FoodView, Macros, MealLogger, myCircadianClock, MyFitnessPal, and MyPlate. Our primary goal was identifying apps that record food timestamps, which 8 of the reviewed apps did (73%). Of those, only 4/11 (36%) allowed users to edit the timestamps, an important feature. Next, we sought to evaluate the usability of the apps, using the System Usability Scale (SUS) across 2 days, with 82% of the apps receiving favorable scores for usability (9/11 apps). To enable use in research and clinic settings, the privacy policies of each app were systematically reviewed using common criteria with 1 Health Insurance Portability and Accountability Act (HIPAA) compliant app (Cronometer). Furthermore, protected health information is collected by 9/11 (81%) of the apps. Lastly, to assess the accuracy of nutrient estimates generated by these apps, we selected 4 sample food items and one researcher’s 3-day dietary record to input into each app. The caloric and macronutrient estimates of the apps were compared to nutrient estimates provided by a registered dietitian using the Nutrition Data System for Research (NDSR). Compared to the 3-day food record, the apps were found to consistently underestimate calories and macronutrients compared to NDSR. Overall, we find the Bitesnap app to provide flexible dietary and food timing functionality capable for research or clinical use with the majority of apps lacking in necessary food timing functionality or user privacy.

The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Study Design, Methods and Sample Description

(1) Background: Caregiver feeding practices during the first two years of a child’s life influence nutrition, growth, and development, as well as long term taste preferences and dietary patterns. Suboptimal feeding practices lead to poorer health outcomes, such as obesity, that persist into adulthood. Although the importance of early life nutrition is well-established, there are no Australia-wide surveys of dietary intakes of children under two years of age. The 2021 Australian Feeding Infants and Toddlers Study (OzFITS) aims to fill this gap. This paper describes the methods and study sample of OzFITS 2021. (2) Methods: OzFITS 2021 is a cross-sectional study of children aged 0 to 23.9 months of age and their caregiver across Australia. Data were collected between April 2020 and April 2021. A telephone-based survey was completed with a caregiver to obtain information on child and caregiver characteristics and feeding practices. For exclusively breastfed infants, the number of breastfeeds in a 24 h period was reported. Dietary intakes for mixed fed children were estimated using a one-day food record, with 30% of caregivers completing a second food record on a non-consecutive day. (3) Results: We enrolled 1140 caregiver and child dyads. Of those eligible to complete a food record, 853 (87%) completed the food record. Compared to the Australian population, caregivers were more likely to be university-educated (>75%), married or in a de facto relationship (94%), and have a household income >$100,000/y (60%). (4) Conclusions: OzFITS 2021 is the first national study to examine food and nutrient intake in Australian children aged under 2 years. The study will provide information on breastfeeding rates and duration, use of breast milk substitutes, and timing of solid food introduction. Dietary intake data will allow the comparison of core food groups and discretionary food intake to Australian guidelines and estimate the prevalence of inadequate intake of key nutrients, like iron. Healthcare practitioners and policymakers can use the study findings as a source of evidence to inform the next iteration of infant feeding guidelines.

Nutritional Status, Selected Nutrients Intake and Their Relationship with the Concentration of Ghrelin and Adiponectin in Patients with Diabetic Nephropathy

Background: Overnutrition is one of the risk factors of chronic kidney disease (CKD). The factors related to both obesity and CKD are adiponectin and ghrelin. The aim of the study was to assess if there is a link of nutritional status and selected nutrients intake with adiponectin and ghrelin in patients with diabetic nephropathy (DN). Methods: The study involved 55 patients diagnosed with DN in the pre-dialysis period (two groups: GFR < 30 and >30 mL/min/1.73 m2). In all participants standard blood tests, total ghrelin and total adiponectin plasma concentrations and anthropometric measurements (BMI, WHR- waist–hip ratio, body composition analysis) were performed. The evaluation of energy and nutrient intakes was made using the three-day food record method. Results: Excessive body weight was found in 92.80% patients. The average daily energy intake was 1979.67 kcal/day (14.45% protein energy, 28.86% fat, and carbohydrates 56.89%). In the group with eGFR < 30 mL/min/1.73 m2 the analysis showed a negative relationship between ghrelin and WHR value, and the creatine and albumin concentrations. There was a positive correlation between ghrelin concentration and the consumption of carbohydrates and sucrose. In the group of patients with eGFR > 30 mL/min/1.73 m2, a positive correlation was found between the concentration of ghrelin and the consumption of vegetable protein, carbohydrates, and glucose. Conclusions: The study confirms the high prevalence of obesity in patients with DN-Excessive supply of protein was found in the patients’ diets, which may contribute to the deterioration of the course of the disease and its prognosis. In patients with eGFR < 30 there was a negative correlation between ghrelin concentration and nutritional status, and in patents with eGFR > 30 between ghrelin concentration and some nutrients intake.

KiESEL - The Children’s Nutrition Survey to Record Food Consumption for the Youngest in Germany

BackgroundWith KiESEL, the Children’s Nutrition Survey to Record Food Consumption, the German Federal Institute for Risk Assessment (BfR) collected representative food consumption data for children aged six months up to five years. KiESEL was one of five modules of KiGGS Wave2 (German Health Interview and Examination Survey for Children and Adolescents) conducted by the Robert Koch-Institute (RKI). The objective was to update the consumption data for children in Germany and to fill a data gap for the age group of five-year-old children. The study provides an up-to-date and comprehensive database that will be used for exposure assessment, as part of risk assessment of Germany’s youngest consumers. MethodsIn the years 2014 to 2017, more than 1000 children from all over Germany participated in KiESEL. During home visits, survey staff conducted a questionnaire-based interview including a food propensity questionnaire (FPQ) on seldom eaten foods and questions concerning consumption outside home, dietary habits and diet during first year. The interviewer measured the children’s height and weight. Families and childcare workers filled out a food record, covering three consecutive days and one independent day. Data are based on the FPQ and present consumption frequencies. Depending on the question, socioeconomic status (SES) and migration background were considered.Results 1104 participants had an interview and filled out the questionnaire on usual food intake, seldom eaten foods and consumption away from home. They were included in sample1. 1008 of these participants additionally reported food consumption of at least three days (sample2). 91.2 % of the children follow no special diet and 0.8 % are vegetarians. 7 % of the older children consuming soya-drink. For some foods differences in consumption across SES or migration status were noted. Children from families with higher SES consume more often soya-based substitute milk as families with lower SES (p<0.00005).ConclusionsKiESEL gathered up-to-date consumption data for more than 1000 children living in Germany, aged six month up to including five years. The data will be used for risk assessments of the BfR and provided to national and international partners.

Validation of the INDDEX24 mobile app vs. a pen-and-paper 24-hour dietary recall using the weighed food record as a benchmark in Burkina Faso

Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform vs. a pen-and-paper (PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18-49 years old from rural Burkina Faso (n=116 INDDEX24; n=115 PAPI). A weighed food record was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percent error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups, and quantities (modalities’ divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at p <.05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percent within +/-20% of WFR 17%-45% for macronutrients; 5%-17% for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.

FAKTOR YANG BERHUBUNGAN TOTAL FOOD LOSS AND WASTE (FLW) PADA KARYAWAN PT. CAMILOPLAS JAYA MAKMUR SELAMA PANDEMI COVID-19

The implementation of large-scale social restrictions during the COVID-19 pandemic has made employees do their work at home so they spend more time ordering food online. This will lead to bad habits that cause food loss and waste (FLW) because the food available at home if not consumed will be wasted. This study aims to determine the factors related to total food loss and waste (FLW) in PT Camiloplast Jaya Makmur employees during the COVID-19 pandemic. The research method is quantitative with a design cross-sectional. Engineering samples total sampling.The analysis of this study used the chi-square. Data were collected using the FLW behavior questionnaire and the form estimated food record 3x24 hours. The results showed that there was a relationship between age (p=0.000, OR=14,385) and gender (p=0.000, OR=20,855) to total food loss and waste (FLW) but there was no relationship between knowledge (p=0,139), income (p=0,826), food selection (p=0,332), lifestyle (p=0,486), frequency of eating (p=0,492) and meal times including breakfast (p=1,000), lunch (p=0,346), and dinner (p=0.476 to the total food loss and waste (FLW). Therefore, employees are expected to be wiser in ordering food online and endeavor to make a list of food to be purchased in order to minimize the occurrence of food loss and waste (FLW).

Can the School Fruit and Vegetable Scheme Be an Effective Strategy Leading to Positive Changes in Children’s Eating Behaviours? Polish Evaluation Results

Background: The School Fruit and Vegetable Scheme (SFVS) was developed to form the habit of eating fruit and vegetables (F&V) among children. The survey aimed to identify both the strengths of the scheme and areas that required support and strengthening in the further implementation of school schemes. Methods: The study was conducted from 2012 to 2015 among students of randomly selected 85 primary schools that participated in the programme (intervention group) or did not participate therein (control group). The F&V consumption among the students was evaluated based on the 3 day food record method. Other behaviours were evaluated via frequency and preference questionnaires. Results: Over the three years of implementing SFVS, fruit consumption significantly increased by approximately 30 g/day, i.e., by 18%. In the control group, it increased only by approximately 4%. At the same time, no increase in vegetable consumption was observed. A number of other positive effects of SFVS were also found. These concerned students’ nutritional attitudes and behaviours, such as a further increase in the children’s knowledge on the health aspects of F&V consumption, the levels of their consumption and an increased preference for fruit in general. Conclusions: The results indicate that providing F&V in schools free of charge can be an effective strategy for enhancing F&V consumption among children, in particular by raising the awareness of the health importance of F&V consumption and gradually influencing children’s eating habits, especially when it comes to the habit of fruit consumption. The issue of vegetable consumption is an area for intervention enhancement. There is also a need for further, in-depth analyses, taking into account the impact of potential confounding factors.

Dietary assessment of schoolchildren: is food record a valid method?

Objective: To verify the relative validity of 24-hour Dietary Recall (R24h) as an assessment tool of schoolchildren´s food intake. Methods: A cross-sectional study of 41 students of a big Brazilian urban center, with a mean age of 0.25–8.35 years and 22% had excess weight. The R24h was applied a day after direct observation of intake (reference method). Weight and height were measured and the participants were categorized according to nutritional status (excess weight or not). The median energy, macronutrients (carbohydrate, protein and lipid) and micronutrients intake (iron, calcium and vitamin A) was compared. The Mann-Whitney test was conducted. Also, Spearman and kappa correlation coefficients were calculated. Results: Median energy and nutrient intake irrespective of nutritional status was similar according to the test and reference methods. Higher correlations were found for protein (r= 0.87) and iron (r = 0.71) but the values were more accentuated among students with excess weight. Kappa coefficient was low for vitamin A, moderate for carbohydrate and lipid, good for iron and protein, and very good for energy. Conclusions: R24h is a valid method for the assessment of food intake among schoolchildren. It is a potential practical and economical food assessment method, which can find application in epidemiological studies focused on food intake in early life.

Dietary intake in indigenous adolescents in rural Buryatia, Russia

Background. The diet of adolescents is an important factor in their future health. The diet is formed under the influence of biological, personal, family, socio-economic, environmental, and cultural factors.The aim: to study the diet of adolescents in rural areas of Buryatia and compare the dietary intake of the Russian and Buryat ethnic groups.Materials and methods. The study included 92 rural adolescents 11–17 years old (44 boys, 48 girls); 49 of them were Buryats, 43 – Russians. Dietary intake was assessed by the food record method. The intake of energy, macronutrients (proteins, fats and carbohydrates) and micronutrients (major groups of vitamins and trace elements) of the diet was determined. The values obtained were compared with references to daily energy and nutrient intake, and between groups of adolescents of different ethnicity.Results. The diets of rural adolescents were not balanced. Only 7.6 % of adolescents include fish in their diet. Milk and dairy products are consumed by 38 % of the respondents. Daily energy intake was significantly lower the recommended guidelines. The diet is characterized by a deficiency of vitamins of groups A, C, and D, group B (with the exception of cobalamin), niacin, biotin, essential trace elements (calcium, phosphorus, iodine), high sodium intake. A significant deficiency of dietary fiber has been noted. The Buryats showed a shift in the ratio of proteins, fats and carbohydrates in the diet towards carbohydrates (1 : 1.2 : 5.3).Conclusion. The results indicate significant disturbances in the composition of the diet in rural adolescents in Buryatia, more pronounced in the Asian subgroup. This can be a rationale for the development of targeted nutrition monitoring programs aimed at preserving the health of the youth.

Development, validity and reproducibility of a dish-based semi-quantitative food frequency questionnaire in Iran

BACKGROUND: The food frequency questionnaire (FFQ) is the method of choice for dietary assessment in epidemiological studies. FFQs focusing on mixed-dishes and simple food items are useful where mixed-dishes are an essential part of food consumption. OBJECTIVE: Regarding the fact that the nature of the Iranian diet is mixed-dish, the present study aimed to design and assess the validity and reproducibility of a dish-based semi-quantitative FFQ in the Iranian adult population. METHODS: A list of 302 food items was collected from four geographical areas around Iran. The validation study was conducted on 97 healthy adults. The FFQ was introduced at the beginning of the study and 10 months after; two three-day food records were collected during the study. Also, biomarkers including 24-hour urinary potassium and nitrogen, serum retinol, and alpha-tocopherol were measured. RESULTS: A 142-food-item FFQ was concluded. The correlation coefficient between the second FFQ and the second three-day food record ranged from 0.225 to 0.323 for macronutrients and 0.128 to 0.476 for micronutrients. The percentile agreements (same or adjacent quartile) between the two methods were more than 60%for all nutrients. The intraclass correlation coefficient between FFQs (except for vitamin E) ranged from 0.363 to 0.578. The correlation coefficient between the second FFQ and the second biomarker assessment was 0.241 for protein.