Author Identifier

Clare Whitton

https://orcid.org/0000-0003-1991-2432

Document Type

Journal Article

Publication Title

American Journal of Clinical Nutrition

Volume

120

Issue

1

First Page

196

Last Page

210

PubMed ID

38710447

Publisher

Elsevier

School

School of Medical and Health Sciences

RAS ID

71198

Funders

Australian Research Council

National Health and Medical Research Council

NIH-NCI (1U01CA130784-01, 1U24CA268228-01) and NIH-NIDDK (1R01DK073711-01A1, 2R56DK073711-04)

Grant Number

ARC Number : 190101723, NHMRC Number : APP2009340

Comments

Whitton, C., Collins, C. E., Mullan, B. A., Rollo, M. E., Dhaliwal, S. S., Norman, R., ... & Kerr, D. A. (2024). Accuracy of energy and nutrient intake estimation versus observed intake using 4 technology-assisted dietary assessment methods: A randomized crossover feeding study. The American Journal of Clinical Nutrition, 120(1), 196-210. https://doi.org/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.

DOI

10.1016/j.ajcnut.2024.04.030

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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