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ARS Home » Plains Area » Grand Forks, North Dakota » Grand Forks Human Nutrition Research Center » Healthy Body Weight Research » Research » Publications at this Location » Publication #308190
Title: Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: A randomized controlled trial

Author
item Raatz, Susan
item SCHEETT, ANGELA - University Of North Dakota
item JOHNSON, LUANN - University Of North Dakota
item Jahns, Lisa

Submitted to: Journal of Medical Internet Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/23/2014
Publication Date: 1/20/2015
Publication URL: http://handle.nal.usda.gov/10113/60173
Citation: Raatz, S.K., Scheett, A.J., Johnson, L.K., Jahns, L.A. 2015. Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: A randomized controlled trial. Journal of Medical Internet Research. 17(1).

Interpretive Summary: Dietary intake assessment with diet records (DR) is a standard research and practice tool in nutrition. Manual entry and analysis of DR is time-consuming and expensive. New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient intake estimation. Adult participants (n=19) enrolled in a cross-over designed clinical trial completed 3-day diet records during each of two wash-out periods. In addition they were randomly assigned to enter their DR in an online dietary analysis program (Nutrihand®) or a hand-held electronic device (Tap & Track™). Means and standard deviations of nutrient intake were calculated for each method. Concordance of the intake estimates were determined by Bland-Altman plots. Coefficients of determination (R2) were calculated for each comparison to assess the strength of the linear relationship between methods. No significant differences were observed between the mean nutrient values for energy, carbohydrate, protein, fat, saturated fatty acids, total fiber or sodium between the recorded DR analyzed in GRAND and either Nutrihand® or Tap & Track™, or for total sugars comparing GRAND and Tap & Track™. In comparison to dietitian entered 3-day DR, electronic methods resulted in no significant difference in mean nutrient estimates but exhibited larger variability, particularly the Tap & Track™ program. However, electronic DR provided mean estimates of energy, macronutrients, and some micronutrients which approximated those of the dietitian analyzed DR and may be appropriate for dietary monitoring of groups. Electronic diet assessment methods have the potential to reduce the cost and burden of DR analysis for nutrition research and clinical practice.

Technical Abstract: Background: Dietary intake assessment with diet records (DR) is a standard research and practice tool in nutrition. Manual entry and analysis of DR is time-consuming and expensive. New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient intake estimation. Objective: To determine the validity of electronic diet recording, we compared responses to 3-day DR kept by Tap & Track™ software for the Apple iPod touch™ and records kept on the Nutrihand® website to DR coded and analyzed by a research dietitian into a customized USDA nutrient analysis program. Methods: Adult participants (n=19) enrolled in a cross-over designed clinical trial [1]. During each of two wash-out periods participants kept written 3-day DR. In addition they were randomly assigned to enter their DR in an online dietary analysis program (Nutrihand®) or a hand-held electronic device (Tap & Track™). They completed an additional 3-day DR and the alternate electronic diet recording methods during the second wash-out. Entries resulted in 228 daily diet records; or 12 for each of 19 participants. Means and standard deviations of nutrient intake were calculated for each method. Concordance of the intake estimates were determined by Bland-Altman plots. Coefficients of determination (R2) were calculated for each comparison to assess the strength of the linear relationship between methods. Results: No significant differences were observed between the mean nutrient values for energy, carbohydrate, protein, fat, saturated fatty acids, total fiber or sodium between the recorded DR analyzed in GRAND and either Nutrihand® or Tap & Track™, or for total sugars comparing GRAND and Tap & Track™. Reported values for total sugars were significantly reduced (p<.05) comparing Nutrihand® to GRAND. Coefficients of determination (R2) for Nutrihand® and Tap & Track™ compared to DR entries into GRAND, respectively, were energy 0.56, 0.01; carbohydrate 0.58, 0.08; total fiber 0.65, 0.37; sugar 0.78, 0.41; protein 0.44, 0.03; fat 0.36, 0.03; saturated fatty acids 0.23, 0.03; sodium 0.20, 0.00; and for Nutrihand® only for cholesterol 0.88; vitamin A 0.02; vitamin C 0.37; calcium 0.05; and iron 0.77. Bland-Altman analysis demonstrates high variability in individual responses for both electronic capture programs with higher 95% limits of agreement for dietary intake recorded on Tan & Track™. Conclusions: In comparison to dietitian entered 3-day DR, electronic methods resulted in no significant difference in mean nutrient estimates but exhibited larger variability, particularly the Tap & Track™ program. However, electronic DR provided mean estimates of energy, macronutrients, and some micronutrients which approximated those of the dietitian analyzed DR and may be appropriate for dietary monitoring of groups. Electronic diet assessment methods have the potential to reduce the cost and burden of DR analysis for nutrition research and clinical practice.