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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #343436
Title: Validity of a digital diet estimation method for use with preschool children

Author
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item ISLAM, NOEMI - Children'S Nutrition Research Center (CNRC)
item SAAB, RABAB - Children'S Nutrition Research Center (CNRC)
item SCHULIN, REBECCA - Pennington Biomedical Research Center
item LIU, YAN - Children'S Nutrition Research Center (CNRC)
item BUTTE, NANCY - Children'S Nutrition Research Center (CNRC)
item APOLZAN, JOHN - Pennington Biomedical Research Center
item MYERS, CANDICE - Pennington Biomedical Research Center
item MARTIN, CORBY - Pennington Biomedical Research Center

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/4/2017
Publication Date: 6/18/2017
Citation: Nicklas, T.A., Islam, N.G., Saab, R., Schulin, R., Liu, Y., Butte, N., Apolzan, J.W., Myers, C.A., Martin, C.K. 2017. Validity of a digital diet estimation method for use with preschool children. Journal of the Academy of Nutrition and Dietetics. doi:10.1016/j.jand.2017.05.005.

Interpretive Summary: Accurate methods of dietary assessment in young children are needed to determine whether their diets are adequate for normal growth and development. The aim of this study was to determine the validity of intake estimations made by human raters (rater method) using the remote food photography method (RFPM) compared with estimations obtained by weighing all foods and beverages consumed by children. Data was collected on 54 African-American and Hispanic children ages 3-5 years. The rater method overestimated total intake in grams and energy intake in minority preschool children in well-controlled conditions. Though The RFPM offers advantages as a dietary assessment method among preschoolers; it does not rely on memory, can be used by multiple caretakers, and allows data to be transferred in real time. The efficiency of the RFPM is limited, requires further refinement, and trained raters are needed to estimate portions.

Technical Abstract: The validity of using the Remote Food Photography Method (RFPM) for measuring food intake of minority preschool children's intake is not well documented. The aim of the study was to determine the validity of intake estimations made by human raters using the RFPM compared with those obtained by weighing all foods and beverages consumed by 3- to 5-year-old children (weighed method). We conducted a cross-sectional observational study. A convenience sample of 54 3- to 5-year-old Hispanic and African-American children were observed during a 12-hour period at Baylor Metabolic Research Unit between June 2013 and January 2014. All foods/beverages consumed by the children were provided by Baylor research coordinators who took and wirelessly transmitted before-and-after pictures of the trays to trained human raters at the Pennington Biomedical Research Center who estimated grams consumed. Energy and macronutrients were calculated using the Food and Nutrient Database for Dietary Studies or food facts data provided by manufacturers. Paired t test, mean differences, and Bland-Altman limits of agreement were performed. Compared to the weighed method, the rater method significantly overestimated total intake by 34 +/- 71 g (P<0.0001), with a mean percent error of 2.9% (root mean square error=7.1%), and total energy intake by 75 +/- 102 kcal (P<0.0001), with a mean percent error of 7.5% (root mean square error=12.3%). The standard error for the macronutrient intakes ranged from 11.0% to 20.2%. The Bland-Altman approach demonstrated a positive slope for the rater method relative to the weighed method for total intake in grams (P=0.006), carbohydrate (P=0.01), and protein (P=0.01) (ie, magnitude of the bias increased with increasing intakes). The rater method overestimated total intake in grams and energy in kilocalories in minority preschool children in a well-controlled condition and needs to be further tested in a free-living environment.