Wearable camera-based dietary assessment of mother-father dyads in urban and rural households in Ghana

Authors: DOMFE, CHRISTABEL - University Of Georgia; MCCRORY, MEGAN - Boston University; BARNOWSKI, TOM - Children'S Nutrition Research Center (CNRC); SAZONOV, EDWARD - University Of Alabama; GHOSH, TONMOY - University Of Alabama; RAJU, VIPRAV - University Of Alabama; FROST, GARY - Imperial College; STEINER-ASIEDU, MATILDA - University Of Ghana; SUN, MINGUI - University Of Pittsburgh; JIA, WENYAN - University Of Pittsburgh; LO, BENNY - Imperial College; ANDERSON, ALEX - University Of Georgia

Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/13/2026
Publication Date: 4/28/2026
Citation: Domfe, C.A., McCrory, M.A., Barnowski, T., Sazonov, E., Ghosh, T., Raju, V., Frost, G., Steiner-Asiedu, M., Sun, M., Jia, W., Lo, B., Anderson, A.K. 2026. Wearable camera-based dietary assessment of mother-father dyads in urban and rural households in Ghana. Current Developments in Nutrition. https://doi.org/10.1016/j.cdnut.2026.107696.
DOI: https://doi.org/10.1016/j.cdnut.2026.107696

Interpretive Summary: Few studies have investigated the dietary intakes of parents in low- and middle-income countries, despite the importance of these data for understanding the household-level double burden of malnutrition (DBM). This cross-sectional study was conducted in one rural and one urban community in Ghana among households with a mother, father, and a child younger than 5 years and/or an adolescent. Dietary intake was assessed using the Automatic Ingestion Monitor 2 (AIM-2), a micro-camera mounted on eyeglasses, which both parents wore over two weekdays and one weekend day. In rural households, mothers had significantly higher energy, vitamin A, and zinc intakes than fathers, whereas fathers had significantly higher iron intakes than mothers. Similar patterns were observed in urban households, where mothers reported higher energy and zinc intakes, while fathers again had higher iron intakes than mothers. The prevalence of overweight and obesity was substantially higher among mothers than fathers in both urban (70% vs. 40%) and rural (67% vs. 30%) households. The coexistence of overweight/obesity and inadequate iron intake among mothers illustrates a distinct manifestation of the household-level DBM in this population.

Technical Abstract: There is a dearth of studies examining the dietary intakes of parents from low- and middle-income countries, which are foundational for understanding the household-level double burden of malnutrition (DBM). Our objective was to assess the energy and nutrient intakes (carbohydrates, protein, fat, vitamin A, folate, zinc, and iron) of mother–father dyads from rural and urban households in Ghana using a wearable camera, an objective measure of dietary intake, not subject to self-reporting errors. In this cross-sectional study, purposive convenience sampling was used to recruit 60 households with a mother, father, and a child younger than 5 y and/or an adolescent from 1 rural and 1 urban community in Ghana. Both parents wore the Automatic Ingestion Monitor 2 (AIM-2) over 2 weekdays and 1 weekend day. Dietary intake was analyzed using custom AIM Annotation Software. Household characteristics were collected via questionnaire, and body mass index (kg/m2) was calculated from measured height and weight. No differences in mean energy, macronutrient, or micronutrient intakes were observed between mothers and fathers within either area of residence. Dyad-level analyses showed that in rural households, mothers had higher caloric (P=0.001), vitamin A (P=0.048), and zinc intakes (P=0.001) than fathers, who had higher iron intakes (P<0.001) than mothers. In urban households, mothers had higher caloric (P=0.006) and zinc intakes (P<0.001) than fathers who had higher iron intakes (P<0.001) than mothers. The prevalence of overweight/obesity was higher among mothers than fathers in both urban (70% versus 40%, P=0.020) and rural (67% versus 30%, P=0.005) households. The coexistence of overweight/obesity and low iron intakes among mothers highlights a unique presentation of the DBM at the household level. The AIM-2 shows promise for addressing limitations of traditional dietary assessment methods through passive and objective image capture.