The Development, Validation, and User Evaluation of Foodbook24: A Web-Based Dietary Assessment Tool Developed for the Irish Adult Population.

BACKGROUND: The application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often specifically designed for a particular country or region. OBJECTIVE: The aim of this study was to describe the development, validation, and user evaluation of a Web-based dietary assessment tool "Foodbook24." METHODS: Foodbook24 is a Web-based, dietary assessment tool consisting of a 24-hour dietary recall (24HDR) and food frequency questionnaire (FFQ) alongside supplementary questionnaires. Validity of the 24HDR component was assessed by 40 participants, who completed 3 nonconsecutive, self-administered 24HDR using Foodbook24 and a 4-day semi-weighed food diary at separate time points. Participants also provided fasted blood samples and 24-hour urine collections for the identification of biomarkers of nutrient and food group intake during each recording period. Statistical analyses on the nutrient and food group intake data derived from each method were performed in SPSS version 20.0 (SPSS Inc). Mean nutrient intakes (and standard deviations) recorded using each method of dietary assessment were calculated. Spearman and Pearson correlations, Wilcoxon Signed Rank and Paired t test were used to investigate the agreement and differences between the nutritional output from Foodbook24 (test method) and the 4-day semi-weighed food diary (reference method). Urinary and plasma biomarkers of nutrient intake were used as an objective validation of Foodbook24. To investigate the user acceptability of Foodbook24, participants from different studies involved with Foodbook24 were asked to complete an evaluation questionnaire. RESULTS: For nutrient intake, correlations between the dietary assessment methods were acceptable to very good in strength and statistically significant (range r=.32 to .75). There were some significant differences between reported mean intakes of micronutrients recorded by both methods; however, with the exception of protein (P=.03), there were no significant differences in the reporting of energy or macronutrient intake. Of the 19 food groups investigated in this analysis, there were significant differences between 6 food groups reported by both methods. Spearman correlations for biomarkers of nutrient and food group intake and reported intake were similar for both methods. A total of 118 participants evaluated the acceptability of Foodbook24. The tool was well-received and the majority, 67.8% (80/118), opted for Foodbook24 as the preferred method for future dietary intake assessment when compared against a traditional interviewer led recall and semi-weighed food diary. CONCLUSIONS: The results of this study demonstrate the validity and user acceptability of Foodbook24. The results also highlight the potential of Foodbook24, a Web-based dietary assessment method, and present a viable alternative to nutritional surveillance in Ireland.

Comparison of a Web-Based 24-h Dietary Recall Tool (Foodbook24) to an Interviewer-Led 24-h Dietary Recall.

Web-based tools have the potential to reduce the cost of dietary assessment; however, it is necessary to establish their performance compared to traditional dietary assessment methods. This study aims to compare nutrient and food intakes derived from Foodbook24 to those obtained from an interview-led 24-h dietary recall (24HDR). Seventy-nine adult participants completed one self-administered 24HDR using Foodbook24 and one interviewer-led 24HDR on the same day. Following a 10 days wash-out period the same process was completed again in opposite order to the previous study visit. Statistical analysis including Spearman's rank order correlation, Mann-Whitney U tests, cross-classification analysis, and "Match", "Omission", and "Intrusion" rates were used to investigate the relationship between both methods. Strong, positive correlations of nutrient intake estimated using both methods was observed (rs = 0.6-1.0; p < 0.001). The percentage of participants classified into the same tertile of nutrient intake distribution using both methods ranged from 58% (energy) to 82% (vitamin D). The overall match rate for food intake between both methods was 85%, while rates for omissions and intrusions were 11.5% and 3.5%, respectively. These results, alongside the reduced cost and participant burden associated with Foodbook24, highlight the tool's potential as a viable alternative to the interviewer-led 24HDR.

A review of the design and validation of web- and computer-based 24-h dietary recall tools.

Technology-based dietary assessment offers solutions to many of the limitations of traditional dietary assessment methodologies including cost, participation rates and the accuracy of data collected. The 24-h dietary recall (24HDR) method is currently the most utilised method for the collection of dietary intake data at a national level. Recently there have been many developments using web-based platforms to collect food intake data using the principles of the 24HDR method. This review identifies web- and computer-based 24HDR tools that have been developed for both children and adult population groups, and examines common design features and the methods used to investigate the performance and validity of these tools. Overall, there is generally good to strong agreement between web-based 24HDR and respective reference measures for intakes of macro- and micronutrients.

The influence of academic examinations on energy and nutrient intake in male university students.

BACKGROUND: Taking examinations is central to student experience at University and may cause psychological stress. Although stress is recognised to impact on food intake, the effects of undertaking examinations on students' dietary intake have not been well characterised. The purpose of this study was to assess how students' energy and nutrient intake may alter during examination periods. METHODS: The study design was a within-subject comparison of students' energy and nutrient intake during an examination period contrasted with that outside an examination period (baseline). A total of 20 male students from the University of Sheffield completed an automated photographic 4-d dietary record alongside four 24-h recalls in each time period. Daily energy and nutrient intake was estimated for each student by time period and change in energy and nutrient intake calculated. Intakes at baseline were compared to UK dietary recommendations. Cluster analysis categorised students according to their change in energy intake between baseline and the examination period. Non-parametric statistical tests identified differences by cluster. RESULTS: Baseline intakes did not meet recommendations for energy, non-milk extrinsic sugars, non-starch polysaccharide and sodium. Three defined clusters of students were identified: Cluster D who decreased daily energy intake by 12.06 MJ (n = 5), Cluster S who had similar energy intakes (n = 13) and Cluster I who substantially increased energy intake by 6.37 MJ (n = 2) between baseline and examination period. There were statistically significant differences (all p < 0.05) in change in intake of protein, carbohydrate, calcium and sodium between clusters. Cluster D recorded greater energy, carbohydrate and protein intakes than Cluster I at baseline. CONCLUSIONS: The majority of students were dietary resilient. Students who demonstrated hypophagia in the examination period had a high energy and nutrient intake at baseline, conversely those who showed hyperphagia had a low energy and nutrient intake. These patterns require confirmation in studies including women, but if confirmed, there is need to address some students' poor food choice especially during examinations.