Validity of a digital photo-based dietary assessment tool: Development and initial evaluation.

Background and aim: To evaluate the validity and user satisfaction of a digital photo-based dietary assessment tool as an alternative to the hand-written paper record method that assists researchers during the pandemic. This study compared nutrient intake and users' satisfaction with methods between a digital photo-based dietary assessment tool, known as the Nutrinote Gama app, and food weighing as the gold standard. Methods: Fifty college students majoring in food and nutrition (90% were women; median age, 21 years) took pictures of their foods and beverages before and after consumption and then uploaded them to the Nutrinote Gama application. Trained nutritionists evaluated plate wastes, and nutritional content was revealed on the Nutrinote Gama application. Parallel to the photo-based method, they kept a weight dietary record and sent it to the researcher. A questionnaire was used to assess participants' satisfaction. Results: No statistical differences (p = 0.89) were observed in the measurement of energy intake between Nutrinote Gama (mean ± standard deviation [SD] = 582.8 ± 131) and food weighing (mean ± SD = 566.1 ± 133). No statistical differences (p = 0.59) were also observed in the measurement of protein, fat (p = 0.434), and carbohydrate (p = 230). The energy, protein, fat, and carbohydrate intakes estimated from the two methods were significantly correlated (r = 0.86, 0.870, 0.811, 0.738, respectively). Over 70% of participants were satisfied with the photo-based record. Conclusion: The results indicate that this digital photo-based dietary assessment tool is valid and user-friendly to estimate nutrient intake.

Evaluation of Pictorial Dietary Assessment Tool for Hospitalized Patients with Diabetes: Cost, Accuracy, and User Satisfaction Analysis.

Although nutritional screening and dietary monitoring in clinical settings are important, studies on related user satisfaction and cost benefit are still lacking. This study aimed to: (1) elucidate the cost of implementing a newly developed dietary monitoring tool, the Pictorial Dietary Assessment Tool (PDAT); and (2) investigate the accuracy of estimation and satisfaction of healthcare staff after the use of the PDAT. A cross-over intervention study was conducted among 132 hospitalized patients with diabetes. Cost and time for the implementation of PDAT in comparison to modified Comstock was estimated using the activity-based costing approach. Accuracy was expressed as the percentages of energy and protein obtained by both methods, which were within 15% and 30%, respectively, of those obtained by the food weighing. Satisfaction of healthcare staff was measured using a standardized questionnaire. Time to complete the food intake recording of patients using PDAT (2.31 ± 0.70 min) was shorter than when modified Comstock (3.53 ± 1.27 min) was used (p < 0.001). Overall cost per patient was slightly higher for PDAT (United States Dollar 0.27 ± 0.02) than for modified Comstock (USD 0.26 ± 0.04 (p < 0.05)). The accuracy of energy intake estimated by modified Comstock was 10% lower than that of PDAT. There was poorer accuracy of protein intake estimated by modified Comstock (<40%) compared to that estimated by the PDAT (>71%) (p < 0.05). Mean user satisfaction of healthcare staff was significantly higher for PDAT than that for modified Comstock (p < 0.05). PDAT requires a shorter time to be completed and was rated better than modified Comstock.

A simple dietary assessment tool to monitor food intake of hospitalized adult patients.

BACKGROUND/OBJECTIVES: Monitoring food intake of patients during hospitalization using simple methods and minimal training is an ongoing problem in hospitals. Therefore, there is a need to develop and validate a simple, easy to use, and quick tool that enables staff to estimate dietary intake. Thus, this study aimed to develop and validate the Pictorial Dietary Assessment Tool (PDAT). SUBJECTS AND METHODS: A total of 37 health care staff members consisting of dietitians, nurses, and serving assistants estimated 130 breakfast and lunch meals consumed by 67 patients using PDAT. PDAT was developed based on the hospital menu that consists of staple food (rice or porridge), animal source protein (chicken, meat, eggs, and fish), and non-animal source protein (tau fu and tempeh), with a total of six pictorials of food at each meal time. Weighed food intake was used as a gold standard to validate PDAT. Agreement between methods was analyzed using correlations, paired t-test, Bland-Altman plots, kappa statistics, and McNemar's test. Sensitivity, specificity, and area under the curve of receiver operating characteristic were calculated to identify whether patients who had an inadequate food intake were categorized as at risk by the PDAT, based on the food weighing method. Agreement between different backgrounds of health care staff was calculated by intraclass correlation coefficient and analysis of variance test. RESULTS: There was a significant correlation between the weighing food method and PDAT for energy (r=0.919, P<0.05), protein (r=0.843, P<0.05), carbohydrate (r=0.912, P<0.05), and fat (r=0.952; P<0.05). Nutrient intakes as assessed using PDAT and food weighing were rather similar (295±163 vs 292±158 kcal for energy; 13.9±7.8 vs 14.1±8.0 g for protein; 46.1±21.4 vs 46.7±22.3 g for carbohydrate; 7.4±3.1 vs 7.4±3.1 g for fat; P>0.05). The PDAT and food weighing method showed a satisfactory agreement beyond chance (k) (0.81 for staple food and animal source protein; 0.735 for non-animal source protein). Intraclass correlation coefficient ranged between 0.91 and 0.96 among respondents. There were no differences in energy, protein, carbohydrate, and fat intake estimated among health care staff (P=0.967; P=0.951; P=0.888; P=0.847, respectively). CONCLUSION: In conclusion, PDAT provides a valid estimation of macronutrient consumption among hospitalized adult patients.