Nutritional Assessment, Body Composition, and Low Energy Availability in Sport Climbing Athletes of Different Genders and Categories: A Cross-Sectional Study.

Climbing is an Olympic discipline in full development and multidisciplinary in nature, where the influences of body composition and nutritional status on performance have not yet been clarified despite the quest for a low weight in anti-gravity disciplines such as climbing. The present cross-sectional study aimed to conduct nutritional (3-day dietary diaries) and body composition (ISAK profile) assessments on sport climbing athletes by gender and climbing level during the months of February and March 2024. The t-test for independent samples and the Mann-Whitney U-test, as well as an ANOVA and the Kruskal-Wallis H-test, were used to compare the distributions of two or more groups, respectively, and Pearson's and Spearman's correlation coefficients were used to estimate the correlations between the different variables. The mean age of the 46 Spanish climbers (22 men and 24 women) was 30 years (SD: 9) with 7.66 years of experience (SD: 6.63). The mean somatotype of the athletes was classified as balanced mesomorph. Negative correlations were observed between fat mass variables and climbing level (p < 0.010), and positive correlations were observed with forearm circumference (p < 0.050). The mean energy availability (EA) was 33.01 kcal-kg FFM-1d-1 (SD: 9.02), with 55.6% of athletes having a suboptimal EA status and 35.6% having low energy availability (LEA). The carbohydrate and protein intakes were below the recommendations in 57.8% and 31.1% of athletes, respectively. There were deficient intakes of all micronutrients except phosphorus in males. These findings suggest that climbing athletes are at a high risk of developing low energy availability states and concomitant problems. Optimal nutritional monitoring may be advisable in this type of athlete to try to reduce the risk of LEA.

Associations of Acetic Acid Intake with Protein and Vitamin Intake Estimated via a Food Recording Application.

A conventional questionnaire-based assessment of acetic acid intake is based on the intake of seasonings such as mayonnaise, which could thereby lead to an underestimation. We here determine the relationships of acetic acid intake with nutrient intake estimated using a food recording app (Asken) based on meal recipes. A total of 141 individuals (48 men and 93 women) used the app for at least 7 days per month. The mean daily intake of acetic acid was 0.16 ± 0.19 g and the mean frequency of acetic acid intake was 2.77 ± 1.66 days per week. A multivariate regression analysis adjusted for age, sex, BMI, and energy intake revealed that the amount of acetic acid consumed was significantly and positively associated with the intake of protein (11.9 (5.1, 18.6), p < 0.001), cholesterol (80.7 (4.5, 156.9), p = 0.04), and all vitamins except vitamin K. The frequency of acetic acid intake was significantly and positively associated with protein (1.04 (0.20, 1.87), p = 0.015), vitamin B1 (0.3 (0.02,0.5), p = 0.031), niacin (0.5 (0.04,1.0), p = 0.032), and vitamin B12 (0.4 (0.1,0.7), p = 0.002) intake, suggesting that individuals who frequently consume acetic acid tend to consume more protein and some vitamins. Thus, the amount and frequency of acetic acid may reflect protein and vitamin intake.

Influence of Dietary Heritage in a Restricted Geographic Area and Role of Food Additives on Risk of Recurrent Kidney Stone.

Dietary factors may be implicated in the formation of kidney stones and should be closely monitored. To achieve this aim, patients are routinely assessed by means of generic dietary recall, a tool widely used by authors in a range of extensive patient populations to record food intake; the findings obtained, however, may be skewed due to dietary variations and underestimation of the effect of food additives. Fifty Frequent Kidney Stone Formers (FKSFs, mean age: 54.3 ± 13.9 years) with normal kidney function, absence of comorbidities, and reliable compliance were selected from a total of 68 patients' resident in Sardinia, an Italian island where genetic admixtures have been relatively rare for generations. The study, conducted from 1 January 2020 to 31 December 2023, was aimed at assessing nutritional values based on the meticulous recording of food quantities, quality, and potential modifications related to food preparation. Patients were selected during an initial clinical check-up and all efforts made to ensure they were capable of reliably recording all food and drinks consumed. A seven-day food diary was provided in which food and drink intake and their impact on 24 h urine output was recorded. The following parameters were measured in both foods and urine output: citrates, oxalates, calcium, phosphorous, uric acid, proteins and nitrogen compounds, magnesium, sulfates, potassium, carbohydrates, free fatty acids. Study outcomes established the presence of hypocitraturia, hyperoxaluria, hypercalciuria, and moderately high levels of nitrogen compounds. Univariate analysis followed by multivariate analysis for further confirmation were performed and the following observations made. Citrate intake correlated with citraturia but did not promote oxaluria; calcium intake promoted onset of sulfaturia, azoturia, and ammoniuria, whilst magnesium correlated with magnesiuria but not with oxaluria, calciuria, phosphaturia, and azoturia; sulfate intake elicited onset of azoturia but not kaliuresis; potassium intake promoted oxaluria and protein intake resulted in onset of ammoniuria and azoturia. (A) The chemical composition of urine based on dietary intake is hard to predict without taking into account the presence of dietary and urinary interferents; (B) the geographic isolation of patients studied underlines the importance of epigenetics in maintaining a traditional dietary heritage. (C) Moreover, the widespread use of food additives should consistently be taken into account to ensure a correct diagnosis of FKSF and set up a valid treatment plan.

Validity and Reproducibility of a Culture-Specific Electronic Food Frequency Questionnaire: A Trinidad and Tobago Diet Assessment Study.

Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate (r = .44, P ≤ .0001) for sweetened beverages to high (r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from (r = .08) for water to (r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.

The habitual degree of weight loss might be associated with specific fat and protein intakes during a period of weight maintenance in athletes used to weight variations: preliminary results from the WAVE study.

Weight variations are common in sporting life, with important inter-individual variability in the degree of an athlete's habitual weight loss. As a part of the WAVE study (NCT04107545), the main objective of this preliminary study was to determine whether the habitual degree of weight loss was associated with anthropometric, body composition, nutritional or psychometric profiles during a period of weight maintenance in athletes accustomed to weight variations. We hypothesized that athletes accustomed to a higher habitual degree of weight loss may have a higher body weight and body fat mass, and may present a more controlled diet regimen and cognitive restriction than athletes with a lower habitual degree of weight loss. During a period of weight maintenance, 62 athletes (24.0 ± 5.3 years; 26 women) completed anthropometry and body composition measurements, a 48-hours food diary and self-reported questionnaires to determine their weight variation practice, nutritional profile and mood state. Athletes were stratified within inter- and intra-quartile groups according to their habitual degree of weight loss. Athletes with a higher habitual degree of weight loss were those who consumed more protein (P < .001) and less fat (P = .01) as a proportion of total energy compared with those losing less weight, without any difference in body composition between the groups. The rapid weight loss score was significantly higher in individuals losing more weight (P < .001) and no difference was observed for the mood state profile. The present results suggest a potential control of nutritional regulation during a period of weight maintenance in order to spare fat-free mass and favor fat mass loss in athletes who are routinely losing more weight. Fat-free mass may be the main nutritional driver due to low body fat mass in athletes, which may limit the "catch-up fat" phenomenon commonly observed in nonathletic population.

Dietary Adequacy of Individuals with Cardiovascular Disease According to Clinical Guidelines in the Brazilian Cardioprotective Nutritional (BALANCE). / Adequação Alimentar de Indivíduos com Doença Cardiovascular Conforme Diretrizes Clínicas no Programa Alimentar Brasileiro Cardioprotetor.

BACKGROUND: Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. OBJECTIVE: To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). METHODS: Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. RESULTS: 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). CONCLUSIONS: Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.

FUNDAMENTO: Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. OBJETIVO: Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). MÉTODOS: Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. RESULTADOS: Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). CONCLUSÕES: A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.

[Comparison study of food, energy and nutrient intake by 24-hour dietary recall method on two consecutive days versus three consecutive days].

OBJECTIVE: To compare the differences in estimated food, energy, and nutrient intakes between the consecutive 3 days 24-hour dietary recall(24HR)(referred to as the 3-day method) and consecutive 2 days 24HR(referred to as the 2-day method) to provide a basis for the use of consecutive 2 days 24HR in China nutrition surveillance. METHODS: Using objective sampling to select participants in northern and southern provinces, dietary data were obtained through consecutive 3 days 24HR, and the average intakes of food, energy and nutrients were calculated for three days from Thursday to Saturday and two days on Friday and Saturday, respectively. The 3-day method was considered as the reference standard method to evaluate the performance of the 2-day method for estimating food, energy and nutrient intakes. RESULTS: Among 778 participants aged 18-60 years in urban and rural areas of two provinces, the errors of the mean and median of 2-day method for estimating the intake of four major food categories less than 6% compared with the 3-day method, and there were significant equivalencies(P<0.025) and no significant differences in four major food categories group(P>0.05). Of the 24 food groups estimated by the 2-day method, 17 had mean errors within 5%, the largest error was in animal offal(13.45%) and the smallest in fruit(0.15%), and there were significant equivalencies(P<0.025) and no significant differences in seven food groups(P>0.05). For energy and nutrients, the mean and median errors of energy were less than 0.5% and there were significant equivalencies(P<0.025) and no significant differences for energy(P>0.05). Among the 25 nutrients, except sodium, iodine and vitamin E, the mean and median errors of the other 22 nutrients were less than 5%, and there were significant equivalencies(P<0.025) and no significant differences in 16 nutrients(P>0.05). CONCLUSION: There was little difference between the two survey method in assessing the intake of high consumption frequency foods, energy and most nutrients at group level, the 2-day method can be used as an alternative to the 3-day method to collect dietary intake data with high consumption rates in the population.

Validity and Reliability of the Turkish Version of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF).

The global consumption of highly (ultra) processed foods (HPFs) is increasing, and it is associated with non-communicable diseases. This study aimed to assess the validity and reliability of the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF). This study included 94 adults. Sociodemographic data were collected, and anthropometric and blood pressure measurements were performed. The sQ-HPF was translated into Turkish and culturally adapted. Dietary intake was assessed using three-day dietary records. Factor analysis and Cronbach's alpha were used to evaluate the validity and consistency of the sQ-HPF. Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Three items from the original sQ-HPF were excluded due to low factor loadings. The Kaiser-Meyer Olkin (KMO) coefficient for the measure of sample adequacy was found to be 0.642 and Bartlett's test of sphericity was found to be significant (p < 0.001). A significant correlation was found between the sQ-HPF score and HPF consumption derived from the 3-day dietary records (p < 0.05). Cronbach's alpha was found to be 0.65. Individuals with higher sQ-HPF scores consumed a significantly greater percentage of energy from HPFs (kcal/day) (p < 0.001). The sQ-HPF demonstrated good test-retest reliability (ICC = 0.76). The Turkish version of the sQ-HPF is a valid and reliable tool for assessing HPF consumption patterns and can be used in epidemiological and clinical studies.

Evaluating the Quality and Comparative Validity of Manual Food Logging and Artificial Intelligence-Enabled Food Image Recognition in Apps for Nutrition Care.

For artificial intelligence (AI) to support nutrition care, high quality and accuracy of its features within smartphone applications (apps) are essential. This study evaluated popular apps' features, quality, behaviour change potential, and comparative validity of dietary assessment via manual logging and AI. The top 200 free and paid nutrition-related apps from Australia's Apple App and Google Play stores were screened (n = 800). Apps were assessed using MARS (quality) and ABACUS (behaviour change potential). Nutritional outputs from manual food logging and AI-enabled food-image recognition apps were compared with food records for Western, Asian, and Recommended diets. Among 18 apps, Noom scored highest on MARS (mean = 4.44) and ABACUS (21/21). From 16 manual food-logging apps, energy was overestimated for Western (mean: 1040 kJ) but underestimated for Asian (mean: -1520 kJ) diets. MyFitnessPal and Fastic had the highest accuracy (97% and 92%, respectively) out of seven AI-enabled food image recognition apps. Apps with more AI integration demonstrated better functionality, but automatic energy estimations from AI-enabled food image recognition were inaccurate. To enhance the integration of apps into nutrition care, collaborating with dietitians is essential for improving their credibility and comparative validity by expanding food databases. Moreover, training AI models are needed to improve AI-enabled food recognition, especially for mixed dishes and culturally diverse foods.

Methodology and challenges for harmonization of nutritional data from seven historical studies.

BACKGROUND: Collection of detailed dietary data is labor intensive and expensive, harmonization of existing data sets has been proposed as an effective tool for research questions in which individual studies are underpowered. METHODS: In this paper, we describe the methodology used to retrospectively harmonize nutritional data from multiple sources, based on the individual participant data of all available studies, which collected nutritional data in Israel between 1963 and 2014. This collaboration was established in order to study the association of red and processed meat with colorectal cancer. Two types of nutritional questionnaires, the Food Frequency Questionnaires (FFQ) and the 24-h dietary recall (24HR recall), and different food composition tables, were used by the participating studies. The main exposure of interest included type of meat (total meat, red meat, and poultry) and level of processing. RESULTS: A total of 29,560 Israeli men and women were enrolled. In studies using FFQ,the weighted mean intakes of total, red, processed meat, and poultry were 95, 27, 37 and 58 gr/day and 92, 25, 10, and 66 gr/day in studies using 24HR recall, respectively.. Despite several methodological challenges, we successfully harmonized nutritional data from the different studies. CONCLUSIONS: This paper emphasizes the significance and feasibility of harmonization of previously collected nutritional data, offering an opportunity to examine associations between a range of dietary exposures and the outcome of interest, while minimizing costs and time in epidemiological studies.

The relative validity of nutrition assessment methods for estimating infant carotenoid intake differs by assessment tool, nutrient database, and milk carotenoid adjustment method.

Validated carotenoid assessment methods are needed to study infant carotenoid nutrition. This is a secondary analysis of repeated diet assessments of healthy participants collected at 4- (n = 21), 6- (n = 12), and 8- (n = 9) months of age in Houston, TX between April 2019 and June 2020. Intake was assessed with 3 assessment tools, analyzed with 3 nutrient databases, and underwent 3 adjustments to account for milk composition variability. We hypothesized that manual adjustment of milk carotenoid intake based on laboratory measurements would improve the validity of all assessment approaches and that using a database with greater coverage of infant food carotenoid compositions would improve accuracy. Generalized linear mixed models assessed associations between tool, nutrient database, age, and milk carotenoid adjustment variables with carotenoid, energy, fruit, and vegetable intakes. The effect of the number of food diary days on intake estimate precision was evaluated by testing the correlation between intake estimates derived from 1, 3, or 5, vs. 7 days. Visit age influenced energy intake estimates (p = .029), along with assessment tool (p = .020). Estimates of vegetable intake were influenced by tool (p = .009). Combined fruit and vegetable intake differed by nutrient database (p = .007). Carotenoid intake differed by age (p =<.0001), tool (p = .002), and nutrient database (p = .004). A minimum of 3 food diary days strongly correlated (rho = 0.79-1) with reference estimates across ages. Milk carotenoid adjustment was most influential in estimating 4-month olds' carotenoid intake, while nutrient database and tool were important for 6- and 8-month-olds', highlighting the dynamic nature of infant diet assessment validity across feeding stages.

Dietary Profile of Patients with Inflammatory Bowel Disease in Clinical Remission-A Preliminary Study.

Imbalanced dietary intake is associated with the development of inflammatory bowel diseases (IBDs) and is often observed during the active phases of Crohn's disease (CD) and ulcerative colitis (UC). Cumulative data also suggest the potential for dietary manipulation in avoiding IBD relapse. However, there is a paucity of dietary data from patients in clinical remission to guide such an approach. Our study aimed to characterize the dietary pattern and adequacy of patients with IBD in clinical remission. Data on dietary intake (three alternate 24 h food records) were collected from 40 patients with IBD (20 CD and 20 UC) and 45 gender-matched healthy controls (HC). Statistical comparisons between patients and controls employed Student's t-test, Mann-Whitney U, chi-squared, and Fisher's exact tests. The adequacy of dietary intake of IBD patients was further studied by assessing the nutrient inadequacy prevalence, estimated using the Dietary Reference Intakes (DRI) framework and the Estimated Average Requirement (EAR) parameter. We observed significant dietary imbalances among patients with IBD compared to the HC group, marked by disparities in both macronutrient and micronutrient intakes. Inadequacies with frequencies >80% were observed for the ingestion of total fiber and 13 micronutrients in IBD patients. Our preliminary findings suggest that imbalanced dietary intake is also characteristic among individuals with IBD during clinical remission, corroborating the need for dietary interventions in this population.

A Mobile-Based Nutrition Tracker App Enhanced Dietitian-Guided 2:1:1 Diet-Induced Weight Loss: An 8-Week Retrospective Cohort Study in Taiwan.

Effective weight management interventions involve a combination of behavioral strategies focusing on dietary changes. Tracing the change through mobile apps has been proven to be a valuable platform for facilitating weight management in many countries. However, the effectiveness of mobile app-based dietary intervention on weight management in Taiwan remains to be determined. By using the designated mobile app, this study aimed to assess the efficacy of the diet intervention, which is based on a 2:1:1 portion control plate and a flexible low-carbohydrate (FLC) diet. This 8-week retrospective cohort study involved 10,297 participants who were divided into two groups: the intervention group (joined an 8-week diet intervention program with the daily diet record assessed by registered dietitians) and the control group (voluntarily using the app without instructional materials or coaching). After eight weeks of intervention, the intervention group showed a higher weight loss percentage (-4.78% vs. -1.54%), body mass index (BMI) (-1.26 kg/m2 vs. 0.69 kg/m2), and diet record completeness (73.52% vs. 28.91%) compared with the control group. With respect to gender, male participants showed higher baseline weight and higher weight loss (-6.02%) in the intervention group. In the intervention group, 2871 participants (33.4%) lost less than 4% of their weight, 5071 participants (58.9%) lost 4-8% of their body weight, and 662 participants (7.7%) lost >8% of their weight. Compared to the low-effectiveness group (weight lost <4%), the high-effectiveness group (weight lost >8%) had a significantly higher diet record completeness (91.61 ± 15.99 vs. 55.81 ± 32.92), dietary compliance (green light %) (88.93 ± 9.9 vs. 77.75 ±17.5), protein intake % (26.34 ± 2.85 vs. 23.49 ± 3.56), and fat intake % (49.66 ± 6.36 vs. 44.05 ± 7.37). Most importantly, the high-effectiveness group had a lower carbohydrate intake % (24.1 ± 7.86 vs. 32.46 ± 9.61). The results remained significant after being stratified by gender. This study found that the use of online applications plus the intervention of dietitians is beneficial for short-term weight loss. The composition of nutrients and dietary compliance also significantly impacted weight loss.

Validation of an web-based dietary assessment tool (RiksmatenFlex) against doubly labelled water and 24 h dietary recalls in pregnant women.

INTRODUCTION: Digital technologies have enabled new possibilities to assess dietary intake and have shown promise in terms of decreased participant burden, improved accuracy and lower costs. However, their potential and validity in pregnant populations are scarcely explored. OBJECTIVES: This study aimed to (a) validate energy intakes obtained from a web-based dietary recall method developed for national surveys (RiksmatenFlex) against total energy expenditure (TEE) by means of the doubly labelled water (DLW) method, and (b) to compare intakes of macronutrients, key unhealthy and healthy foods as well as adherence to food-based dietary guidelines between RiksmatenFlex and repeated 24 h telephone dietary recalls in healthy Swedish pregnant women. METHODS: This study was conducted as a nested validation within the HealthyMoms trial. Intakes of foods, macronutrients and energy were assessed during three days through RiksmatenFlex and 24 h telephone dietary recalls, and Swedish Healthy Eating Index (SHEI) scores were also calculated for both methods (n = 52). For 24 women, TEE was also assessed through the DLW method. Paired Samples T-tests and Wilcoxon Signed Ranks Tests were used to identify differences between means for foods, macronutrients, energy and SHEI scores. Pearson correlation coefficient or Spearman's rho were performed to identify relationships between variables. To compare energy intake (RiksmatenFlex) with TEE (DLW method) and 24 h telephone dietary recalls, Bland and Altman plots were constructed. RESULTS: Average energy intake from RiksmatenFlex (10,015 [SD 2004] kJ) was not statistically different from TEE (10,252 [SD 1197] kJ) (p = 0.596) (mean difference: -237 kJ/24 h). Correspondingly, there were small mean differences between average intakes of key unhealthy and healthy foods and average SHEI scores between RiksmatenFlex and 24 h telephone dietary recalls. However, the Bland and Altman plots showed wide limits of agreement for all dietary variables (e.g., for energy intake using RiksmatenFlex versus TEE: ±4239 kJ/24 h). High correlations between the investigated dietary variables for the two dietary methods were observed (r = 0.751 to 0.931; all p < 0.001). CONCLUSION: RiksmatenFlex captured average intakes of energy, unhealthy and healthy food groups and adherence to food-based dietary guidelines in a comparable way to 24 h telephone dietary recalls and the DLW method. Our results support the validity of RiksmatenFlex as a web-based dietary assessment method for future use in pregnancy for intervention studies and national dietary surveys.

Relative validity of an intelligent ordering system to estimate dietary intake among university students from a medical school in Shanghai, China.

BACKGROUND: Dietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the "intelligent ordering system" (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation. METHODS: Medical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis. RESULTS: IOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females. CONCLUSION: Despite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females.

Validation of a digital food frequency questionnaire for the Northern Sweden Diet Database.

BACKGROUND: Dietary habits strongly influence health, with poor diets contributing to numerous deaths annually. Addressing this requires improved dietary habits and consistent monitoring thereof. In northern Sweden, a validated food frequency questionnaire (FFQ) has been used for decades, but trends show that its ability to accurately measure intake has diminished. With changing eating habits and food supply, updating the FFQ was crucial, leading to the development of FFQ2020. This study assessed FFQ2020's relative validity using 24-hour recalls and evaluated its reproducibility. METHODS: Participants were recruited from one of the northern-Sweden population-based health screenings and by advertising. Food intake was registered in an electronic food frequency questionnaire (FFQ2020) (test instrument) and reference data were obtained by six repeated electronic 24-hour dietary recalls (24HDR). Intakes of single foods were aggregated into food groups and healthy diet index scores, and daily energy and nutrient intakes were estimated. Results from the two methods were described and tested in univariate analyses and correlation tests, Bland Altman plots, cross-classification validity, and intra-class correlation analyses. RESULTS: Totally, 628 adults were invited to participate in the study. Of these, 320 joined, and 244 completed at least four 24HDRs. The median intakes in food groups, as well as the mean index scores and estimated nutrient intakes, were largely similar between the FFQ2020 and 24HDR recordings. The correlation coefficients between the two assessments ranged from 0.253 to 0.693 for food groups, 0.520 to 0.614 for diet indices, and 0.340 to 0.629 for energy and nutrients. Intra-class correlation coefficients indicated at least good reproducibility for intakes of food groups, diet index scores, and nutrients. Generally, Bland-Altman plots did not reveal any gross systematic disagreement between the two methods for any of the assessments. However, there were single observations located outside the upper or lower 95% confidence interval (CI) limits for the difference between FFQ2020 and the 24HDR recordings. CONCLUSION: In concert, the results suggest that the relative validity and reproducibility of FFQ2020 are acceptable for trend analyses and group comparisons in large-scale studies but also that extended reference periods would improve the precision of less frequently consumed foods.

Validity of dietary intake methods in cancer cachexia.

PURPOSE OF REVIEW: Accurate assessment of dietary intake, especially energy and protein intake, is crucial for optimizing nutritional care and outcomes in patients with cancer. Validation of dietary assessment methods is necessary to ensure accuracy, but the validity of these methods in patients with cancer, and especially in those with cancer cachexia, is uncertain. Validating nutritional intake is complex because of the variety of dietary methods, lack of a gold standard method, and diverse validation measures. Here, we review the literature on validations of dietary intake methods in patients with cancer, including those with cachexia, and highlight the gap between current validation efforts and the need for accurate dietary assessment methods in this population. RECENT FINDINGS: We analyzed eight studies involving 1479 patients with cancer to evaluate the accuracy and reliability of 24-hour recalls, food records, and food frequency questionnaires in estimating energy and protein intake. We discuss validation methods, including comparison with biomarkers, indirect calorimetry, and relative validation of dietary intake methods. SUMMARY: Few have validated dietary intake methods against objective markers in patients with cancer. While food records and 24-hour recalls show potential accuracy for energy and protein intake, this may be compromised in hypermetabolic patients. Additionally, under- and overreporting of intake may be less frequent, and the reliability of urinary nitrogen as a protein intake marker in patients with cachexia needs further investigation. Accurate dietary assessment is important for enhancing nutritional care outcomes in cachexia trials, requiring validation at multiple time points throughout the cancer trajectory.

Empowering Diabetics: Advancements in Smartphone-Based Food Classification, Volume Measurement, and Nutritional Estimation.

Diabetes has emerged as a worldwide health crisis, affecting approximately 537 million adults. Maintaining blood glucose requires careful observation of diet, physical activity, and adherence to medications if necessary. Diet monitoring historically involves keeping food diaries; however, this process can be labor-intensive, and recollection of food items may introduce errors. Automated technologies such as food image recognition systems (FIRS) can make use of computer vision and mobile cameras to reduce the burden of keeping diaries and improve diet tracking. These tools provide various levels of diet analysis, and some offer further suggestions for improving the nutritional quality of meals. The current study is a systematic review of mobile computer vision-based approaches for food classification, volume estimation, and nutrient estimation. Relevant articles published over the last two decades are evaluated, and both future directions and issues related to FIRS are explored.

Evaluating the Validity of the PortionSize Smartphone Application for Estimating Dietary Intake in Free-Living Conditions: A Pilot Study.

OBJECTIVE: Evaluate the validity of the PortionSize application. METHODS: In this pilot study, 14 adults used PortionSize to record their free-living food intake over 3 consecutive days. Digital photography was the criterion measure, and the main outcomes were estimated intake of food (grams), energy (kilocalories), and food groups. Equivalence tests with ±25% equivalence bounds and Bland-Altman analysis were performed. RESULTS: Estimated gram intake from PortionSize was equivalent (P < 0.001) to digital photography estimates. PortionSize and digital photography estimated energy intake, however, were not equivalent (P = 0.08), with larger estimates from PortionSize. In addition, PortionSize and digital photography were equivalent for vegetable intake (P = 0.01), but PortionSize had larger estimates of fruits, grains, dairy, and protein intake (P >0.07; error range 11% to 23%). CONCLUSIONS AND IMPLICATIONS: Compared with digital photography, PortionSize accurately estimated food intake and had reasonable error rates for other nutrients; however, it overestimated energy intake, indicating further application improvements are needed for free-living conditions.

Assessing the relative validity of a web-based self-administered 24-hour dietary recall in a Canadian adolescent's population.

BACKGROUND: Healthy eating habits at a young age are crucial to support growth and development and good general health. In this context, monitoring youth dietary intakes adequately with valid tools is important to develop efficient interventions and identify groups that are more at risk of inadequate intakes. This study aimed to assess the relative validity of the self-administered web-based 24-h dietary recall (R24W) for evaluating energy and nutrient intakes among active adolescents. METHODS: Participants were invited to complete one interviewer-administered 24-h dietary dietary recall and the R24W on up to three occasions within one month. A total of 272 French-speaking active adolescents aged 12 to 17 years from the province of Québec were invited to complete three R24W and one interview-administered 24-h recall. Student's t-test and correlations were conducted on sex-adjusted data. Percent differences, cross-classification (percentage of agreement), weighted Kappa and Bland-Altman plots were calculated. RESULTS: Mean (SD) energy intake from the R24W was 8.8% higher than from the interview-administered 24-h dietary recall (2558 kcal ± 1128 vs. 2444 kcal ± 998, p < 0.05). Significant differences in mean nutrient intake between the R24W and the interview-administered 24-h dietary recall ranged from 6.5% for % E from fat (p < 0.05) to 25.2% for saturated fat (p < 0.001), i.e., higher values with R24W. Sex-adjusted correlations were significant for all nutrients except for % E from proteins and thiamin (range: 0.24 to 0.52, p < 0.01). Cross-classification demonstrated that 36.6% of the participants were classified in the same fourth with both methods, 39.6% in the adjacent fourth, and 5.7% misclassified. Bland-Atman plots revealed proportional bias between the two methods for 7/25 nutrients. Completing at least two recalls with the R24W increased the precision of intake estimates. CONCLUSION: These data suggest that the R24W presents an acceptable relative validity compared to a standard interview-administered 24-h recall for estimating energy and most nutrients in a cohort of French-speaking adolescents from the province of Québec.