Accepted for/Published in: JMIR Research Protocols
Date Submitted: Aug 13, 2021
Date Accepted: Nov 10, 2021
Date Submitted to PubMed: Dec 20, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Accuracy and cost-effectiveness of technology-assisted dietary assessment (ACE-TADA): Protocol for a randomized cross-over feeding study to compare the Automated Self-Administered Dietary Assessment Tool (ASA24), Intake24, and an image-assisted Mobile Food Record 24-hour recall (mFR24) relative to observed intake.
ABSTRACT
Background:
The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology, and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden and cost, but need to be evaluated to inform large-scale use.
Objective:
To compare accuracy, acceptability and cost-effectiveness of three technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across three meals.
Methods:
Using a controlled feeding study design, 24HR data collected using three methods will be obtained for comparison to observed intake. One hundred and fifty healthy adults, aged 18-70 years, will be recruited and will complete online demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study centre on three separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR recall using one of three methods, the Automated Self-Administered Dietary Assessment Tool (ASA24), Intake24, or the Image-assisted Mobile Food Record 24-hour recall (mFR24). The sequence of the three methods will be randomized, with each participant exposed to each method approximately one week apart. Acceptability and preferred 24HR method will be assessed by questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared to observed intake for each day. Linear Mixed Models will be used, with 24HR method and method order as fixed effects, to assess differences by 24HR method. Reporting bias will be assessed by examining ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-squared tests. Psychosocial, demographic, and cognitive factors associated with energy misreporting will be evaluated using chi-squared tests and multivariable logistic regression. Financial costs, time costs, and cost-effectiveness of each 24HR will be assessed and compared using repeated measures ANOVA tests.
Results:
Participant recruitment commenced in March 2021, and is planned to be complete by the end of 2021.
Conclusions:
This protocol outlines the methodology of a study which will evaluate the accuracy, acceptability, and cost-effectiveness of three technology-enabled dietary assessment methods. This will inform the selection of dietary assessment method in future studies on nutrition surveillance and epidemiology.
Citation
