JMIR Publications

ABSTRACT

Background:

Malaysia is a multicultural country with the main ethnic groups being Malays, Chinese, and Indians. This creates a rich food culture with distinct dishes, cooking styles, and portion sizes, making dietary assessment challenging. Intake24 is a web-based 24-hour dietary recall system that automates data collection, reduces recall bias, and saves time. It supports self-reporting of the previous day's food and beverage intake using structured prompts, searchable food lists, portion-size images, and linked food composition data. As it was originally developed in the United Kingdom, adaptation for Malaysia is needed to address differences in language, food culture, mixed dishes, portion sizes, terminology, and local food composition data.

Objective:

This paper aims to describe a protocol for the development and relative validation of Intake24 Malaysia (Intake24-MY) for the Malaysian population.

Methods:

This paper describes two phases in adapting Intake24-MY: (1) the development process and (2) the validation study. Phase 1 consists of the following components: (1a) system translation that will involve machine translation tools, bilingual translators, (1b) food list development, which consists of Malaysian and globally familiar foods, (1c) four options of portion-size estimation and photograph validation study, (1d) food-composition data and recipe calculation, (1e) small-scale, which will involve 10 adults to identify the foods and technical issues. Pilot testing will be conducted among 100 adults to compare 2 days' dietary intake using Intake24-MY against an interviewer-led 24-hour dietary recall, and (1f) user guide development. Phase (2a) single-meal validation study that will be conducted among 100 adults, comparing Intake24-MY with observed intake. Phase 2b) cross-sectional study conducted among 482 Malaysian adults to compare 4 days of dietary intake using Intake24-MY against an interviewer-led 24-hour dietary recall. A structured questionnaire will be used to assess the feedback on the usability of Intake24-MY. The Bland-Altman method will be used to determine the agreement between these methods.

Results:

The study was funded in December 2023, with data collection starting in June 2024 and continuing. Data analysis is set to begin in August 2026, with results expected by 2027. This study has received approval from the Monash University Human Research Ethics Committee (MUHREC ID: 41337).

Conclusions:

ntake24-MY is being developed as a multilingual, digital dietary assessment tool for Malaysia. The planned validation study will determine its agreement with interviewer-led 24-hour dietary recalls and assess its usability among Malaysian adults. If shown to be valid and acceptable, Intake24-MY can support more efficient dietary data collection in Malaysia’s multicultural population.