Abstract
Valid and useful dietary assessment methods for adolescents with type 1 diabetes (T1D) are needed. In this study, we compared an image-based method with a written food diary for dietary intake estimation among adolescents with T1D and evaluated the adolescents’ experiences of the methods. Adolescents with T1D aged 13 to 18 years (n = 13) photographed their meals (n = 264) with a mobile phone camera and simultaneously kept a written food diary for four consecutive days. The participants filled out electronic background and feedback questionnaires. The agreement between the methods was evaluated using intraclass correlation coefficients (ICCs) and Bland–Altman plot analyses. The agreement between the methods was moderate to excellent for the energy intake (ICC = 0.91, 95% confidence interval (CI): 0.66 to 0.97, p < 0.001) and good to excellent for total carbohydrate intake (ICC = 0.95, 95% CI: 0.84 to 0.99, p < 0.001). The adolescents considered photographing easier and faster than keeping a food diary. In conclusion, the image-based method appeared comparable to the food diary for dietary intake estimation among adolescents with T1D. The photographing of meals may become a useful dietary assessment tool for adolescents with T1D, but must be further developed and validated.
Highlights
The reliable measurement of dietary intake is necessary in nutrition research
Accurate dietary intake data are especially necessary in the treatment of type 1 diabetes (T1D), where nutrition counselling supports healthy eating habits and is an important part of diabetes self-treatment and good metabolic control [1]
Sixteen adolescents with T1D aged 13 to 18 years participated, and thirteen of them were included in this study (Table 1)
Summary
The reliable measurement of dietary intake is necessary in nutrition research. Traditional dietary assessment methods, such as a food diary and a food frequency questionnaire, are useful but have limitations [2]. These methods are time-consuming and burdensome for patients and can result in reporting errors and deviations from a normal diet [3]. Previous studies have underlined challenges in the measurement of dietary intake in adolescents, such as the tendency to misreport [4,5,6,7,8]. Food records were found to underestimate energy intake by 19–41% compared with the doubly labelled water method in children and adolescents [10]. Worries about self-image and rebellion against authorities are typical at this stage of life and can result in poor adherence to study protocols [11]
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