Does Digital Photography Improve the Accuracy of Diet Records in the Elderly?

Abstract

Utilizing digital photography alongside food records could prove to be a feasible way to refine the accuracy of food records in the elderly population. We determined whether the accuracy of 3‐day food records is improved by use of an accompanying digital photographic food record. Three day diet records were entered into the Nutrition Data System for Research (NDSR) both with and without the accompanying digital photography. We used total estimated energy expenditure (TEE), as assessed by the DRI's to determine overall accuracy of each method. Bland Altman regression, paired t‐tests and ratio of energy intake to total energy expenditure was used to determine variance between the methodologies. Our results shows that the digital photographic record helped to refine 157 items during data entry. Overall energy intake to TEE ratio was similar, indicating a high level of agreement between each method. Mean energy and protein intake did not significantly differ between the methodologies (p=0.75 and 0.73). We concluded that while accuracy was improved through the use of accompanying digital photographs, this did not significantly correct the tendency of underreporting. Given the qualitative improvement in food record data obtained using this technique, further research is needed to determine optimal use of digital photography.Supported by Dept. Dietetics and Nutrition and NIH to RW.