First-Stage Development and Validation of a Web-Based Automated Dietary Modeling Tool: Using Constraint Optimization Techniques to Streamline Food Group and Macronutrient Focused Dietary Prescriptions for Clinical Trials.

Yasmine Probst,Evan Morrison,Hoa Khanh Dam,Emma Sullivan

doi:10.2196/jmir.5459

Yasmine Probst, Evan Morrison + Show 2 more

Open Access

https://doi.org/10.2196/jmir.5459

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Abstract

BackgroundStandardizing the background diet of participants during a dietary randomized controlled trial is vital to trial outcomes. For this process, dietary modeling based on food groups and their target servings is employed via a dietary prescription before an intervention, often using a manual process. Partial automation has employed the use of linear programming. Validity of the modeling approach is critical to allow trial outcomes to be translated to practice.ObjectiveThis paper describes the first-stage development of a tool to automatically perform dietary modeling using food group and macronutrient requirements as a test case. The Dietary Modeling Tool (DMT) was then compared with existing approaches to dietary modeling (manual and partially automated), which were previously available to dietitians working within a dietary intervention trial.MethodsConstraint optimization techniques were implemented to determine whether nonlinear constraints are best suited to the development of the automated dietary modeling tool using food composition and food consumption data. Dietary models were produced and compared with a manual Microsoft Excel calculator, a partially automated Excel Solver approach, and the automated DMT that was developed.ResultsThe web-based DMT was produced using nonlinear constraint optimization, incorporating estimated energy requirement calculations, nutrition guidance systems, and the flexibility to amend food group targets for individuals. Percentage differences between modeling tools revealed similar results for the macronutrients. Polyunsaturated fatty acids and monounsaturated fatty acids showed greater variation between tools (practically equating to a 2-teaspoon difference), although it was not considered clinically significant when the whole diet, as opposed to targeted nutrients or energy requirements, were being addressed.ConclusionsAutomated modeling tools can streamline the modeling process for dietary intervention trials ensuring consistency of the background diets, although appropriate constraints must be used in their development to achieve desired results. The DMT was found to be a valid automated tool producing similar results to tools with less automation. The results of this study suggest interchangeability of the modeling approaches used, although implementation should reflect the requirements of the dietary intervention trial in which it is used.

Highlights

The measurement of nutrients and prescription of foods for clinical studies can be a difficult task requiring consideration of a number of different elements [1]
Automated modeling tools can streamline the modeling process for dietary intervention trials ensuring consistency of the background diets, appropriate constraints must be used in their development to achieve desired results
Constraint optimization was used to ensure the Dietary Modeling Tool (DMT) was suited to developing individual dietary prescriptions that are needed in dietary intervention trials as the Australian food guidance system (AFGS) targeted population groups

Summary

Introduction

The measurement of nutrients and prescription of foods for clinical studies can be a difficult task requiring consideration of a number of different elements [1]. Within a randomized controlled trial design, intervening using a food-/nutrient-based approach will inherently result in changes to dietary intake during the trial, potentially affecting the outcomes This is evident when a target food is provided to participants, with studies showing that the target food will be eaten in addition to rather than substituted into the usual diet [3], resulting in increased energy (calories or kilojoules) intake due to the intervention. Standardizing the background diet of participants during a dietary randomized controlled trial is vital to trial outcomes For this process, dietary modeling based on food groups and their target servings is employed via a dietary prescription before an intervention, often using a manual process. Validity of the modeling approach is critical to allow trial outcomes to be translated to practice

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Discussion

Conclusion