Scaling up Dietary Data for Decision-Making in Low-Income Countries: New Technological Frontiers

Winnie Bell,Brooke A Colaiezzi,Cathleen S Prata,Jennifer C Coates

doi:10.3945/an.116.014308

Abstract

AbstractDietary surveys in low-income countries (LICs) are hindered by low investment in the necessary research infrastructure, including a lack of basic technology for data collection, links to food composition information, and data processing. The result has been a dearth of dietary data in many LICs because of the high cost and time burden associated with dietary surveys, which are typically carried out by interviewers using pencil and paper. This study reviewed innovative dietary assessment technologies and gauged their suitability to improve the quality and time required to collect dietary data in LICs. Predefined search terms were used to identify technologies from peer-reviewed and gray literature. A total of 78 technologies were identified and grouped into 6 categories: 1) computer- and tablet-based, 2) mobile-based, 3) camera-enabled, 4) scale-based, 5) wearable, and 6) handheld spectrometers. For each technology, information was extracted on a number of overarching factors, including the primary purpose, mode of administration, and data processing capabilities. Each technology was then assessed against predetermined criteria, including requirements for respondent literacy, battery life, requirements for connectivity, ability to measure macro- and micronutrients, and overall appropriateness for use in LICs. Few technologies reviewed met all the criteria, exhibiting both practical constraints and a lack of demonstrated feasibility for use in LICs, particularly for large-scale, population-based surveys. To increase collection of dietary data in LICs, development of a contextually adaptable, interviewer-administered dietary assessment platform is recommended. Additional investments in the research infrastructure are equally important to ensure time and cost savings for the user.

Highlights

Interventions and policies that seek to improve human health through diet or influence the effects of food systems on dietary outcomes require high-quality data on the food and nutrient intake of individuals
A total of 78 distinct technologies were identified and grouped into 6 categories. These categories cover a spectrum of innovation, ranging from computerand tablet-based dietary assessment programs that are in widespread use in high-income countries to highly innovative technologies that are still under development, such as handheld spectrometers (Figure 2)
In addition it is the first to consider the conditions of many low-income countries (LICs) contexts, which are often constrained by illiteracy, innumeracy, limited internet connectivity, and intermittent electricity, among other factors

Summary

Introduction

Interventions and policies that seek to improve human health through diet or influence the effects of food systems on dietary outcomes require high-quality data on the food and nutrient intake of individuals. High-income countries increasingly rely on self-administered computer- and web-based surveys to implement these methods, whereas low-income countries (LICs) continue to rely on interviewer-administered, paper-based questionnaires because of low literacy rates and sporadic internet connectivity [2]. The time-consuming process in most LICs of collecting, entering, transforming, and analyzing data is exacerbated by the lack of research infrastructure needed to process dietary data (e.g., food composition databases [FCDBs] and portion-size conversion factors). Because of these constraints, the collection of individual dietary data is commonly perceived to be cost- and timeprohibitive, resulting in a dearth of routinely available dietary data in LICs

Methods

Results

Conclusion