Abstract
BackgroundThe application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often specifically designed for a particular country or region.ObjectiveThe aim of this study was to describe the development, validation, and user evaluation of a Web-based dietary assessment tool “Foodbook24.”MethodsFoodbook24 is a Web-based, dietary assessment tool consisting of a 24-hour dietary recall (24HDR) and food frequency questionnaire (FFQ) alongside supplementary questionnaires. Validity of the 24HDR component was assessed by 40 participants, who completed 3 nonconsecutive, self-administered 24HDR using Foodbook24 and a 4-day semi-weighed food diary at separate time points. Participants also provided fasted blood samples and 24-hour urine collections for the identification of biomarkers of nutrient and food group intake during each recording period. Statistical analyses on the nutrient and food group intake data derived from each method were performed in SPSS version 20.0 (SPSS Inc). Mean nutrient intakes (and standard deviations) recorded using each method of dietary assessment were calculated. Spearman and Pearson correlations, Wilcoxon Signed Rank and Paired t test were used to investigate the agreement and differences between the nutritional output from Foodbook24 (test method) and the 4-day semi-weighed food diary (reference method). Urinary and plasma biomarkers of nutrient intake were used as an objective validation of Foodbook24. To investigate the user acceptability of Foodbook24, participants from different studies involved with Foodbook24 were asked to complete an evaluation questionnaire.ResultsFor nutrient intake, correlations between the dietary assessment methods were acceptable to very good in strength and statistically significant (range r=.32 to .75). There were some significant differences between reported mean intakes of micronutrients recorded by both methods; however, with the exception of protein (P=.03), there were no significant differences in the reporting of energy or macronutrient intake. Of the 19 food groups investigated in this analysis, there were significant differences between 6 food groups reported by both methods. Spearman correlations for biomarkers of nutrient and food group intake and reported intake were similar for both methods. A total of 118 participants evaluated the acceptability of Foodbook24. The tool was well-received and the majority, 67.8% (80/118), opted for Foodbook24 as the preferred method for future dietary intake assessment when compared against a traditional interviewer led recall and semi-weighed food diary.ConclusionsThe results of this study demonstrate the validity and user acceptability of Foodbook24. The results also highlight the potential of Foodbook24, a Web-based dietary assessment method, and present a viable alternative to nutritional surveillance in Ireland.
Highlights
BackgroundDietary assessment methodologies are known to have both strengths and limitations [1]
We investigated the relative validity of a Web-based 24-hour dietary recall (24HDR) tool, Foodbook24
This study only investigates the validity of the 24HDR component of the Foodbook24 tool, the tool itself incorporates the use of blended assessment methods that has the potential to yield more accurate data on habitual intake [5]
Summary
BackgroundDietary assessment methodologies are known to have both strengths and limitations [1]. The 24-hour dietary recall (24HDR) method is associated with low participant burden and can provide reliable intake data with minimal bias [3]. The application of technology in dietary assessment has made it possible to minimize the reliance on trained interviewers and instead facilitate automated self-administered 24HDR via Web-based platforms and mobile phone apps [5]. Web-based methodologies facilitate the collection of dietary intake across many geographic locations [6], from large cohorts [7], and are often preferred by participants compared with the traditional methods [8,9]. An example of a successful Web-based 24-hour recall tool is the ASA24 developed by the National Cancer Institute, USA. The application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often designed for a particular country or region
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