Abstract
Dietary assessment in older adults can be challenging. The Novel Assessment of Nutrition and Ageing (NANA) method is a touch-screen computer-based food record that enables older adults to record their dietary intakes. The objective of the present study was to assess the relative validity of the NANA method for dietary assessment in older adults. For this purpose, three studies were conducted in which a total of ninety-four older adults (aged 65-89 years) used the NANA method of dietary assessment. On a separate occasion, participants completed a 4 d estimated food diary. Blood and 24h urine samples were also collected from seventy-six of the volunteers for the analysis of biomarkers of nutrient intake. The results from all the three studies were combined, and nutrient intake data collected using the NANA method were compared against the 4 d estimated food diary and biomarkers of nutrient intake. Bland-Altman analysis showed a reasonable agreement between the dietary assessment methods for energy and macronutrient intake; however, there were small, but significant, differences for energy and protein intake, reflecting the tendency for the NANA method to record marginally lower energy intakes. Significant positive correlations were observed between urinary urea and dietary protein intake using both the NANA and the 4 d estimated food diary methods, and between plasma ascorbic acid and dietary vitamin C intake using the NANA method. The results demonstrate the feasibility of computer-based dietary assessment in older adults, and suggest that the NANA method is comparable to the 4 d estimated food diary, and could be used as an alternative to the food diary for the short-term assessment of an individual's dietary intake.
Highlights
Dietary assessment in older adults can be challenging
A total of 103 older adults were initially recruited for the validation across the three studies; nine participants were excluded from the analysis, leaving a total of ninetyfour participants
The present study demonstrated a good-to-moderate correlation between the Nutrition and Ageing (NANA) method and the 4 d estimated food diary for total energy intake (r 0·88), macronutrient intake and micronutrient intake
Summary
Dietary assessment in older adults can be challenging. The Novel Assessment of Nutrition and Ageing (NANA) method is a touch-screen computer-based food record that enables older adults to record their dietary intakes. There has been an increased drive towards the application of information and communication technologies (mobile phones, personal digital assistant (PDA) and computers) in the development of novel dietary assessment methods(9 – 11), typically using computer-assisted 24 h dietary recall-(12 – 16), diet history-(17 – 19) or FFQbased(20 – 23) approaches These information and communication technology-based approaches offer great potential to reduce the cost, improve the accuracy and reduce both participant and researcher burden of dietary assessment[9,24]. Older adults reported more difficulty than younger adults in using a touch-screen audio computer-assisted self-interview for the assessment of diet, health and lifestyle in a population of American Indians, and cited a desire for more instructions[19] This evidence highlights the need for computer-based dietary assessment methods that are more appropriate for use with older adults
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