Validity of the PortionSize application compared with that of MyFitnessPal for accurately estimating intake: a randomized crossover laboratory-based evaluation

Abstract

BackgroundPortionSize offers real-time feedback on dietary intake, including intake of MyPlate food groups but requires further evaluation on a larger sample in a laboratory-based setting. MyFitnessPal (MFP) is a commonly used commercial dietary assessment application, and to our knowledge, no known studies have evaluated MFP in a laboratory setting. ObjectivesThe overall objective was to test the validity of PortionSize and MFP to accurately measure intake compared with that of weighed food (WB) and to compare error between applications. A secondary objective was to test usability, satisfaction, and user preference between applications. MethodsThis randomized crossover study was completed between February and October 2021. Participants (N = 43) used both applications to estimate intake in a laboratory setting. Participants were provided with a preweighed plated meal and plated leftovers. Two 1-sided t tests assessed equivalence (±21% bounds) between simulated intake from PortionSize and WB, and MFP and WB. The primary outcome was energy intake, and secondary outcome measures were portion size (in grams), food groups, and other nutrients. Differences in relative absolute error, usability, satisfaction, and user preference between applications were evaluated using dependent samples t tests. Cohen d assessed effect size. ResultsFor PortionSize, energy and portion size were underestimated by 13.3% and 14.0%, respectively, and were not equivalent to WB. For MFP, energy was overestimated by 7.0%, and equivalent to WB (P = 0.04). Relative absolute error for energy did not differ between applications. For PortionSize, Cohen d was small (<0.2) for fruits, grains, protein foods, and specific nutrients. No differences were seen with usability, and the only difference for satisfaction was that participants found it easier to use MFP to find foods consumed (P = 0.019), and participants preferred using MFP (P = 0.014). ConclusionsPortionSize requires further updates to improve energy estimates and usability but demonstrates clinical utility for tracking food group and nutrient intake. PortionSize did not outperform MFP for measuring energy intake. Clinical Trial RegistryThis trial was registered at clinicaltrials.gov as NCT04700904 (https://classic.clinicaltrials.gov/ct2/show/NCT04700904).