Computerized Portion-Size Estimation Compared to Multiple 24-Hour Dietary Recalls for Measurement of Fat, Fruit, and Vegetable Intake in Overweight Adults

doi:10.1016/j.jada.2011.07.004

Journal of the American Dietetic Association

Volume 111, Issue 10, October 2011, Pages 1578-1583

https://doi.org/10.1016/j.jada.2011.07.004 Get rights and content

Abstract

Validated self-report methods of dietary assessment exist and might be improved in terms of both accuracy and cost-efficiency with computer technology. The objectives of this preliminary study were to develop an initial version of an interactive CD-ROM program to estimate fruit, vegetable, and fat intake, and to compare it to multiple 24-hour dietary recalls (averaged over 3 days). In 2009, overweight male and female adults (n=205) from Lane County, OR, completed computerized and paper versions of fruit, vegetable, and fat screening instruments, and multiple 24-hour dietary recalls. Summary scores from the 10-item National Cancer Institute Fruit and Vegetable Scan and the 18-item Block Fat Screener were compared to multiple 24-hour dietary recall−derived fruit/vegetable and fat intake estimates (criterion measures). Measurement models were used to derive deattenuated correlations with multiple 24-hour dietary recalls of paper and CD-ROM administrations of Fruit and Vegetable Scan fruit intake, vegetable intake, and fruit and vegetable intake, and Block Fat Screener fat intake. The computerized assessment and paper surveys were related to multiple 24-hour dietary recall−derived fruit/vegetable and fat intake. Deattenuated correlation coefficients ranged from 0.50 to 0.73 (all P≤0.0001). The CD-ROM−derived estimate of fruit intake was more closely associated with 24-hour dietary recall (r=0.73) than the paper-derived estimate (r=0.54; P<0.05), but the other comparisons did not differ significantly. Findings from this preliminary study with overweight adults indicate the need for additional enhancements to the CD-ROM assessment and more extensive validation studies.

Section snippets

Sample

A total of 207 overweight or obese adults was recruited and enrolled in the study from June 2007 through November 2009. Participants were paid $50. The Oregon Research Institute Institutional Review Board approved the study protocol and all participants provided written informed consent. Power analyses indicated that with 200 individuals, the study had sufficient power to detect medium to small effects (R²=0.05).

Interactive CD-ROM Program

Two widely used dietary screeners were adapted for the CD-ROM program: the National

Participant Characteristics

Of people reached by telephone, 70% were deemed eligible, 97% agreed to participate, and 85% completed all three assessments. Of those not completing the study, most missed appointments and were thereafter unreachable (n=28). Baseline participant characteristics are presented in Table 1. The recruited sample averaged 59 years of age. Most were female, were self-identified as white, had <$50,000 income, and were not employed. Average body mass index (calculated as kg/m²) was 32.2, and most

Discussion

Accurate portrayal of dietary intake requires both frequency and portion size; frequency is the more important of the two (54, 62, 63, 64, 65), but portion-size estimation makes an important contribution (3, 4, 5, 6). The computerized screeners developed in this preliminary investigation and tested in a sample of older, overweight adults focused on enhanced portion-size estimation, and produced correlations with multiple 24-hour dietary recalls in line with previously published studies (49, 50,

Applications to General Practice

The study indicated that interactive computerized dietary screeners offer similar estimates to paper assessment and significantly correlate with multiple 24-hour dietary recalls estimates for measuring fruit and vegetable and fat intake in overweight adults. Our findings suggest that the computerized version of the Fruit and Vegetable Scan and Block Fat Screener is feasible for use in qualitative clinical or quantitative research situations where it is not possible to administer longer dietary

Future Research

This study is one of very few focused specifically on increasing portion size estimation accuracy. Results are encouraging. The next step in this line of research is to identify and test more innovative ways to increase accuracy of portion estimation. Also, more formal validation is needed. Future research should vigorously test a revised version with other populations and with the use of in vivo observational portion-serving methods in addition to multiple 24-hour dietary recall, and

D. J. Toobert and S. E. Hampson are senior research scientists, Oregon Research Institute, Eugene, OR

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D. J. Toobert and S. E. Hampson are senior research scientists, Oregon Research Institute, Eugene, OR

L. A. Strycker is a senior research associate, Oregon Research Institute, Eugene, OR

E. Westling is a research associate, Oregon Research Institute, Eugene, OR

S. M. Christiansen is President, InterVision Media, Eugene, OR

T. G. Hurley is a senior biostatistician and manager of the Diet Assessment Unit, Arnold School of Public Health, University of South Carolina, Columbia

J. R. Hébert is a Health Sciences Distinguished Professor, Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia

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ResearchResearch and Practice InnovationsComputerized Portion-Size Estimation Compared to Multiple 24-Hour Dietary Recalls for Measurement of Fat, Fruit, and Vegetable Intake in Overweight Adults

Abstract

Section snippets

Sample

Interactive CD-ROM Program

Participant Characteristics

Discussion

Applications to General Practice

Future Research

J Am Diet Assoc

J Am Diet Assoc

Am J Clin Nutr

J Am Diet Assoc

J Am Diet Assoc

Ann Epidemiol

J Nutr

Ann Epidemiol

Am J Clin Nutr

J Am Diet Assoc

Am J Clin Nutr

J Am Diet Assoc

J Am Diet Assoc

J Am Diet Assoc

J Am Diet Assoc

Nutr Res

J Am Diet Assoc

J Am Diet Assoc

J Nutr Educ Behav

Patient Educ Couns

Am J Clin Nutr

J Nutr Educ

J Nutr Educ Behav

Ann Epidemiol

J Nutr Educ

J Am Diet Assoc

Am J Clin Nutr

J Nutr

J Nutr

J Am Diet Assoc

J Nutr

J Nutr

J Am Diet Assoc

Research
Research and Practice Innovations
Computerized Portion-Size Estimation Compared to Multiple 24-Hour Dietary Recalls for Measurement of Fat, Fruit, and Vegetable Intake in Overweight Adults