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  • Original Article
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Validation of photographic food records in children: are pictures really worth a thousand words?

European Journal of Clinical Nutrition volume 63, pages 1025–1033 (2009)Cite this article

Abstract

Background/Objectives:

Self-reported food records are commonly used to estimate dietary intake. However, diet diaries are time consuming for participants and children are often unfamiliar with standard portion sizes or weights/volume of foods that can add to the error associated with self-reported intake. We hypothesize that photographic food records to assess dietary intake will be as accurate as a standard food diary and will decrease participant/family burden.

Subjects/Methods:

A total of 28 healthy subjects, 10–16 years, consumed a weighed diet for 3 days and returned any uneaten items for weigh back on day 4. During the 3 days of weighed diet, subjects recorded all intake both using a standard diet diary and taking photographs before and after consumption. Photographs were analyzed by two independent dieticians for estimation of serving size. The actual amount consumed was compared to the diary and photographic estimates through Spearman's correlation coefficients and confidence intervals.

Results:

There was no difference between the diet diary and photographic estimates of total energy, carbohydrate, fat, protein, fiber, vitamins A, D and E, calcium, iron or zinc compared to actual intake. However, both participants and their parents reported that the photographic method was quicker, simpler and would be preferred if they were to record dietary intake in the future. In this study cohort, 36% of subjects accurately reported actual daily energy intake (±5% of actual intake), only 29% underreported energy intake and 35% overreported energy intake.

Conclusions:

Photographic food records can be used to accurately estimate dietary intake in a pediatric population. In addition, this method is less burdensome for the participants and their family.

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Acknowledgements

This work was supported by NIH grant M01 RR00069. In addition, we thank Kodak, United States, for the donation of all disposable cameras utilized in this study. Janine Higgins conceived of the study design and was responsible for overall study coordination, conducting patient visits, data analysis and paper preparation. Audrey LaSalle was responsible for patient scheduling, day-to-day study coordination, conducting patient visits and data entry. Melanie Kasten conducted all data entry in NDS and assisted with paper preparation. Kristin Bing contributed to the study design and paper preparation. Pan Zhaoxing conducted all statistical analyses and assisted with paper preparation. Teresa Witten and Susan Ridzon conducted all dietician estimates of foods and serving sizes from study photographs.

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Author notes

  1. Dr JA Higgins, Pediatric General Clinical Translational Research Center, The Children's Hospital, 13123 E 16th Avenue, Box B218, Aurora, CO 80045, USA

  2. Dr JA Higgins, Adult General Clinical Translational Research Center, University of Colorado Denver, Aurora, CO 80045, USA. E-mail: Janine.Higgins@ucdenver.edu

Authors and Affiliations

  1. Center for Human Nutrition, University of Colorado Denver, Aurora, CO, USA

    J A Higgins & K N Bing

  2. Pediatric General Clinical Translational Research Center, University of Colorado Denver, Aurora, CO, USA

    J A Higgins, A L LaSalle, P Zhaoxing & M Y Kasten

  3. Adult General Clinical Translational Research Center, University of Colorado Denver, Aurora, CO, USA

    S E Ridzon

  4. Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA

    T L Witten

Authors
  1. J A Higgins
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  2. A L LaSalle
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  3. P Zhaoxing
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  4. M Y Kasten
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  5. K N Bing
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  6. S E Ridzon
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  7. T L Witten
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Corresponding author

Correspondence to J A Higgins.

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Conflict of interest

All authors read and approved the final article and have no conflict of interest to disclose.

Appendices

Table A1

Table a1 Diet templates for all outpatient meals
Full size table

Table A2

Table a2 Exit questionnaire administered to subjects and parents/guardians
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Higgins, J., LaSalle, A., Zhaoxing, P. et al. Validation of photographic food records in children: are pictures really worth a thousand words?. Eur J Clin Nutr 63, 1025–1033 (2009). https://doi.org/10.1038/ejcn.2009.12

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  • DOI: https://doi.org/10.1038/ejcn.2009.12

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