Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: Randomized controlled trial

Abstract

Background: Dietary intake assessment with diet records (DR) is a standard research and practice tool in nutrition. Manual entry and analysis of DR is time-consuming and expensive. New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient intake estimation. Objective: To determine the validity of electronic diet recording. We Compared Responses to 3-day DR Kept by Tap Track Software for the Apple IPod Touch and Records Kept on the Nutrihand Website to DR Coded and Analyzed by A Res. Dietitian into A Customized US Dept. of Agric. Nutrient Anal. Prog., Entitled GRand . Methods: Adult Participants Enrolled in A Crossover-designed Clin. Trial. during Each of Two Washout Periods, Participants Kept A Written 3-day DR. in Addition, They Were Randomly Assigned to Enter Their DR in A Web-based Dietary Anal. Prog. or A Handheld Electron. Device . They Completed An Additional 3-day DR and the Alt. Electron. Diet Recording Methods during the Second Washout. Entries Resulted in 228 Daily Diet Records or 12 for Each of 19 Participants. Means of Nutrient Intake Were Calculated for Each Method. Concordance of the Intake Estimates Were Determined by Bland-Altman Plots. Coefficients of Determination Were Calculated for Each Comparison to Assess the Strength of the Lin. Relationship between Methods. Results: No Significant Differences Were Observed between the Mean Nutrient Values for Ener., Carbohydrate, Protein, Fat, Saturated Fatty Acids, Total Fiber, or Sodium between the Recorded DR Analyzed in GRand and Either Nutrihand or Tap Track, or for Total Sugars Comparing GRand and Tap Track. Reported Values for Total Sugars Were Significantly Reduced Comparing Nutrihand to GRAND. Coefficients of Determination for Nutrihand and Tap Track Compared to DR Entries into GRAND, Respectively, Were Ener. .56, .01; Carbohydrate .58, .08; Total Fiber .65, .37; Sugar .78, .41; Protein .44, .03; Fat .36, .03; Saturated Fatty Acids .23, .03; Sodium .20, .00; and for Nutrihand only for Cholesterol .88; Vit. A .02; Vit. C .37; Calcium .05; and Iron .77. Bland-Altman Anal. Demonstrates High Variability in Individual Responses for Both Electron. Capture Programs with Higher 95% Limits of Agreement for Dietary Intake Recorded on Tap Track. Conclusions: in Comparison to Dietitian-entered 3-day DR, Electron. Methods Resulted in No Significant Difference in Mean Nutrient Estimates but Exhibited Larger Variability, Particularly the Tap Track Prog.. However, Electron. DR Provided Mean Estimates of Ener., Macronutrients, and Some Micronutrients, Which Approximated Those of the Dietitian-analyzed DR and May Be Appropriate for Dietary Monitoring of Groups. Electron. Diet Assess. Methods Have the Potential to Reduce the Cost and Burden of DR Anal. for Nutr. Res. and Clin. Pract..