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Research and Professional Brief
The Use of a Personal Digital Assistant for Dietary Self-Monitoring Does Not Improve the Validity of Self-Reports of Energy Intake

https://doi.org/10.1016/j.jada.2006.05.004Get rights and content

Abstract

Underreporting of energy intake is a pervasive problem and resistant to improvement, especially among people with overweight and obesity. The goal of this study was to investigate whether the use of a personal digital assistant (PDA) for dietary self-monitoring would reduce underreporting prevalence and improve the validity of self-reported energy intake. Adults with overweight and obesity (n=61, 92% women, mean age 48.2 years, mean body mass index 32.3) were provided with a PalmZire 21 (Palm, Inc, Sunnyvale, CA) loaded with Calorie King’s Diet Diary software (version 3.2.2, 2002, Family Health Network, Costa Mesa, CA). Subjects participated in a 24-week in-person behavioral weight control program and were asked to self-monitor their diet and exercise habits using the PDA. Basal metabolic rate and physical activity level were estimated at baseline. Energy intake from 7-day electronic food records were collected within the first month of the weight-control program. As subjects were actively losing weight, Bandini’s adjustments were used to correct self-reported energy intake for weight loss. In this group, where 41% of the subjects were categorized as low-energy reporters, the use of a PDA did not improve validity of energy reporting when compared to what is reported in the literature.

Section snippets

Methods

Subjects were recruited through newspaper advertisements and asked to enroll via a secure Web site developed for this study that screened out volunteers who did not meet basic study criteria. After subsequent telephone screening and group orientation, 61 white adults (56 women and 5 men) between ages 19 and 68 years (mean 48.2 years) with a baseline body mass index between 25 and 39.9 (mean 32.3) signed informed consent forms and were enrolled in a 24-week behavioral weight-control program.

Results and Discussion

Complete data for estimating the prevalence and extent of low energy reporting (weight data for 2 consecutive weeks with a 7-day food record electronically submitted in between) were available for 42 (90% women) of 61 subjects. Seventeen subjects (41%) had adjusted self-reported energy intake:BMR values that fell below the cut-offs and were classified as low-energy reporters (Table). Twenty-four (57%) had values that fell within the range to be classified as valid reporters and one female

Conclusions

Whereas accuracy of dietary records may not be critical for weight loss, food and nutrition professionals need to be aware that food records will continue to be highly inaccurate regardless of the dietary intake method. This is particularly important to consider when making dietary recommendations to an overweight/obese population trying to lose weight. Dietary self-monitoring has long been considered a cornerstone of behavioral weight-control programs (22) and weight loss success is strongly

B. A. Yon is a public health nutritionist; at the time of the study, she was a research assistant, University of Vermont, Burlington.

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    B. A. Yon is a public health nutritionist; at the time of the study, she was a research assistant, University of Vermont, Burlington.

    R. K. Johnson is a professor of Nutrition and dean of the College of Agriculture and Life Sciences

    J. Harvey-Berino is a professor of Nutrition and chair of the Department of Nutrition and Food Sciences

    B. C. Gold is a clinical coordinator, Department of Nutrition and Food Sciences, University of Vermont, Burlington.

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