Elsevier

Nutrition

Volume 30, Issues 11–12, November–December 2014, Pages 1257-1266
Nutrition

Review
Feasibility and validity of mobile phones to assess dietary intake

https://doi.org/10.1016/j.nut.2014.02.020Get rights and content

Abstract

Current limitations of conventional dietary assessment methods restrict the establishment of diet–disease relationships and efficacy of dietary interventions. Technology, in particular the use of mobile phones, may help resolve methodologic limitations, in turn improving the validity of dietary assessment and research and associated findings. This review aims to evaluate the validity, feasibility, and acceptability of dietary assessment methods that have been deployed on mobile phone platforms. In August 2013, electronic databases for health sciences were searched for English, peer-reviewed, full-text articles, published from January 1, 2001 onward; and accompanied by a hand search of available relevant publications from universities and government bodies. Studies were not limited by design, length, setting, or population group. Of 194 articles, 12 met eligibility criteria: mobile phone as the dietary recording platform and validation of energy and/or macronutrient intake against another dietary or biological reference method. Four dietary recoding methods had been validated on mobile phone platforms: electronic food diary, food photograph-assisted self-administered, 24 h recall, food photograph analysis by trained dietitians, and automated food photograph analysis. All mobile phone dietary assessment methods showed similar, but not superior, validity or reliability when compared with conventional methods. Participants' satisfaction and preferences for mobile phone dietary assessment methods were higher than those for conventional methods, indicating the need for further research. Validity testing in larger and more diverse populations, over longer durations is required to evaluate the efficacy of these methods in dietary research.

Introduction

The complex relationships between diet and disease etiology are not yet fully understood. Among the many barriers to ascertaining these answers lies the accuracy of dietary assessment methods. Methods of dietary assessment available today are fraught with inherent and extrinsic methodologic problems making accurate measures of nutritional intake extremely difficult [1]. This has the potential to lead to erroneous associations between diet and disease and inhibits the ability to assess efficacy of dietary interventions [2], [3]. The development of accurate assessment methods has been part of ongoing research in the fields of dietetics and epidemiology. Recently, research has focused on harnessing technology as a viable solution to current methodologic shortcomings.

Technology has the potential to reduce researcher and participant burden, improve adherence and communication, automate and standardize coding, and upgrade data quality [4], [5], [6]. In turn, these features are likely to reduce costs associated with dietary-related research and health care. Of particular interest is the use of mobile phones in aiding dietary assessment.

Ownership of mobile phones has grown exponentially over the past 10 y with an estimated 3.2 billion active users in 2012 [7]. Mobile phones have a variety of advantageous technological features such as wireless communication, built-in cameras, global positioning systems (GPS), accelerometers, high-speed microprocessors, portable designs, and connectivity to external devices via bluetooth and infra-red, making them a convenient and suitable platform for dietary research.

These features have been implemented successfully in dietary management and intervention studies [8], [9], [10], [11]. Less research, however, has investigated the validity of mobile phones for assessing dietary intake. Personal digital assistant (PDA) devices employing food photographs and electronic food diaries have previously proven to be a valid measure of macro- and micronutrient intake [12], [13]. In the past decade, the use of PDA devices has been superseded by mobile phones, in particular smartphones. The aim of this review is to assess the current literature surrounding the validity, feasibility, and acceptability of the methods used to record individual's dietary intake using mobile phones, with the intent of informing future research and practice.

Section snippets

Methods

A structured literature search was undertaken in August 2013, with a predefined search protocol establishing inclusion and exclusion criteria. Studies using mobile phones as the dietary recording platform and published in peer-reviewed English journals from January 1, 2001 onward were included. The year 2001 was chosen to reflect the mainstream inception of the term smartphone. All study designs, lengths, settings, and population groups were considered. Validation of energy and/or macronutrient

Results

The database search yielded 20 764 publications when search strings were combined. We extracted 194 full-text articles into Endnote X6 (Thomson Reuters) for further review. Four additional articles were retrieved following a manual search of authors and screening of selected articles and bibliographies. After applying inclusion and exclusion criteria, 15 eligible studies were selected. Hand searching of universities and government bodies yielded one additional dissertation containing four

Discussion

Three main dietary assessment methods using mobile phones were discovered by this literature review. These were exclusively self-reported dietary intake methods (mobile phone electronic food diary and food photograph recall aids), analysis of food photographs by trained dietitians, and automated food photograph or video analysis. With the exception of one study [14], high levels of satisfaction were reported for mobile phone dietary assessment methods [17], [18], [19], [20], [22], [30].

Conclusion

Use of mobile phones to record dietary intake showed potential to reduce research costs through automated real-time coding but methods using photographs currently suffer from natural and technological limitations. The unanimous satisfaction and preference for mobile phone dietary assessment methods over conventional methods suggests further research is warranted.

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  • Cited by (0)

    Both authors contributed to conception, study design, generation, analysis, and interpretation of data and revision and approval of the final manuscript. DBS drafted the first version of the manuscript.

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