Dietary Assessment of domoic acid Exposure: What can be learned from traditional methods and new applications for a technology assisted device.

Three Tribal Nations in the Pacific Northwest United States comprise the members of the CoASTAL cohort. These populations may be at risk for neurobehavioral impairment, i.e., amnesic shellfish poisoning, from shellfish consumption as a result of repeated, low-level domoic acid (DA) exposure present in local clams. Previous work with this cohort confirmed a high proportion of clam consumers with varying levels of potential exposure over time. Since clams are an episodically consumed food, traditional dietary records do not fully capture exposure. Frequency questionnaires can capture accumulated doses over time and this data can be used to examine dose-response relationships with periodic studies of memory and learning. However, frequency questionnaires cannot be used to assess consumption and memory response in real time. To address this shortcoming, a modified technology assisted dietary assessment (TADA) iPod application was developed to capture images of the clam meal, sourcing data, and associated memory functioning within 24 hours and seven days after consumption. This methodology was piloted with razor clam meals consumed by members from the CoASTAL cohort. Preliminary findings suggest that the TADA iPod application is potentially useful in collecting real-time data with respect to razor clam consumption, as well as one day and seven day memory outcome data. This technology holds promise for addressing the challenges of other HAB related dietary exposure outcome studies.