Shigeko Kato1, Kayo Waki1,2, Sadako Nakamura3,4, Sanae Osada5, Haruka Kobayashi6, Hideo Fujita1, Takashi Kadowaki2, Kazuhiko Ohe7. 1. 1Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan. 2. 2Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan. 3. 3Institute of Food, Nutrition and Health, Jumonji University, 2-1-28 Sugasawa, Niiza-Shi, Saitama 352-8510 Japan. 4. 4Division of Nutrition Science, Graduate School of Human Health Science, University of Nagasaki, Siebold, 1-1-1 Manabino, Nagayo-chyo, Nagasaki, 851-2195 Japan. 5. Junior College, Department of Food and Nutrition, Kagawa Education Institute of Nutrition, 3-24-3, Komagome, Toshima-ku, Tokyo, 170-8481 Japan. 6. 6Business Department of Healthcare Business Smart-life Solutions Department, NTT DOCOMO, Inc., 2-11-1 Nagatacho, Chiyoda-ku, Tokyo, 100-6111 Japan. 7. 7Department of Medical Informatics, School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan.
Abstract
BACKGROUND: The accuracy of estimating nutritional intake and balance from photos of meals has not been well documented. However, DialBetics (DB)-our diabetes self-management support system, which is based on information and communication technologies-relies on the photos that type 2 diabetes patients take of their meals with smartphones. Therefore, we designed a study to evaluate this accuracy. METHODS: We prepared 61 dishes whose actual amount/value of total energy and each nutrient were known: protein, fat, carbohydrates, dietary fiber and salt. Their balance-the protein-fat-carbohydrate ratio-was also known, constituting the weighed food record (WFR). Smartphone photos of those dishes were taken, and three registered dietitians evaluated each dish from those photos, naming the dish and estimating the amount of each nutrient in it, plus the dish's balance. These estimated DB and WFR values were compared using the Wilcoxon matched-pairs rank-sum test; intraclass correlation coefficients (ICCs) were calculated. Agreement between the two values for each dish was assessed by Bland-Altman analysis. RESULTS: There were significant ICCs-0.84 for fat (95 % confidence interval 0.75-0.90) and 0.93 for carbohydrates (0.88, 0.96)-but no statistically significant differences between DB and WRF for other nutrients or balance. Bland-Altman analysis showed that differences between the two values were random and not biased against nutrient intake; 95 % limits of agreement were acceptable although wide (energy -198 to 210 kcal/dish; carbohydrates -22.7 to 25.8 g/dish). CONCLUSION: DB's diet evaluation by photos is reliable with apparent potential for assessing diets.
BACKGROUND: The accuracy of estimating nutritional intake and balance from photos of meals has not been well documented. However, DialBetics (DB)-our diabetes self-management support system, which is based on information and communication technologies-relies on the photos that type 2 diabetes patients take of their meals with smartphones. Therefore, we designed a study to evaluate this accuracy. METHODS: We prepared 61 dishes whose actual amount/value of total energy and each nutrient were known: protein, fat, carbohydrates, dietary fiber and salt. Their balance-the protein-fat-carbohydrate ratio-was also known, constituting the weighed food record (WFR). Smartphone photos of those dishes were taken, and three registered dietitians evaluated each dish from those photos, naming the dish and estimating the amount of each nutrient in it, plus the dish's balance. These estimated DB and WFR values were compared using the Wilcoxon matched-pairs rank-sum test; intraclass correlation coefficients (ICCs) were calculated. Agreement between the two values for each dish was assessed by Bland-Altman analysis. RESULTS: There were significant ICCs-0.84 for fat (95 % confidence interval 0.75-0.90) and 0.93 for carbohydrates (0.88, 0.96)-but no statistically significant differences between DB and WRF for other nutrients or balance. Bland-Altman analysis showed that differences between the two values were random and not biased against nutrient intake; 95 % limits of agreement were acceptable although wide (energy -198 to 210 kcal/dish; carbohydrates -22.7 to 25.8 g/dish). CONCLUSION: DB's diet evaluation by photos is reliable with apparent potential for assessing diets.
Entities:
Keywords:
Dietary intake; Dish photograph; Self-management; Telemedicine; Type 2 diabetes
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