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Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

Priority Research Centre in Physical Activity and Nutrition and School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia
School of Exercise and Nutrition Sciences, Faculty of Health, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Western Australia 6027, Australia
Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia
School of Medicine, University of Queensland, Woolloongabba, Queensland 4102, Australia
Author to whom correspondence should be addressed.
Nutrients 2015, 7(6), 4897-4910;
Received: 15 April 2015 / Revised: 3 June 2015 / Accepted: 9 June 2015 / Published: 17 June 2015
(This article belongs to the Special Issue Assessment of Nutrient Intakes)
Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77–0.99) was lower when compared with the 3-day WFR (ICC = 0.82–0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required. View Full-Text
Keywords: diabetes; doubly labelled water; image-based dietary records; nutrition assessment diabetes; doubly labelled water; image-based dietary records; nutrition assessment
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Rollo, M.E.; Ash, S.; Lyons-Wall, P.; Russell, A.W. Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes. Nutrients 2015, 7, 4897-4910.

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