Validation of photographic food records in children: are pictures really worth a thousand words?
OBJECTIVE
Self-reported food records are commonly used to estimate dietary intake. However, diet diaries are time consuming for participants and children are often unfamiliar with standard portion sizes or weights/volume of foods that can add to the error associated with self-reported intake. We hypothesize that photographic food records to assess dietary intake will be as accurate as a standard food diary and will decrease participant/family burden.


METHODS
A total of 28 healthy subjects, 10-16 years, consumed a weighed diet for 3 days and returned any uneaten items for weigh back on day 4. During the 3 days of weighed diet, subjects recorded all intake both using a standard diet diary and taking photographs before and after consumption. Photographs were analyzed by two independent dieticians for estimation of serving size. The actual amount consumed was compared to the diary and photographic estimates through Spearman's correlation coefficients and confidence intervals.


RESULTS
There was no difference between the diet diary and photographic estimates of total energy, carbohydrate, fat, protein, fiber, vitamins A, D and E, calcium, iron or zinc compared to actual intake. However, both participants and their parents reported that the photographic method was quicker, simpler and would be preferred if they were to record dietary intake in the future. In this study cohort, 36% of subjects accurately reported actual daily energy intake (+/-5% of actual intake), only 29% underreported energy intake and 35% overreported energy intake.


CONCLUSIONS
Photographic food records can be used to accurately estimate dietary intake in a pediatric population. In addition, this method is less burdensome for the participants and their family.
Higgins
J A
JA
Center for Human Nutrition, University of Colorado Denver, Aurora, CO 80045, USA. Janine.Higgins@ucdenver.edu
LaSalle
A L
AL
Zhaoxing
P
P
Kasten
M Y
MY
Bing
K N
KN
Ridzon
S E
SE
Witten
T L
TL
D000293:Adolescent; D002648:Child; D004032:Diet; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D010781:Photography / Q000379:methods; D015203:Reproducibility of Results