title: Quantifying accurate calorie estimation using the "think aloud" method.
abstract: OBJECTIVE
  Clients often have limited time in a nutrition education setting. An improved understanding of the strategies used to accurately estimate calories may help to identify areas of focused instruction to improve nutrition knowledge.
  
  
  METHODS
  A "Think Aloud" exercise was recorded during the estimation of calories in a standard dinner meal (415 kcal) in 15 nutrition-trained and 15 untrained subjects. Accuracy of participant estimation was assessed, and estimation strategies were compared in accurate vs inaccurate estimators.
  
  
  RESULTS
  Accurate participants were more likely to demonstrate an ability to convert between common portion size measurements and serving sizes, possess some knowledge of energy density, and properly implement basic math skills.
  
  
  CONCLUSIONS
  The "Think Aloud" methodology was informative in assessing the cognitive processes behind a nutrition exercise, and further use is warranted. Focused instruction in portion size conversion, energy density, and the use of math skills may enhance calorie estimation accuracy.
authors.affiliation: Public and Allied Health Sciences Department, Delaware State University, Dover, DE 19901, USA. mholmstrup@desu.edu
authors.forename: Michael E
authors.initials: ME
authors.lastname: Holmstrup
authors.forename: Kay
authors.initials: K
authors.lastname: Stearns-Bruening
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rozelle
mesh_terms: D000328:Adult; D004435:Eating / Q000523:psychology; D002149:Energy Intake; D005260:Female; D005502:Food / Q000145:classification; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008433:Mathematics; D052756:Nutritional Sciences / Q000193:education*