@Article{info:doi/10.2196/11531,
author="B{\'e}jar, Luis Mar{\'i}a
and Garc{\'i}a-Perea, Mar{\'i}a Dolores
and Reyes, {\'O}scar Adri{\'a}n
and V{\'a}zquez-Lim{\'o}n, Esther",
title="Relative Validity of a Method Based on a Smartphone App (Electronic 12-Hour Dietary Recall) to Estimate Habitual Dietary Intake in Adults",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Apr",
day="11",
volume="7",
number="4",
pages="e11531",
keywords="epidemiologic methods; diet records; mobile apps; nutrition assessment",
abstract="Background: Accurate dietary assessment is key to understanding nutrition-related outcomes and for estimating the dietary change in nutrition-based interventions. When researching the habitual consumption of selected food groups, it is essential to be aware of factors that could possibly affect reporting accuracy. Objective: This study aimed to evaluate the relative validity of the current-day dietary recall, a method based on a smartphone app called electronic 12-hour dietary recall (e-12HR), to categorize individuals according to habitual intake, in the whole sample of adults and in different strata thereof. Methods: University students and employees over 18 years recorded the consumption of 10 selected groups of food using e-12HR during 28 consecutive days. During this period, they also completed 4 dietary records. Once the period was finished, the subjects then completed a food frequency questionnaire (FFQ) and a usability-rating questionnaire for e-12HR. The food group intakes estimated by the e-12HR app, the dietary records, and the FFQ were categorized into sextiles: less than once a week, once or twice a week, 3-4 times a week, 5-6 times a week, once or twice a day, and 3 or more times a day. The 10 selected groups with e-12HR were compared with 4 dietary records and an FFQ reference method, in the whole sample and in different strata thereof: age (years): <25 and ≥25; gender: females and males; occupation: students and employees; smoking: no and yes; physical activity (minutes/week): ≥150 and <150; and body mass index (kg/m2): <25 and ≥25. The association between the different methods was assessed using Spearman correlation coefficient (SCC). Cross-classification and kappa statistic were used as a measure of agreement between the different methods. Results: In total, 203 participants completed the study (56.7{\%} [115/203] women, and 43.3{\%} [88/203] men). For all food groups and all participants, the mean SCC for e-12HR versus FFQ was 0.67 (≥0.62 for all strata). On average, 50.7{\%} of participants were classified into the same category (≥47.0{\%} for all strata) and 90.2{\%} within the nearest category (≥88.6{\%} for all strata). Mean weighted kappa was 0.49 (≥0.44 for all strata). For e-12HR versus RDs, mean SCC was 0.65 (≥0.57 for all strata). On average, 50.0{\%} of participants were classified into the same category (≥47.0{\%} for all strata) and 88.2{\%} within the nearest category (≥86.1{\%} for all strata). Mean weighted kappa was 0.50 (≥0.44 for all strata). Conclusions: The results indicate that e-12HR generated categories of dietary intake highly comparable with the 2 reference methods in the whole sample and in different strata thereof. The inclusion of photographs to facilitate estimation of the servings consumed generated correlation/agreement data between e-12HR and the FFQ that were similar to a previous study using an older version of the app, which did not include photographs. ",
issn="2291-5222",
doi="10.2196/11531",
url="https://mhealth.jmir.org/2019/4/e11531/",
url="https://doi.org/10.2196/11531",
url="http://www.ncbi.nlm.nih.gov/pubmed/30973343"
}