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      A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls

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          Abstract

          Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 ± 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 ± 820 kJ/24 h and 6040 ± 680kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls ( ρ = 0.665–0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.

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          Energy balance and its components: implications for body weight regulation.

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            A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water.

            Measuring dietary intake in children enables the assessment of nutritional adequacy of individuals and groups and can provide information about nutrients, including energy, food, and eating habits. The aim of this review was to determine which dietary assessment method(s) provide a valid and accurate estimate of energy intake by comparison with the gold standard measure, doubly labeled water (DLW). English-language articles published between 1973 and 2009 and available from common nutrition databases were retrieved. Studies were included if the subjects were children birth to age 18 years and used the DLW technique to validate reported energy intake by any other dietary assessment method. The review identified 15 cross-sectional studies, with a variety of comparative dietary assessment methods. These included a total of 664 children, with the majority having <30 participants. The majority of dietary assessment method validation studies indicated a degree of misreporting, with only eight studies identifying this to a significant level (P<0.05) compared to DLW estimated energy intake. Under-reporting by food records varied from 19% to 41% (n=5 studies) with over-reporting most often associated with 24-hour recalls (7% to 11%, n=4), diet history (9% to 14%, n=3), and food frequency questionnaires (2% to 59%, n=2). This review suggested that the 24-hour multiple pass recall conducted over at least a 3-day period that includes weekdays and weekend days and uses parents as proxy reporters is the most accurate method to estimate total energy intake in children aged 4 to 11 years, compared to total energy expenditure measured by DLW. Weighed food records provided the best estimate for younger children aged 0.5 to 4 years, whereas the diet history provided better estimates for adolescents aged≥16 years. Further research is needed in this area to substantiate findings and improve estimates of total energy expenditure in children and adolescents. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
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              The validity of self-reported energy intake as determined using the doubly labelled water technique.

              In the 1980s the development of the doubly labelled water (DLW) technique made it possible to determine the validity of dietary assessment methods using external, independent markers of intake in free-living populations. Since then, the accuracy of self-reported energy intake (EI) has been questioned on a number of occasions as under-reporting has been found to be prevalent in many different populations. This paper is a review of investigations using the DLW technique in conjunction with self-reported EI measures in groups including adults, children and adolescents, obese persons, athletes, military personnel and trekking explorers. In studies where a person other than the subject is responsible for recording dietary intake, such as parents of young children, EI generally corresponds to DLW determined energy expenditure. However, in instances where the subjects themselves report their intake, EI is generally under-reported when compared with energy expenditure. It was originally believed that this phenomenon of under-reporting was linked to increased adiposity and body size, however, it is now apparent that other factors, such as dietary restraint and socio-economic status, are also involved. This paper therefore aims to present a more comprehensive picture of under-reporting by tying in the findings of many DLW studies with other studies focusing particularly on the characteristics and mechanisms for under-reporting. Awareness of these characteristics and mechanisms will enable researchers to obtain more accurate self-reports of EI using all dietary recording techniques.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                15 January 2016
                January 2016
                : 8
                : 1
                : 50
                Affiliations
                [1 ]Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge 141 83, Sweden; christine.delisle.nystrom@ 123456ki.se
                [2 ]Department of Clinical and Experimental Medicine, Faculty of the Health Sciences, Linköping University, Linköping 581 83, Sweden; elisabet.forsum@ 123456liu.se (E.F.); hannahenriksson77@ 123456hotmail.se (H.H.)
                [3 ]Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm 171 77, Sweden; ylva.trolle@ 123456ki.se
                [4 ]Department of Food and Nutrition, and Sport Science, University of Gothenburg, P.O. Box 300, Gothenburg 405 30, Sweden; christel.larsson@ 123456gu.se
                [5 ]National Institute for Health Innovation, The University of Auckland, P.O. Box 92019, Auckland 1142, New Zealand; r.maddison@ 123456auckland.ac.nz
                [6 ]Department of Medical and Health Sciences, Faculty of the Health Sciences, Linköping University, Linköping 581 83, Sweden; toomas.timpka@ 123456liu.se
                Author notes
                [* ]Correspondence: marie.lof@ 123456ki.se ; Tel.: +46-85-2481095
                Article
                nutrients-08-00050
                10.3390/nu8010050
                4728662
                26784226
                bdac77d6-f30e-47f7-bc3c-313d032ac8f5
                © 2016 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 November 2015
                : 12 January 2016
                Categories
                Article

                Nutrition & Dietetics
                mobile phones,energy intake,food intake,total energy expenditure,child,dlw,24 h dietary recall

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