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      Accuracy in the estimation of children's food portion sizes against a food picture book by parents and early educators

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          Abstract

          Validated methodological aids for food quantification are needed for the accurate estimation of food consumption. Our objective was to assess the validity of an age-specific food picture book, which contains commonly eaten foods among Finnish children, for parents and early educators in estimating food portion sizes. The food picture book was developed to assist in portion size estimation when filling in food records in the Increased health and wellbeing in preschools (DAGIS) study. All ninety-five food pictures in the book, each containing three or four different portion sizes, were evaluated at real-time sessions. Altogether, seventy-three parents and 107 early educators or early education students participated. Each participant evaluated twenty-three or twenty-four portions by comparing presented pre-weighed food portions against the corresponding picture from the food picture book. Food portions were not consumed by participants. The total proportion of correct estimations varied from 36 % (cottage cheese) to 100 % (fish fingers). Among the food groups, nearly or over 90 % of the estimations were correct for bread, pastries and main courses (‘piece products’ such as meatballs and chicken nuggets). Soups, porridges, salads and grated and fresh vegetables were least correctly estimated (<65 % correct estimations). There were small differences in evaluations of berries and fresh fruits, warm vegetables and pastries between the parents and early educators, but other estimations were mostly similar. The children's food picture book was found to be a useful aid for the estimation of food portion sizes. Parents and early educators evaluated the portion sizes with similar accuracy.

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          Sample Size Determination for Some Common Nonparametric Tests

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            Food photography II: use of food photographs for estimating portion size and the nutrient content of meals.

            The aim of the present study was to determine the errors in the conceptualization of portion size using photographs. Male and female volunteers aged 18-90 years (n 136) from a wide variety of social and occupational backgrounds completed 602 assessments of portion size in relation to food photographs. Subjects served themselves between four and six foods at one meal (breakfast, lunch or dinner). Portion sizes were weighed by the investigators at the time of serving, and any waste was weighed at the end of the meal. Within 5 min of the end of the meal, subjects were shown photographs depicting each of the foods just consumed. For each food there were eight photographs showing portion sizes in equal increments from the 5th to the 95th centile of the distribution of portion weights observed in The Dietary and Nutritional Survey of British Adults (Gregory et al. 1990). Subjects were asked to indicate on a visual analogue scale the size of the portion consumed in relation to the eight photographs. The nutrient contents of meals were estimated from food composition tables. There were large variations in the estimation of portion sizes from photographs. Butter and margarine portion sizes tended to be substantially overestimated. In general, small portion sizes tended to be overestimated, and large portion sizes underestimated. Older subjects overestimated portion size more often than younger subjects. Excluding butter and margarine, the nutrient content of meals based on estimated portion sizes was on average within +/- 7% of the nutrient content based on the amounts consumed, except for vitamin C (21% overestimate), and for subjects over 65 years (15-20% overestimate for energy and fat). In subjects whose BMI was less than 25 kg/m2, the energy and fat contents of meals calculated from food composition tables and based on estimated portion size (excluding butter and margarine) were 5-10% greater than the nutrient content calculated using actual portion size, but for those with BMI 30 kg/m2 or over, the calculated energy and fat contents were underestimated by 2-5%. The correlation of the nutrient content of meals based on actual or estimated portion sizes ranged from 0-84 to 0-96. For energy and eight nutrients, between 69 and 89% subjects were correctly classified into thirds of the distribution of intake using estimated portion size compared with intakes based on actual portion sizes. When 'average' portion sizes (the average weight of each of the foods which the subjects had served themselves) were used in place of the estimates based on photographs, the number of subjects correctly classified fell to between 60 and 79%. We report for the first time the error associated with conceptualization and the nutrient content of meals when using photographs to estimate food portion size. We conclude that photographs depicting a range of portion sizes are a useful aid to the estimation of portion size. Misclassification of subjects according to their nutrient intake from one meal is reduced when photographs are used to estimate portion size, compared with the use of average portions. Age, sex, BMI and portion size are all potentially important confounders when estimating food consumption or nutrient intake using photographs.
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              Accuracy in the estimation of food servings against the portions in food photographs.

              In diet surveys, quantitative underestimation of food consumption may be due to intentional misreporting or false portion-size reporting. Perception of food photographs used as aids for assessing the actual amounts may have an effect. This study was carried out to assess the validity of food photographs. A real-time test protocol where 52 presented food servings were compared against photographed portions with similar food items. Volunteers from the Rehabilitation Company Petrea (in Turku) were recruited, 161 adults participated, and for 146 subjects, complete data were collected. The proportions of correct estimations and reporting errors, in weights and percentages, are presented by gender and food group. Food descriptors, portion-size options and subject characteristics were studied as potential determinants of accuracy in portion-size estimation. The total proportion of exactly correct estimations was 51% in men and 49% in women. The overall reporting error was -10 g in men and +1 g in women for the 52 food servings. Underreporting was typical for bread, spread and cold cuts and dishes in both genders. Over-reporting was typical for cereals in both genders and for snacks, vegetables and fruit in women. The estimation error was associated with the portion-size options but not associated with the energy density of food items, education or body mass index. Food portions in photographs seem to be a useful aid for the quantification of most food items. However, validation studies are needed to test the applicability of photographs for estimating current portions and for searching better tools in dietary surveys.
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                Author and article information

                Contributors
                On behalf of : on behalf of the DAGIS Consortium Group
                Journal
                J Nutr Sci
                J Nutr Sci
                JNS
                Journal of Nutritional Science
                Cambridge University Press (Cambridge, UK )
                2048-6790
                2018
                27 December 2018
                : 7
                : e35
                Affiliations
                [1 ]School of Food and Agriculture, Seinäjoki University of Applied Sciences , PO Box 412, 60101 Seinäjoki, Finland
                [2 ]Department of Food and Nutrition, University of Helsinki , PO Box 66, 00014 University of Helsinki, Finland
                [3 ]Department of Social Research, Faculty of Social Sciences, University of Turku , Assistentinkatu 7, 20014 Turku, Finland
                [4 ]Folkhälsan Research Center , Paasikivenkatu 4, 00250 Helsinki, Finland
                [5 ]Department of Public Health, Clinicum, University of Helsinki , PO Box 20, 00014 University of Helsinki, Finland
                Author notes
                [* ]Corresponding author:, Kaija Nissinen, email kaija.nissinen@ 123456seamk.fi
                Article
                S2048679018000265 00026
                10.1017/jns.2018.26
                6313402
                30627432
                eb7aead7-f623-427e-910b-bd3e07dee546
                © The Author(s) 2018

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 June 2018
                : 16 October 2018
                : 09 November 2018
                Page count
                Figures: 2, Tables: 3, References: 22, Pages: 10
                Categories
                Research Article

                food photographs,validation,visual perception,early education professionals,parents,dagis, increased health and wellbeing in preschools

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