Validation of a Digital Diet Method for Use With Preschoolers

The Validation of a Digital Diet Method project is very innovative because it links three methods to address the gap in measuring food intake of HS preschool children. Data collection is based on EMA theory; participant burden is low, and the Food Image App decreases participant and staff burden even further. Data management and analysis are semi-automated and relies on advanced computer algorithms. A strength of this approach is its semi-automation, which allows us to leverage the strengths of human operators and computer automation.

Study Overview

• Status: Completed
• Conditions: Feeding Behaviors

Detailed Description

The goal of the proposed research is to modify the Remote Food Photography Method (RFPM) for use with preschoolers. Primary caregivers (the majority will be mothers) and HS assistants will use a Smartphone to capture 24-hour images of HS children's food selection and plate waste. The RFPM, Ecological Momentary Assessment (EMA). and the Food Photography Application© will be used to estimate the energy and nutrient intake of preschoolers. The accuracy of the RFPM will be examined by determining the energy and nutrient intake (collectively referred to as food intake [FI]) to established methods: 1) actual gram (g) weights of laboratory-based test meals and 2) doubly labeled water (DLW) in a natural environment.

• Study Type: Observational
• Enrollment (Actual): 94

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • USDA/ARS Children's Nutrition Research Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 5 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

With an anticipated attrition rate of 15%, 62 children will be recruited, resulting in a sample size of 54 after attrition (14 HA boys; 14 HA girls; 13 AA boys; 13 AA girls).

Description

Inclusion Criteria:

• 3-5 years old
• Attends Head Start
• African-American
• Hispanic American
• Can physically complete the tasks required in the proposed research

Exclusion Criteria:

• Younger than 3 years old
• Older than 5 years old
• Does not attend Head Start
• Race/Ethnicity other than African-American or Hispanic-American
• Cannot physically complete the tasks required in the proposed research

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort
African American Girls; -25% of sample is African American Girls
African American Boys; -25% of sample is African American Boys
Hispanic American Girls; -25% of sample is Hispanic American Girls
Hispanic American Boys; -25% of sample is Hispanic American Boys

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
This experiment will compare energy intake (EI) calculated using the test method (Remote Food Photography Method or RFPM) against energy intake calculated using weight measures (actual weighing of all food/beverages consumed).	The Bland-Altman method was used to measure the agreement between digital photography estimated weight and actual weight. This method uses a two step process that evaluates the accuracy (validity) of a "new" measurement technique compared to and existing "gold standard", which was the actual weights of foods.	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
This experiment will compare energy intake (EI) calculated using the test method (Remote Food Photography Method or RFPM) against energy expenditure using the Doubly Labeled Water method (DLW).	The Same statistical analysis methods used for the Primary Outcome Measure will be applied. Additionally, the Bland-Altman technique will be used to assess the degree of agreement between the two methods.	12 months

Collaborators and Investigators

• Sponsor: Baylor College of Medicine
• Collaborators: National Cancer Institute (NCI); National Institutes of Health (NIH)

Publications and helpful links

General Publications

• Nicklas TA, O'Neil CE, Stuff J, Goodell LS, Liu Y, Martin CK. Validity and feasibility of a digital diet estimation method for use with preschool children: a pilot study. J Nutr Educ Behav. 2012 Nov-Dec;44(6):618-23. doi: 10.1016/j.jneb.2011.12.001. Epub 2012 Jun 23.
• Nicklas T, Saab R, Islam NG, Wong W, Butte N, Schulin R, Liu Y, Apolzan JW, Myers CA, Martin CK. Validity of the Remote Food Photography Method Against Doubly Labeled Water Among Minority Preschoolers. Obesity (Silver Spring). 2017 Sep;25(9):1633-1638. doi: 10.1002/oby.21931. Epub 2017 Jul 31.
• Nicklas T, Islam NG, Saab R, Schulin R, Liu Y, Butte NF, Apolzan JW, Myers CA, Martin CK. Validity of a Digital Diet Estimation Method for Use with Preschool Children. J Acad Nutr Diet. 2018 Feb;118(2):252-260. doi: 10.1016/j.jand.2017.05.005. Epub 2017 Jun 19.

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2012
• Primary Completion (Actual): May 1, 2015
• Study Completion (Actual): December 1, 2016

Study Registration Dates

• First Submitted: October 31, 2012
• First Submitted That Met QC Criteria: November 8, 2012
• First Posted (Estimate): November 12, 2012

Study Record Updates

• Last Update Posted (Actual): July 12, 2017
• Last Update Submitted That Met QC Criteria: July 11, 2017
• Last Verified: July 1, 2017

More Information

Terms related to this study

• Keywords: digital technology; children; preschool; Head Start; nutrition assessment; eating behavior
• Other Study ID Numbers: H-29112; R01CA142919-01A1 (U.S. NIH Grant/Contract)