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Validating the use of photos to measure dietary intake: the method used by DialBetics, a smartphone-based self-management system for diabetes patients

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Abstract

Background

The accuracy of estimating nutritional intake and balance from photos of meals has not been well documented. However, DialBetics (DB)—our diabetes self-management support system, which is based on information and communication technologies—relies on the photos that type 2 diabetes patients take of their meals with smartphones. Therefore, we designed a study to evaluate this accuracy.

Methods

We prepared 61 dishes whose actual amount/value of total energy and each nutrient were known: protein, fat, carbohydrates, dietary fiber and salt. Their balance—the protein-fat-carbohydrate ratio—was also known, constituting the weighed food record (WFR). Smartphone photos of those dishes were taken, and three registered dietitians evaluated each dish from those photos, naming the dish and estimating the amount of each nutrient in it, plus the dish’s balance. These estimated DB and WFR values were compared using the Wilcoxon matched-pairs rank-sum test; intraclass correlation coefficients (ICCs) were calculated. Agreement between the two values for each dish was assessed by Bland-Altman analysis.

Results

There were significant ICCs—0.84 for fat (95 % confidence interval 0.75–0.90) and 0.93 for carbohydrates (0.88, 0.96)—but no statistically significant differences between DB and WRF for other nutrients or balance. Bland-Altman analysis showed that differences between the two values were random and not biased against nutrient intake; 95 % limits of agreement were acceptable although wide (energy −198 to 210 kcal/dish; carbohydrates −22.7 to 25.8 g/dish).

Conclusion

DB’s diet evaluation by photos is reliable with apparent potential for assessing diets.

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Abbreviations

DB:

DialBetics

WFR:

Weighed food record

ICC:

Intraclass correlation coefficient

24hR:

24-hour recalls

ICT:

Information and communication technologies

apps:

Smartphone applications

PDA:

Personal digital assistant

RD:

Registered dietitian

PFC ratio:

Protein-fat-carbohydrate ratio

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Acknowledgments

This work was funded by NTT DOCOMO and was partly supported by JSPS KAKENHI grant nos. 23790559 and 24700843. The authors thank Dr. Tsuneyuki Oku and Dr. Katsuhisa Omagari, University of Nagasaki, for their valuable advice.

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Authors and Affiliations

  1. Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Shigeko Kato, Kayo Waki & Hideo Fujita

  2. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kayo Waki & Takashi Kadowaki

  3. Institute of Food, Nutrition and Health, Jumonji University, 2-1-28 Sugasawa, Niiza-Shi, Saitama, 352-8510, Japan

    Sadako Nakamura

  4. Division of Nutrition Science, Graduate School of Human Health Science, University of Nagasaki, Siebold, 1-1-1 Manabino, Nagayo-chyo, Nagasaki, 851-2195, Japan

    Sadako Nakamura

  5. Junior College, Department of Food and Nutrition, Kagawa Education Institute of Nutrition, 3-24-3, Komagome, Toshima-ku, Tokyo, 170-8481, Japan

    Sanae Osada

  6. Business Department of Healthcare Business Smart-life Solutions Department, NTT DOCOMO, Inc., 2-11-1 Nagatacho, Chiyoda-ku, Tokyo, 100-6111, Japan

    Haruka Kobayashi

  7. Department of Medical Informatics, School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazuhiko Ohe

Authors
  1. Shigeko Kato
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  2. Kayo Waki
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  3. Sadako Nakamura
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  4. Sanae Osada
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  5. Haruka Kobayashi
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  6. Hideo Fujita
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  7. Takashi Kadowaki
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  8. Kazuhiko Ohe
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Corresponding author

Correspondence to Kayo Waki.

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Conflict of interest

SK is a member of the Department of Ubiquitous Health Informatics, which is engaged in a cooperative program between the University of Tokyo and NTT DOCOMO. KW is a member of the Department of Ubiquitous Health Informatics, which is engaged in a cooperative program between the University of Tokyo and NTT DOCOMO. HF is a member of the Department of Ubiquitous Health Informatics, which is engaged in a cooperative program between the University of Tokyo and NTT DOCOMO. HK is a member of NTT DOCOMO. SN, SO, TK and KO declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Kato, S., Waki, K., Nakamura, S. et al. Validating the use of photos to measure dietary intake: the method used by DialBetics, a smartphone-based self-management system for diabetes patients. Diabetol Int 7, 244–251 (2016). https://doi.org/10.1007/s13340-015-0240-0

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  • DOI: https://doi.org/10.1007/s13340-015-0240-0

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