肥胖孕妇的食物摄影不能准确衡量能量摄入。
Food Photography Is Not an Accurate Measure of Energy Intake in Obese, Pregnant Women.
机构信息
Reproductive Endocrinology and Women's Health Laboratory, Biostatistics Core, Ingestive Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA.
Department of Women's Health, Dell Medical School, University of Texas, Austin, TX.
出版信息
J Nutr. 2018 Apr 1;148(4):658-663. doi: 10.1093/jn/nxy009.
BACKGROUND
To improve weight management in pregnant women, there is a need to deliver specific, data-based recommendations on energy intake.
OBJECTIVE
This cross-sectional study evaluated the accuracy of an electronic reporting method to measure daily energy intake in pregnant women compared with total daily energy expenditure (TDEE).
METHODS
Twenty-three obese [mean ± SEM body mass index (kg/m2): 36.9 ± 1.3] pregnant women (aged 28.3 ±1.1 y) used a smartphone application to capture images of their food selection and plate waste in free-living conditions for ≥6 d in early (13-16 wk) and late (35-37 wk) pregnancy. Energy intake was evaluated by the smartphone application SmartIntake and compared with simultaneous assessment of TDEE obtained by doubly labeled water. Accuracy was defined as reported energy intake compared with TDEE (percentage of TDEE). Ecological momentary assessment prompts were used to enhance data reporting. Two-one-sided t tests for the 2 methods were used to assess equivalency, which was considered significant when accuracy was >80%.
RESULTS
Energy intake reported by the SmartIntake application was 63.4% ± 2.3% of TDEE measured by doubly labeled water (P = 1.00). Energy intake reported as snacks accounted for 17% ± 2% of reported energy intake. Participants who used their own phones compared with participants who used borrowed phones captured more images (P = 0.04) and had higher accuracy (73% ± 3% compared with 60% ± 3% of TDEE; P = 0.01). Reported energy intake as snacks was significantly associated with the accuracy of SmartIntake (P = 0.03). To improve data quality, excluding erroneous days of likely underreporting (<60% TDEE) improved the accuracy of SmartIntake, yet this was not equivalent to TDEE (-22% ± 1% of TDEE; P = 1.00).
CONCLUSIONS
Energy intake in obese, pregnant women obtained with the use of an electronic reporting method (SmartIntake) does not accurately estimate energy intake compared with doubly labeled water. However, accuracy improves by applying criteria to eliminate erroneous data. Further evaluation of electronic reporting in this population is needed to improve compliance, specifically for reporting frequent intake of small meals. This trial was registered at www.clinicaltrials.gov as NCT01954342.
背景
为改善孕妇的体重管理，需要提供特定的、基于数据的能量摄入建议。
目的
本横断面研究评估了一种电子报告方法在测量孕妇日常能量摄入方面的准确性，与总能量消耗（TDEE）相比。
方法
23 名肥胖孕妇（平均 ± SEM 体重指数（kg/m2）：36.9 ± 1.3）在孕早期（13-16 周）和孕晚期（35-37 周）自由生活条件下使用智能手机应用程序拍摄食物选择和餐盘浪费的图像，持续至少 6 天。通过智能手机应用程序 SmartIntake 评估能量摄入，并与同时通过双标记水评估的 TDEE 进行比较。准确性定义为报告的能量摄入与 TDEE 相比（TDEE 的百分比）。使用生态瞬时评估提示来增强数据报告。使用双单侧 t 检验评估两种方法的等效性，当准确性大于 80%时，认为等效性显著。
结果
SmartIntake 应用程序报告的能量摄入占双标记水测量的 TDEE 的 63.4% ± 2.3%（P=1.00）。报告的零食摄入量占报告能量摄入量的 17% ± 2%。与使用借来的手机的参与者相比，使用自己手机的参与者拍摄的图像更多（P=0.04），准确性更高（SmartIntake 为 73% ± 3%，TDEE 为 60% ± 3%；P=0.01）。报告的零食摄入量与 SmartIntake 的准确性显著相关（P=0.03）。为了提高数据质量，排除可能低估的错误天数（<60% TDEE）可提高 SmartIntake 的准确性，但这与 TDEE 并不等效（-22% ± 1% TDEE；P=1.00）。
结论
使用电子报告方法（SmartIntake）获得的肥胖孕妇的能量摄入与双标记水相比，不能准确估计能量摄入。然而，通过应用标准消除错误数据可提高准确性。需要进一步评估该人群的电子报告以提高依从性，特别是对频繁摄入小餐的报告。本试验在 www.clinicaltrials.gov 注册为 NCT01954342。
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