Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden.
MRC Elsie Widdowson Laboratory, Cambridge CB I 9NL, UK.
Nutrients. 2018 Dec 4;10(12):1904. doi: 10.3390/nu10121904.
Overreporting of dietary intake in infants is a problem when using food records (FR), distorting possible relationships between diet and health outcomes. Image-assisted dietary assessment may improve the accuracy, but to date, evaluation in the pediatric setting is limited. The aim of the study was to compare macronutrient and energy intake by using an active image-assisted five-day FR against a regular five-day FR, and to validate image-assistance with total energy expenditure (TEE), was measured using doubly labeled water. Participants in this validation study were 22 healthy infants randomly selected from the control group of a larger, randomized intervention trial. The parents reported the infants' dietary intake, and supplied images of main course meals taken from standardized flat-surfaced plates before and after eating episodes. Energy and nutrient intakes were calculated separately using regular FR and image-assisted FRs. The mean (± standard deviations) energy intake (EI) was 3902 ± 476 kJ/day from the regular FR, and 3905 ± 476 kJ/day from the FR using active image-assistance. The mean EI from main-course meals when image-assistance was used did not differ (1.7 ± 55 kJ, = 0.89) compared to regular FRs nor did the intake of macronutrients. Compared to TEE, image-assisted FR overestimated EI by 10%. Without validation, commercially available software to aid in the volume estimations, food item identification, and automation of the image processing, image-assisted methods remain a more costly and burdensome alternative to regular FRs in infants. The image-assisted method did, however, identify leftovers better than did regular FR, where such information is usually not readily available.
在使用食物记录（FR）时，婴儿的饮食摄入过高报告是一个问题，这会扭曲饮食与健康结果之间的可能关系。图像辅助饮食评估可能会提高准确性，但迄今为止，儿科领域的评估有限。本研究的目的是比较使用主动图像辅助 5 天 FR 与常规 5 天 FR 时的宏量营养素和能量摄入，并使用双标记水测量总能量消耗（TEE）来验证图像辅助的准确性。这项验证研究的参与者是从更大规模、随机干预试验的对照组中随机选择的 22 名健康婴儿。父母报告了婴儿的饮食摄入情况，并提供了在进食前后从标准化平面餐盘拍摄的主菜图像。使用常规 FR 和图像辅助 FR 分别计算能量和营养素摄入量。常规 FR 的平均（±标准差）能量摄入量（EI）为 3902±476kJ/天，使用主动图像辅助 FR 的 EI 为 3905±476kJ/天。使用图像辅助时，主菜的平均 EI 摄入量（1.7±55kJ， = 0.89）与常规 FR 相比没有差异，宏量营养素的摄入量也没有差异。与 TEE 相比，图像辅助 FR 高估了 10%的 EI。如果没有验证，那么商用软件可以辅助体积估计、食物项目识别以及图像处理的自动化，但图像辅助方法在婴儿中仍然是一种成本更高、负担更重的常规 FR 替代方法。然而，图像辅助方法确实比常规 FR 更好地识别了剩余食物，而常规 FR 通常无法提供此类信息。
