Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
Nutrients. 2019 Nov 7;11(11):2696. doi: 10.3390/nu11112696.
The ecological momentary assessment (EMA) of eating behaviors represents an innovative, detailed and valid approach to capture the complexity of food intake and to overcome limitations of traditional dietary assessment methods. Moreover, EMA studies might generate a large variety of data (e.g., dietary, behavioral, physical, sociopsychological, and contextual information), thereby enabling to examine concurrent exposures and events. Due to the increasing number of studies in this field of research, here we systematically reviewed EMA methods for the assessment of dietary intake in epidemiological studies, and discussed implications and perspectives for future research. Our study summarized several protocols and platforms that may be applied to assess diet in terms of eating frequency, choices, and habits. Nearly 38% of studies used an event-contingent strategy by asking participants to report foods and beverages consumed in real-time at each eating occasion. Instead, approximately 55% of studies used a signal-contingent prompting approach that notified the participants to record their dietary consumption. The remaining studies used a combination of event- and signal-contingent protocols to compare their accuracy or to improve the assessment of dietary data. Although both approaches might improve the accuracy and ecological validity of dietary assessment-also reducing the burden for participants-some limitations should nevertheless be considered. Despite these limitations, our systematic review pointed out that EMA can be applied in various fields of nutritional epidemiology, from the identification of determinants of dietary habits in healthy people to the management of patients with eating or metabolic disorders. However, more efforts should be encouraged to improve the validity and the reliability of EMA and to provide further technological innovations for public health research and interventions.
饮食行为的生态瞬时评估（EMA）代表了一种创新、详细和有效的方法，可以捕捉食物摄入的复杂性，并克服传统饮食评估方法的局限性。此外，EMA 研究可能会产生大量数据（例如，饮食、行为、身体、社会心理和环境信息），从而能够同时检查暴露和事件。由于该研究领域的研究越来越多，我们在这里系统地回顾了 EMA 方法在流行病学研究中评估饮食摄入的方法，并讨论了对未来研究的影响和观点。我们的研究总结了几种可能适用于评估饮食频率、选择和习惯的协议和平台。近 38%的研究使用事件触发策略，要求参与者实时报告每次进食时所吃的食物和饮料。相比之下，大约 55%的研究使用信号触发提示方法通知参与者记录他们的饮食消费。其余的研究使用事件和信号触发协议的组合来比较它们的准确性或改善饮食数据的评估。尽管这两种方法都可以提高饮食评估的准确性和生态有效性——也减轻了参与者的负担——但仍应考虑一些局限性。尽管存在这些局限性，但我们的系统评价指出，EMA 可以应用于营养流行病学的各个领域，从确定健康人群饮食习惯的决定因素到管理饮食或代谢障碍患者。然而，应该鼓励更多的努力来提高 EMA 的有效性和可靠性，并为公共卫生研究和干预措施提供进一步的技术创新。
