Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.
Center for Health Promotions and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Intellect Disabil Res. 2021 Apr;65(4):340-347. doi: 10.1111/jir.12816. Epub 2021 Jan 14.
There are currently no validated methods for energy intake assessment in adolescents with intellectual and developmental disabilities (IDD). The purpose of this study was to determine the feasibility of collecting 3-day image-assisted food records (IARs) and doubly labelled water (TDEE ) data in adolescents with IDD and to obtain preliminary estimates of validity and reliability for energy intake estimated by IAR.
Adolescents with IDD completed a 14-day assessment of mean daily energy expenditure using doubly labelled water. Participants were asked to complete 3-day IARs twice during the 14-day period. To complete the IAR, participants were asked to fill out a hard copy food record over three consecutive days (two weekdays/one weekend day) and to take before and after digital images of all foods and beverages consumed using an iPad tablet provided by the study. Energy intake from the IAR was calculated using Nutrition Data System for Research. Mean differences, intraclass correlations and Bland-Altman limits of agreement were performed.
Nineteen adolescents with IDD, mean age 15.1 years, n = 6 (31.6%) female and n = 6 (31.6%) ethnic/racial minorities, enrolled in the trial. Participants successfully completed their 3-day food records and self-collected doubly labelled water urine samples for 100% of required days. Images were captured for 67.4 ± 30.1% of all meals recorded at assessment 1 and 72.3 ± 29.5% at assessment 2. The energy intake measured by IAR demonstrated acceptable test-retest reliability (intraclass correlation = 0.70). On average, IAR underestimated total energy intake by -299 ± 633 kcal/day (mean per cent error = -9.6 ± 22.2%); however, there was a large amount of individual variability in differences between the IAR and TDEE (range = -1703 to 430).
The collection of IAR and TDEE is feasible in adolescents with IDD. While future validation studies are needed, the preliminary estimates obtained by this study suggest that in adolescents with IDD, the IAR method has acceptable reliability and may underestimate energy intake by ~9%.
目前，针对智障和发育障碍（ID）青少年，尚无能量摄入评估的验证方法。本研究旨在确定在 ID 青少年中收集 3 天图像辅助食物记录（IAR）和双标水（TDEE）数据的可行性，并获得 IAR 估计能量摄入的初步有效性和可靠性估计。
ID 青少年使用双标水完成了 14 天的平均日常能量消耗评估。参与者被要求在 14 天期间内两次完成 3 天的 IAR。为了完成 IAR，参与者被要求在连续三天（两天工作日/一天周末）填写纸质食物记录，并使用研究提供的 iPad 平板电脑拍摄所有食用的食物和饮料的前后数字图像。使用 Research 营养数据系统计算 IAR 的能量摄入。进行均值差异、组内相关系数和 Bland-Altman 协议界限分析。
19 名 ID 青少年（平均年龄 15.1 岁），n=6（31.6%）为女性，n=6（31.6%）为少数民族/种族少数群体，参加了试验。参与者成功完成了他们的 3 天食物记录，并自行收集了 100%所需天数的双标水尿液样本。在评估 1 时，图像被捕获了记录的所有餐点的 67.4±30.1%，在评估 2 时捕获了 72.3±29.5%。IAR 测量的能量摄入具有可接受的测试-重测可靠性（组内相关系数=0.70）。平均而言，IAR 低估了总能量摄入 -299±633kcal/天（平均百分比误差=-9.6±22.2%）；然而，IAR 和 TDEE 之间的差异存在很大的个体差异（范围=-1703 至 430）。
在 ID 青少年中，IAR 和 TDEE 的收集是可行的。虽然需要进一步的验证研究，但本研究获得的初步估计表明，在 ID 青少年中，IAR 方法具有可接受的可靠性，可能低估能量摄入约 9%。
