Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Nutrients. 2021 Sep 10;13(9):3158. doi: 10.3390/nu13093158.
As an important part of antenatal care for pregnant women in China, dietary assessment plays a positive role in maternal and fetal health. Shortcomings in the associated methodologies require improvement. Our purpose was to develop a novel WeChat Applet for image-based dietary assessment (WAIDA) and evaluate its relative validity among pregnant women in China. Data on 251 lunch meals of pregnant women in their second trimester were analyzed. The differences in food weight, energy, and nutrient estimates by the dietary recall or WAIDA method with the weighing method were compared using paired t-tests. Pearson correlation coefficients were used to analyze the correlation between food weight, energy, and nutrient intake obtained from the recall or WAIDA method and those obtained from the weighing method. The Bland-Altman analysis was used to examine the agreement between the recall or WAIDA method and the weighing method for energy and nutrients. Compared with the weighing method, the variation range of food weight, energy and nutrients estimated by the WAIDA method was smaller and more stable than that estimated by the recall method. Compared with the recall method, the correlations suggested a better relationship between the energy and nutrient intakes from the weighing method and those estimated by the WAIDA method (0.752-0.970 vs. 0.480-0.887), which were similar to those of food weight (0.332-0.973 vs. -0.019-0.794). The Bland-Altman analysis showed that the mean differences of the energy and nutrients estimated from the recall method were further away from zero relative to the weighing method compared to the WAIDA method and with numerically wider 95% confidence intervals. The spans between the upper and lower 95% limit of agreement (LOAs) of the energy and nutrients obtained by the WAIDA method were narrower than those obtained by the recall method, and the majority of the data points obtained by the WAIDA method lay between the LOAs, closer to the middle horizontal line. Compared with the recall method, the WAIDA method is consistent with the weighing method, close to the real value of dietary data, and expected to be suitable for dietary assessment in antenatal care.
作为中国孕妇产前保健的重要组成部分，膳食评估对母婴健康起着积极的作用。相关方法学的不足需要改进。我们的目的是开发一种新的基于图像的膳食评估微信小程序（WAIDA），并评估其在中国孕妇中的相对有效性。分析了 251 名孕妇在孕中期的 251 份午餐数据。通过配对 t 检验比较了膳食回顾或 WAIDA 方法与称重方法在食物重量、能量和营养素估计值上的差异。采用 Pearson 相关系数分析了膳食回顾或 WAIDA 方法与称重方法获得的食物重量、能量和营养素摄入量之间的相关性。采用 Bland-Altman 分析检验了膳食回顾或 WAIDA 方法与称重方法在能量和营养素方面的一致性。与称重方法相比，WAIDA 方法估计的食物重量、能量和营养素的变化范围更小，更稳定，而膳食回顾方法则更不稳定。与膳食回顾方法相比，WAIDA 方法的能量和营养素摄入量与称重方法的估计值之间的相关性更好（0.752-0.970 与 0.480-0.887），与食物重量的相关性相似（0.332-0.973 与-0.019-0.794）。Bland-Altman 分析表明，与 WAIDA 方法相比，膳食回顾方法估计的能量和营养素的均值差异相对于称重方法更远离零，且数值上的 95%置信区间更宽。WAIDA 方法获得的能量和营养素的上下 95%限差值（LOA）之间的跨度比膳食回顾方法更窄，且 WAIDA 方法获得的大部分数据点落在 LOA 之间，更接近中间水平线。与膳食回顾方法相比，WAIDA 方法与称重方法一致，更接近膳食数据的真实值，预计适合产前保健中的膳食评估。
