J Acad Nutr Diet. 2023 Mar;123(3):427-437.e2. doi: 10.1016/j.jand.2022.08.116. Epub 2022 Aug 10.
Development of methods to accurately measure dietary intake in free-living situations-restaurants or otherwise-is critically needed to understand overall dietary patterns.
This study aimed to develop and test reliability and validity of digital images (DI) for measuring children's dietary intake in quick-service restaurants (QSRs), validating against weighed plate waste (PW) and bomb calorimetry (BC).
In 2016, cross-sectional data were collected at two time points within a randomized controlled trial assessing children's leftovers in QSRs from parents of 4- to 12-year-old children.
PARTICIPANTS/SETTING: Parents (n = 640; mean age = 35.9 y; 70.8% female) consented and agreed to provide their child's PW for digital imaging, across 11 QSRs in Massachusetts in areas with low socioeconomic status and ethnically diverse populations.
Outcome measures were interrater reliability for DIs, correspondence between methods for energy consumed and left over, and correspondence between methods across varying quantities of PW.
Intraclass correlations, percent agreement, Spearman correlations, Wilcoxon signed rank tests, and Bland-Altman plots were used.
Interrater reliability ratings for DIs had substantial intraclass correlations (ICC = 0.94) but not acceptable exact percent agreement (80.2%); DI and PW energy consumed were significantly correlated (r = 0.96, P < 0.001); DI slightly underestimated energy consumed compared with PW (Mdiff = -1.61 kcals, P < 0.001). Bland-Altman plots showed high DI-PW correspondence across various energy amounts and revealed few outliers. Energy left over by BC was highly correlated with DI (r = 0.87, P < 0.001) and PW (r = 0.90, P < 0.001); and mean differences were not significantly different from DI (Mdiff = 9.77 kcal, P = 0.06) or PW (Mdiff = -2.84 kcal, P = 0.20).
Correspondence was high between PW and DI assessments of energy consumed, and high with BC energy left over. Results demonstrate reliability and practical validity of digital images for assessing child meal consumption in QSR settings.
在自由生活环境中（如餐厅）准确测量饮食摄入的方法亟待开发，以便全面了解整体饮食模式。
本研究旨在开发和测试数字图像（DI）测量儿童在快餐店（QSR）饮食摄入量的可靠性和有效性，并通过称重盘残羹（PW）和量热计（BC）进行验证。
2016 年，在一项随机对照试验中，在两个时间点收集了横断面数据，评估了来自 4 至 12 岁儿童父母的 QSR 中儿童的剩饭。
参与者/设置：父母（n=640；平均年龄 35.9 岁；70.8%女性）同意并同意为数字成像提供他们孩子的 PW，在马萨诸塞州的 11 家 QSR 中，涉及社会经济地位较低和种族多样化的人群。
结果测量为 DI 的评分者间可靠性、方法之间消耗和剩余能量的一致性以及 PW 不同数量之间方法的一致性。
使用了组内相关系数、百分比一致性、斯皮尔曼相关系数、Wilcoxon 符号秩检验和 Bland-Altman 图。
DI 的评分者间可靠性评分具有较高的组内相关系数（ICC=0.94），但百分比一致性不令人满意（80.2%）；DI 和 PW 的消耗能量显著相关（r=0.96，P<0.001）；与 PW 相比，DI 略低估了消耗的能量（Mdiff=-1.61 千卡，P<0.001）。Bland-Altman 图显示，在各种能量水平下，DI-PW 具有高度一致性，且很少出现异常值。BC 测量的剩余能量与 DI（r=0.87，P<0.001）和 PW（r=0.90，P<0.001）高度相关；DI 和 PW 之间的平均差异无统计学意义（Mdiff=9.77 千卡，P=0.06）或 PW（Mdiff=-2.84 千卡，P=0.20）。
PW 和 DI 评估的消耗能量之间具有高度一致性，与 BC 剩余能量也具有高度一致性。结果表明，数字图像在 QSR 环境中评估儿童膳食摄入量具有可靠性和实际有效性。
