Brummer Julian, Glasbrenner Christina, Hechenbichler Figueroa Sieglinde, Koehler Karsten, Höchsmann Christoph
Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Front Nutr. 2024 Jan 8;10:1308348. doi: 10.3389/fnut.2023.1308348. eCollection 2023.
Accurate dietary assessment remains a challenge, particularly in free-living settings. Continuous glucose monitoring (CGM) shows promise in optimizing the assessment and monitoring of ingestive activity (IA, i.e., consumption of calorie-containing foods/beverages), and it might enable administering dietary Just-In-Time Adaptive Interventions (JITAIs).
In a scoping review, we aimed to answer the following questions: (1) Which CGM approaches to automatically detect IA in (near-)real-time have been investigated? (2) How accurate are these approaches? (3) Can they be used in the context of JITAIs?
We systematically searched four databases until October 2023 and included publications in English or German that used CGM-based approaches for human (all ages) IA detection. Eligible publications included a ground-truth method as a comparator. We synthesized the evidence qualitatively and critically appraised publication quality.
Of 1,561 potentially relevant publications identified, 19 publications (17 studies, total = 311; for 2 studies, 2 publications each were relevant) were included. Most publications included individuals with diabetes, often using meal announcements and/or insulin boluses accompanying meals. Inpatient and free-living settings were used. CGM-only approaches and CGM combined with additional inputs were deployed. A broad range of algorithms was tested. Performance varied among the reviewed methods, ranging from unsatisfactory to excellent (e.g., 21% vs. 100% sensitivity). Detection times ranged from 9.0 to 45.0 min.
Several CGM-based approaches are promising for automatically detecting IA. However, response times need to be faster to enable JITAIs aimed at impacting acute IA. Methodological issues and overall heterogeneity among articles prevent recommending one single approach; specific cases will dictate the most suitable approach.
准确的饮食评估仍然是一项挑战，尤其是在自由生活环境中。持续葡萄糖监测（CGM）在优化摄入活动（IA，即含热量食物/饮料的消耗）的评估和监测方面显示出前景，并且它可能有助于实施即时适应性饮食干预（JITAIs）。
在一项范围综述中，我们旨在回答以下问题：（1）已经研究了哪些用于（近）实时自动检测IA的CGM方法？（2）这些方法的准确性如何？（3）它们能否用于JITAIs的背景下？
我们系统地检索了四个数据库直至2023年10月，并纳入了使用基于CGM的方法进行人类（所有年龄段）IA检测的英文或德文出版物。符合条件的出版物包括一种作为对照的真实方法。我们对证据进行了定性综合并严格评估了出版物质量。
在识别出的1561篇潜在相关出版物中，纳入了19篇出版物（17项研究，共311例；2项研究各有2篇相关出版物）。大多数出版物纳入了糖尿病患者，经常使用餐食公告和/或随餐注射胰岛素。使用了住院和自由生活环境。部署了仅CGM的方法以及CGM与其他输入相结合的方法。测试了广泛的算法。在所审查的方法中，性能各不相同，从不尽人意到优秀（例如，灵敏度为21%对100%）。检测时间从9.0分钟到45.0分钟不等。
几种基于CGM的方法在自动检测IA方面很有前景。然而，响应时间需要更快，以便实施旨在影响急性IA的JITAIs。方法学问题和文章之间的总体异质性使得无法推荐单一方法；具体情况将决定最合适的方法。
