Basso Melissa, Zhang Liangzi, Savva George M, Cohen Kadosh Kathrin, Traka Maria H
School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.
School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.
Nutrients. 2025 May 27;17(11):1823. doi: 10.3390/nu17111823.
: Dietary intake plays a crucial role in health research, yet existing methods for its measurement can lead to participant burden, lengthy recording, and human errors, and do not account for age-specific variations. Libro is a real-time diet-tracking mobile-based app offering flexible features. An automated food recording program within Libro was customized for young people vulnerable to eating misbehaviour. This preliminary study assessed its relative validity using a self-administered 24 h recall method as the reference method. : The relative validity of Libro was tested by adopting a cross-over design that recorded food intake over a period of 3 non-consecutive weekdays and 1 weekend day with both methods. The participants were recruited online through a mental health research charity, and this study was conducted fully online. The primary outcome was the concordance of total energy intake between the two methods, with secondary outcomes focusing on the intake of protein, carbohydrates, fats, free sugars, fibre, and trans-fatty acids. Test-retest validity was assessed per method with the intraclass correlation coefficient; a Bland-Altman plot and -test were performed to test agreement at the group level; correlation coefficient and cross-classification were performed to assess agreement at the individual level. : Forty-seven participants were included in the final analysis. The average intraclass correlation coefficient for energy intake measured by Libro over four days was 0.85 (95% CI: 0.76-0.91). Compared to Intake24, the average energy intake recorded using Libro was significantly lower (mean difference: -554 Kcal, 95% CI: -804.1 to -305.6 Kcal, < 0.001), potentially driven by the reduced reporting of foods rich in free sugars. The correlation coefficient for average energy intake measured by Libro vs. Intake24 was 0.32 (95% CI: 0.03, 0.55), with only 27.7% of subjects classified in the same quartile with both methods (κ = 0.31, 95% CI: -0.03, 0.55). Concordance varied across specific dietary component measures. : While Libro had good test-retest reliability if adopting a multiple administration method, it underreported energy and other aspects of dietary intake, along with poor classification performance compared to Intake24 in a population vulnerable to eating misbehaviour. We suggest that future studies improve user experience to increase compliance and data accuracy.
饮食摄入在健康研究中起着至关重要的作用，但现有的测量方法可能会给参与者带来负担、记录时间长且容易出现人为错误，并且没有考虑到特定年龄的差异。Libro是一款基于移动设备的实时饮食跟踪应用程序，具有灵活的功能。Libro中的自动食物记录程序是为易出现饮食行为问题的年轻人定制的。这项初步研究使用自我管理的24小时回顾法作为参考方法评估了其相对有效性。
通过采用交叉设计来测试Libro的相对有效性，该设计使用两种方法在3个非连续工作日和1个周末日记录食物摄入量。参与者通过一个心理健康研究慈善机构在线招募，并且这项研究完全在线进行。主要结果是两种方法之间总能量摄入的一致性，次要结果集中在蛋白质、碳水化合物、脂肪、游离糖、纤维和反式脂肪酸的摄入量上。每种方法的重测信度通过组内相关系数进行评估；进行Bland-Altman图和t检验以测试组水平的一致性；进行相关系数和交叉分类以评估个体水平的一致性。
最终分析纳入了47名参与者。Libro在四天内测量的能量摄入的平均组内相关系数为0.85（95%CI：0.76 - 0.91）。与Intake24相比，使用Libro记录的平均能量摄入显著更低（平均差异：-554千卡，95%CI：-804.1至-305.6千卡，P < 0.001），这可能是由于富含游离糖的食物报告减少所致。Libro测量的平均能量摄入与Intake24的相关系数为0.32（95%CI：0.03，0.55），两种方法中只有27.7%的受试者被分类在相同的四分位数中（κ = 0.31，95%CI：-0.03，0.55）。不同特定饮食成分测量的一致性各不相同。
虽然如果采用多次管理方法，Libro具有良好的重测信度，但在易出现饮食行为问题的人群中，它低估了能量和饮食摄入的其他方面，并且与Intake24相比分类性能较差。我们建议未来的研究改善用户体验以提高依从性和数据准确性。
