Comparison of Visual Estimation Methods for Regular and Modified Textures: Real-Time vs Digital Imaging

• Published in: Journal of the Academy of Nutrition and Dietetics Vol. 112; no. 10; pp. 1636 - 1641
• Main Authors: Parent, Maxim, Niezgoda, Helen, MSc, Keller, Heather H., PhD, RD, FDC, Chambers, Larry W., PhD, FACE, HonFFPH(UK), FCAHS, Daly, Shauna
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2012; Elsevier
• Subjects: Biological and medical sciences; color; Deglutition Disorders - diet therapy; diet; Energy Intake; Feeding. Feeding behavior; Food Analysis - instrumentation; Food Analysis - methods; Food Services; food waste; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Humans; image analysis; Internal Medicine; long term care; mixing; Observer Variation; Photography - instrumentation; Photography - methods; Reproducibility of Results; sauces; Signal Processing, Computer-Assisted; starch; vegetables; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Visual Perception; Food waste; Reliability; Food intake; Modified texture food; Metabolic diseases; Digital image; Estimation; Comparative study
• ISSN: 2212-2672; 2212-2680
• DOI: 10.1016/j.jand.2012.06.367

Abstract A variety of methods are available for assessing diet; however, many are impractical for large research studies in an institutional environment. Technology, specifically digital imaging, can make diet estimations more feasible for research. Our goal was to compare a digital imaging method of estimating regular and modified-texture main plate food waste with traditional on-site visual estimations, in a continuing and long-term care setting using a meal-tray delivery service. Food waste was estimated for participants on regular (n=36) and modified-texture (n=42) diets. A tracking system to ensure collection and digital imaging of all main meal plates was developed. Four observers used a modified Comstock method to assess food waste for vegetables, starches, and main courses on 551 main meal plates. Intermodal, inter-rater, and intra-rater reliability were calculated using intraclass correlation for absolute agreement. Intermodal reliability was based on one rater's assessments. The digital imaging method results were in high agreement with the real-time visual method for both regular and modified-texture food (intraclass correlation=0.90 and 0.88, respectively). Agreements between observers for regular diets were higher than those for modified-texture food (range=0.91 to 0.94; 0.82 to 0.91, respectively). Intra-rater agreements were very high for both regular and modified-texture food (range=0.93 to 0.99; 0.91 to 0.98). The digital imaging method is a reliable alternative to estimating regular and modified-texture food waste for main meal plates when compared with real-time visual estimation. Color, shape, reheating, mixing, and use of sauces made modified-texture food waste slightly more difficult to estimate, regardless of estimation method.