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. 2021 Oct 26;13(11):3790.
doi: 10.3390/nu13113790.

Validation of a Web-Based, Time-Use Application to Assess Children's School Meal Intakes: My E-Diary for Activities and Lifestyle (MEDAL)

Sarah Yi Xuan Tan  1 , Airu Chia  1 , Ray Sugianto  1 , Huiying Eunice Tong  1 , Ian Yi Han Ang  1 , Lynette Pei-Chi Shek  2   3 , Seang Mei Saw  1   4   5 , Falk Müller-Riemenschneider  1 , Mary Foong-Fong Chong  1   6
Affiliations

Validation of a Web-Based, Time-Use Application to Assess Children's School Meal Intakes: My E-Diary for Activities and Lifestyle (MEDAL)

Sarah Yi Xuan Tan et al. Nutrients. .

Abstract

My E-Diary for Activities and Lifestyle (MEDAL), a web-based application, was developed to assess the diets of children. This study examined the validity of school recess meals reported by children on MEDAL, using meal photography as the reference. Recess meals were photographed by trained researchers, and food items and portion sizes of recess meals reported on MEDAL were compared to recess meal photos. Validity was assessed by percentages of match, omission and intrusion for food items and percentages of the match, underestimation and overestimation for portion sizes. The Mann-Whitney test and the Wilcoxon matched-pairs signed-rank test examined if sex, school and day of recording influenced the validity of food item reporting. We found that participants (n = 33, aged 10-11 years) recalled 60.2% of food items consumed at recess accurately (matches); omissions (24.6%) were more common than intrusions (15.2%). Omissions tended to be side dishes, and intrusions tended to be high-calorie items. Sex, school and day of recording did not influence validity. For food portion sizes, 58.3% of items were accurately reported. Overestimations (33.3%) were more common than underestimations (8.3%). In conclusion, these children were able to report food items consumed during school recess meals using MEDAL, albeit with limitations on the degree of accuracy.

Keywords: children; dietary intake; meal photography; self-report; validity; web-based application.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
School meal photography booth setup.
Figure 2
Figure 2
Images for dark green leafy vegetables (top), and white rice (bottom), presented for portion size selection in MEDAL.
Figure 3
Figure 3
MEDAL diet validation participant flow diagram.
See this image and copyright information in PMC

References

    1. Kelder S.H., Perry C.L., Klepp K.I., Lytle L.L. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am. J. Public Health. 1994;84:1121–1126. doi: 10.2105/AJPH.84.7.1121. - DOI - PMC - PubMed
    1. Baxter S.D., Hitchcock D.B., Royer J.A., Smith A.F., Guinn C.H. Fourth-grade children’s dietary reporting accuracy by meal component: Results from a validation study that manipulated retention interval and prompts. Appetite. 2017;113:106–115. doi: 10.1016/j.appet.2017.02.005. - DOI - PMC - PubMed
    1. Lu A.S., Baranowski J., Islam N., Baranowski T. How to engage children in self-administered dietary assessment programmes. J. Hum. Nutr. Diet. 2014;27((Suppl. 1)):5–9. doi: 10.1111/j.1365-277X.2012.01258.x. - DOI - PMC - PubMed
    1. de Vlieger N.M., Weltert M., Molenaar A., McCaffrey T.A., Rollo M.E., Truby H., Livingstone B., Kirkpatrick S.I., Boushey C.J., Kerr D.A., et al. A systematic review of recall errors associated with portion size estimation aids in children. Appetite. 2020;147:104522. - PubMed
    1. Illner A.K., Freisling H., Boeing H., Huybrechts I., Crispim S.P., Slimani N. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology. Int. J. Epidemiol. 2012;41:1187–1203. doi: 10.1093/ije/dys105. - DOI - PubMed

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