Estimation of food portion sizes in women of childbearing age and young children in Ouagadougou (Burkina Faso) using a food photography atlas and salted replicas: Comparison with weighed records

Abstract

Quantitative assessment of foods consumed when using 24-hour dietary recall requires accurate tools to estimate portion sizes. Therefore, we developed a food portion photography atlas with age-appropriate portion sizes for 11 foods frequently consumed by young children (sizes for 6-11-month- and for 12-23-month-old children) and women of childbearing age in Ouagadougou, Burkina Faso capital. We then compared the accuracy and precision of portion estimation with this atlas and with salted replicas relative to weighed records (the reference). After weighing, we randomly assigned food portions to 67 women and their children. The next day, women estimated the served portions and leftovers by recall using the atlas and then salted replicas (n = 1156 measurements, ranging from 19 to 113 for each food). For most food types, the portions estimated with the atlas and salted replicas were positively correlated and showed good concordance with the weighed records. However, accuracy and precision varied in function of the estimation method, food type, and age group. The mean crude differences ranged from -28 to +12g (with errors in absolute values from 24 to 69%) for children, and from -32 to +44g (errors from 17 to 56%) for women. The atlas-based method showed the lowest Lin's concordances (coefficients of 0.1 to 0.2) for the leafy vegetable dish, meat, and fish in 12-23-month-old children. Bland-Altman plots indicated that the salted replicas allowed estimating the consumed portions with fewer errors than the photographic atlas (56 to 91% vs 46 to 79% between the limits of ±50%). Our study highlights that mothers have difficulties in perceiving the quantities of food consumed by their children. Our findings also indicate that the food atlas could be used in food consumption surveys when salted replicas are not available for all food types.

Fig 1. Flow diagram presenting a schematic overview of the study program.

Fig 2. Examples from the food photography atlas.

(a) Stiff cereal porridge portions for 6-11-month-old children; (b) Stiff cereal porridge portions for 12-23-month-old children; (c) Stiff cereal porridge portions for women; (d) Groundnut paste sauce portions for 6-11-month-old children; (e) Groundnut paste sauce portions for 12-23-month-old children; (f) Groundnut paste sauce portions for women.

Fig 3. Flowchart of participants and data inclusion for the validation study.

For 6-11-month-old children, 9 food items were offered in 7 consecutive days (4 food items were proposed in two different days and 5 food items only once). For 12-23-month-old children and for women, 11 food items were offered in 7 consecutive days (4 food items were proposed in two different days and 7 food items only once). *measurement = 1 weighed record of the actually consumed quantity + 1 estimation of the consumed quantity with the FP + 1 estimation with the SR.

Fig 4. Comparison of the portion sizes estimated with the two methods (FP-R and SR-R) with the consumed portion size (WR) using Bland Altman plots.

(a) Stiff cereal porridge eaten by 6-11-month-old children; (b) Groundnut paste sauce eaten by 6-11-month-old children; (c) Stiff cereal porridge eaten by 12-23-month-old children; (d) Groundnut paste sauce eaten by 12-23-month-old children; (e) Stiff cereal porridge eaten by women; (f) Groundnut paste sauce eaten by women.