Laurel A. Littlefield

Evidence Review of Technology and Dietary Assessment

SIGNIFICANCE Diets high in fruit and vegetable consumption are associated with a decrease in chronic diseases. Dietary factors are linked to 4 of the 10 leading noncommunicable causes of death: cardiovascular disease, some cancers, stroke, and type 2 diabetes. Accurately measuring dietary patterns has many challenges. Dietary intake measurement has traditionally relied on self-report instruments such as 24-hour recall, food record, and food frequency questionnaires to record consumption history. These methods have inherent limitations in detecting small but important changes in fruit and vegetable consumption patterns. Promising advances in technology have made more sophisticated techniques for recording dietary intake possible. Computers and Web-based programs, handheld personal digital assistants with cameras and telephone cards, smart phones, cameras, and video recorders options may reduce the burden of recording what has been consumed. Furthermore, technology-based methods of dietary assessment may provide a higher degree of reliability and validity in visually determining fruit and vegetable consumption, and additional study is warranted. PURPOSE The purpose of this article is to present a review of the evidence on the effectiveness of technology-based methods for dietary assessment, which included fruit and vegetable consumption. APPROACH One hundred and eighty-seven articles published between 1998 and 2008 were initially identified. Fifteen met the study inclusion criteria and were evaluated by an interdisciplinary team using the Stetler Strength of Evidence Scale. RESULTS Six technology-based methods for dietary assessment were identified. Findings from validity and reliability testing of technology-based methods are encouraging and need replication. Clinically important features offered through technology may reduce reporting burden and offer behavioral feedback to users. Methodologically sound, empirical research into using technology-based application for dietary assessment in a variety of populations of sufficient size is needed.

Effectiveness of cell phones and mypyramidtracker.gov to estimate fruit and vegetable intake

AIM AND BACKGROUND Inadequate fruit and vegetable intake is linked to leading causes of global mortality and rise in obesity. Measuring fruit and vegetable intake is problematic. Advances in cell phone technologies may improve the accuracy and ease of recording diet. This study tested the effectiveness of using cell phones with digital pictures to prompt memory and mypyramidtracker.gov to estimate self-reported fruit and vegetable intake in 69 college students. METHODS A repeated measures design was used. Focus groups provided feedback on the acceptability, usability, and feasibility of cell phones for diet recording in this population. RESULTS A statistically significant difference in fruit and vegetable scores, F(1, 58)=4.64, p=.04, was supported between cell phone use for short-term memory prompt and mypyramidtracker.gov alone. CONCLUSIONS Cell phone pictures improved memory and accuracy of recall when using an online self-reported interactive diet record and was considered an easy, relevant, and accessible way to record diet.

The effect of exercise intensity and excess post-exercise oxygen consumption on postprandial blood lipids in physically-inactive men

Reductions in postprandial lipemia have been observed following aerobic exercise of sufficient energy expenditure. Increased excess postexercise oxygen consumption (EPOC) has been documented when comparing high- versus low-intensity exercise. The contribution of EPOC energy expenditure to alterations in postprandial lipemia has not been determined. The purpose of this study was to evaluate the effects of low- and high-intensity exercise on postprandial lipemia in healthy, sedentary, overweight and obese men (age, 43 ± 10 years; peak oxygen consumption, 31.1 ± 7.5 mL·kg-1·min-1; body mass index, 31.8 ± 4.5 kg/m2) and to determine the contribution of EPOC to reductions in postprandial lipemia. Participants completed 4 conditions: nonexercise control, low-intensity exercise at 40%-50% oxygen uptake reserve (LI), high-intensity exercise at 70%-80% oxygen uptake reserve (HI), and HI plus EPOC re-feeding (HI+EERM), where the difference in EPOC energy expenditure between LI and HI was re-fed in the form of a sports nutrition bar (Premier Nutrition Corp., Emeryville, Calif., USA). Two hours following exercise participants ingested a high-fat (1010 kcals, 99 g sat fat) test meal. Blood samples were obtained before exercise, before the test meal, and at 2, 4, and 6 h postprandially. Triglyceride incremental area under the curve was significantly reduced following LI, HI, and HI+EERM when compared with nonexercise control (p < 0.05) with no differences between the exercise conditions (p > 0.05). In conclusions, prior LI and HI exercise equally attenuated postprandial triglyceride responses to the test meal. The extra energy expended during EPOC does not contribute significantly to exercise energy expenditure or to reductions in postprandial lipemia in overweight men.