September Summary

Question 1

Jenn brought up that overweight/obese individuals may be underestimating their food intake due to their awareness of people making judgment of what and how much they eat, while Carly suggested it may be due to the individual’s unreadiness for changing their diet. Steph also mentioned it could be due to mindless eating rather than intentionally misreporting, while Gina brought up a similar point about unawareness and forgetting what one eats in a day. Gina also discussed the benefits of using food diaries: mainly raising client’s awareness of what they are eating. She suggested that bringing a spouse, using measuring tools, plate diagrams and continuing to use probing questions with food recalls are some ways to help increase the accuracy of diet recalls. John mentioned the importance of training individuals to properly measure foods so they have a better understanding of portions. Sophie suggested using a step-by-step tool to increase accuracy due to being more user-friendly and providing examples to the user. Amanda brought up that recording food intake in diaries as they eat is another way to increase accuracy. 

Question 2

Jenn pointed out the wide range in data points likely averaged out in the end leading to a more accurate average but not in estimating individual energy intake. Carly mentioned that those who overestimated and those who underestimated their intake were put together for an average. Gina gave some great examples of that. The average between 49 and 51 is the same average as 1 and 99. While Abby gave a comparison to using A1C values to give a big picture of blood glucose levels, but not a great use for day-to-day measurements. Looking at the results from the perspective of using A1C provided a clarification of the tool. The contributors agreed with the points made that the average was accurate due to the differences in the sample evening out, while examining an individual would allow us to see how far off they are as Desiray mentioned. 

Question 3

Jenn, Carly, Gina and Steph brought up great points about trouble using technology especially among older users, limited access to smartphones with digital cameras among low-income population, and taking the pictures properly as obstacles. Younger users may be more apt to using digital photography and recalls for their dietary assessment. Contributors pointed out the appealing aspect of taking pictures for their diet assessment versus than writing it down, and making tracking food intake less of a way to point out a person’s failure as Gina mentioned. John brought up the obstacle of accuracy among different recipes. He pointed out that using DP + Recall may be accurate for a foodservice cafeteria setting, but not at home. Abby mentioned that DP+R is likely a short-term assessment method since people would get tired of continually tracking their food. Steph, Amanda and Abby brought up that people may forget to snap pictures of everything a person is eating such as snacks and perhaps forgetting to take the pictures until one is mid-way through their food. Jenn and Amanda also pointed out the obstacle of inaccuracy of the tool in interpreting the picture since plates differ in size and pictures may not be at the best angle to provide the best estimate of portions. Sophie mentioned the problem of timing since clients may be in settings that does not allow them to take pictures or it would be inappropriate, forcing them to recall their food intake later. Desiray finds mindless eating to be another obstacle in using DP+R for a diet assessment.

Recommendations for Practice

Most of the contributors can agree that this new technology is a great advancement and tool for the young population who are quite tech savvy. However, it may be a struggle for older individuals to utilize digital photography while some may struggle with getting access to digital cameras. The tool’s ability to accurately estimate the portion sizes as well as actual nutrient contribution of each recipe is questionable since home-cooked meals are not standardized. Therefore, for certain situations such as in hospitals where patients are provided meals and at school settings, digital photography in addition to recall may be a reliable method to use, however, it is not developed enough for home-users. Additionally, the tool may not be appropriate for estimating individual energy intake daily. Further research and development needs to be completed to improve digital photography as a diet-recall tool. Perhaps it could be better utilized as a weekly measurement rather than daily. Currently, this new technology does not seem like a reliable method for RDs to assess their client’s diet. However, it may be useful for clients to record pictures of their meals so they can better recall what they ate and provide a visual to RDs about the portion sizes.  

Summary by: Vivian Lau