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Development of myfood24

Published academic papers detailing the development and validation of myfood24

Usability of myfood24 Healthcare and Mathematical Diet Optimisation in Clinical Populations: A Pilot Feasibility Randomised Controlled Trial

Threapleton et al., 2022

success smart medical doctor working with operating room as concept
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Monitoring nutritional intake is of clinical value, but few existing tools offer electronic dietary recording, instant nutritional analysis, and a platform connecting healthcare teams with patients that provides timely, personalised support. This feasibility randomised controlled trial tests the usability of ‘myfood24 Healthcare’, a dietary assessment app and healthcare professional website, in two clinical populations. Patients were recruited from a weight management programme (n21) and from a group of gastroenterology surgery outpatients (n = 27). They were randomised into three groups: standard care, myfood24, or myfood24 + diet optimisation (automated suggestions for dietary improvement). The participants were asked to record their diet at least four times over eight weeks. During the study, healthcare professionals viewed recorded dietary information to facilitate discussions about diet and nutritional targets. The participants provided feedback on usability and acceptability. A total of 48 patients were recruited, and 16 were randomised to each of the three groups. Compliance among app users (n = 32) was reasonable, with 25 (78%) using it at least once and 16 (50%) recording intake for four days or more. Among users, the mean (standard deviation) number of days used was 14.0 (17.5), and the median (interquartile range) was six (2.5–17.0) over 2 months. Feedback questionnaires were completed by only 23 of 46 participants (50%). The mean System Usability Score (n = 16) was 59 (95% confidence interval, 48–70). Patient and healthcare professional feedback indicates a need for more user training and the improvement of some key app features such as the food search function. This feasibility study shows that myfood24 Healthcare is acceptable for patients and healthcare professionals. These data will inform app refinements and its application in a larger clinical effectiveness trial.
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Development of an Arabic food composition database for use in an Arabic online dietary assessment tool (myfood24)

Areej Bawajeeh et al., 2021

Middle East (1)
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A comprehensive food composition database (FCDB) is essential for assessing dietary intake of nutrients. However, currently available food composition data for Gulf Cooperation Council countries (GCC) is limited. The aim was to develop an Arabic FCDB of foods commonly available in the GCC (initial focus on Saudi Arabia and Kuwait), which will be integrated into an Arabic version of an online dietary assessment tool, myfood24. The Arabic FCDB was built using a standardized approach identifying currently available foods from existing food composition tables (FCTs), research articles, back-of-pack (BOP) nutrient labels on food products, with additional generic food items from the UK Composition of Foods Integrated Database (CoFID). The development of the FCDB used a 6-step approach: food identification, cleaning, mapping, translation, allocating portion sizes, and quality checking. The database includes a total of 2016 food items, 30 % of which have standard portion size images in addition to other options for portion size estimation. The database and myfood24 have been translated into Arabic to be suitable for Arabic users. These tools will help to assess dietary intake for 51 million people in the GCC. Future work will cover more foods from other Middle Eastern countries to serve over 400 million Arabic speakers in the region.

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Validation of the web-based self-administered 24-h dietary recall myfood24-Germany: comparison with a weighed dietary record and biomarkers

Stefenie A. J. Koch et al., 2021

Germany
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Purpose: We aimed to validate myfood24-Germany, a web-based 24-h dietary recall (24HDR), by comparing its performance with a weighed dietary record (WDR) and biomarkers.

Methods: 97 adults (77% female) completed a 3-day WDR with a 24-h urine collection on day 3, followed by at least one 24HDR with myfood24-Germany (corresponding to day 3 of the WDR). Intake of energy and 32 nutrients assessed by myfood24-Germany and the WDR for the same day were compared (method comparison). Intakes of protein and potassium assessed by myfood24-Germany/WDR were compared with intake estimated from urinary biomarkers for protein and potassium (biomarker comparison).

Results: In the method comparison, significant correlations were found for energy and all tested nutrients (range 0.45-0.87). There was no significant difference between both methods in the assessed mean energy and macronutrient intake. However, myfood24-Germany underestimated mean intake of 15 nutrients. In the biomarker comparison, protein intake reported by myfood24-Germany/WDR was on average 10%/8% lower than estimated by biomarker. There was no significant difference in mean potassium intake assessed by myfood24-Germany/WDR and biomarker. However, a shared bias in the assessment of potassium intake was observed for both instruments. Concordance correlation coefficients (pc) and weighted Kappa coefficients (κ) confirmed good agreement with the biomarker estimates for myfood24-Germany/WDR in case of protein (pc = 0.58/0.66, κ = 0.51/0.53) and moderate agreement in case of potassium (pc = 0.44/0.51; κ = 0.30/0.33).

Conclusion: Our results suggest that myfood24-Germany is of comparable validity to traditional dietary assessment methods.

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Development and evaluation of image-series for portion size estimation in dietary assessment among adults

Lorentz Salvesen et al., 2021

Norway (1)
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Portion size images are advantageous in dietary assessment. The aim of the present study was to develop and validate new culturally specific image-series for portion size estimation to be used in a new Norwegian version of a British web-based dietary assessment tool (myfood24). Twenty-three image-series of different foods, each containing seven portion size images, were created and validated in a group of adults (n 41, 58 % female) aged 19–44 (median 23), out of which 63 % had higher (tertiary) education. The participants compared 46 portions of pre-weighed foods to the portion size images (1886 comparisons in total). Portion size estimations were either classified as correct, adjacent or misclassified. The weight discrepancy in percentage between the chosen and the correct portion size image was also calculated. Mann–Whitney U tests were used to explore if portion size estimation accuracy differed across sample characteristics, or if it depended on how the foods were presented. For thirty-eight of the forty-six presented food items, the participants selected the correct or adjacent portion size image 98 % on average. The remaining eight food items were on average misclassified by 27 % of the participants. Overall, a mean weight discrepancy of 2⋅5 % was observed between the chosen and the correct portion size images. Females estimated portion size more accurately than males (P = 0⋅019). No other significant differences in estimation accuracy were observed. In conclusion, the new image-series performed satisfactorily, except for the image-series depicting bread, caviar spread and marzipan cake, which will be altered. The present study demonstrates the importance of validating portion size estimation tools.
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Developing an online food composition database for an Indigenous population in south-western Uganda

Giulia Scarpa et al., 2021

Uganda (1)
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Objective:

To develop an online food composition database of locally consumed foods among an Indigenous population in south-western Uganda.

Design:

Using a community-based approach and collaboration with local nutritionists, we collected a list of foods for inclusion in the database through focus group discussions, an individual dietary survey and markets and shops assessment. The food database was then created using seven steps: identification of foods for inclusion in the database; initial data cleaning and removal of duplicate items; linkage of foods to existing generic food composition tables; mapping and calculation of the nutrient content of recipes and foods; allocating portion sizes and accompanying foods; quality checks with local and international nutritionists; and translation into relevant local languages.

Setting:

Kanungu District, south-western Uganda.

Participants:

Seventy-four participants, 36 Indigenous Batwa and 38 Bakiga, were randomly selected and interviewed to inform the development of a food list prior the construction of the food database.

Results:

We developed an online food database for south-western Uganda including 148 commonly consumed foods complete with values for 120 micronutrients and macronutrients. This was for use with the online dietary assessment tool myfood24. Of the locally reported foods included, 56 % (n 82 items) of the items were already available in the myfood24 database, while 25 % (n 37 items) were found in existing Ugandan and Tanzanian food databases, 18 % (n 27 items) came from generated recipes and 1 % (n 2 items) from food packaging labels.

Conclusion:

Locally relevant food databases are sparse for African Indigenous communities. Here, we created a tool that can be used for assessing food intake and for tracking undernutrition among the communities living in Kanungu District. This will help to develop locally relevant food and nutrition policies.

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Adaptation and Evaluation of myfood24-Germany: A Web-Based Self-Administered 24-h Dietary Recall for the German Adult Population

Stefenie A. J. Koch et al., 2020

The aim of this paper was to develop and evaluate the German adaptation of myfood24. The amin adaptation was the development of an appropriate German food database. myfood24 was successfully adapted for the use by German adults and is now the first fully automated online system for self-administered 24HDRs in Germany.

Flag of Germany - Button on Black Computer Keyboard.
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Abstract

Our aim was to develop and evaluate a German adaptation of myfood24, a fully automated, web-based 24-h dietary recall (24HDR). To complete a self-administered 24HDR with myfood24, users have to search and enter consumed foods within the underlying database by a free text search. The adaptation process thus mainly consisted of the development of an appropriate food database. myfood24-Germany was evaluated in 92 adults aged 17–78 years (study 1). Participants completed four non-consecutive 24HDRs and answered an evaluation questionnaire after the final recall. The System Usability Scale Score (SUS Score, 0–100) was calculated. Users’ search behavior was examined with screen recordings in 15 adults aged 20–60 years (study 2). Participants had to enter three sample meals presented as food packaging or pictures. The final database included 11,501 food items (7203 generic and 4298 branded items) with up to 131 nutrients. In study 1, the median completion time for a 24HDR was 15 min. The median SUS score of 78 indicated good usability. The majority of participants considered the overall user-friendliness as good (46%) or very good (21%), and 75% were willing to use myfood24-Germany regularly. Both studies showed that finding and choosing an appropriate item within the database was a major challenge. A German version of myfood24 was successfully developed. The user evaluation indicated a short completion time, good usability and acceptability of the tool, and confirmed its feasibility for repeated short-term application.

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Validity of an online 24-h recall tool (myfood24) for dietary assessment in population studies: comparison with biomarkers and standard interviews

Petra Wark et al., 2018

The study aimed to compare myfood24 with interviewer-administered 24hr recalls and both of these against nutrient biomarkers. Results between myfood24 with the more time consuming and costly interviewer-led 24hr recall results were similar, suggesting myfood24 could be a more efficient way to analyse diet, particularly when looking on a large scale.

Women interviewing another women
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Abstract

Online dietary assessment tools can reduce administrative costs and facilitate repeated dietary assessment during follow-up in large-scale studies. However, information on bias due to measurement error of such tools is limited. We developed an online 24-h recall (myfood24) and compared its performance with a traditional interviewer-administered multiple-pass 24-h recall, assessing both against biomarkers. Metabolically stable adults were recruited and completed the new online dietary recall, an interviewer-based multiple pass recall and a suite of reference measures. Longer-term dietary intake was estimated from up to 3 × 24-h recalls taken 2 weeks apart. Estimated intakes of protein, potassium and sodium were compared with urinary biomarker concentrations. Estimated total sugar intake was compared with a predictive biomarker and estimated energy intake compared with energy expenditure measured by accelerometry and calorimetry. Nutrient intakes were also compared to those derived from an interviewer-administered multiple-pass 24-h recall. Biomarker samples were received from 212 participants on at least one occasion. Both self-reported dietary assessment tools led to attenuation compared to biomarkers. The online tools resulted in attenuation factors of around 0.2–0.3 and partial correlation coefficients, reflecting ranking intakes, of approximately 0.3–0.4. This was broadly similar to the more administratively burdensome interviewer-based tool. Other nutrient estimates derived from myfood24 were around 10–20% lower than those from the interviewer-based tool, with wide limits of agreement. Intraclass correlation coefficients were approximately 0.4–0.5, indicating consistent moderate agreement. Our findings show that, whilst results from both measures of self-reported diet are attenuated compared to biomarker measures, the myfood24 online 24-h recall is comparable to the more time-consuming and costly interviewer-based 24-h recall across a range of measures.

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Development of a New Branded UK Food Composition Database for an Online Dietary Assessment Tool

Michelle Carter et al., 2016

The study aimed to create a new UK food database that reflected the wide range of food products available in supermarkets. To do this, a semi-automated process was used to map micronutrient data from food composition tables to ‘Back of Pack’ nutrient data for branded items. Version 1 of the database contained data on 120 macro- and micronutrients for 40,274 food and drinks items. 

Man drawing out dataset on whiteboard
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Abstract

The current UK food composition tables are limited, containing ~3300 mostly generic food and drink items. To reflect the wide range of food products available to British consumers and to potentially improve accuracy of dietary assessment, a large UK specific electronic food composition database (FCDB) has been developed. A mapping exercise has been conducted that matched micronutrient data from generic food codes to “Back of Pack” data from branded food products using a semi-automated process. After cleaning and processing, version 1.0 of the new FCDB contains 40,274 generic and branded items with associated 120 macronutrient and micronutrient data and 5669 items with portion images. Over 50% of food and drink items were individually mapped to within 10% agreement with the generic food item for energy. Several quality checking procedures were applied after mapping including; identifying foods above and below the expected range for a particular nutrient within that food group and cross-checking the mapping of items such as concentrated and raw/dried products. The new electronic FCDB has substantially increased the size of the current, publically available, UK food tables. The FCDB has been incorporated into myfood24, a new fully automated online dietary assessment tool and, a smartphone application for weight loss.

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Agreement between an online dietary assessment tool (myfood24) and an interviewer-administered 24-h dietary recall in British adolescents aged 11–18 years

Salwa Albar et al., 2016

The study aimed to validate myfood24 against an interviewer-administered 24hr recall among children aged 11-18 years old. The study found that the data collected using the 2 methods were similar suggesting that myfood24 could be used to more efficiently assess dietary intake in comparison to the more costly and time consuming interviewer-led 24hr recall.

Smiling family cooking together in the kitchen
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Abstract

myfood24 Is an online 24-h dietary assessment tool developed for use among British adolescents and adults. Limited information is available regarding the validity of using new technology in assessing nutritional intake among adolescents. Thus, a relative validation of myfood24 against a face-to-face interviewer-administered 24-h multiple-pass recall (MPR) was conducted among seventy-five British adolescents aged 11–18 years. Participants were asked to complete myfood24 and an interviewer-administered MPR on the same day for 2 non-consecutive days at school. Total energy intake (EI) and nutrients recorded by the two methods were compared using intraclass correlation coefficients (ICC), Bland–Altman plots (using between and within-individual information) and weighted κ to assess the agreement. Energy, macronutrients and other reported nutrients from myfood24 demonstrated strong agreement with the interview MPR data, and ICC ranged from 0·46 for Na to 0·88 for EI. There was no significant bias between the two methods for EI, macronutrients and most reported nutrients. The mean difference between myfood24 and the interviewer-administered MPR for EI was −230 kJ (−55 kcal) (95 % CI −490, 30 kJ (−117, 7 kcal); P=0·4) with limits of agreement ranging between 39 % (3336 kJ (−797 kcal)) lower and 34 % (2874 kJ (687 kcal)) higher than the interviewer-administered MPR. There was good agreement in terms of classifying adolescents into tertiles of EI (κ w =0·64). The agreement between day 1 and day 2 was as good for myfood24 as for the interviewer-administered MPR, reflecting the reliability of myfood24. myfood24 Has the potential to collect dietary data of comparable quality with that of an interviewer-administered MPR.

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Formative evaluation of the usability and acceptability of myfood24 among adolescents: a UK online dietary assessments tool

Salwa Albar et al., 2015

The study aimed to gain feedback on the usability and acceptability of myfood24 and use this to improve the system. After making alterations to myfood24 based on the initial round of feedback, the study found that the usability of myfood24 was deemed to be ‘good’.

Happy groups of students using laptop on campus
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Abstract

myfood24 is a new online 24 h dietary assessment tool developed for use among the UK population. Limited information is available on the usability and acceptability of such tools. Hence this study aims to determine the usability and acceptability of myfood24 among British adolescents (11-18y) before and after making the improvements. A total of 84 adolescents were involved in two stages. In stage-I (beta-version of myfood24), 14 adolescents were recruited, 7 of whom (group-1) were asked to enter standardized tasks in a testing room with screen capture software. The remaining 7-adolescents (group-2) were asked to report their previous food intake using myfood24 at home. All participants then completed a usability and acceptability questionnaire. Stage-II was carried out after making amendments to the live-version of myfood24 in which 70 adolescents were asked to enter their food intake for two days and then complete the same questionnaire. Thematic analysis was conducted of observer comments and open-ended questions. Navigation, presentation errors and failure to find functions were the main usability issues identified in the beta-version. Significant improvements were found in the usability and acceptability of most functions after implementing certain features like a spell checker, auto-fill option, and adding ‘mouse hover’ to help with the use of some functions. Adolescents’ perceptions of searching food items, selecting food portion sizes and making a list function were significantly improved in the live-version. The mean completion time of myfood24 reduced from 31 (SD = 6) minutes in the beta-version to 16 (SD = 5) minutes in the live-version. The mean system usability score (SUS) of myfood24 improved from 66/100 (95 % CI 60, 73) in the beta-version to 74/100 (95 % CI 71, 77) in the live-version, which is considered as ‘good’. Of the adolescents in stage-II, 41 % preferred using myfood24 to the interviewer-administered 24 h recall because myfood24 was quicker, easier to use and provided the adolescents with privacy when reporting dietary intake. Considering adolescents’ feedback has helped in improving the usability and acceptability of the final-version of myfood24. myfood24 appears to support adolescents’ need in reporting their dietary intake, which may potentially improve the overall quality of adolescents’ self-reported dietary information.

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Development of a UK Online 24-h Dietary Assessment Tool: myfood24

Michelle Carter et al. , 2015

The study aimed to create a flexible system that could assess dietary intake in order to reduce researcher burden. myfood24 was developed with input from a range of age groups: adolescents, adults and older adults and was usability tested.

myfood identity rectangle
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Abstract

Assessment of diet in large epidemiological studies can be costly and time consuming. An automated dietary assessment system could potentially reduce researcher burden by automatically coding food records. myfood24 (Measure Your Food on One Day) an online 24-h dietary assessment tool (with the flexibility to be used for multiple 24 h-dietary recalls or as a food diary), has been developed for use in the UK population. Development of myfood24 was a multi-stage process. Focus groups conducted with three age groups, adolescents (11–18 years) (n = 28), adults (19–64 years) (n = 24) and older adults (≥65 years) (n = 5) informed the development of the tool, and usability testing was conducted with beta (adolescents n = 14, adults n = 8, older adults n = 1) and live (adolescents n = 70, adults n = 20, older adults n = 4) versions. Median system usability scale (SUS) scores (measured on a scale of 0–100) in adolescents and adults were marginal for the beta version (adolescents median SUS = 66, interquartile range (IQR) = 20; adults median SUS = 68, IQR = 40) and good for the live version (adolescents median SUS = 73, IQR = 22; adults median SUS = 80, IQR = 25). Myfood24 is the first online 24-h dietary recall tool for use with different age groups in the UK. Usability testing indicates that myfood24 is suitable for use in UK adolescents and adults.

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