Application of myfood24

Academic publications that have used myfood24 to analyse food and nutrient intake

A repeated cross-sectional survey assessing changes in diet and nutrient quality of English primary school children’s packed lunches between 2006 and 2016

Charlotte Evans et al. , 2020

In 2016 there were no meal standards in place for children's packed lunches. This study analyses the difference in nutrient quality in children's packed lunches from 2006 to 2016. Dietary data from lunches in 2016 were analysed using myfood24. Results from this survey confirm that the level of sugar in packed lunches has decreased since 2006, but they continue to be dominated by sweet and savoury snack and sugary drinks.

Three children laying on green grass on ground and eating sandwiches and smiling, healthy food, good friendship and love and happiness without limit )
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Objective Mandatory school meal standards were introduced in 2006 in England; however, no legislation exists for packed lunches. This study analyses provision of foods and nutrients in packed lunches in 2016 to highlight differences in diet and nutrient quality since 2006.
Design Two cross-sectional surveys of children’s packed lunches were conducted in 2006 and 2016. Data were analysed using multilevel regression models taking into account the clustering of children within primary schools.
Setting Data were collected from 1148 children who attended 76 schools across England in 2006 and from 323 children attending 18 schools across England in 2016.
Participants Children were included if they regularly ate a packed lunch prepared at home (approximately half of children take a packed lunch to school) and were aged 8–9 years (in year 4), for both surveys.
Outcome measures Data collected in both years included provision of weight and type of food, nutrients and proportion of lunches meeting individual and combined school meal standards.
Results Frequency of provision and portion size of some food types changed substantially between surveys. Frequency of provision of confectionery in lunches reduced by 9.9% (95% CI −20.0 to 0.2%), sweetened drinks reduced by 14.4% (95% CI −24.8 to −4.0%), and cakes and biscuits not containing chocolate increased by 9.6% (95% CI 3.0 to 16.3%). Vegetable provision in lunches remained low. Substantial changes were seen in the percentage of lunches meeting some nutrient standards: non-milk extrinsic sugars (19%, 95%CI 10 to 29%), vitamin A (−8%, 95%CI −12 to −4%), vitamin C (−35%, 95%CI −42 to −28%) and zinc (−8%, 95%CI −14 to −1%).
Conclusions Packed lunches remain low quality with few meeting standards set for school meals. Provision of sugars has reduced due to reductions in provision and portion size of sugary drinks and packaged sweet foods; however, provision of some nutrients has worsened.

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Relationship of the Frequency, Distribution, and Content of Meals/Snacks to Glycaemic Control in Gestational Diabetes: The myfood24 GDM Pilot Study

Michelle A. Morris et al., 2019

The aim of this study was to examine the calorie and carbohydrate intake in women with gestational diabetes mellitus, in association with glycaemic control. The women involved in the study self-recorded their dietary intake using myfood24. The study showed that having more snacks across the day helped the women to achieve their glucose targets.

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This study examines nutritional intakes in Gestational diabetes mellitus piloting the myfood24 tool, to explore frequency of meals/snacks, and daily distribution of calories and carbohydrates in relation to glycaemic control. A total of 200 women aged 20–43 years were recruited into this prospective observational study between February 2015 and February 2016. Diet was assessed using myfood24, a novel online 24-h dietary recall tool. Out of 200 women 102 completed both ≥1 dietary recalls and all blood glucose measurements. Blood glucose was self-measured as part of usual care. Differences between groups meeting and exceeding glucose targets in relation to frequency of meal/snack consumption and nutrients were assessed using chi-squared and Mann–Whitney tests. Women achieving a fasting glucose target <5.3 mmol/L, compared to those exceeding it, consumed three meals (92% vs. 78%: p = 0.04) and three snacks (10% vs. 4%: p = 0.06) per day, compared with two or less; and in relation to evening snacks, consumed a higher percentage of daily energy (6% vs. 5%: p = 0.03) and carbohydrates (8% vs. 6%: p = 0.01). Achieving glycaemic control throughout the day was positively associated with snacking (p = 0.008). Achieving glucose targets was associated with having more snacks across the day, and may be associated with frequency and distribution of meals and nutrients. A larger study is required to confirm this.

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‘Your Tube’: the role of different diets in children who are gastrostomy fed: protocol for a mixed methods exploratory sequential study

Johanna Taylor et al., 2019

There is a growing number of children who require all or some of their nutrition via gastronomy tubes. This study looks into the risks, benefits and resource implications for parents using home-blended food for their children with gastronomy tubes compared with the currently recommended formulas. The home-blended dietary information was collected through the use of myfood24.

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Introduction Increasing numbers of children require having all, or part, of their nutritional intake via gastrostomy. More parents are using home-blended meals to feed their children, with many reporting beneficial effects such as improved gastro-oesophageal reflux, less constipation and less distress in their child. This study aims to identify the important outcomes of tube feeding in this population, compare the safety, outcomes and resource use of those on a home-blended diet compared with a formula diet and assess feasibility of long-term follow-up of children recruited to this study.
Methods and analyses This is a mixed methods study of children (aged 6 months to 18 years) who are gastrostomy feed dependent recruited via general, community and specialist paediatric and dietetic services. Workstream 1 (WS1): a qualitative study involving semistructured interviews with parents (n~20) and young people (n~5–10), and focus groups with health professionals (n~25), will provide evidence of appropriate outcome measures and the feasibility/acceptability of proposed data collection methods for WS2. It will gather data on: desired outcomes of gastrostomy feeding, variability in diets and reasons; use of oral feeding; perceived benefits of the alternative diets, resources associated with gastrostomy feeding and safety issues. Data will be analysed using thematic analysis.
WS2: a cohort study of 300 children who are gastrostomy fed. Data will be collected at months 0, 9 and 18 from parents, children (if appropriate) and clinicians using standardised measures and questionnaires developed specifically for the study. Data collected will include gastrointestinal symptoms, health and other outcomes (child, parent), dietary intake, anthropometry, healthcare usage, safety outcomes and resource use. Outcomes in the home-blended and formula groups will be compared using appropriate multiple regression analyses.
Ethics and dissemination The study has been approved by a research ethics committee (REC reference: 19/YH/0028). Results will be disseminated through publications and presentations for professionals and families.

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Use of Online Dietary Recalls among Older UK Adults: A Feasibility Study of an Online Dietary Assessment Tool

Heather A. Ward et al., 2019

This paper examined the feasibility of using myfood24 in a cohort of older adults. Unhealthy diets are a risk factor for chronic diseases, and this has become more important with our aging population. The study included 299 participants and demonstrated that dietary recall on myfood24 was feasible for older adults with some support needed when multiple recalls were collected.

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This study examined the feasibility of including myfood24, an online 24-hour dietary recall tool, in a cohort studies of older adults. Participants (n = 319) were recruited during follow-up visits for the CHARIOT-Pro Sub-study, a prospective study of cognitively healthy adults aged 60–85 years at baseline. Email invitations were sent over three consecutive months, with weekly reminders. Multivariable regression models were applied to examine the number of recalls completed in relation to technology readiness (TR) scores and demographic characteristics. Ninety-four percent of people agreed to participate. Among participants, 67% completed at least one recall, and 48% completed two or more. Participants who completed multiple recalls reported higher self-confidence with technology and received a higher TR score than those who did not complete any recalls. A one-point higher TR score was associated with higher odds of completing three recalls compared to zero recalls (OR 1.70, 95% CI 0.96–3.01); this association was further attenuated after adjustment for demographic and other TR-related covariates (OR 1.35, 95% CI 0.63–2.88). This study demonstrates reasonable participation rates for a single myfood24 recall among older adults participating in a cohort study but suggests that further support may be required to obtain multiple recalls in this population.

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A smartphone based attentive eating intervention for energy intake and weight loss: results from a randomised controlled trial

Victoria Whitelock et al., 2019

Across english-speaking high-income countries obesity rates are over 30% and the health problems associated with this are substantial. Laboratory studies suggest that eating whilst distracted can increase later food intake and can impair memory for what has been eaten. The aim of this control trial was to prove the concept for the effectiveness of attentive eating to reduce energy intake and promote weight loss. myfood24 was used to report 24 hour energy intake.

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Laboratory studies suggest that eating more ‘attentively’ (e.g. attending to food being eaten and recalling eating episodes) can reduce food intake among participants with both healthy weight and overweight. The aim of this trial was to assess whether a smartphone application that encourages a more attentive eating style reduces energy intake and promotes weight loss.

In an open-label, single centre, parallel groups, individually randomised controlled trial, 107 adults with overweight/obesity in Merseyside, UK used an attentive eating smartphone application along with standard dietary advice (intervention group) or standard dietary advice only (control group) for 8 weeks. The primary outcomes were change in body weight at 8 weeks and energy intake at 4 and 8 weeks. Additional outcomes included self-reported eating behaviours measured at 8 weeks. Differences between groups were assessed with linear regression (adjusted) using multiple imputation for missing data. Study protocol registered prospectively at (https://doi.org/10.17605/osf.io/btzhw).

There was no significant difference between the intervention and control group in weight lost at 8 weeks, or change in self-reported 24 h or objective taste-test energy intake at 4 or 8 weeks. Mean weight loss in the intervention group (n = 53) was 1.2 kg and 1.1 kg in the control group (n = 54), adjusted difference of − 0.10 (− 1.6 to 1.3) kg. Self-reported eating behaviours at 8 weeks also did not differ across groups. The intervention was largely used as intended and a per protocol analysis confined to participants in the intervention group that used the attentive eating smartphone application regularly and as intended also showed no effect on energy intake or weight loss.

A smartphone based attentive eating intervention and standard dietary advice did not result in reduced energy intake or greater weight loss at 4 or 8 week follow-up than standard dietary advice alone.

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Development and relative validation of a short food frequency questionnaire for assessing dietary intakes of non-alcoholic fatty liver disease patients

Carla Bredin et al. , 2019

Non-alcoholic fatty liver disease (NAFLD) is currently the leading cause of liver disease in the developed world. The aim of this research was to develop and validate a short food frequency questionnaire to assess the food and drink associated with obesity and NAFLD in Ireland. The data obtained highlights the urgent need to identify those at risk of NAFLD and rapidly assess their dietary intake.

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Purpose This work aimed to design and validate a novel short food frequency questionnaire (SFFQ) to assess habitual intakes of food items related to non-alcoholic fatty liver disease (NAFLD) in a cohort of European patients.
Methods A 48-item SFFQ was created, with questions from existing FFQs and expert knowledge, emphasizing foods and nutrients implicated in NAFLD pathogenesis. Consenting, fibroscan-diagnosed, NAFLD patients completed the SFFQ during a short interview and were asked to complete a 4-day diet diary (4DDD) at home for return by mail. Nutritional intakes were assessed utilizing the myfood24™ food composition dataset and estimated energy requirements (EER) were calculated using sex-, age- and weight-specific equations. Agreement between the dietary instruments was assessed by Spearman correlations and Bland Altman analysis.
Results Fifty-five patients completed both the SFFQ and the 4DDD within 30 weeks; 42 (76%) were diagnosed with simple steatosis, whereas 13 (24%) had biopsy-proven steatohepatitis; the majority were overweight or obese, with a median (25th; 75th percentile) BMI of 33.2 kg/m2 (29.3; 36.0). Reported energy intakes were well below EER with a median intake of 73% of requirements, suggesting widespread under-reporting. Significant correlations were observed between sugar (r=0.408, P=0.002), fat (r=0.44, P=0.001), fruits (r=0.51, P=0.0001) and vegetables (r=0.40, P=0.0024) measurements by the SFFQ and 4DDD. Bland Altman plots with regression analysis demonstrated broad comparability with the 4DDD for intakes of fat (bias −13.8 g/day) and sugar (bias + 12.9 g/day).
Conclusions A novel SFFQ designed to be minimally burdensome to participants was effective at assessing dietary intakes in NAFLD patients.

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Keeping Track: Triangulating Methods to Measure the Food Environment: A Pilot Study

Windi Marwa et al. , 2019

Obesity poses a global health challenge and it is predicted that by 2050, 50% of the British population could be obese. This pilot study explores the potential of using global positioning systems when triangulated with myfood24 to measure food environments. Methodological triangulation was shown to be feasible in food environment research.

Close-up of female staff holding basket of vegetables in organic section of supermarket
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This article explores the potential of using Global Positioning Systems (GPS) to capture valuable data in measuring food environments. Such
data, when triangulated with more conventional methods of collection, for example daily 24-hour dietary recalls and food purchase receipts,
allow researchers to gain a fuller picture of individual activity in dynamic food environments. This is vital to understanding both individual
and environmental factors that influence individuals’ decision and behaviour patterns within food environments. However, the practicalities of
triangulating data collection methods are challenging to both researchers and participants, and so a pilot study was undertaken to test different
methods of measuring the food environment. Recruitment for the pilot study took place between August and September 2017 and of the 16
participants initially recruited, 13 took part and completed all data collection methods and provided valuable feedback about the experience. The

participants’ perspectives on the process of triangulating methods, along with the findings, are discussed in the paper.

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Exploring the Feasibility of Use of An Online Dietary Assessment Tool (myfood24) in Women with Gestational Diabetes

Carla Gianfrancesco et al., 2018

A recent study explored the feasibility and usability of myfood24 in 199 women with gestational diabetes. The study found that the usability was good and demonstrated that myfood24 could be used to support women to self-manage gestational diabetes.  

Happy pregnant woman being checked by doctor in clinic
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myfood24 is an online 24 hr dietary recall tool developed for nutritional epidemiological research. Its clinical application has been unexplored. This mixed methods study explores the feasibility and usability of myfood24 as a food record in a clinical population, women with gestational diabetes (GDM). Women were asked to complete five myfood24 food records, followed by a user questionnaire (including the System Usability Scale (SUS), a measure of usability), and were invited to participate in a semi-structured interview. Of the 199 participants, the mean age was 33 years, mean booking body mass index (BMI) 29.7 kg/m2, 36% primiparous, 57% White, 33% Asian. Of these, 121 (61%) completed myfood24 at least once and 73 (37%) completed the user questionnaire; 15 were interviewed. The SUS was found to be good (mean 70.9, 95% CI 67.1, 74.6). Interviews identified areas for improvement, including optimisation for mobile devices, and as a clinical management tool. This study demonstrates that myfood24 can be used as an online food record in a clinical population, and has the potential to support self-management in women with GDM. However, results should be interpreted cautiously given the responders’ demographic characteristics. Further research to explore the barriers and facilitators of uptake in people from ethnic minority and lower socioeconomic backgrounds is recommended.

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Traditional methods v. new technologies – dilemmas for dietary assessment in large-scale nutrition surveys and studies

Birdem Amoutzopoulos et al. , 2018

The aim of this paper is to summarise the current and future applications of dietary assessment technologies. There are currently few examples of large-scale nutrition surveys using technology to measure dietary intake. These large scale studies still use traditional methods for dietary assessment. Employing these new technologies has the potential to lower the cost and time taken for data collection and improve data quality.

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The aim of the present paper is to summarise current and future applications of dietary assessment technologies in nutrition surveys in developed countries. It includes the discussion of key points and highlights of subsequent developments from a panel discussion to address strengths and weaknesses of traditional dietary assessment methods (food records, FFQ, 24 h recalls, diet history with interviewer-assisted data collection) v. new technology-based dietary
assessment methods (web-based and mobile device applications). The panel discussion ‘Traditional methods v. new technologies: dilemmas for dietary assessment in population surveys’, was held at the 9th International Conference on Diet and Activity Methods (ICDAM9), Brisbane, September 2015. Despite respondent and researcher burden, traditional methods have been most commonly used in nutrition surveys. However, dietary assessment technologies offer potential advantages including faster data processing and better data quality. This is a fast-moving field and there is evidence of increasing demand for the use of new technologies amongst the general public and researchers. There is a need for research and investment to support efforts being made to facilitate the inclusion of new technologies for rapid, accurate and representative data.

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healthy eating concept - close up of tablet with several dieting statistics

Innovative approaches to estimate individual usual dietary intake in large-scale epidemiological studies

Johanna Conrad et al. , 2017

In dietary studies, ideally a subjects dietary intake should be measured on each day, but this is rarely achieved. This paper reviews recent literature on innovative approaches for the improvement of the assessment of usual dietary intake - including myfood24.

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Valid estimation of usual dietary intake in epidemiological studies is a topic of present interest. The aim of the present paper is to review recent literature on innovative approaches focussing on: (1) the requirements to assess usual intake and (2) the application in largescale settings. Recently, a number of technology-based self-administered tools have been developed, including short-term instruments such as web-based 24-h recalls, mobile food
records or simple closed-ended questionnaires that assess the food intake of the previous 24 h. Due to their advantages in terms of feasibility and cost-effectiveness these tools may be superior to conventional assessment methods in large-scale settings. New statistical methods have been developed to combine dietary information from repeated 24-h dietary recalls and FFQ. Conceptually, these statistical methods presume that the usual food intake of a subject equals the probability of consuming a food on a given day, multiplied by the average
amount of intake of that food on a typical consumption day. Repeated 24-h recalls from the same individual provide information on consumption probability and amount. In addition, the FFQ can add information on intake frequency of rarely consumed foods. It has been suggested that this combined approach may provide high-quality dietary information. A promising direction for estimation of usual intake in large-scale settings is the integration of both statistical methods and new technologies. Studies are warranted to assess the validity of estimated usual intake in comparison with biomarkers.

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