Expansion and Assessment of a Web-Based 24-Hour Dietary Recall Tool, Foodbook24, for Use Among Diverse Populations Living in Ireland: Comparative Analysis.

Abstract

Background: Currently, the methods used to collect dietary intake data in Ireland are inflexible to the needs of certain populations, who are poorly represented in nutrition and health data as a result. As the Irish population is becoming increasingly diverse, there is an urgent need to understand the habitual food intake and diet quality of multiple population subgroups, including different nationalities and ethnic minorities, in Ireland. Foodbook24 is an existing web-based 24-hour dietary recall tool, which has previously been validated for use within the general Irish adult population. Because of its design, Foodbook24 can facilitate the improved inclusion of dietary intake assessment in Ireland.

Objective: We aimed to examine the suitability of expanding the Foodbook24 tool, improving the reliability and accuracy of dietary intake data collected among prominent nationalities in Ireland.

Methods: This study consisted of three distinct parts: (1) expansion of Foodbook24, (2) testing its usability (ie, acceptability study), and (3) examining the accuracy (ie, comparison study) of the updated Foodbook24 tool. To expand Foodbook24, national survey data from Brazil and Poland were reviewed and commonly consumed food items were added to the food list. All foods were translated into Polish and Portuguese. The acceptability study used a qualitative approach whereby participants provided a visual record of their habitual diet. The comparison study consisted of one 24-hour dietary recall using Foodbook24 and one interviewer-led recall completed on the same day, repeated again 2 weeks later. Comparison study data were analyzed using Spearman rank correlations, Mann-Whitney U tests, and κ coefficients.

Results: The expansion of the Foodbook24 food list resulted in 546 additional foods. The acceptability study reported that 86.5% (302/349) of foods listed by participants were available in the updated food list. From the comparison study, strong and positive correlations across 8 food groups (44% of a total of 18 food groups) and 15 nutrients (58% of a total of 26 nutrients) were identified (r=0.70-0.99). Only intakes of potatoes and potato dishes and nuts, herbs, and seeds significantly differed across methods of assessment, where correlations across these food groups were low (r=0.56 and r=0.47, respectively). The incidence of food omissions varied across samples, with Brazilian participants omitting a higher percentage of foods in self-administered recalls than other samples (6/25, 24% among the Brazilian vs 5/38, 13% among the Irish cohort).

Conclusions: The updated food list is representative of most foods consumed by Brazilian, Irish, and Polish adults in Ireland. Dietary intake data reported in Foodbook24 are not largely different from food groups and nutrient intakes reported via traditional methods. This study has demonstrated that Foodbook24 may be appropriate for use in future research investigating the dietary intakes of Brazilian, Irish, and Polish groups in Ireland.