Photo-assisted recall increases estimates of energy and macronutrient intake in adults with intellectual and developmental disabilities

Abstract

Diet assessment of adults with intellectual and developmental disabilities (IDD) is challenging due to their limited cognitive abilities. The objective of this study was to examine the feasibility and outcomes of combining photos with 24-hour dietary recalls for the assessment of energy and macronutrient intake in adults with IDD. Participants used an iPad 2 tablet computer to take photos of all food and beverages consumed before a standard, multiple-pass, 24-hour dietary recall. Following the standard 24-hour diet recall, the photos were reviewed with the participant for clarification details (e.g., portion size, etc.) and differences were recorded. The standard 24-hour recall and the photo-assisted recall were entered separately into Nutrition Data System for Research for computerized dietary analysis. Sixty-four eating occasions were entered from 23 participants (48% female; mean age 26.4 ±9.7 years). Participants captured photos for 66.5% ± 30.4% of all recorded eating occasions. Greater energy intake per eating occasion was reported with the photo-assisted recalls than the standard recalls (625.6 ± 85.7 kcals vs. 497.2 ± 86.6 kcals, p=0.002) and a greater intake of grams of fat (p=0.006) protein (p=0.029) and carbohydrates (p=0.003). Photo-assisted 24-hour recalls provided a significant increase in total calories and macronutrient content compared to a standard 24-hour recall and may be a feasible method to enhance dietary assessment in adults with IDD.