The complementary role of technology in improving dietary assessment and personalising dietary intervention methods

Abstract

At present, the most widely used dietary assessment methods in dietetic practice and nutrition epidemiology are self-reported tools, which are not suitable for capturing the dietary intake of populations with irregular eating patterns, such as young adults.

The overarching aim of the present research was to objectively examine young adults’ eating patterns and explore how technology-mediated methods can be used to improve dietary assessment and monitoring for this population group. To meet this aim, six studies were conducted: 1) a secondary analysis of wearable camera data to examine the intra-individual variability of eating timing among young adults, 2) a cross-sectional study using food images to examine the association between temporal eating patterns and diet quality in young adults, 3) a double-blinded crossover study to compare the compliance, validity, and acceptability of signal-contingent ecological momentary assessment (EMA) delivered at fixed intervals versus at personalised timepoints to capture dietary data in young adults, 4) a scoping review of sensor-based devices capable of capturing ingestion behaviours in real-time, 5) an updated scoping review of sensor-based devices, and 6) a formative trial developing and assessing the performance of a wrist accelerometer-only algorithm for the detection of eating and drinking in free-living young adults.

Overall, this thesis confirms the highly variable nature of young adults’ eating behaviours using objective, technology-mediated methods, and highlights the importance of accounting for this variability when selecting or designing an appropriate dietary assessment method. It illustrates how technology-mediated methods can be integrated to support more accurate nutrition assessment, enable just-in-time adaptive interventions, and facilitate continuous, real-time monitoring, ultimately improving health outcomes for young adults.