University of Oulu

Heikkilä, L.; Vanhala, M.; Korpelainen, R.; Tossavainen, P. Agreement between an Image-Based Dietary Assessment Method and a Written Food Diary among Adolescents with Type 1 Diabetes. Nutrients 2021, 13, 1319.

Agreement between an image-based dietary assessment method and a written food diary among adolescents with type 1 diabetes

Saved in:
Author: Heikkilä, Laura1,2,3,4,5; Vanhala, Marja1,2,3; Korpelainen, Raija1,2,3;
Organizations: 1Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., FI-90101 Oulu, Finland
2Center for Life Course Health Research, Faculty of Medicine, University of Oulu, FI-90014 Oulu, Finland
3Medical Research Center, Oulu University Hospital and University of Oulu, FI-90014 Oulu, Finland
4Department of Pediatrics and Adolescents, Oulu University Hospital, FI-90029 Oulu, Finland
5PEDEGO Research Unit, University of Oulu, FI-90014 Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Multidisciplinary Digital Publishing Institute, 2021
Publish Date: 2021-05-17


Valid and useful dietary assessment methods for adolescents with type 1 diabetes (T1D) are needed. In this study, we compared an image-based method with a written food diary for dietary intake estimation among adolescents with T1D and evaluated the adolescents’ experiences of the methods. Adolescents with T1D aged 13 to 18 years (n = 13) photographed their meals (n = 264) with a mobile phone camera and simultaneously kept a written food diary for four consecutive days. The participants filled out electronic background and feedback questionnaires. The agreement between the methods was evaluated using intraclass correlation coefficients (ICCs) and Bland–Altman plot analyses. The agreement between the methods was moderate to excellent for the energy intake (ICC = 0.91, 95% confidence interval (CI): 0.66 to 0.97, p < 0.001) and good to excellent for total carbohydrate intake (ICC = 0.95, 95% CI: 0.84 to 0.99, p < 0.001). The adolescents considered photographing easier and faster than keeping a food diary. In conclusion, the image-based method appeared comparable to the food diary for dietary intake estimation among adolescents with T1D. The photographing of meals may become a useful dietary assessment tool for adolescents with T1D, but must be further developed and validated.

see all

Series: Nutrients
ISSN: 2072-6643
ISSN-E: 2072-6643
ISSN-L: 2072-6643
Volume: 13
Issue: 4
Article number: 1319
DOI: 10.3390/nu13041319
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: This research was funded by the Alma and K.A. Snellman Foundation, Oulu, Finland; the Finnish Medical Foundation, Finland; and the Foundation for Pediatric Research, Finland.
Copyright information: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (