Validation of a novel image-weighed technique for monitoring food intake and estimation of portion size in hospital settings: A pilot study

Objective: Optimal nutrition for hospital patients is crucial and routine monitoring of patients' nutrient intake is imperative. However, personalised monitoring and customised intervention using traditional methods is challenging and labour-intensive, consequently it is often neglected in hospital settings. The present pilot study aimed to examine the reliability and validity of the Dietary Intake Monitoring System (DIMS) against the weighed food method (WFM). Design: The DIMS 2.0 is composed of an integrated digital camera, weighing scale, radio-frequency identification sensor and WIFI connection for real-time image and weight dietary data acquisition and analysis. The DIMS equipment was used to collect data for a paired set of meals both before and after meal consumption at lunchtime. Setting: Odense University Hospital, Denmark. Subjects: Photos and weights of seventeen patient meals were captured. Results: The results showed a significant correlation between DIMS and WFM for energy (r=0.99, P<0.01) and protein intake (r=0.98, P<0.01). Intraclass correlation coefficients (ICC) revealed a high degree of agreement among the four non-trained assessors for estimates of portion size of each food item before (0.88, P<0.01) and after consumption (0.99, P<0.01). The ICC for energy and protein intake were 0.99 (P<0.01) and 0.99 (P<0.01), respectively. Bland-Altman plots revealed no systematic bias. Conclusions: Considering the huge benefits associated with routine monitoring, technological advances have made it possible to develop a novel, easy-to-use DIMS that, according to the findings, is a valid alternative for use in hospital settings.