Comparison of different food consumption methods to digital food photography method of elderly in nursing home

Main Article Content

Tuğçe Orkun Erkılıç
Neslişah Rakıcıoğlu


food record methods, digital photography, food consumption, food frequency questionnaire, elderly


Background: Detection of food consumption by digital photography is a recently applied method in the world. The main purpose of the present study was to identify the most efficient method in determining the food consumption of the elderly in the nursing home by comparing different food consumption records to the digital photography method. Methods: A total of 52 (27 men, 25 women) elders, who did not have a neurological or psychiatric disturbance, were included in the study. The study was carried out in Ankara Seyranbağları Nursing Home Directorate for the Elderly Care and Rehabilitation Center. Nutritional status was screened using a questionnaire from the Mini-Nutritional Assessment, basic characteristics were determined and anthropometric measurements were assessed. Food consumption of elderly people was evaluated by daily food record, 24 hour retrospective food record, food frequency, and digital photography method, and the relevancy of these methods for the elderly were evaluated. Results: Most of the consumed food groups (milk, yoghurt, cheese, red meat, potatoes, fruit, oil, and sugar group for elderly men, eggs, red meat, fish, meat products, legume, bread, cereals, other vegetables and fat group for elderly women) were found to be highest according to food frequency, and then food records and lowest mean values were obtained by digital photography. At the end of the research, when the mean consumption of energy, protein, fat, and carbohydrate of elderly were ordered in descending order, it was seen that for all genders the order was same: the highest means had seen on food records than food frequency and the lowest means had seen on digital photography. Conclusions: As a result, the digital photography method can record the full food consumption of the elderly in the nursing home and it is also a promising method.


Download data is not yet available.
Abstract 227 | PDF Downloads 80


1. Erdoğan T, Tunca H. Dahiliye Polikliniğine Başvuran Geriatrik Hastaların Çok Yönlü Fonksiyonel Değerlendirilmesi ve Beslenme Durumlarının İrdelenmesi. Osmangazi Tıp Dergisi. 2016; 38 (3), 17-24.
2. Türkiye İstatistik Kurumu Haber Bülteni. İstatistiklerle Yaşlılar. 2019; sayı: 33712. [Internet] 2020. [Erişim Tarihi 7 Ağustos 2020].
3. Rakıcıoğlu N. Yaşlı Beslenmesi. Turkiye Klinikleri. J. Nutr. Diet-Special Topics. 2015; 1(1): 33-9.
4. Goldbohm RA, Veer P, Brant PA, Hof MA, Brants HA, Sturmans F, ve ark. Reproducibilty of a food frequency questionaire and stability of dietary habits determined from five annualy repeated measurements. Eur J Clin Nutr. 1995; 49: 420-429.
5. Rocet HR, Berkey CS, Colditz GA. Evaluation of dietary assessment instruments in adolescents. Curr Opin Clin Nutr Metab Care. 2003; 6: 557-562.
6. Thompson FE, Subar AF. Dietary Assessment Methodology. Nutrition in the Prevention and Treatment of Disease, 2nd ed. London: Elsevier Academic Press; 2008.
7. Guıdance of EFSA. General principles for the collection of national food consumption data in the view of a pan-European dietary survey. EFSA Journal. 2009; 7(12):1435.
8. Thompson FE, Byers T. Dietary assessment resource menual. J Nutr. 1994; 124: 2245-2317.
9. Dwyer JT, Kral EA, Coleman KA. The problem of memory in nutritional epidemiology research. J Am Diet Assoc. 1987; 87: 1509-1512.
10. Meldin C, Skinner JD. Individual dietary intake methodology: a 50-year review of progress. J Am Dier Assoc. 1988; 88: 1250-1257.
11. Aronoff S, Rosenblatt S, Braithwaite S, Egan JW, Mathisen AL, Schneider RL. Pioglitazone hydrochloride monoteraphy improves glycemic control in the treatment of patients with type-2 diabetes: a 6-month randomized placebo-controlled dose response study. Diabetes Care. 2000; 23: 1605-1611.
12. Black AE, Cole TJ. Biased over- or under-reporting is characteristic of individuals whether over time or by differetn assesment methods. J Am Diet Assoc. 2001; 101: 70-80.
13. Goris AH, Meijer EP, Kester A, Westerterp KR. Use of triaxial accelerometer to validate reported food intakes. Am J Clin Nutr. 2001; 73: 549-553.
14. Kaczkowski CH, Jones PJ, Feng J, Bayley HS. Four day multimedia diet records underestimate energy needs in middle-aged and elderly women as determined by doubly-labeled water. J Nutr. 2000; 130: 802-805.
15. Haraldsdottir J, Hermansen B. Repeated 24-h recall with young school children. A feasible alternative to dietary history from parents. Eur J Clin Nutr. 1995; 49: 729-739.
16. Kroke A, Klipstein-Grobusch K, Voss S, Möseneder J, Thielecke F, Noack R, et al. Validation of a self-administered food-frequency questionaire administered in the European Prospective Investigation into Cancer and Nutrition (EPİC) Study: comparison of energy, protein and macronutrient intakes estimated with the double- labeled water, urinary nitrogen and repeated 24-h dietary recall methods. Am J Clin Nutr. 1999; 70: 439-447.
17. Livingstone MB, Robson PJ. Measurement of dietary intake in children. Proc Nutr Soc. 2000; 59: 279-293.
18. Wang DH, Kogashiwa OS, Kira S. Validity and reliability of a dietary assessment method: the application of a digital camera with a mobile phone card attachment. J Nutr Sci Vitaminol. 2002; 48: 498-504.
19. Baysal A, Aksoy M, Besler T, Bozkurt N, Keçecioğlu S, Mercanlıgil S, Merdol Kutluay T, Pekcan G, Yıldız E. Diyet El Kitabı (6.Baskı). Hatiboğlu Yayınevi, Ankara, 2011.
20. Baysal A. Yaşlılık ve Beslenme. Türkiye Diyetisyenler Derneği Yayını No:7. Çağın Basım Yayın Tic.Şti. Ankara, 1994.
21. Pekcan G. Beslenme Durumunun Saptanması, TC Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü Beslenme ve Fiziksel Aktiviteler Daire Başkanlığı Beslenme Bilgi Serisi 1.Klasmat Matbaacılık, Ankara, 2008.
22. Bird G, Elwood PC. The dietary intakes of subjects estimated from photographs compared with a weighed record. Human Nutrition. 1983; 37A, 470-473.
23. Higgins JA, LaSalle AL, Zhaoxing P, Kasten MY, Bing KN, Ridzon SE, Witten TL. Validation of photographic food records in children: are pictures really worth a thousand words? Eur J Clin Nutr. 2009; 63: 1025-1033.
24. Orkun T. İlkokul Çocuklarında Besin Tüketiminin Dijital Fotoğraflama Yöntemiyle Saptanması [Yüksek Lisans Tezi]. Hacettepe Üniversitesi; Ankara: 2012.
25. Williamson DA, Martin PD, Allen HR, Most MM, Alfonso AJ, Thomas V. ve ark. Changes in food intake and body weigh associated with basic combat training. Military Medicine. 2002; 167(3), 248−253.
26. Williamson DA, Allen HR, Martin PD, Alfonso AJ, Gerald B, Hunt A. Comparison of digital photography to weighed and visual estimation of portion sizes. Journal of the American Dietetic Association. 2003; 103(9), 1139−1145.
27. Williamson DA, Allen HR, Martin PD, Alfonso A, Gerald B, Hunt A. Digital photography: A new method for estimating food intake in cafeteria settings. Eating and Weight Disorders. 2009; 9(1), 24−28.
28. Pouyet V. Cuvelier G. Benattar L, Giboreau A. A photographic method to measure food item intake. Validation in geriatric institutions. 2015; Appetite; Volume 84, 11-19.
29. Casperson SL, Sieling J, Moon J, Johnson L, Roemmich JN, Whigham L. A Mobile Phone Food Record App To Digitally Capture Dietary Intake For Adolescents İn A Free-Living Environment: Usability Study. JMIR Health &Health, 2015; vol. 3.
30. Chen HC, Jia W, Yue Y, Li Z, Sun YN, Fernstrom JD, Sun M. Model Based Measurement Of Food Portion Size For İmage-Based Dietary Assessment Using 3D/2D Registration. Meas. Sci. Technol. 2013; 24; 105701.
31. Illner AK, Freisling H, Boeing H, Huybrechts I, Crispim SP, Slimani N. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology. International Journal of Epidemiology. 2012; 41: 1187–1203.
32. Lazarte CE, Encinas ME, Alegre C, Granfeldt Y. Validation of digital photographs, as a tool in 24-h recall, for the improvement of dietary assessment among rural populations in developing countries. Nutrition Journal. 2012; 11:61.
33. Martin CK, Nicklas T, Gunturk B, Correa JB, Allen HR, Champagne C. Measuring food intake with digital photography. J Hum Nutr Diet. 2014; 27(0 1): 72–81
34. World Health Organization (WHO). Global database on body mass index, BMI classification; Adapted from WHO, 1995, WHO, 2000 and WHO 2004 [Internet]. 2016 [Erişim Tarihi 4 Mayıs 2016].
35. Alpar R. Uygulamalı çok değişkenli istatistiksel yöntemlere giriş 1. 2. Baskı, Ankara, Nobel, 2003.
36. Akgül A. Tıbbi araştırmalarda istatistiksel analiz teknikleri, spss uygulamaları. 3.basım. Ankara: Ofset, 2005.
37. Ekman A, Litton JE. New times, new needs; e-epidemiology. Eur J Epidemiol. 2007; 22: 285–92.
38. Schatzkin A, Subar AF, Moore S et al. Observational epidemiologic studies of nutrition and cancer: the next generation (with better observation). Cancer Epidemiol Biomarkers Prev. 2009; 18: 1026–32.
39. Bingham SA, Gill C, Welch A et al. Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records. Br J Nutr. 1994; 72: 619–43.
40. Bingham SA. Limitations of the various methods for collecting dietary intake data. Ann Nutr Metab. 1991; 35: 117–27.
41. Swanson M. Digital photography as a tool to measure school cafeteria consumption. Journal of School Health. 2008; 78(8), 432–437.
42. Hinton EC, Brunstrom JM, Fay SH, Wilkinson LL, Ferriday D, Rogers PJ, et al. Using photography in ‘The Restaurant of the Future’. A useful way to assess portion selection and plate cleaning? Appetite. 2013; 63(1), 31–35.
43. Simmons SF, Reuben D. Nutritional intake monitoring for nursing home residents: a comparison of staff documentation, direct observation, and photography methods. J Am Geriatr Soc. 2000; 48: 209–13.
44. Goris AH, Westerterp-Plantenga MS, Westerterp KR. Undereating and underrecording of habitual food intake in obese men: selective underreporting of fat intake Am. J. Clin. Nutr. 2000; 71 130–4.
45. Livingstone MBE, Robson PJ, Wallace JMW. Issues in dietary intake assessment of children and adolescent Br. J. Nutr. 2004; 92, S213–22.
46. Margetts BM, Nelson M. Design Concepts in Nutritional Epidemiology, Oxford University Pres, New York, 1991.
47. Decker MD, Booth AL, Dewey M, Fricker RS, Hutchenson RH, Schaffner W. Validity of food consumption histories in a foodborne outbreak investigation. American Journal Epidemiology. 1986; 124, 859-863.
48. Soykan A, Burgut R. Beslenme sıklığı anketlerinin geçerliliği ve güvenilirliği. [Yüksek Lisans Tezi]. Adana: Çukurova Üniversitesi; 2007.
49. Staveren WA. de Groot LC, Blauw YH, van der Wielen RP. Assessing diets of elderly people. Problems and approaches. The American Journalof Clinical Nutrition. 1994; 59(1), 221S–223S.
50. Boushey CJ, Kerr DA, Wright J, Lutes KD, Eber DS, Delp EJ. Use of technology in children’s dietary assessment Eur. J. Clin. Nutr. 2009; 63, S50–57.
51. Arab L, Estrin D, Kim DH, Burke J, Goldman J. Feasibility testing of an automated image-capture method to aid dietary recall. Eur. J. Clin. Nutr. 2011; 65, 1156–62.
52. Sökülmez KP. Şahin G. Samsun’da Kendi Evinde Yaşayanlara göre Huzurevinde Kalan 65 Yaş ve Üzeri Bireylerin Beslenme Durumlarının Değerlendirilmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2015; 5 (1): 22-27.
53. Van Horn L. Assessing dietary intake: new ideas and better approaches. J Am Diet Assoc. 2006; 106: 1533.
54. Penn L, Boeing H, Boushey CJ et al. Assessment of dietary intake: NuGO symposium report. Genes Nutr. 2010; 5: 205–13.
55. Frood A. Technology: a flavour of the future. Nature. 2010; 468: S21–S22.
56. Stumbo PJ, Weiss R, Newman JW et al. Web-enabled and improved software tools and data are needed to measure nutrient intakes and physical activity for personalized health research. J Nutr. 2010; 140:2104–15.
57. Shatenstein B, Ferland G. Absence of nutritional or clinical consequences of decentralized bulk food portioning in elderly nursing home residents with dementia in Montreal. Journal of the American Dietetic Association. 2000; 100(11), 1354–1360.
58. Appleton KM. Increases in energy, protein and fat intake following the addition of sauce to an older person’s meal. Appetite. 2009; 52(1), 161–165.
59. De Jong N, De Graaf C, Van Staveren WA. Effect of sucrose in breakfast items on pleasantness and food intake in the elderly. Physiology & Behavior. 1996; 60(6), 1453–1462.
60. Griep MI, Mets TF, Massart DL. Different effects of flavour amplification of nutrient dense foods on preference and consumption in young and elderly subjects. Food Quality and Preference. 1997; 8(2), 151–156.
61. Essed NH, Staveren WA, Kok FJ, Graaf C. No effect of 16 weeks flavor enhancement on dietary intake and nutritional status of nursing home elderly. Appetite, 2007; 48, 29-36.
62. Mathey MFAM, Siebelink E, de Graaf C, Van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 2001; 56(4), M200–205.
63. Nijs K, de Graaf C, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents. Cluster randomised controlled trial. BMJ: British Medical Journal. 2006; 332(7551), 1180–1183.
64. Dunne TE, Neargarder SA, Cipolloni PB, Cronin-Golomb A. Visual contrast enhances food and liquid intake in advanced Alzheimer’s disease. Clinical Nutrition. 2004; 23(4), 533–538.
65. Salas-Salvadó J, Torres M, Planas M, Altimir S, Pagan C, Gonzalez ME, et al. Effect of oral administration of a whole formula diet on nutritional and cognitive status in patients with Alzheimer’s disease. Clinical Nutrition. 2005; 24(3), 390–397.
66. Lassen AD, Poulsen S, Ernst L, Andersen KK, Biltoft-Jensen A, Tetens I. Evaluation of a digital method to assess evening meal intake in a free-living adult population. Food & Nutrition Research. 2010; 54(5311).
67. Martin CK, Han H, Coulon SM, Allen HR, Champagne CM, Anton SD. A novel method to remotely measure food intake of free-living individuals in real time. The remote food photography method. British Journal of Nutrition. 2009; 101(3), 446–456.

Most read articles by the same author(s)