A group of researchers is trying to fix one of the most significant shortcomings of dietary research: the reliance on memory in determining what, and how much, food or drink subjects have consumed.

Scientists at the University of Massachusetts Medical School say they have received a $1 million grant from the National Science Foundation to develop a system that can improve intake accuracy. The plan is to use Google Glass -- a head-mounted display that can take pictures, videos, and do many of the things that smartphones can -- to record what participants eat and then upload the data to the digital cloud, where researchers can then access it.

The project, known as Flexware, will be pilot tested in a clinical trial to see if it will be more accurate than current methods to measure caloric intake in obese patients, said principal investigator Yunsheng Ma, PhD, at the University of Massachusetts in an email. He added that the total trial length will be 5 weeks; for the first half, the participants won't use Google Glass but will rely on the common method of 24-hour diet recall. During the second half, participants will use the system, and the two results will be compared.

Most diet researchers rely on participants recalling what they ate and recording it in a diet notebook or responding to a food frequency questionnaire. Much of the data that underlie the formulation of the 2015 dietary guidelines relied on these memory-based methods, but it can be unreliable, MedPage Today reported last year. Sometimes, the research is so inaccurate that a majority of men and women reported an energy intake that was not plausible given their physiology, according to the story.

That story from MedPage Today was "part of the motivation for this project," wrote Ma. "We are testing to see if using the Google Glass is an acceptable, feasible, and more accurate method to document food intake as compared to traditional food diary tracking."

The Need For Better Research

Dietary research has been under the spotlight recently because of the new and controversial dietary guidelines. Just this month, two popular media outlets, Voxand FiveThirtyEight, have run stories about the significant shortcomings of dietary research, and about recall surveys in particular. In addition to the problem of unreliable memories, there's also the possibility of underreporting consumption of stigmatized products.

A recent study found that soda intake was associated with slightly more fat around the belly. But it relied on food frequency questionnaires for intake of sugar-sweetened beverages (SSBs), and the authors cited a 1999 study in which there was a correlation coefficient between the food frequency questionnaire and dietary record of 0.51 for SSBs and 0.66 for diet soda, which uses artificial sweeteners.

That's a "fairly good correlation, but there's quite a lot of variation in that number," said Rebecca Goldin, PhD, the director of STATS.org, in an interview.

"Interpreting how high a coefficient would need to be to be clinically meaningful depends on the things being correlated," added Perry Wilson, MD, at the Yale University School of Medicine, in an email. "For [food frequency questionnaires], I think the performance for SSBs can be characterized as poor to moderate.

"Alternative methods to get a sense of what people consume would be most welcome," Wilson wrote.

Flexware

With the new program, participants would push a button to record video and audio that can "enhance the estimates" of what they ate, said Ma. He said he's working with three computer scientists to develop the system. Ideally, the recorded video and audio files will be automatically uploaded to the cloud, an Internet-based storage that is accessible remotely, when the device is connected to WiFi.

"We are doing this research because people often have difficulty recording what they eat, the portion size and where they eat," said Ma in a press release. "Accurate estimation of dietary intake, especially caloric intake, is important for assessing the effectiveness of weight loss interventions."

There's still a lot of work that needs to go in to Flexware before it is ready to systematically store and transfer large quantities of data. In addition, Ma added that there are concerns over cybersecurity, "a new frontier," as they will be transferring sensitive health-related data over the Internet. They plan to blur the human body in the video after the participant records the food and uploads it.

"It has become popular for individuals to take photos of meals and post to Facebook, Instagram and Snapchat or text photos to others," said Ma. "This study has the potential for significant breakthroughs for the development of mobile cloud dietary assessment, which can lead to increased awareness of intake and subsequent change that can address weight-related conditions such as diabetes."

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