To develop and validate a photographic food atlas of common
foods for dietary assessment in southern Nepal.
We created a life-sized photographic atlas of 40 locally
prepared foods. Between March and June 2014, data collectors weighed
portion sizes that respondents consumed during one mealtime and then a
different data collector revisited the household the next day to record
respondents’ estimations of their previous day’s intakes using the
atlas. Validity was assessed by percentage error, Cohen’s weighted
kappa, and Bland–Altman limits of agreement.
Dhanusha and Mahottari districts in southern Nepal.
A random sample of 95 adults in 48 rural households with a pregnant woman.
Overall, respondents underestimated their intakes (mean error
=−4·5 %). Rice and dal (spiced lentil soup) intakes were underestimated
(−14·1 % and −34·5 %, respectively), but vegetable curry intake was
overestimated (+20·8 %). Rice and vegetable curry portion size images
were significantly reliably selected (Cohen’s weighted kappa (se):
rice=0·391 (0·105); vegetable curry=0·430 (0·139)), whereas dal images
were not. Energy intake over one mealtime was under-reported by an
average of 569 kJ (136 kcal; 4·5 % error) using recall compared with the
The photographic atlas is a useful tool for field
estimation of dietary intake. Average errors were low, and there was
‘modest’ agreement between weighed and recalled portion size image
selection of rice and vegetable curry food items. Error in energy
estimation was low but with wide limits of agreement, suggesting that
there is scope for future work to reduce error further.
Harris-Fry, H.; Paudel, P.; Karn, M.; Mishra, N.; Thakur, J.; Paudel, V.; Harrisson, T.; Shrestha, B.; Manandhar, D.S.; Costello, A.; Cortina-Borja, M.; Saville, N. Development and validation of a photographic food atlas for portion size assessment in the southern plains of Nepal. Public Health Nutrition (2016) : 1-13. [DOI: 10.1017/S1368980016000537]
Development and validation of a photographic food atlas for portion size assessment in the southern plains of Nepal