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The journal of nutrition, health & aging

Published in:

01-06-2017

Validation of the photography method for nutritional intake assessment in hospitalized elderly subjects

Authors: Fiammetta Monacelli, M. Sartini, V. Bassoli, D. Becchetti, A. L. Biagini, A. Nencioni, M. Cea, R. Borghi, F. Torre, P. Odetti

Published in: The journal of nutrition, health & aging | Issue 6/2017

Abstract

Objective

The aim of the present study was to validate the photographic indirect method as an accurate and specific tool to assess nutritional intake in a cohort of elderly hospitalized patients.

Design

this is a prospective observational study.

Setting

hospital (geriatric acute ward and transitional care of IRCCSS AUO San Martino Hospital, Genoa, Italy).

Participants

255 consecutive elderly hospitalized patients. Measurements: assessment of malnutrition by: Mini nutritional assessment (MNA) and abbreviated Comprehensive geriatric assessment (CIRS; Barthel index, SPMSE). The direct method (Gold standard): food dish weight (before lunch) and residual (after lunch) food dish weight and estimation of the percentage of eaten food and of residual food for each dish. The percentages of food intake and residual food were calculated according to the following formula: intake %= initial weight of the dishes- residual food weight)/ initial weight dish x100. The unit of variable was the percentage. The indirect photographic method with extrapolation of the lunch food intake by photographic method confronting initial meal and residual meal (25% quartile food dish estimation).

Results

The results showed a significant correlation between the direct method (weighing residual food) and the indirect photographic method(n=255; r=0.9735; p<0.001) as well as a significant positive correlation between the indirect photographic method and the food caloric estimation calculated by the direct method (n=255; r= 0.6489, p<0.001). Intraclass coefficient (ICC), showed a highly significant degree of agreement between the gold standard and the indirect photographic method (ICC: 0.69; p<0.0001). Additionally, the results showed a good inter rater agreement of the indirect photographic method (kappa-statistic measure of interrater agreement: (Z=13.04; p<0.001); agreement 70.29% e Kappa=0.5965) and a good specificity of the indirect method as it was independent on the single food item.

Conclusions

The study originally provided the validation of the indirect photographic method for the assessment of nutritional intake in a vast cohort of hospitalized elderly subjects. The present results moved a step forward in the appropriate assessment of nutrition intake in frail elderly, providing an easy to use tool that may be incorporate in routine clinical practice for early and targeted therapeutic interventions.

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Title: Validation of the photography method for nutritional intake assessment in hospitalized elderly subjects
Authors: Fiammetta Monacelli
M. Sartini
V. Bassoli
D. Becchetti
A. L. Biagini
A. Nencioni
M. Cea
R. Borghi
F. Torre
P. Odetti
Publication date: 01-06-2017
Publisher: Springer Paris
Published in: The journal of nutrition, health & aging / Issue 6/2017
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-016-0814-y

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Validation of the photography method for nutritional intake assessment in hospitalized elderly subjects

Abstract

Objective

Design

Setting

Participants

Results

Conclusions

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Conclusions

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