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There are many constraints to conducting national food consumption surveys for national nutrition surveillance, including cost, time, and participant burden. Validated web-based dietary assessment technologies offer a potential solution to many of these constraints.
This study aims to investigate the feasibility of using a previously validated, web-based, 24-hour recall dietary assessment tool (Foodbook24) for nutrition surveillance by comparing the demographic characteristics and the quality of dietary intake data collected from a web-based cohort of participants in Ireland to those collected from the most recent Irish National Adult Nutrition Survey (NANS).
Irish adult participants (aged ≥18 years) were recruited to use Foodbook24 (a web-based tool) between March and October 2016. Demographic and dietary intake (assessed by means of 2 nonconsecutive, self-administered, 24-hour recalls) data were collected using Foodbook24. Following the completion of the study, the dietary intake data collected from the web-based study were statistically weighted to represent the age-gender distribution of intakes reported in the NANS (2008-2010) to facilitate the controlled comparison of intake data. The demographic characteristics of the survey respondents were investigated using descriptive statistics. The controlled comparison of weighted mean daily nutrient intake data collected from the Foodbook24 web-based study (329 plausible reporters of a total of 545 reporters) and the mean daily nutrient intake data collected from the NANS (1051 plausible reporters from 1500 reporters) was completed using the Wilcoxon–Mann-Whitney U test in Creme Nutrition software.
Differences between the demographic characteristics of the survey participants across the 2 surveys were observed. Notable differences included a lower proportion of adults aged ≥65 years and a higher proportion of females who participated in the web-based Foodbook24 study relative to the NANS study (
These findings suggest that by using targeted recruitment strategies in the future to ensure the recruitment of a more representative sample, there is potential for web-based methodologies such as Foodbook24 to be used for nutrition surveillance efforts in Ireland.
Dietary assessment is of paramount importance for the surveillance of public health [
Previous research on the use of web-based dietary assessment tools has demonstrated the feasibility of their use in terms of large-scale dietary intake data collection [
These criticisms are not unique to technology-based self-reported methods but are, in fact, unique to all self-report dietary assessment methodologies, including paper-based measures such as estimated food diaries and interviewer-administered 24HDRs [
National food consumption surveys are necessary to estimate dietary intake at the population level to provide an evidence base for developing and evaluating health policy and to investigate food safety risks, such as contaminant exposure [
The feasibility of a self-administered web-based platform to collect nationally representative data in Ireland has yet to be investigated. The collection of nationally representative consumption data incurs a large financial cost, with the most recent National Adult Nutrition Survey (NANS; 2008-2011) in Ireland, costing approximately €5 million (US $5.9 million) to coordinate and execute [
Foodbook24 is a self-administered web-based tool that was developed for an Irish adult population and consists of different components that facilitate the collection of dietary intake data without direct interaction with a researcher. The development, validity, and user acceptability of the Foodbook24 tool are described elsewhere [
In this regard, this study aims to investigate the feasibility of using a web-based dietary assessment tool for the purposes of nutrition surveillance in Ireland by (1) comparing the demographic characteristics of participants that sign up to use the web-based Foodbook24 tool relative to the most recent Irish NANS and (2) investigating the quality of dietary intake data collected via the web-based Foodbook24 tool relative to the most recent Irish NANS by means of a controlled comparison.
The Foodbook24 project was a collaborative research project between the University College Dublin and University College Cork with the aim of developing and validating a web-based dietary assessment tool for the Irish adult population. In brief, the design of the Foodbook24 tool was informed by guidelines issued on the collection of national food consumption data by the EFSA in 2009 [
The Foodbook24 study was conducted between March and October 2016. Participants were recruited via the Foodbook24 website, which was aided by advertising of the study in newspapers, posters, e-flyers, social media, and word of mouth. This study was conducted in accordance with the guidelines laid down in the Declaration of Helsinki 1983, and ethical approval was obtained from the University College Dublin Human Research Ethics Committee (LS 15-77 Gibney-Timon). A targeted recruitment strategy to ensure the recruitment of a nationally representative sample of Irish adults (as used in NANS) was not used in this study to allow for the investigation of the demographic characteristics of participants interested in taking part in a study using web-based methodologies. A total of 1385 participants were screened to participate in the web-based study via the Foodbook24 website, and 1095 participants provided demographic data. Participants were eligible to take part in the study if they were aged ≥18 years, fluent in both written and verbal English, had regular access to the internet, and agreed to the information collected as part of the study while ensuring their confidentiality, to be used for the purposes of food and health research. Once participants were screened and provided informed consent using the web-based tool, they had the choice to complete the demographics questionnaire and the first (of two) 24HDR immediately or they had the option to complete these at a later time. A series of email reminders were scheduled to remind participants to log in to the tool and complete the next required component of the tool (
Stages of the Foodbook24 tool in the web-based study. 24HDR: 24-hour dietary recall.
The NANS investigated habitual food and beverage consumption, lifestyle, health indicators, and attitudes toward food and health in a representative sample (n=1500) of adults aged 18 to 90 years recruited in the Republic of Ireland between 2008 and 2010 [
Food intake data collected from NANS were analyzed using WISP version 4.0 (Tinuviel Software). The food composition data linked to the NANS data set are derived from UK food composition tables [
The Henry equation was used to identify misreporters of energy intake (EI) in both surveys. Basal metabolic rate (BMR) was calculated using standard equations based on gender, weight, and age [
As there was a large difference in the final number and characteristics of reporters in both surveys, a weighted adjustment was applied to compare population nutrient and food intake recorded in both surveys. Sampling weights were applied to the Foodbook24 data to account for differential probabilities of participant characteristics and nonresponse, applying appropriate sampling weights based on age and gender [
Descriptive statistics (demographic data and evaluation questionnaire data) for both survey populations were computed and compared using a Chi-square analysis in SPSS (version 20). The dietary intake data recorded in both studies were averaged across days, creating mean daily food and nutrient intake, for analysis. The mean, SD, median, and IQR of each nutrient and food group were calculated using Crème Nutrition. The Wilcoxon–Mann-Whitney U test was used to compare the weighted Foodbook24 food and nutrient intake data against intake data recorded from the NANS.
A total of 1095 adult participants (766 females and 329 males) signed up to the Foodbook24 web-based study, and 1500 adult participants (740 males and 760 females) were recruited to complete the NANS. As evident from
Demographic characteristics of participants involved in the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Demographic | Foodbook24 web-based study total population (n=1095) | Foodbook24 web-based study completers (n=572) | Foodbook24 web-based study dropouts (n=523) | National Adult Nutrition Survey (n=1500) | |||||||||||
Age (years), range | 18-89 | —a | — | 18-90 | — | — | |||||||||
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.25 | <.001b | |||||||||||||
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18-35 | 501 (45.8) | 253 (44.2) | 248 (47.4) | 531 (35.4) |
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36-50 | 358 (32.7) | 187 (32.7) | 171 (33.7) | 436 (29.1) |
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51-64 | 200 (18.3) | 110 (17.7) | 90 (17.3) | 306 (20.4) |
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>65 | 36 (3.3) | 22 (3.9) | 14 (2.6) | 226 (15.1) |
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<.001c | <.001b | |||||||||||||
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Female | 766 (70) | 416 (73) | 350 (67) | 765 (51) |
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Male | 329 (30) | 156 (27) | 173 (33) | 735 (49) |
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.07 | <.001b | |||||||||||||
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Underweight (<18.5) | 28 (2.6) | 16 (2.8) | 12 (3.4) | 10 (0.7) |
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Normal weight (18.5-24.9) | 608 (55.5) | 300 (52.4) | 300 (57.4) | 492 (32.8) |
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Overweight (25-29.9) | 331 (30.2) | 184 (32.1) | 147 (28.1) | 532 (35.5) |
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Obese (>30) | 127 (11.6) | 69 (12.06) | 58 (11.1) | 318 (21.2) |
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.24 | <.001b | |||||||||||||
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Professional or manager or tech | 740 (67.6) | 392 (68.5) | 348 (66.4) | 670 (44.7) |
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Nonmanual skilled | 163 (14.9) | 83 (14.5) | 80 (15.3) | 267 (17.8) |
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Manual skilled | 22 (2.0) | 9 (1.5) | 13 (2.5) | 213 (14.2) |
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Semiskilled/unskilled | 131 (12.4) | 59 (10.0) | 72 (13.7) | 285 (19.0) |
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Retired/unemployed | 24 (2.1) | 13 (2.2) | 11 (1.75) | 64 (4.3) |
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.05c | <.001b | |||||||||||||
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Primary | 16 (1.5) | 15 (2.6) | 11 (2.1) | 139 (9.3) |
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Secondary | 188 (17.2) | 86 (15.0) | 102 (19.6) | 650 (43.3) |
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Tertiary | 890 (81.3) | 480 (84.0) | 410 (78.2) | 682 (45.5) |
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aNot available.
bSignificant difference in demographic information between the Foodbook24 and National Adult Nutrition Survey studies, as defined by Chi-square analysis.
cSignificant difference in demographic information between the Foodbook24 study completers and dropouts, as defined by Chi-square analysis.
dExcludes missing values.
Nutrient intake of adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Nutrient | Foodbook24, mean daily intakea (SD) | National Adult Nutrition Survey, mean daily intakeb (SD) | Difference (%) | |
Energy (kcal/day) | 2174.74 (521.63) | 2227.46 (623.56) | .37 | 2.42 |
Carbohydrate (g/day) | 246.98 (69.98) | 252.55 (76.64) | .61 | 2.25 |
Starch (g/day) | 140.53 (56.24) | 146.73 (46.95) | <.001c | 4.41 |
Total sugars (g/day) | 98.33 (35.6) | 101.11 (43.83) | .68 | 2.83 |
Dietary fiber (g/day) | 24.08 (10.72) | 20.67 (8.03) | <.001c | −14.17 |
Fat (g/day) | 88.35 (29.75) | 84.66 (28.62) | <.001c | −4.18 |
Monounsaturated fat (g/day) | 31.26 (11.2) | 30.97 (11.25) | .31 | −0.93 |
Polyunsaturated fat (g/day) | 14.2 (6.24) | 14.8 (6.67) | .16 | 4.2 |
Saturated fat (g/day) | 36.46 (15.47) | 33.35 (12.88) | <.001c | −8.53 |
Protein (g/day) | 85.71 (30.51) | 89.66 (26.43) | <.001c | 4.61 |
Percent energy (protein) | 15.83 (3.80) | 16.44 (3.41) | <.001c | 3.67 |
Percent energy (carbohydrate) | 43.17 (8.02) | 45.57 (7.29) | <.001c | 5.27 |
Percent energy (total sugars) | 15.37 (5.83) | 18.19 (6.17) | <.001c | 15.47 |
Percent energy (fat) | 36.52 (7.52) | 34.21 (6.30) | <.001c | −6.74 |
Percent energy (monounsaturated fat) | 13.07 (3.46) | 12.46 (2.67) | .20 | −4.93 |
Percent energy (polyunsaturated fat) | 6.11 (2.11) | 6.07 (2.29) | <.001c | −0.64 |
Percent energy (saturated fat) | 14.71 (4.40) | 13.44 (3.44) | <.001c | −9.41 |
Calcium (mg/10 MJ) | 1029.46 (356.17) | 1124.308 (438.46) | <.001c | 8.43 |
Carotene (µg/10 MJ) | 5185.62 (4799.66) | 4545.71 (3990.98) | .84 | −14.07 |
Copper (mg/10 MJ) | 1.42 (0.45) | 1.44 (1.83) | .05 | 1.71 |
Folate (µg/10 MJ) | 322.44 (125.82) | 434.35 (326.35) | <.001c | 25.76 |
Iron (mg/10 MJ) | 14.51 (4.07) | 17.21 (19.80) | .42 | 15.70 |
Magnesium (mg/10 MJ) | 363.79 (87.89) | 344.85 (100.62) | <.001c | −5.49 |
Potassium (mg/10 MJ) | 462.74 (357.46) | 593.44 (829.67) | .66 | 22.02 |
Retinol (µg/10 MJ) | 1.83 (0.66) | 3.76 (9.22) | <.001c | 51.40 |
Riboflavin (mg/10 MJ) | 2905.23 (940.71) | 2923.08 (642.762) | <.001c | 0.61 |
Sodium (mg/10 MJ) | 2.36 (6.19) | 3.57 (9.61) | .06 | 33.80 |
Vit B12 (µg/10 MJ) | 2.52 (0.90) | 4.74 (9.12) | <.01c | 46.76 |
Vitamin B6 (mg/10 MJ) | 136.64 (93.86) | 149.52 (289.00) | <.014c | 8.61 |
Vitamin C (mg/10 MJ) | 3.24 (2.73) | 5.51 (7.53) | <.001c | 41.24 |
Vitamin D (µg/10 MJ) | 13.09 (5.08) | 16.57 (35.40) | <.02c | 20.96 |
Vitamin E (mg/10 MJ) | 10.71 (3.24) | 12.25 (8.10) | <.001c | 12.53 |
aMean daily intake of energy and nutrients reported in the Foodbook24 web-based study.
bMean daily intake of energy and nutrients reported in the National Adult Nutrition Survey in Ireland.
cSignificant difference in the reporting of nutrient intake between the 2 dietary assessment surveys, as defined by the Wilcoxon–Mann-Whitney U test.
In
Nutrient intakes of female adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Nutrients | Foodbook24, mean daily intakea (SD) | National Adult Nutrition Survey, mean daily intakeb (SD) | Difference (%) | |
Energy (kcal/day) | 1899.20 (388.60) | 1891.82 (425.81) | .25 | −0.39 |
Energy (KJ/day) | 7946.26 (1625.93) | 7915.38 (1781.59) | .25 | −0.39 |
Carbohydrate (g/day) | 218.76 (57.31) | 218.39 (55.61) | .63 | −0.17 |
Total sugars (g/day) | 80.28 (33.29) | 90.28 (34.98) | <.001c | 11.08 |
Starch (g/day) | 118.32 (39.39) | 123.58 (34.09) | <.001c | 4.26 |
Protein (g/day) | 74.23 (21.75) | 75.89 (18.73) | .005c | 2.19 |
Fat (g/day) | 77.79 (23.54) | 73.24 (21.00) | .01c | −6.20 |
Monounsaturated fat (g/day) | 27.76 (8.95) | 26.56 (8.51) | .02 c | −4.49 |
Polyunsaturated fat (g/day) | 12.94 (4.80) | 13.52 (5.61) | .17 | 4.29 |
Saturated fat (g/day) | 31.64 (12.87) | 28.54 (9.58) | <.001c | −10.84 |
Percent energy (protein) | 15.71 (3.59) | 16.36 (3.31) | <.001c | 3.95 |
Percent energy (carbohydrate) | 43.34 (8.26) | 46.48 (6.57) | <.001c | 6.74 |
Percent energy (total sugars) | 15.95 (6.11) | 19.09 (5.89) | <.001c | 16.41 |
Percent energy (fat) | 36.67 (7.53) | 34.90 (6.06) | <.001c | −5.09 |
Percent energy (monounsaturated fat) | 13.15 (3.50) | 12.61 (2.60) | <.001c | −4.31 |
Percent energy (polyunsaturated fat) | 6.16 (2.05) | 6.45 (2.38) | .10 | 4.55 |
Percent energy (saturated fat) | 14.76 (4.35) | 13.61 (3.43) | <.001c | −8.48 |
Dietary fiber (g/day) | 22.42 (7.74) | 18.99 (7.12) | <.001c | −18.06 |
Calcium (mg/10 MJ) | 1039.28 (362.02) | 1200.53 (525.56) | <.001c | 13.43 |
Carotene (µg/10 MJ) | 5539.38 (5076.67) | 5345.24 (4511.80) | .63 | −3.63 |
Copper (mg/10 MJ) | 1.430 (0.43) | 1.58 (2.38) | .03c | 9.71 |
Folate (µg/10 MJ) | 322.27 (121.01) | 453.04 (339.78) | <.001c | 28.86 |
Iron (mg/10 MJ) | 14.49 (4.03) | 18.88 (25.06) | .25 | 23.23 |
Magnesium (mg/10 MJ) | 366.60 (83.52) | 358.21 (120.25) | <.001c | −2.34 |
Potassium (mg/10 MJ) | 3737.89 (882.44) | 3758.36 (988.83) | .34 | 0.54 |
Retinol (µg/10 MJ) | 460.97 (363.38) | 575.55 (566.87) | .30 | 19.91 |
Riboflavin (mg/10 MJ) | 1.81 (0.66) | 4.46 (11.85) | <.001c | 59.27 |
Sodium (mg/10 MJ) | 2891.48 (941.44) | 2915.64 (626.97) | .09 | 0.83 |
Vit B12 (µg/10 MJ) | 4.93 (3.07) | 10.46 (57.43) | <.001c | 52.90 |
Vitamin B6 (mg/10 MJ) | 2.46 (0.86) | 5.57 (11.99) | <.001c | 55.80 |
Vitamin C (mg/10 MJ) | 146.27 (96.64) | 186.36 (378.23) | <.001c | 21.51 |
Vitamin D (µg/10 MJ) | 3.21 (2.63) | 6.25 (7.56) | <.001c | 48.61 |
Vitamin E (mg/10 MJ) | 13.10 (4.85) | 20.13 (44.56) | <.001c | 34.92 |
aMean daily intake of energy and nutrients reported in the Foodbook24 web-based study.
bMean daily intake of energy and nutrients reported in the National Adult Nutrition Survey in Ireland.
cSignificant difference in the reporting of nutrient intake between the 2 dietary assessment surveys as defined by the Wilcoxon–Mann-Whitney U test.
Nutrient intakes of male adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Nutrients | Foodbook24, mean daily intakea (SD) | National Adult Nutrition Survey, mean daily intakeb (SD) | Difference (%) | |
Energy (kcal/day) | 2497.07 (398.62) | 2582.557 (602.03) | .10 | 3.31 |
Energy (KJ/day) | 10447.76 (1667.85) | 10805.42 (2518.92) | .10 | 3.31 |
Carbohydrate (g/day) | 282.79 (60.18) | 286.26 (80.02) | .67 | 1.21 |
Total sugars (g/day) | 90.55 (33.49) | 111.94 (49.12) | .04c | 19.11 |
Starch (g/day) | 168.40 (53.36) | 169.27 (46.99) | .48 | 0.52 |
Protein (g/day) | 101.28 (31.85) | 104.73 (27.72) | .02c | 3.30 |
Fat (g/day) | 100.49 (27.74) | 96.24 (30.50) | .04c | −4.41 |
Monounsaturated fat (g/day) | 35.79 (11.34) | 35.33 (11.89) | .22 | −1.29 |
Polyunsaturated fat (g/day) | 16.55 (7.15) | 16.33 (7.48) | .46 | −1.38 |
Saturated fat (g/day) | 40.56 (14.64) | 38.14 (13.94) | .01c | −6.36 |
Percent energy (protein) | 16.20 (4.35) | 16.52 (3.51) | <.001c | 1.92 |
Percent energy (carbohydrate) | 42.64 (7.26) | 44.66 (7.86) | <.001c | 4.53 |
Percent energy (total sugars) | 13.63 (4.47) | 17.28 (6.33) | <.001c | 21.11 |
Percent energy (fat) | 36.07 (7.51) | 33.53 (6.46) | <.001c | −7.58 |
Percent energy (monounsaturated fat) | 12.83 (3.32) | 12.30 (2.72) | <.001c | −4.29 |
Percent energy (polyunsaturated fat) | 5.95 (2.28) | 5.68 (2.13) | <.001c | −4.79 |
Percent energy (saturated fat) | 14.55 (4.59) | 13.28 (3.44) | <.001c | −9.62 |
Dietary fiber (g/day) | 26.63 (12.70) | 22.41 (8.79) | <.001c | −18.80 |
Calcium (mg/10 MJ) | 1000.01 (338.42) | 1047.35 (309.90) | .003c | 4.52 |
Carotene (µg/10 MJ) | 4124.35 (3677.76) | 3738.54 (3191.90) | .77 | −10.32 |
Copper (mg/10 MJ) | 1.40 (0.49) | 1.31 (0.99) | .04c | −6.96 |
Folate (µg/10 MJ) | 322.93 (140.06) | 415.48 (311.39) | <.001c | 22.28 |
Iron (mg/10 MJ) | 14.56 (4.19) | 15.53 (12.18) | .38 | 6.25 |
Magnesium (mg/10 MJ) | 355.36 (99.96) | 331.37 (73.51) | .28 | −7.24 |
Potassium (mg/10 MJ) | 3501.05 (799.94) | 3443.25 (669.11) | .33 | −1.68 |
Retinol (µg/10 MJ) | 468.03 (341.16) | 611.51 (1029.34) | .17 | 23.46 |
Riboflavin (mg/10 MJ) | 1.86 (0.69) | 3.05 (5.31) | <.001c | 39.13 |
Sodium (mg/10 MJ) | 2946.47 (943.10) | 2930.59 (658.83) | .57 | −0.54 |
Vit B12 (µg/10 MJ) | 4.98 (2.93) | 6.27 (6.57) | <.001c | 20.53 |
Vitamin B6 (mg/10 MJ) | 2.71 (0.99) | 3.91 (4.56) | <.001c | 30.55 |
Vitamin C (mg/10 MJ) | 107.75 (78.65) | 112.33 (144.26) | <.001c | 4.08 |
Vitamin D (µg/10 MJ) | 3.32 (3.01) | 4.77 (7.44) | .08 | 30.39 |
Vitamin E (mg/10 MJ) | 13.08 (5.73) | 12.97 (22.14) | <.001c | −0.82 |
aMean daily intake of energy and nutrients reported in the Foodbook24 web-based study.
bMean daily intake of energy and nutrients reported in the National Adult Nutrition Survey in Ireland.
cSignificant difference in the reporting of nutrient intake between the 2 dietary assessment surveys as defined by the Wilcoxon–Mann-Whitney U test.
Food group intakes (grams) of adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Food group | Foodbook24, mean (SD)a | Consumers, n (%)b | National Adult Nutrition Survey, mean (SD)c | Consumers, n (%)d | |||||||
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Other breads (eg, linseed bread) | 20.37 (35.65) | 128 (39.09) | 13.84 (26.9) | 374 (35.59) | .06 | |||||
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Other breakfast cereals (eg, porridge) | 85.64 (113.76) | 151 (45.76) | 40.72 (84.75) | 293 (27.88) | <.001e | |||||
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Rice and pasta, flours, grains, and starch | 54.27 (86.67) | 153 (46.67) | 34.95 (53.31) | 498 (47.38) | .23 | |||||
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Ready-to-eat breakfast cereals | 18.11 (28.49) | 135 (41.21) | 24.53 (30.53) | 646 (61.47) | <.001e | |||||
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White sliced bread and rolls | 15.49 (35.33) | 83 (25.15) | 55.64 (55.19) | 832 (79.16) | <.001e | |||||
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Wholemeal and brown bread and rolls | 61.6 (69.87) | 214 (65.15) | 56.23 (56.94) | 774 (73.64) | .90 | |||||
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Alcoholic beverages | 174.89 (334.14) | 126 (38.18) | 356.49 (620.15) | 638 (60.7) | <.001e | |||||
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Coffees | 187.85 (219.41) | 181 (55.15) | 124.85 (211.12) | 490 (46.62) | <.001e | |||||
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Teas | 424.99 (395.92) | 237 (72.12) | 465.96 (430.98) | 874 (83.16) | .13 | |||||
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Water | 682.87 (928.29) | 219 (66.67) | 536.84 (588.48) | 857 (81.54) | .72 | |||||
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Carbonated beverages | 25.27 (90.16) | 34 (10.3) | 84.44 (167.19) | 380 (36.16) | <.001e | |||||
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Diet carbonated beverages | 30.72 (126.05) | 27 (8.18) | 22.03 (81.75) | 127 (12.08) | .39 | |||||
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Cheeses | 12.47 (20.97) | 170 (51.82) | 15.06 (19.02) | 707 (67.27) | .27 | |||||
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Butter (over 80% fat) | 11.03 (15.02) | 184 (56.06) | 4.36 (10.61) | 396 (37.68) | <.001e | |||||
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Whole milk | 27.5 (89.88) | 56 (16.97) | 116.95 (181.83) | 669 (63.65) | <.001e | |||||
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Low-fat spreads (under 40% fat) | 2.14 (5.36) | 53 (16.06) | 4.47 (11.18) | 296 (28.16) | .01e | |||||
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Low-fat, skimmed, and fortified milks | 43.66 (121.78) | 91 (27.58) | 99.76 (151.47) | 526 (50.05) | <.001e | |||||
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Other milks and milk-based beverages | 12.53 (89.42) | 26 (7.88 | 16.08 (56.25) | 137 (13.04) | .10 | |||||
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Yogurts | 30.56 (57.81) | 121 (36.67) | 33.07 (52.22) | 447 (42.53) | .04 | |||||
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Bananas | 37.88 (50.93) | 145 (43.94) | 28.9 (42.62) | 485 (46.15) | .10 | |||||
|
Citrus fruits | 26.65 (71.24) | 87 (26.36) | 15.35 (42.56) | 213 (20.27) | .10 | |||||
|
Green vegetables | 13.61 (28.33) | 100 (30.3) | 13.89 (21.78) | 474 (45.1) | <.001e | |||||
|
Other fruits (berries, apples, etc) | 125.42 (126.42) | 247 (75.15) | 53.74 (78.34) | 609 (57.94) | <.001e | |||||
|
Other vegetables | 42.58 (50.17) | 224 (68.18) | 26.72 (32.17) | 745 (70.88) | <.001e | |||||
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Vegetable and pulse dishes | 29.21 (47.43) | 177 (53.94) | 20.56 (43.67) | 477 (45.39) | <.001e | |||||
|
Potatoes (boiled/baked/mashed) | 55.26 (92.45) | 128 (38.79) | 79.41 (80.51) | 801 (76.21) | <.001e | |||||
|
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Beef and veal | 15.01 (34.12) | 64 (19.39) | 19.41 (31.66) | 408 (38.82) | <.001e | |||||
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Beef and veal dishes | 24.65 (64.85) | 56 (16.97) | 35.03 (57.67) | 373 (35.49) | <.001e | |||||
|
Bacon and ham | 9.93 (24.78) | 92 (27.88) | 22.46 (25.58) | 797 (75.83) | <.001e | |||||
|
Chicken, turkey, and game | 33.41 (64.58) | 113 (34.24) | 28.76 (37.02) | 595 (56.52) | <.001e | |||||
|
Poultry and game dishes | 32.32 (98.08) | 73 (22.12) | 23.24 (48.99) | 274 (26.07) | .53 | |||||
|
Eggs and egg dishes | 33.51 (58.53) | 131 (39.7) | 17.62 (24.61) | 550 (52.33) | .91 | |||||
|
Fish and fish products | 27.39 (50.42) | 102 (30.91) | 24.98 (36.58) | 520 (49.48) | <.001e | |||||
|
Fish dishes | 7.35 (31.48) | 23 (6.97) | 4.59 (19.54) | 77 (7.33) | .83 | |||||
|
Lamb | 3.59 (17.43) | 11 (3.33) | 5.52 (16.47) | 143 (13.61) | .02e | |||||
|
Lamb, pork, and bacon dishes | 7.19 (30.62) | 30 (9.09) | 5.45 (25.96) | 72 (6.85) | .59 | |||||
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Meat products | 8.77 (29.4) | 41 (12.42) | 17.62 (29.16) | 479 (45.58) | <.001e | |||||
|
Pork | 5.36 (20.96) | 20 (6.06) | 6.64 (17.69) | 179 (17.03) | .01 e | |||||
|
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Cakes, pastries, and buns | 20.96 (36.35) | 128 (38.79) | 20.53 (32.24) | 510 (48.53) | .04e | |||||
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Biscuits, including crackers | 27.89 (44.23) | 218 (63.33) | 14.13 (20.38) | 675 (64.22) | <.001e | |||||
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Chocolate confectionery | 13.64 (20.55) | 166 (50.61) | 11.05 (16.74) | 554 (52.71) | .89 | |||||
|
Ice creams | 10.16 (22.75) | 74 (22.42) | 6.79 (15.72) | 260 (24.74) | .61 | |||||
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Nonchocolate confectionery | 5.04 (13) | 80 (24.24) | 3.94 (11.69) | 240 (22.84) | .91 | |||||
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Savory snacks | 5.27 (13.03) | 104 (31.52) | 6.73 (12.69) | 408 (38.82) | .008e | |||||
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Nuts and seeds; herbs and spices | 6.04 (13.24) | 139 (42.12) | 3.44 (10.3) | 263 (25.02) | <.001e | |||||
|
Soups, sauces, and miscellaneous foods | 47.48 (76.06) | 244 (74.24) | 60.75 (71.79) | 920 (87.54) | <.001e |
aMean daily intake of food groups in grams per day reported in the Foodbook24 web-based study.
bPercentage of participants who reported consuming the respective food group in the Foodbook24 web-based study.
cMean daily intake of food groups in grams per day reported in the National Adult Nutrition Survey in Ireland.
dPercentage of participants who reported consuming the respective food groups in the National Adult Nutrition Survey in Ireland.
eSignificant difference in the reporting of food group intake between the 2 dietary assessment surveys, as defined by the Wilcoxon–Mann-Whitney U test.
The main results of the participants’ evaluations (n=425) of Foodbook24 during the web-based study are depicted in
Participant acceptability of Foodbook24 in the web-based study (N=425).
Question posed to participant | Participant responses, n (%) | |
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||
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Changed a lot | 9 (2.1) |
|
Changed a little | 119 (28) |
|
No change at all | 297 (69.8) |
|
||
|
Too long | 42 (9.8) |
|
Okay | 327 (76.9) |
|
Short | 56 (13.1) |
|
||
|
Difficult | 13 (3) |
|
Okay | 127 (29.8) |
|
Easy/very easy | 285 (67.0) |
|
||
|
Difficult | 21 (4.9) |
|
Okay | 191 (44.9) |
|
Easy/very easy | 213 (50.1) |
|
||
|
1 week | 38 (8.9) |
|
1 month | 153 (36.0) |
|
6 months | 200 (47.1) |
|
No | 34 (8.0) |
This study addressed the potential of a web-based tool to collect meaningful dietary intake data at a national level by comparing the demographic characteristics and a controlled comparison of dietary intakes between adult participants in the Foodbook24 web-based study and a nationally representative sample of the Irish population NANS study. Overall, our findings suggest key differences in demographic characteristics between survey respondents; however, similar ranges of nutrient and food group data were observed across both studies.
The successful recruitment and retention of participants in research studies is essential for optimizing validity [
It is possible that the demographic characteristic differences observed between the web-based Foodbook24 study and the NANS study are large because of the recruitment efforts undertaken in both studies rather than methods by which the surveys were presented and delivered. For the web-based study, targeted recruitment efforts to ensure the recruitment of a nationally representative sample were not undertaken. This allowed for the investigation of the rate and route of recruitment and characteristics of responders to be examined; that is, were older adults signing up to use Foodbook24 without being directly asked to do so? The findings of this research demonstrate that most participants were female with a higher level of education, suggesting that targeted recruitment strategies are needed when recruiting online nutrition studies and surveys if representative samples are to be achieved.
In contrast, the NANS study employed a multistage, stratified recruitment strategy, and although it was costly, this resulted in the successful recruitment of a sample representative of the Irish adult population. To achieve higher participation rates in web-based nutrition surveillance efforts using Foodbook24 in the future, the use of vast, recurrent multimedia campaigns (television, radio, national/regional newspapers, and billboards) should be considered. This recruitment strategy was employed in the NutriNet Sante study, wherein more than 50,000 participants were successfully recruited to web-based nutrition research [
Participants’ evaluation of Foodbook24 in the web-based study highlighted a willingness to use the tool on a long-term basis (
The results of the web-based Foodbook24 study compared with the NANS study showed significant differences with respect to the demographic characteristics of the populations recruited. A primary challenge for researchers employing web-based self-report surveys is the ability to engage target populations in the survey, as the method heavily relies on self-selection (referring to when survey participants are allowed to decide whether or not they want to participate in a survey) [
There was a significantly lower proportion of older adult participants in the web-based Foodbook24 survey compared with the NANS, although the range of ages of the participants in both studies was very similar, which suggests the potential for the use of Foodbook24 in this population. Ward et al [
Gender is an important determinant of health-risk and health-promoting behaviors [
In the Foodbook24 web-based study, a higher proportion (608/1095, 55.52%) of participants reported a BMI within the normal BMI category (18.5-24.9) compared with 32.8% (492/1500) in the NANS study and a lower proportion (127/1095, 11.59%) with obesity compared with 21.2% (318/1500) in the NANS. Web-based anthropometric measurements were self-reported compared with measurements taken by trained researchers in NANS; however, research has shown that self-reported anthropometric data can be reliable when validated against in-person measures [
Although both web-based and interviewer-administered dietary assessment tools are prone to similar measurement errors and correlated person-specific biases [
In this study, the discrepancies observed between intakes from both NANS and the web-based study may be because of different time points of data collection and the changes in food consumption trends between those time points; however, it is important to consider the impact of the different dietary assessment methodologies on nutrient and food group data from both surveys. It is also possible that by presenting the participant with a limited food and beverage list in the Foodbook24 tool compared with open-ended entry options as per the food diary method may also explain some of the discrepancies observed. Future development research to address this potential issue is currently underway. De Keyzer et al [
The data collected from the web-based study compared with the NANS study clearly highlight the potential of Foodbook24 for the rapid identification of food trends over time if used in a rolling data collection capacity. Higher consumption rates of coffee, pulses, and exotic fruits and lower consumption of food items such as white bread and ready-to-eat breakfast cereals were observed in the web-based data compared with NANS. Alcoholic beverages were reported as consumed less frequently in the web-based study compared with NANS, which is likely because of the fact that alcoholic beverages are more frequently consumed on weekend days [
Estimating the usual intake of episodically consumed foods based on a limited number of 24HDRs per participant can be challenging for their use in national consumption surveys [
This study acknowledges the limitations to this analysis, as it was performed using dietary intake data collected using 2 different methodologies (2×nonconsecutive 24-hour recalls vs 4-day semiweighed food diary) at 2 different time points (5 years apart; the Irish NANS was completed in 2011 and the web-based Foodbook24 study was completed in 2016) and in separate adult cohorts (a random adult sample population vs a representative adult population). As such, the differences observed in this analysis may be because of differences in the education, BMI, and social classes of participants involved in the 2 studies, making it inherently difficult to compare. However, a number of efforts have been made to address these limitations, including (1) completing a controlled comparison of dietary intakes by applying sampling weights to the Foodbook24 data to account for differential probabilities of participant characteristics and nonresponse (based on age and gender), and (2) coding and analyzing the data from both cohorts by using the same food grouping structure and compositional food tables to explore the potential of using a web-based platform to collect dietary intake data of a similar quality relative to data collected using a pen- and paper-based dietary assessment method in Ireland.
As it stands, open-source web-based surveys delivered via Foodbook24 do not result in the collection of dietary intake data from a representative sample of the Irish adult population. Although web-based methodologies offer standardized collection and analysis of data, the use of these tools to collect data from representative samples of populations is challenging. Future investigations of the comparison of methodologies should also control for factors such as social class or education, as the findings from this analysis demonstrate that responders with lower socioeconomic status and education were not proportionally represented in the web-based study sample. Although further work is warranted, a carefully designed recruitment strategy for the use of Foodbook24 in national nutrition surveys, especially considering population groups that may require extra support and training, has the potential to exceed the recruitment rates of previous national surveys. Platform adaptations, such as the collection of brand-level data and adapted approaches for groups such as older adults and infants, need to be considered for the collection of nationally representative food consumption information. This research demonstrates the capability of Foodbook24 to collect acceptable food and nutrient intake data from large survey populations. These findings support the use of Foodbook24 as a semicontinuous monitoring system in Ireland that would provide a cost-effective platform to collect valuable information to regularly evaluate the dietary intake of the general Irish adult population. This would allow for the rapid identification of food trends and for the development and monitoring of effective policies on nutrition and food safety in the future.
Nutrient intakes of adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Nutrient intakes of female adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Nutrient intakes of male adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
Food group intakes (grams) of adequate reporters from the Foodbook24 web-based study (2016) and the National Adult Nutrition Survey (2011).
24-hour dietary recall
Automated Self-Administered 24 hours
basal metabolic rate
European Food Safety Authority
energy intake
food choice questionnaire
food frequency questionnaire
National Adult Nutrition Survey
National Diet and Nutrition Survey
The project is funded by the Irish Department of Agriculture, Food, and Marine under the Diet Ireland Project 13F424. The authors wish to acknowledge each participant who participated in the study. In addition, the authors would also like to acknowledge Creme Global for developing the software for Foodbook24 and for permitting the use of Creme Food software for the analysis described in this study.
CT, EG, JW, and AF conceived and designed the experiments. CT analyzed the data and wrote the initial draft of this manuscript. All authors have been involved in the overall development of Foodbook24. All authors contributed to the writing of this manuscript and read and approved the final manuscript.
None declared.