Photo-Assisted Recall Increases Estimates of Energy and Macronutrient Intake in Adults with Intellectual and Developmental Disabilities

Diet assessment of adults with intellectual and developmental disabilities is challenging because of their limited cognitive abilities. The objective of this study was to examine the feasibility and outcomes of combining photos with 24-hour dietary recalls for the assessment of energy and macronutrient intakes in adults with intellectual and developmental disabilities. Participants used an iPad 2 tablet computer (Apple) to take photos of all food and beverages consumed before a standard, multiple-pass, 24-hour dietary recall. After the standard 24-hour diet recall, the photos were reviewed with the participant for clarification details (eg, portion size) and differences were recorded. The standard 24-hour recall and photo-assisted recall were entered separately into the Nutrition Data System for Research for computerized dietary analysis. Sixty-four eating occasions were entered from 23 participants (48% female; mean age 26.4±9.7 years). Participants captured photos for 66.5%±30.4% of all recorded eating occasions. Greater energy intake per eating occasion was reported with the photo-assisted recalls than the standard recalls (625.6±85.7 kcal vs 497.2±86.6 kcal; P=0.002) and a greater intake of grams of fat (P=0.006), protein (P=0.029), and carbohydrates (P=0.003). Photo-assisted 24-hour recalls provided a significant increase in total calories and macronutrient content compared with a standard 24-hour recall and may be a feasible method to enhance dietary assessment in adults with intellectual and developmental disabilities.