Korean Journal of Community Nutrition

Research Article

[English]
Validity of Estimating Sodium Intake using a Mobile Phone Application of 24-hour Dietary Recall with Meal Photos: Seo-Yoon Kim, Sang-Jin Chung; Korean J Community Nutr 2020;25(4):317-328. Published online August 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.4.317

Objective
The objective of this study was to verify the validity of a mobile phone application (app) that applies a 24-hour dietary recall with meal photos, as a means of being a more accurate method of estimating dietary sodium intake.
Methods
Of the 203 subjects enrolled, 172 subjects (84 males and 88 females) were selected for the final analysis, excluding those with an intake less than 500 kcal and urine output less than 500 ml. Dietary sodium assessment methods used for comparing with the 24-hour urinary sodium excretion are as follows: 1) face-to-face 24-hour dietary recall, 2) 24-hour dietary recall using the mobile app, 3) face-to-face 24-hour dietary recall considering liquid intakes from soup, stew, water kimchi and noodle, etc (liquid-based dishes), 4) 24-hour dietary recall using the mobile app considering liquid intakes from liquid-based dishes, and 5) food frequency questionnaire. Repeated ANOVA with Bonferroni method was used for comparing the average sodium intake, and Pearson’s correlation was applied to correlate the methods used.
Results
In women, no significant difference was observed in the average sodium intake between all methods. Moreover, analysis in men and total adults revealed no significant difference between the 24-hour urinary sodium secretion, and 24-hour dietary recall using the app and 24-hour dietary recall using the app considering liquid intakes. Sodium intake by food frequency questionnaire was significantly different when compared with the intake determined from 24-hour urinary sodium excretion. Sodium intake from all methods (except food frequency questionnaire) significantly correlated with values obtained from 24-hour urine sodium excretion.
Conclusions
Results of this study validated a mobile phone app using a 24-hour dietary recall with meal photos to better estimate dietary sodium intakes. It is believed that further studies in the future will enable the application as a tool to more accurately determine sodium intake.

Citations

Citations to this article as recorded by

Dietary Sodium and Fluid Restriction for Patients with Heart Failure
Eloisa Colin-Ramirez, Amitai Segev, Meghan Rozmahel, Justin Ezekowitz
Current Treatment Options in Cardiovascular Medicine.2024; 26(12): 347. CrossRef
Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults
Taisun Hyun, Mi-Kyeong Choi, Young-Ran Heo, Heekyong Ro, Young-Hee Han, Yeon-Kyung Lee
Nutrition Research and Practice.2023; 17(2): 284. CrossRef
Validity of Interviewer-Administered 24-h Dietary Recalls in Older Korean Women: A Pilot Study
Seunghee Kim, Clara Y. Park
Nutrients.2023; 15(7): 1757. CrossRef

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Validation Studies

[English]
Development and Evaluation of Validity of Dish Frequency Questionnaire (DFQ) and Short DFQ Using Na Index for Estimation of Habitual Sodium Intake: Sook Mee Son, Gwui Yeop Huh, Hong Sup Lee; Korean J Community Nutr 2005;10(5):677-692. Published online October 31, 2005

Abstract PDF: The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed 65% agreement to be classified into the same quartile and showed significant correlation (r = 0.563 p < 0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9 mg, female: 6127.6 mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9 mg, female: 5107.4 mg). The sodium intake estimated with DFQ55 (male: 4848.5 mg, female: 4884.3 mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed 39~50% agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was 62.5%, 81.8% and 53.2%, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were 73.8%, 84.0%, 62.0%, respectively. It seems the short DFQs using Na index14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.

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