Data-driven integration of emerging technologies to generate a Standardised and Objective Dietary Intake Assessment Tool

Lead Research Organisation: Aberystwyth University
Department Name: IBERS

Abstract

Nutrition surveys aim to understand how usual diets impact health. The problem with this is that we don't have an accurate tool to assess diet. We rely on people telling us what they have eaten in the last day or month. However, it is difficult to remember what and how much we have eaten. The surveys used also struggle to capture the range of diets in the UK. Often, people we want to talk to about their diets find these methods unsuitable.

There are lots of emerging ways in which we can assess diet. We can use urine and finger-prick blood samples to test for 'markers' of food and drinks. The benefit of these is that they give us objective data. We can also use wearable cameras to assess foods and diets. Artificial intelligence software is used to determine the type and amount of food eaten. Additionally, new online tools are making it easier for us to self-report. However, no single tool can accurately measure all aspects of the diet.

The aim of this project is to develop a combined tool to accurately assess diet. To do so, we will determine the optimal combination(s) of these emerging methods. The final tool will be easy-to-use and low cost. The combined tool will capture all aspects of the diet.

This project involves four expert teams. Our expertise spans each of the emerging tools. This includes nutrition studies, bio-sampling, chemical analysis, wearable camera technology and web-based diet assessment. First, we will assess the performance of each tool in a small group of people (~ 30). Volunteers will attend a clinical unit 2 times for 4 days to eat standard meals. The meals will represent foods eaten in the UK. Blood, urine, self-reported diet, and food images will be captured. This trial will guide the running of a longer remote trial. The larger trial will involve around 120 people and test habitual diet. We will validate the use of the tools in a home setting. The data will then be analysed to identify which food components are measured accurately by each different tool. This will enable us to determine the optimal combination of measurement techniques to enable comprehesive coverage of the UK diet. We will test use of the combined tool in a final remote trial. This study will involve people often excluded from research. For example, we will engage people from disadvantaged backgrounds and minority ethnic groups. This will help us ensure the tool is not only accurate but suitable for the wider UK population.

Throughout the project, we will talk to members of the public to ensure the trials are easy to follow. To ensure uptake of the combined tool, we will hold workshops with key stakeholders. This will include representatives of the nutrition research community and government departments.

Technical Summary

The reliable and objective assessment of habitual diet is a major challenge in nutrition research. New technologies are emerging, but unlikely to solve this problem independently. Metabolites derived from food, found in either urine or blood offer objective 'biomarkers' of dietary intake. Similarly, the analysis of images derived from wearable cameras can discern much about eating behaviour. Our overall aim is to evaluate the optimal combination(s) of measurements provided by these emerging technologies to monitor accurately habitual dietary intake in real-life settings.

In a controlled food intervention, we will first calibrate the ability of each technology to monitor exposure to a comprehensive range of foods commonly consumed in the UK. First morning void urine samples collected using vacuum tube technology and capillary blood samples obtained using the OneDraw Blood Collection device will be analysed using already standardised quantitative LC-MS/MS methods to measure the concentration of more than 80 dietary intake and nutritional status biomarkers. Images from unobtrusive cameras will be analysed using deep learning semantic segmentation and AI methods to predict dietary intake.

A second study with 'rolling' recruitment will validate how each diet assessment tool can be deployed unsupervised to assess habitual diet remotely in a larger, free-living population. The subsequent data will be modelled using machine learning to determine the optimal combination of diet assessment tools to assess habitual eating behaviour.

The acceptability and performance of a minimal, low burden novel integrated tool will then be tested both in free-living individuals generally representative of the UK population and in 'hard to engage/low compliance' demographic groups. Throughout the programme we will consult with PPI groups and stakeholders to ensure that the new technology is perceived as highly acceptable, easy to use and cost effective.

Publications

10 25 50
 
Description 1-year PhD scholarship from Georgian International Education to support the SoDIAT Study 1 and extend the application of the methodology to the Georgian population
Amount £0 (GBP)
Funding ID LEPL International Education Center of Georgia 
Organisation University of Reading 
Sector Academic/University
Country United Kingdom
Start 01/2024 
End 01/2025
 
Description Fruit and Vegetable consumption level biomarker discovery 
Organisation Queen's University Belfast
Department School of Medicine, Dentistry and Biomedical Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Used metabolomics methods to discover potential biomarkers of Total Fruit and Vegetable Exposure level in urine. My team helped to design the urine sampling method and experimental statistical design. Trained a visiting Post doc in metabolomics methods
Collaborator Contribution Undertook a Fruit and Vegetable dietary intervention as part of an MRC grant. Collected dietary exposure data and specifically timed urine samples.
Impact Potential biomarkers are currently under structural analysis. Collaboration is multidisciplinary linking Nutrition Research in Belfast with Metabolomics and Machine Learning in Aberystwyth
Start Year 2014
 
Description Fruit and Vegetable consumption level biomarker discovery 
Organisation Queen's University Belfast
Department School of Medicine, Dentistry and Biomedical Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Used metabolomics methods to discover potential biomarkers of Total Fruit and Vegetable Exposure level in urine. My team helped to design the urine sampling method and experimental statistical design. Trained a visiting Post doc in metabolomics methods
Collaborator Contribution Undertook a Fruit and Vegetable dietary intervention as part of an MRC grant. Collected dietary exposure data and specifically timed urine samples.
Impact Potential biomarkers are currently under structural analysis. Collaboration is multidisciplinary linking Nutrition Research in Belfast with Metabolomics and Machine Learning in Aberystwyth
Start Year 2014
 
Description Standardised MRM tests for dietary exposure biomarker quantification 
Organisation University of Barcelona
Department Faculty of Pharmacy
Country Spain 
Sector Academic/University 
PI Contribution Identified Meat and Fish biomarkers and quantification methods
Collaborator Contribution Identified Fruit and Veg Biomarkers and quantification methods
Impact We have joined a EIT-Health consortium (Cook 2 Health) which funds our collaboration
Start Year 2015
 
Description Undernutrition monitoring in older people 
Organisation University of Southampton
Department Faculty of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution We have worked in an NHIR pilot project STREAM to integrate spot urine and dried blood spot collection protocols to test the acceptibility and technical quality of the use of biofluides to monitor eating behaviour
Collaborator Contribution Partners have modifed clinical trial protocols, ethics and logistics to integrate biofluid sampling into protocol. Specifically STREAM has purchased urine collection kits and taken dried blood spot kits and develop procedures to interact with primary care centres to get GPs to recruit poitentially undernourished patients willing to collect samples and send back to analytical lab in Aberystwyth for future biomarker analysis
Impact UKRI grant applications currently in preparation
Start Year 2016
 
Title Clinical Trial registration ISRCTN13562899 
Description A dual-site dietary intervention study to integrate dietary assessment methods Diet has a huge impact on the health and well-being of individuals and is a major contributor to the development of a range of chronic health conditions, such as diabetes, cardiovascular diseases, and many cancers. Many countries are facing rising levels of obesity and diet-related disease due to changes in dietary choices and eating behaviour, as well as more sedentary lifestyles. The robustness and impact of strategies aimed at addressing nutrition-related problems are consistently undermined by misreporting of dietary intake caused by our lack of an accurate tool to assess and monitor dietary intakes. Self-reporting tools used traditionally to capture information about diet include Food Frequency Questionnaires (FFQs), 24-hour dietary recalls and food diaries. These tools struggle to categorise and represent accurately dietary intake and often involve costly expert researcher support, a substantial burden to study/survey participants and are subject to poor compliance, dietary change, and significant reporting bias. To improve dietary reporting, the researchers will bring together three additional technologies which have shown promise in improving accurate reporting of dietary intake. These are urine biomarkers, capillary blood biomarkers and wearable micro cameras. The overall aim of this study is to improve the accuracy of dietary reporting by combining all these tools. 
Type Preventative Intervention - Physical/Biological risk modification
Current Stage Of Development Refinement. Non-clinical
Year Development Stage Completed 2024
Development Status Under active development/distribution
Impact Trial in progress 
URL https://www.isrctn.com/ISRCTN13562899?q=sodiat&filters=&sort=&offset=1&totalResults=1&page=1&pageSiz...
 
Description 6th Annual Food and Nutritional Sciences PhD Research Symposium (University of Reading). Eka Bobokhidze 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Department made aware of new dietary assessment technologies being trialled, may lead to collaborations. Also the PhD student gained experience in presenting to an academic audience.
Year(s) Of Engagement Activity 2023
 
Description British Nutrition Society Annual Day. "Diet and Cardiovascular Health - 'One for all and all for one". Royal College of Physicians, London, UK. Julie Lovegrove 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Invited presentation for award of the British Nutrition Foundation Prize
interest in collaboration and further invitation for scientific presentations, also large dissemination of the ambitions of past and current studies
Year(s) Of Engagement Activity 2023
 
Description Conference Poster International Sarcopenia Translational Research Conference, Newcastle, 5 & 6th October 2023 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Conference Poster
International Sarcopenia Translational Research Conference, Newcastle, 5 & 6th October 2023
sparked questions and discussion afterwards
Year(s) Of Engagement Activity 2023
URL https://conferences.ncl.ac.uk/istrc20/
 
Description Conference Talks- Rural Health and Care Wales Conference, 15th November 2023 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Approaches to screening for frailty and nutritional status in community dwelling older adults
sparked questions and discussion afterwards
Year(s) Of Engagement Activity 2023
URL https://ruralhealthandcare.wales/rhcw-events/cynhadledd-iechyd-a-gofal-gwledig-cymru-2023-rural-heal...
 
Description Consumer Lab: building academic industry partnerships to ensure sustained acceptance of healthy foods: Advisory Panel 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The panel met on 01/03/2023 to decide the remit of the BBSRC Diet and Health Open Innovation Research Club (OIRC) - Consumer Lab. It was an interesting meeting bringing together a group of Psychologists interested in modifying human eating behaviour with the MRC team planning to use biomarker technology and passive microcameras to monitor diatary intake in community settings.
Year(s) Of Engagement Activity 2023
 
Description Food Innovation event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact Attendance at the Food Innovation event 8-9th Feb 2024, 4 pitch presentations and 4 networking cards displayed
Year(s) Of Engagement Activity 2024
URL https://web-eur.cvent.com/event/63f1b26a-6a6b-42ea-91c4-f6012646be21/summary
 
Description Invited Roundtable Participation What is the evidence base and plausible biological mechanisms for health impacts of ultra-processed foods? - UK Government Office for Science 20th, November 2023 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Invited Roundtable Participation
What is the evidence base and plausible biological mechanisms for health impacts of ultra-processed foods? - UK Government Office for Science 20th, November 2023
Year(s) Of Engagement Activity 2023
 
Description Invited talk. International Symposium on Cardiovascular Metabolomics - Yenepoya (Deemed to be University), Mangalore 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invited Talk

International Symposium on Cardiovascular Metabolomics - Yenepoya (Deemed to be University), Mangalore. 19th May 2023
University increased interest in related subject areas
Year(s) Of Engagement Activity 2023
 
Description PhaNuSpo Symposium. "Dietary Fats and CVD risk- Dispelling the Myths". University of Vienna, Austria 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invited presentation to Department in Nutrition in University of Vienna. Collaborative links were initiated.
interest in collaboration and further invitation for scientific presentations.
Year(s) Of Engagement Activity 2024
 
Description Rural Health and Care Conference 8th-9th November 2022 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other audiences
Results and Impact SMART Recovery is an Aberystwyth University led Welsh government funded project that
is supporting businesses in the development of innovative and 'functional foods' to promote
recovery from the effects of the pandemic and stimulate growth through the creation of new
opportunities. Additionally, there is a need both now, and in the long-term, to help Wales
manage non-communicable diseases, chronic conditions and improve recovery from long-term
systemic inflammatory conditions (e.g., pre-diabetes and long-covid). A major factor of this
strategy will be diet, with emphasis shifting to healthier diets to increase the health benefits of
foods, alongside basic nutrition.
With representatives of the Welsh Food and Drink industry, Aberystwyth University
researchers and Innovation Strategy, SMART Recovery is developing a framework to assist in
the development and exploitation of health enhancing Food and Drink.
Year(s) Of Engagement Activity 2022
 
Description University College London Seminar. "Dietary Fats and CVD risk". London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Invited presentation to UCL Seminar
Further invitation for scientific presentations.
Year(s) Of Engagement Activity 2024