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Understanding and intervening on eating behavior often necessitates measurement of energy intake (EI); however, commonly utilized and widely accepted methods vary in accuracy and place significant burden on users (e.g., food diaries), or are costly to implement (e.g., doubly labeled water). Thus, researchers have sought to leverage inexpensive and low-burden technologies such as wearable sensors for EI estimation. Paradoxically, one such methodology that estimates EI via smartwatch-based bite counting has demonstrated high accuracy in laboratory and free-living studies, despite only measuring the amount, not the composition, of food consumed. This secondary analysis sought to further explore this phenomenon by evaluating the degree to which EI can be explained by a sensor-based estimate of the amount consumed versus the energy density (ED) of the food consumed. Data were collected from 82 adults in free-living conditions (51.2% female, 31.7% racial and/or ethnic minority; Mage = 33.5, SD = 14.7) who wore a bite counter device on their wrist and used smartphone app to implement the Remote Food Photography Method (RFPM) to assess EI and ED for two weeks. Bite-based estimates of EI were generated via a previously validated algorithm. At a per-meal level, linear mixed effect models indicated that bite-based EI estimates accounted for 23.4% of the variance in RFPM-measured EI, while ED and presence of a beverage accounted for only 0.2% and 0.1% of the variance, respectively. For full days of intake, bite-based EI estimates and ED accounted for 41.5% and 0.2% of the variance, respectively. These results help to explain the viability of sensor-based EI estimation even in the absence of information about dietary composition.
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Etnicidade , Grupos Minoritários , Adulto , Humanos , Feminino , Masculino , Dieta , Ingestão de Energia , RefeiçõesRESUMO
To date, nutritional epidemiology has relied heavily on relatively weak methods including simple observational designs and substandard measurements. Despite low internal validity and other sources of bias, claims of causality are made commonly in this literature. Nutritional epidemiology investigations can be improved through greater scientific rigor and adherence to scientific reporting commensurate with research methods used. Some commentators advocate jettisoning nutritional epidemiology entirely, perhaps believing improvements are impossible. Still others support only normative refinements. But neither abolition nor minor tweaks are appropriate. Nutritional epidemiology, in its present state, offers utility, yet also needs marked, reformational renovation. Changing the status quo will require ongoing, unflinching scrutiny of research questions, practices, and reporting-and a willingness to admit that "good enough" is no longer good enough. As such, a workshop entitled "Toward more rigorous and informative nutritional epidemiology: the rational space between dismissal and defense of the status quo" was held from July 15 to August 14, 2020. This virtual symposium focused on: (1) Stronger Designs, (2) Stronger Measurement, (3) Stronger Analyses, and (4) Stronger Execution and Reporting. Participants from several leading academic institutions explored existing, evolving, and new better practices, tools, and techniques to collaboratively advance specific recommendations for strengthening nutritional epidemiology.
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Avaliação Nutricional , Projetos de Pesquisa , Humanos , CausalidadeRESUMO
Dietary lapses (i.e., specific instances of nonadherence to recommended dietary goals) contribute to suboptimal weight loss outcomes during lifestyle modification programs. Passive eating monitoring could enhance lapse measurement via objective assessment of eating characteristics that could be markers for lapse (e.g., more bites consumed). The purpose of this study was to evaluate if passively-inferred eating characteristics (i.e., bites, eating duration, and eating rate), measured via wrist-worn device, could distinguish dietary lapses from non-lapse eating. Adults (n = 25) with overweight/obesity received a 24-week lifestyle modification intervention. Participants completed ecological momentary assessment (EMA; repeated smartphone surveys) biweekly to self-report on dietary lapses and non-lapse eating episodes. Participants wore a wrist device that captured continuous wrist motion. Previously-validated algorithms inferred eating episodes from wrist data, and calculated bite count, duration, and rate (seconds per bite). Mixed effects logistic regressions revealed no simple effects of bite count, duration, or eating rate on the likelihood of dietary lapse. Moderation analyses revealed that eating episodes in the evening were more likely to be lapses if they involved fewer bites (B = -0.16, p < .05), were shorter (B = -0.54, p < .05), or had a slower rate (B = 1.27, p < .001). Statistically significant interactions between eating characteristics (Bs = -0.30 to -0.08, ps < .001) revealed two distinct patterns. Eating episodes that were 1. smaller, slower, and shorter than average, or 2. larger, quicker, and longer than average were associated with increased probability of lapse. This study is the first to use objective eating monitoring to characterize dietary lapses throughout a lifestyle modification intervention. Results demonstrate the potential of sensors to identify non-adherence using only patterns of passively-sensed eating characteristics, thereby minimizing the need for self-report in future studies. CLINICAL TRIALS REGISTRY NUMBER: NCT03739151.
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Pedometers are popular for counting steps as a daily measure of physical activity, however, errors as high as 96% have been reported in previous work. Many reasons for pedometer error have been studied, including walking speed, sensor position on the body and pedometer algorithm, demonstrating some differences in error. However, we hypothesize that the largest source of error may be due to differences in the regularity of gait during different activities. During some activities, gait tends to be regular and the repetitiveness of individual steps makes them easy to identify in an accelerometer signal. During other activities of everyday life, gait is frequently semi-regular or unstructured, which we hypothesize makes it difficult to identify and count individual steps. In this work, we test this hypothesis by evaluating the three most common types of pedometer algorithm on a new data set that varies the regularity of gait. A total of 30 participants were video recorded performing three different activities: walking a path (regular gait), conducting a within-building activity (semi-regular gait), and conducting a within-room activity (unstructured gait). Participants were instrumented with accelerometers on the wrist, hip and ankle. Collectively, 60,805 steps were manually annotated for ground truth using synchronized video. The main contribution of this paper is to evaluate pedometer algorithms when the consistency of gait changes to simulate everyday life activities other than exercise. In our study, we found that semi-regular and unstructured gaits resulted in 5-466% error. This demonstrates the need to evaluate pedometer algorithms on activities that vary the regularity of gait. Our dataset is publicly available with links provided in the introduction and Data Availability Statement.
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Actigrafia , Marcha , Algoritmos , Humanos , Caminhada , Velocidade de CaminhadaRESUMO
This paper presents new methods to detect eating from wrist motion. Our main novelty is that we analyze a full day of wrist motion data as a single sample so that the detection of eating occurrences can benefit from diurnal context. We develop a two-stage framework to facilitate a feasible full-day analysis. The first-stage model calculates local probabilities of eating P(Ew) within windows of data, and the second-stage model calculates enhanced probabilities of eating P(Ed) by treating all P(Ew) within a single day as one sample. The framework also incorporates an augmentation technique, which involves the iterative retraining of the first-stage model. This allows us to generate a sufficient number of day-length samples from datasets of limited size. We test our methods on the publicly available Clemson All-Day (CAD) dataset and FreeFIC dataset, and find that the inclusion of day-length analysis substantially improves accuracy in detecting eating episodes. We also benchmark our results against several state-of-the-art methods. Our approach achieved an eating episode true positive rate (TPR) of 89% with 1.4 false positives per true positive (FP/TP), and a time weighted accuracy of 84%, which are the highest accuracies reported on the CAD dataset. Our results show that the daily pattern classifier substantially improves meal detections and in particular reduces transient false detections that tend to occur when relying on shorter windows to look for individual ingestion or consumption events.
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Algoritmos , Punho , Humanos , Movimento (Física) , Probabilidade , RefeiçõesRESUMO
Objective: Lifestyle intervention can produce clinically significant weight loss and reduced disease risk/severity for many individuals with overweight/obesity. Dietary lapses, instances of non-adherence to the recommended dietary goal(s) in lifestyle intervention, are associated with less weight loss and higher energy intake. There are distinct "types" of dietary lapse (e.g., eating an off-plan food, eating a larger portion), and behavioral, psychosocial, and contextual mechanisms may differ across dietary lapse types. Some lapse types also appear to impact weight more than others. Elucidating clear lapse types thus has potential for understanding and improving adherence to lifestyle intervention. Methods: This 18-month observational cohort study will use real-time digital assessment tools within a multi-level factor analysis framework to uncover "lapse phenotypes" and understand their impact on clinical outcomes. Adults with overweight/obesity (n = 150) will participate in a 12-month online lifestyle intervention and 6-month weight loss maintenance period. Participants will complete 14-day lapse phenotyping assessment periods at baseline, 3, 6, 12, and 18 months in which smartphone surveys, wearable devices, and geolocation will assess dietary lapses and relevant phenotyping characteristics. Energy intake (via 24-h dietary recall) and weight will be collected at each assessment period. Results: This trial is ongoing; data collection began on 31 October 2022 and is scheduled to complete by February 2027. Conclusion: Results will inform novel precision tools to improve dietary adherence in lifestyle intervention, and support updated theoretical models of adherence behavior. Additionally, these phenotyping methods can likely be leveraged to better understand non-adherence to other health behavior interventions. Trial Registration: This study was prospectively registered https://clinicaltrials.gov/study/NCT05562427.
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BACKGROUND: Accurately identifying eating patterns, specifically the timing, frequency, and distribution of eating occasions (EOs), is important for assessing eating behaviors, especially for preventing and managing obesity and type 2 diabetes (T2D). However, existing methods to study EOs rely on self-report, which may be prone to misreporting and bias and has a high user burden. Therefore, objective methods are needed. METHODS: We aim to compare EO timing using objective and subjective methods. Participants self-reported EO with a smartphone app (self-report [SR]), wore the ActiGraph GT9X on their dominant wrist, and wore a continuous glucose monitor (CGM, Abbott Libre Pro) for 10 days. EOs were detected from wrist motion (WM) using a motion-based classifier and from CGM using a simulation-based system. We described EO timing and explored how timing identified with WM and CGM compares with SR. RESULTS: Participants (n = 39) were 59 ± 11 years old, mostly female (62%) and White (51%) with a body mass index (BMI) of 34.2 ± 4.7 kg/m2. All had prediabetes or moderately controlled T2D. The median time-of-day first EO (and interquartile range) for SR, WM, and CGM were 08:24 (07:00-09:59), 9:42 (07:46-12:26), and 06:55 (04:23-10:03), respectively. The median last EO for SR, WM, and CGM were 20:20 (16:50-21:42), 20:12 (18:30-21:41), and 21:43 (20:35-22:16), respectively. The overlap between SR and CGM was 55% to 80% of EO detected with tolerance periods of ±30, 60, and 120 minutes. The overlap between SR and WM was 52% to 65% EO detected with tolerance periods of ±30, 60, and 120 minutes. CONCLUSION: The continuous glucose monitor and WM detected overlapping but not identical meals and may provide complementary information to self-reported EO.
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Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Punho , Autorrelato , Estado Pré-Diabético/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Monitoramento Contínuo da Glicose , Automonitorização da Glicemia , Glicemia , Obesidade/diagnósticoRESUMO
Measuring the energy intake (kcal) of a person in day-to-day life is difficult. The best laboratory tool achieves 95 % accuracy on average, while tools used in daily living typically achieve 60-80 % accuracy. This paper describes a new method for measuring intake via automated tracking of wrist motion. Our method uses a watch-like device with a micro-electro-mechanical gyroscope to detect and record when an individual has taken a bite of food. Two tests of the accuracy of our device in counting bites found that our method has 94 % sensitivity in a controlled meal setting and 86 % sensitivity in an uncontrolled meal setting, with one false positive per every 5 bites in both settings. Preliminary data from daily living indicates that bites measured by the device are positively related to caloric intake illustrating the potential of the device to monitor energy intake. Future research should seek to further explore the relationship between bites taken and kilocalories consumed to validate the device as an automated measure of energy intake.
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Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Movimento (Física) , Punho , Adolescente , Adulto , Feminino , Humanos , MasculinoRESUMO
In this work, we describe a new method to detect periods of eating by tracking wrist motion during everyday life. Eating uses hand-to-mouth gestures for ingestion, each of which lasts a few seconds. Previous works have detected these gestures individually and then aggregated them to identify meals. The novelty of our approach is that we analyze a much longer window (0.5-15 min) using a convolutional neural network. Longer windows can contain other gestures related to eating, such as cutting or manipulating food, preparing foods for consumption, and resting between ingestion events. The context of these other gestures can improve the detection of periods of eating. We test our methods on the public Clemson all-day dataset, which consists of 354 recordings containing 1063 eating episodes. We found that accuracy at detecting eating increased by 15% in ≥4 min windows compared to ≤15 s windows. Using a 6 min window, we detected 89% of eating episodes, with 1.7 false positives for every true positive (FP/TP). These are the best results achieved to date on this dataset.
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OBJECTIVES: Behavioral obesity treatment (BOT) produces clinically significant weight loss and health benefits for many individuals with overweight/obesity. Yet, many individuals in BOT do not achieve clinically significant weight loss and/or experience weight regain. Lapses (i.e., eating that deviates from the BOT prescribed diet) could explain poor outcomes, but the behavior is understudied because it can be difficult to assess. We propose to study lapses using a multi-method approach, which allows us to identify objectively-measured characteristics of lapse behavior (e.g., eating rate, duration), examine the association between lapse and weight change, and estimate nutrition composition of lapse. METHOD: We are recruiting participants (n = 40) with overweight/obesity to enroll in a 24-week BOT. Participants complete biweekly 7-day ecological momentary assessment (EMA) to self-report on eating behavior, including dietary lapses. Participants continuously wear the wrist-worn ActiGraph Link to characterize eating behavior. Participants complete 24-hour dietary recalls via structured interview at 6-week intervals to measure the composition of all food and beverages consumed. RESULTS: While data collection for this trial is still ongoing, we present data from three pilot participants who completed EMA and wore the ActiGraph to illustrate the feasibility, benefits, and challenges of this work. CONCLUSION: This protocol will be the first multi-method study of dietary lapses in BOT. Upon completion, this will be one of the largest published studies of passive eating detection and EMA-reported lapse. The integration of EMA and passive sensing to characterize eating provides contextually rich data that will ultimately inform a nuanced understanding of lapse behavior and enable novel interventions.Trial registration: Registered clinical trial NCT03739151; URL: https://clinicaltrials.gov/ct2/show/NCT03739151.
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BACKGROUND: Behavioral obesity treatment (BOT) is a gold standard approach to weight loss and reduces the risk of cardiovascular disease. However, frequent lapses from the recommended diet stymie weight loss and prevent individuals from actualizing the health benefits of BOT. There is a need for innovative treatment solutions to improve adherence to the prescribed diet in BOT. OBJECTIVE: The aim of this study is to optimize a smartphone-based just-in-time adaptive intervention (JITAI) that uses daily surveys to assess triggers for dietary lapses and deliver interventions when the risk of lapse is high. A microrandomized trial design will evaluate the efficacy of any interventions (ie, theory-driven or a generic alert to risk) on the proximal outcome of lapses during BOT, compare the effects of theory-driven interventions with generic risk alerts on the proximal outcome of lapse, and examine contextual moderators of interventions. METHODS: Adults with overweight or obesity and cardiovascular disease risk (n=159) will participate in a 6-month web-based BOT while using the JITAI to prevent dietary lapses. Each time the JITAI detects elevated lapse risk, the participant will be randomized to no intervention, a generic risk alert, or 1 of 4 theory-driven interventions (ie, enhanced education, building self-efficacy, fostering motivation, and improving self-regulation). The primary outcome will be the occurrence of lapse in the 2.5 hours following randomization. Contextual moderators of intervention efficacy will also be explored (eg, location and time of day). The data will inform an optimized JITAI that selects the theory-driven approach most likely to prevent lapses in a given moment. RESULTS: The recruitment for the microrandomized trial began on April 19, 2021, and is ongoing. CONCLUSIONS: This study will optimize a JITAI for dietary lapses so that it empirically tailors the provision of evidence-based intervention to the individual and context. The finalized JITAI will be evaluated for efficacy in a future randomized controlled trial of distal health outcomes (eg, weight loss). TRIAL REGISTRATION: ClinicalTrials.gov NCT04784585; http://clinicaltrials.gov/ct2/show/NCT04784585. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33568.
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This study evaluated feasibility and acceptability of adding energy balance modeling displayed on weight graphs combined with a wrist-worn bite counting sensor against a traditional online behavioral weight loss program. Adults with a BMI of 27-45 kg/m2 (83.3% women) were randomized to receive a 12-week online behavioral weight loss program with 12 weeks of continued contact (n = 9; base program), the base program plus a graph of their actual and predicted weight change based on individualized physiological parameters (n = 7), or the base program, graph, and a Bite Counter device for monitoring and limiting eating (n = 8). Participants attended weekly clinic weigh-ins plus baseline, midway (12 weeks), and study culmination (24 weeks) assessments of feasibility, acceptability, weight, and behavioral outcomes. In terms of feasibility, participants completed online lessons (M = 7.04 of 12 possible lessons, SD = 4.02) and attended weigh-ins (M = 16.81 visits, SD = 7.24). Six-month retention appears highest among nomogram participants, and weigh-in attendance and lesson completion appear highest in Bite Counter participants. Acceptability was sufficient across groups. Bite Counter use (days with ≥ 2 eating episodes) was moderate (47.8%) and comparable to other studies. Participants lost 4.6% ± 4.5 of their initial body weight at 12 weeks and 4.5% ± 5.8 at 24 weeks. All conditions increased their total physical activity minutes and use of weight control strategies (behavioral outcomes). Although all groups lost weight and the study procedures were feasible, acceptability can be improved with advances in the technology. Participants were satisfied with the online program and nomograms, and future research on engagement, adherence, and integration with other owned devices is needed. ClinicalTrials.gov Identifier: NCT02857595.
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BACKGROUND: For virtual environments (VEs) to be useful in training it is important to understand the negative effects of VE exposure. The purpose of this study was to observe head movements in virtual and real environments and the relation between those movements and simulator sickness. METHOD: There were 48 men who were trained in 4-person teams in either a head-mounted display (HMD)-based VE or in a real world environment. Head position data were collected in both systems and simulator sickness scores were collected in the VE. The relationship of head movements and sickness scores in theVE was examined and the degree of head movements in the real world and VE compared. RESULTS: Differences were found in the length of time subjects spent moving their heads; subjects with the highest sickness scores moved their heads less often than other subjects in the VE. Also, subjects moved their heads significantly less and less often in the VE (means: 3 degrees x 50 ms(-1), 71% of trial time not moving head), compared to the real world (means: 10 degrees 50 ms(-1), 59% of trial time not moving head). CONCLUSIONS: This study observed that when head movements are quantified, past assumptions of the link between increased sickness scores and decreased head movements may not hold. Though not linked to simulator sickness, head movements were reduced in the VE compared to the real world. Though observational in nature, this study is one of the first to quantify head movements and how they may relate to simulator sickness.
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Movimentos da Cabeça , Enjoo devido ao Movimento/etiologia , Interface Usuário-Computador , Adolescente , Simulação por Computador , Humanos , Masculino , Análise e Desempenho de Tarefas , Adulto JovemRESUMO
Self-efficacy (SE) and information processing (IP) may be important constructs to target when designing mHealth interventions for weight loss. The goal of this study was to examine the relationship between SE and IP with weight loss at six-months as part of the Dietary Interventions Examining Tracking with mobile study, a six-month randomized trial with content delivered remotely via twice-weekly podcasts. Participants were randomized to self-monitor their diet with either a mobile app (n = 42) or wearable Bite Counter device (n = 39). SE was assessed using the Weight Efficacy Life-Style Questionnaire and the IP variables assessed included user control, cognitive load, novelty, elaboration. Regression analysis examined the relationship between weight loss, SE change & IP at six months. Results indicate that elaboration was the strongest predictor of weight loss (ß =-0.423, P = 0.011) among all SE & IP variables and that for every point increase in elaboration, participants lost 0.34 kg body weight.
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BACKGROUND: This study builds on previous research that seeks to estimate kilocalorie intake through microstructural analysis of eating behaviors. As opposed to previous methods, which used a static, individual-based measure of kilocalories per bite, the new method incorporates time- and food-varying predictors. A measure of kilocalories per bite (KPB) was estimated using between- and within-subjects variables. OBJECTIVE: The purpose of this study was to examine the relationship between within-subjects and between-subjects predictors and KPB, and to develop a model of KPB that improves over previous models of KPB. Within-subjects predictors included time since last bite, food item enjoyment, premeal satiety, and time in meal. Between-subjects predictors included body mass index, mouth volume, and sex. PARTICIPANTS/SETTING: Seventy-two participants (39 female) consumed two random meals out of five possible meal options with known weights and energy densities. There were 4,051 usable bites measured. MAIN OUTCOME MEASURES: The outcome measure of the first analysis was KPB. The outcome measure of the second analysis was meal-level kilocalorie intake, with true intake compared to three estimation methods. STATISTICAL ANALYSES PERFORMED: Multilevel modeling was used to analyze the influence of the seven predictors of KPB. The accuracy of the model was compared to previous methods of estimating KPB using a repeated-measured analysis of variance. RESULTS: All hypothesized relationships were significant, with slopes in the expected direction, except for body mass index and time in meal. In addition, the new model (with nonsignificant predictors removed) improved over earlier models of KPB. CONCLUSIONS: This model offers a new direction for methods of inexpensive, accurate, and objective estimates of kilocalorie intake from bite-based measures.
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Ingestão de Alimentos/psicologia , Ingestão de Energia , Comportamento Alimentar/psicologia , Refeições/psicologia , Tamanho da Porção de Referência/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Saciação , Adulto JovemRESUMO
BACKGROUND: Mobile dietary self-monitoring methods allow for objective assessment of adherence to self-monitoring; however, the best way to define self-monitoring adherence is not known. OBJECTIVE: The objective was to identify the best criteria for defining adherence to dietary self-monitoring with mobile devices when predicting weight loss. DESIGN: This was a secondary data analysis from two 6-month randomized trials: Dietary Intervention to Enhance Tracking with Mobile Devices (n=42 calorie tracking app or n=39 wearable Bite Counter device) and Self-Monitoring Assessment in Real Time (n=20 kcal tracking app or n=23 photo meal app). PARTICIPANTS/SETTING: Adults (n=124; mean body mass index=34.7±5.6) participated in one of two remotely delivered weight-loss interventions at a southeastern university between 2015 and 2017. INTERVENTION: All participants received the same behavioral weight loss information via twice-weekly podcasts. Participants were randomly assigned to a specific diet tracking method. MAIN OUTCOME MEASURES: Seven methods of tracking adherence to self-monitoring (eg, number of days tracked, and number of eating occasions tracked) were examined, as was weight loss at 6 months. STATISTICAL ANALYSES PERFORMED: Linear regression models estimated the strength of association (R2) between each method of tracking adherence and weight loss, adjusting for age and sex. RESULTS: Among all study completers combined (N=91), adherence defined as the overall number of days participants tracked at least two eating occasions explained the most variance in weight loss at 6 months (R2=0.27; P<0.001). Self-monitoring declined over time; all examined adherence methods had fewer than half the sample still tracking after Week 10. CONCLUSIONS: Using the total number of days at least two eating occasions are tracked using a mobile self-monitoring method may be the best way to assess self-monitoring adherence during weight loss interventions. This study shows that self-monitoring rates decline quickly and elucidates potential times for early interventions to stop the reductions in self-monitoring.
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Dieta Redutora , Cooperação do Paciente , Autocuidado/métodos , Telemedicina , Programas de Redução de Peso/métodos , Adulto , Terapia Comportamental , Dieta Redutora/métodos , Dieta Redutora/estatística & dados numéricos , Etnicidade , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Estados Unidos , Redução de PesoRESUMO
BACKGROUND: Conclusions regarding bite count rates and body mass index (BMI) in free-living populations have primarily relied on self-report. The objective of this exploratory study was to compare the relationship between BMI and bite counts measured by a portable sensor called the Bite Counter in free-living populations and participants eating in residence. METHODS: Two previously conducted studies were analyzed for relationships between BMI and sensor evaluated bite count/min, and meal duration. Participants from the first study (N = 77) wore the bite counter in a free-living environment for a continuous period of 14 days. The second study (N = 214) collected bite count/min, meal duration, and total energy intake in participants who consumed one meal in a cafeteria. Linear regression was applied to examine relationships between BMI and bite count/min. RESULTS: There was no significant correlation in the free-living participants average bite counts per second and BMI (R2 = 0.03, p = 0.14) and a significant negative correlation in the cafeteria participants (R 2 = 0.04, p = 0.03) with higher bite count rates observed in lean versus obese participants. There was a significant correlation between average meal duration and BMI in the free-living participants (R 2 = 0.08, p = 0.01). Total energy intake in the cafeteria participants was also significantly correlated to meal duration (R 2 = 0.31, p < 0.001). CONCLUSIONS: With additional novel applications of the Bite Counter, insights into free-living eating behavior may provide avenues for future interventions that are sustainable for long term application.
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Heart rate variability (HRV) is traditionally analyzed while a subject is in a controlled environment, such as at rest in a clinic, where it can be used as a medical indicator. This paper concerns analyzing HRV outside of controlled environments, such as on an actively moving person. We describe automated methods for inter-heartbeat interval (IBI) error detection and correction. We collected 124,998 IBIs from 18 subjects, undergoing a variety of active motions, for use in evaluating our methods. Two human graders manually labeled each IBI, evaluating 10% of the IBIs as having an error, which is a far greater error percentage than has been examined in any previous study. Our automated method had a 96% agreement rate with the two human graders when they themselves agreed, with a 49% rate of matching specific error corrections and a 0.01% false alarm rate.
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Eletrocardiografia Ambulatorial/métodos , Frequência Cardíaca/fisiologia , Adolescente , Adulto , Artefatos , Autoanálise , Eletrocardiografia Ambulatorial/instrumentação , Reações Falso-Positivas , Nível de Saúde , Humanos , Estudantes , Análise e Desempenho de Tarefas , Fatores de TempoRESUMO
This paper describes a study to test the accuracy of a method that tracks wrist motion during eating to detect and count bites. The purpose was to assess its accuracy across demographic (age, gender, and ethnicity) and bite (utensil, container, hand used, and food type) variables. Data were collected in a cafeteria under normal eating conditions. A total of 271 participants ate a single meal while wearing a watch-like device to track their wrist motion. A video was simultaneously recorded of each participant and subsequently reviewed to determine the ground truth times of bites. Bite times were operationally defined as the moment when food or beverage was placed into the mouth. Food and beverage choices were not scripted or restricted. Participants were seated in groups of 2-4 and were encouraged to eat naturally. A total of 24 088 bites of 374 different food and beverage items were consumed. Overall the method for automatically detecting bites had a sensitivity of 75% with a positive predictive value of 89%. A range of 62-86% sensitivity was found across demographic variables with slower eating rates trending toward higher sensitivity. Variations in sensitivity due to food type showed a modest correlation with the total wrist motion during the bite, possibly due to an increase in head-toward-plate motion and decrease in hand-toward-mouth motion for some food types. Overall, the findings provide the largest evidence to date that the method produces a reliable automated measure of intake during unrestricted eating.
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Ingestão de Energia/fisiologia , Comportamento Alimentar/fisiologia , Alimentos , Reconhecimento Automatizado de Padrão/métodos , Punho/fisiologia , Adolescente , Adulto , Idoso , Desenho de Equipamento , Feminino , Monitores de Aptidão Física , Alimentos/classificação , Alimentos/estatística & dados numéricos , Gestos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Movimento/fisiologia , Gravação em Vídeo , Adulto JovemRESUMO
The universal eating monitor (UEM) is a table-embedded scale used to measure grams consumed over time while a person eats. It has been used in laboratory settings to test the effects of anorectic drugs and behavior manipulations such as slowing eating, and to study relationships between demographics and body weight. However, its use requires restricted conditions on the foods consumed and behaviors allowed during eating in order to simplify analysis of the scale data. Individual bites can only be measured when the only interaction with the scale is to carefully remove a single bite of food, consume it fully, and wait a minimum amount of time before the next bite. Other interactions are prohibited such as stirring and manipulating foods, retrieving or placing napkins or utensils on the scale, and in general anything that would change the scale weight that was not related to the consumption of an individual bite. This paper describes a new algorithm that can detect and measure the weight or individual bites consumed during unrestricted eating. The algorithm works by identifying time periods when the scale weight is stable, and then, analyzing the surrounding weight changes. The series of preceding and succeeding weight changes is compared against patterns for single food bites, food mass bites, and drink bites to determine if a scale interaction is due to a bite or some other activity. The method was tested on 271 subjects, each eating a single meal in a cafeteria setting. A total of 24 101 bites were manually annotated in synchronized videos to establish ground truth as to the true, false, and missed detections of bites. Our algorithm correctly detected and weighed approximately 39% of bites with approximately one false positive (FP) per ten actual bites. The improvement compared to the UEM is approximately three times the number of true detections and a 90% reduction in the number of FPs. Finally, an analysis of bites that could not be weighed compared to those that could be weighed revealed no statistically significant difference in average weight. These results suggest that our algorithm could be used to conduct studies using a table scale outside of laboratory or clinical settings and with unrestricted eating behaviors.