Estimation Of Food Portion Sizes: A Comparison Between The Use Of Household Measures And A Photographic Food Atlas In A Rural Population In Ghana

Abstract

Background: Dietary assessment can be defined as “a comprehensive evaluation of a person's food intake”. It serves as the basis for the diagnosis and management of chronic diseases. A number of dietary assessment techniques exist but the appropriateness of use depends on the purpose and food eating habits. Some examples of dietary methods are weighed food records, estimated food records and household measures, to name but a few. Household measures such as cups and spoons are most commonly used in Ghana. A photographic atlas of commonly consumed carbohydrate Ghanaian foods was developed by Peprah Boateng to aid in dietary assessment and counselling. The tool was validated among a cross section of participants in Accra and this study is focused on testing this tool in the rural area to confirm its use across the nation. Aim: To validate a photographic food atlas of commonly consumed carbohydrates based foods with estimated food portion sizes using household measures in Asesewa, a rural community in Ghana Method: A cross sectional study involving a three day dietary intake from individuals through face-to-face interviews using a structured pre-tested questionnaire to all males and females within the age group of eighteen (18) years and seventy (70) years who visited the Nutrition and Research center and the Asesewa Regional Hospital within the time period of collecting the data. Data collection was divided into three (3) main parts: socio-demographic and anthropometry, 24-hour recall and portion size estimation. Results: A significantly greater proportion, 63.7% (121), of the participants underestimated the carbohydrate food (P <0.0001). Twenty-nine per cent (55) of participants overestimated whilst only 5.3% correctly estimated the portion size of carbohydrate food. There was no significant difference in gender estimations of carbohydrate foods (P= 0.295). However, a higher proportion of female participants were able to estimate correctly (7.9 %) compared to males (3.0 %). No significant differences (P>0.05) were found between the number of participants who underestimated or overestimated carbohydrate among gender. Among the age range of participants, higher proportion (69.0%) within the age range of 39 to 49 years underestimated portion size of fufu followed by those within 50 to 60 years and 17 to 27 years indicated by 62.5% and 61.7% respectively. Similarly, higher proportion (75.0%) within the age range of 39 to 49 years underestimated portion size of banku compared to the other age ranges. Boiled yam on the other hand was estimated correctly by higher proportion (66.7%) of participants within the age range of 39-49 years followed by those within 17 to 27 years and 28 to 38 years as indicated by 47.1% and 42.9% respectively. Boiled rice was highly overestimated by the participants with the 61 to 70-year range and 17 to 27-year range (65.2%). Underestimation of sugar was seen among a statistically significant percentage (P=0.041; 93.8%) of participants within the 39 to 49-year range. Conclusion: Portion size estimation of these carbohydrate foods using the photographic food atlas and the household measures showed an overall correct estimation of 5.3%, under and overestimation of 63.7% and 28.9% respectively. Gender showed no significant effect on portion size estimation although more females estimated carbohydrate food correctly compared to the males. The effects of the different BMI categories on participants’ ability to correctly estimate or overestimate were not significant. However, significant effect of BMI on underestimation of portion size in food was observed.