Summary
Background: Pictograms have been shown by many studies to be an effective way of conveying information.
An easy-to-understand pictorial description is essential for communication of dietary
intake in the computer era.
Objectives: We proposed a novel approach that represents textual descriptions of dietary intake
into a pictorial representation with the concept of pictograms. The computational
implementation in terms of a web-based tool was investigated on how well the pictograms
carry their intended message.
Methods: 1) We investigated how well the pictograms are comprehended in terms of subjects’
accuracy rate and response time. In the study (n = 90), pictorial variants with three
types of food images (black-and-white sketch, colored sketch, and colored photograph)
were tested. 2) We also investigated how well subjects were able to select the standard
food size among various food portions with the use of the tool. A comparison was made
against the current standard of an educational session taught by a registered dietitian.
We recruited 86 university students who were asked to select a standard size out of
five different size categories. Three types of shapes were used. The bowl is the container
that is widely used in the participants’ country. The pork strip was to represent
foods with elliptical cross-section. The apple was used to represent a baseball-like
size and shape.
Results: Two pictograms with black-and-white food image were low of less than 50% in accuracy
rate. The rest of the twenty-seven pictograms derived from portions of the nine foods
were well understood with high accuracy rates (above 85%). Participants in using the
tool without the dietitian’s session was better than participants in the dietitian
education session in selecting a standard portion size of an apple (p < 0.0001; p
= 0.0009 after adjustment for gender and age). The rate of correct bowl and pork strip
size estimates were similar between the two conditions (p > 0.05).
Conclusion: The development of pictograms could be used as a computational visual aid for comprehending
and identifying dietary intake. Broader investigation is required for considering
the effectiveness of the picto-grams on recall, measurement, or estimation as well
as for further evaluation in the clinical practice.
Keywords
Pictogram-based method - visualization - food portion - dietary intake
