Validation Information: Novel Assessment of Nutrition and Ageing method (NANA)
Timon 2015
The validation of a computer-based food record for older adults: the Novel Assessment of Nutrition and Ageing (NANA) method
Dietary assessment in older adults can be challenging. The Novel Assessment of Nutrition and Ageing (NANA) method is a touch-screen computer-based food record that enables older adults to record their dietary intakes. The objective of the present study was to assess the relative validity of the NANA method for dietary assessment in older adults. For this purpose, three studies were conducted in which a total of ninety-four older adults (aged 65-89 years) used the NANA method of dietary assessment. On a separate occasion, participants completed a 4d estimated food diary. Blood and 24h urine samples were also collected from seventy-six of the volunteers for the analysis of biomarkers of nutrient intake. The results from all the three studies were combined, and nutrient intake data collected using the NANA method were compared against the 4d estimated food diary and biomarkers of nutrient intake. Bland-Altman analysis showed a reasonable agreement between the dietary assessment methods for energy and macronutrient intake; however, there were small, but significant, differences for energy and protein intake, reflecting the tendency for the NANA method to record marginally lower energy intakes. Significant positive correlations were observed between urinary urea and dietary protein intake using both the NANA and the 4d estimated food diary methods, and between plasma ascorbic acid and dietary vitamin C intake using the NANA method. The results demonstrate the feasibility of computer-based dietary assessment in older adults, and suggest that the NANA method is comparable to the 4d estimated food diary, and could be used as an alternative to the food diary for the short-term assessment of an individual's dietary intake.
Total number of nutrients validated: 16
Not all of the nutrients validated in the validation studies are included in the table below, as statistical data was only selected to be displayed for a number of nutrients, this included:
- Energy
- Fat
- Saturated Fat
- Mono-unsaturated Fat
- Poly-unsaturated Fat
- Carbohydrates
- Protein
- Sugar
- Non‐starch polysaccharides(NSP)
- Sodium
- Calcium
- Iron
- Zinc
- Retinol
- Folate
- Folic Acid
- Vitamin B12
- Vitamin C
- Fruit & Vegetables
- Urinary Nitrogen
To find information on the other validated nutrients please read the validation study.
- Energy
- Macronutrients: 5
- Micronutrients: 10
| Comparator | Lifestage | Sex | Nutrient Measured | Mean Difference | Standard Deviation | Correlation Coefficient | Cohen's Kappa Coefficient | Percentage Agreement | Percentage Agreement Categories | Lower Limits of Agreement | Upper Limits of Agreement |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Estimated Food Diary | Elderly | Both | Energy (kcal) | -60 | 196 | 0.88 (P) | -451 | 332 | |||
| Energy (kJ) | -249 | 819 | 0.88 (P) | -1887 | 1389 | ||||||
| Protein (g) | -4 | 11 | 0.75 (P) | -26 | 19 | ||||||
| Fat (g) | -1 | 12 | 0.83 (P) | -24 | 22 | ||||||
| Saturated Fat (g) | 0.2 | 6 | 0.75 (P) | -12 | 12 | ||||||
| Carbohydrates (g) | 1 | -5 | 0.83 (P) | -69 | 59 | ||||||
| Fibre (NSP) (g) | 0.5 | 3 | 0.77 (P) | -6 | 7 | ||||||
| Calcium (mg) | -39 | 249.9 | 0.56 (P) | -538.8 | 460.8 | ||||||
| Iron (mg) | -0.8 | 3.0 | 0.572 (P) | -7.5 | 6.0 | ||||||
| Retinol (µg) | 71 | 1078 | 0.389 (S) | -2084 | 2226 | ||||||
| Folate (µg) | -18 | 122.7 | 0.37 (P) | -264 | 226.9 | ||||||
| Vitamin B12 (µg) | -0.9 | 5.1 | 0.265 (S) | -11.1 | 9.4 | ||||||
| Vitamin C (mg) | -13.9 | 50.7 | 0.614 (P) | -115.3 | 87.5 |
Some results have been calculated using statistical techniques based on the published data.
For further information on statistical terms click on Statistical tests used in validation studies
All correlations coefficients in the table are unadjusted unless stated otherwise. For adjusted correlation coefficients and other statistical methods used in the study e.g. paired t-tests, please read the validation articles.
- # Adjusted
- † Energy adjusted.
- ‡ For loge-transformed, energy-adjusted nutrient intakes.
- ^ Adjacent included.
- ᵟ Participants provided identical responses.
- (w) = Weighted.
Timon CM, Astell AJ, Hwang F, Adlam TD, Smith T, Maclean L, Spurr D, Forster SE, Williams EA. The validation of a computer-based food record for older adults: the Novel Assessment of Nutrition and Ageing (NANA) method. British Journal of Nutrition. 2015 Feb 28;113(04):654-64.