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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.

Web Link

Validation Information

Year of Publication

Tool Information

Dietary Exposure Measured
Full Nutrient
Tool Type
Food Diary Estimated
Timeframe Tool Measures info
1 day
Portion Size Measures info
Using a webcam, photographs of food and drinks items were captured before consumption and of any leftovers. If the participants ate outside of the home they could verbally describe the portion size. The determination of portion sizes was then decided by a nutritionist.
Reporting Method info
Format info
Supplements Measured
Administration Method info

Study Information

Study Location
Sheffield and York, England and St Andrews, Scotland
Associated Nutrient Database
WinDiets research software (version 2010; Robert Gordon University).
Comparator Validated Against
Food Diary Estimated


Sample Size
Age of Population

Range: 65-89 years

Mean: 72.7 years

Other Notable Characteristics
Elderly population, living in the community without diagnosis of dementia.

Total number of nutrients validated: 16 info

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 info Mean Difference Standard Deviation info Correlation Coefficient info Cohen's Kappa Coefficient Percentage Agreement Percentage Agreement Categories info 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.