Development and validation of a digital photographic food atlas of Malaysian foods

Introduction: Portion size estimation elements (PSEE), such as food atlas, are utilised to improve portion size estimation accuracy in dietary assessments. Digital food atlases offer advantages like high accuracy, convenience, and portability. This study aimed to develop and validate a digital food atlas comprising commonly consumed Malaysian foods. Methods: Foods were selected based on national food consumption data. Photographs were taken at 45-degree angle under standard lighting conditions. During validation study, 41 Malaysian university staff and students (mean age 25±9 years) were recruited to estimate the portion of 33 preweighted foods using the atlas. Validity of the atlas was determined by comparing actual versus estimated weight of test foods using Wilcoxon signed-rank test. Subsequently, a usability questionnaire evaluated the atlas’s usefulness. Results: In total, 91 foods were included in the atlas. Significant differences were present in 23 food items tested in validation study, ranging from 54.9% underestimation to 95.1% overestimation. The digital food atlas received high usability scores, with an average of 3.2/4 for carbohydrate foods, and 3.3/4 for protein and fruit/vegetable sections. Conclusion: This study developed and validated a digital food atlas of commonly consumed local foods, potentially improving accuracy of portion size estimation in dietary assessments. Further modification by including wider range of foods and validation among diverse ethnic and age groups is warranted before its widespread use. Integration into clinical practice, research, and public health initiatives could further support dietary assessment and portion size education.