Reducing error in estimating caloric intake: A comparison of two educational modalities

The rise in obesity in the U.S. may be due partially to the reported difference between perceived and actual caloric intake. The purpose of the study is to compare the efficacy of two educational modalities designed to reduce error in estimating caloric intake. Following IRB approval, participants (n = 23; 12 male, 11 female) were randomized to one of two intervention groups. All took pre- and post-tests designed to gauge portion size and calorie count estimation accuracy. Six days over the next 2 weeks, both groups submitted emails containing personal portion size and calorie count estimates for all foods consumed. The text-only group (TO) received individualized feedback 1x/week while the text-and-image group (IT) attached photos of foods consumed and received feedback 3x/week. Both groups reduced the mean absolute percent error in caloric estimates on teh test, but TO showed a slightly greater reduction (p = 0.05). The TO group also reported that its modality encouraged significantly greater awareness of their daily food consumption (p = 0.01). Additionally, trends existed for participants with lower pre-test scores to experience greater post-intervention performance improvement (adjusted r² = 0.75; p = 0.00). In conclusion, exposure to diet education decreases error in estimating caloric intake especially for those with the greatest initial margin of error. Cognitive feedback delivered less frequently may be more effective in reducing estimation error. More research is necessary to determine the most effective learning method for nutrition education.