Wearable Camera-Based Dietary Assessment of Mother-Father Dyads in Urban and Rural Households in Ghana.

BACKGROUND

There is a dearth of studies examining the dietary intakes of parents from low- and middle-income countries, which are foundational for understanding the household-level double burden of malnutrition (DBM).

OBJECTIVES

To assess the energy and nutrient intakes (carbohydrates, protein, fat, vitamin A, folate, zinc, and iron) of mother-father dyads from rural and urban households in Ghana using a wearable camera, an objective measure of dietary intake, not subject to self-reporting errors.

METHODS

In this cross-sectional study, purposive convenience sampling was used to recruit 60 households with a mother, father, and a child younger than 5 y and/or an adolescent from 1 rural and 1 urban community in Ghana. Both parents wore the Automatic Ingestion Monitor 2 (AIM-2) over 2 weekdays and 1 weekend day. Dietary intake was analyzed using custom AIM Annotation Software. Household characteristics were collected via questionnaire, and body mass index (kg/m2) was calculated from measured height and weight.

RESULTS

No differences in mean energy, macronutrient, or micronutrient intakes were observed between mothers and fathers within either area of residence. Dyad-level analyses showed that in rural households, mothers had higher caloric (P = 0.001), vitamin A (P = 0.048), and zinc intakes (P = 0.001) than fathers, who had higher iron intakes (P < 0.001) than mothers. In urban households, mothers had higher caloric (P = 0.006) and zinc intakes (P < 0.001) than fathers who had higher iron intakes (P < 0.001) than mothers. The prevalence of overweight/obesity was higher among mothers than fathers in both urban (70% versus 40%, P = 0.020) and rural (67% versus 30%, P = 0.005) households.

CONCLUSIONS

The coexistence of overweight/obesity and low iron intakes among mothers highlights a unique presentation of the DBM at the household level. The AIM-2 shows promise for addressing limitations of traditional dietary assessment methods through passive and objective image capture.