Integrated Spreadsheets for Nutritional Analysis of Population Diet Surveys

Summary

This paper presents a system of integrated spreadsheets using simple formulas to calculate nutrient and food group intakes and the contributions of food groups to nutrient intakes for analysis of population diet survey data. The system accommodates quantitative, semiquantitative, and nonquantitative food intake data and a user-supplied food composition table.

Abstract

It can be challenging to calculate nutrient intakes in population diet surveys because existing nutritional analysis software is generally oriented toward analyzing intakes of individuals and may not allow users to input or easily modify the food composition data used in the analysis. These are drawbacks that are more problematic in low- and middle-income country settings. While there are numerous software-assisted dietary assessment platforms that conduct onboard nutritional analysis and are appropriate for use in large surveys, they are often similarly limited, and further restrict users to specific assessment modalities. This paper presents a multifunctional system of integrated spreadsheets for nutritional analysis of population diet surveys (ISNAPDS) that provides a solution for situations in which data have been collected but cannot be adequately analyzed with existing software. The protocol involves supplying the system with fully customizable data on food composition, food group classifications, and food intake (food intake in g/day may be entered directly or calculated based on user-supplied intake frequencies and either standard or variable serving sizes). Following data entry, the user modifies a set of simple pre-populated formulas to match them to the structure of the input data and the system applies these formulas to calculate nutrient and food group intakes, and the contributions of food groups to nutrient intakes for all members of the survey population. The flexibility of the ISNAPDS system allows it to accommodate the global diversity of foods consumed and analyze quantitative, semiquantitative, and nonquantitative food consumption data collected using prospective and retrospective assessment methods employing different reference periods and portion size estimation methods. To date, the system has been applied in published and ongoing analyses of 24 h recall, diet record, food frequency, and disaggregated household consumption data from population surveys in China, Ethiopia, India, Mongolia, Thailand, and a multi-country analysis of 10 sub-Saharan African countries.

Introduction

Data on population, food, and nutrient intake are important for understanding the burden of malnutrition in populations and the relationships between diet and health, and play important roles in designing, monitoring, and evaluating evidence-based nutrition policies and programs^1,2.

After data on food intake have been collected, software is used to multiply the amount of each food consumed by its nutrient composition to obtain data on nutrient intake (nutritional analysis)³, a process that used to be performed manually until the advent of mainframe computers<....

Protocol

The protocol is accompanied by example results based on applying the ISNAPDS system in analysis of actual population survey data in Mongolia. The procedures followed for collecting data in this survey were in accordance with the ethical standards of the Mongolian Ministry of Health Ethical Review Board and the Harvard T.H. Chan School of Public Health Institutional Review Board (Protocol #21002). The eligible participants provided written informed consent to join the study and provide publishable data prior to enrolment and were free to withdraw from the study at any time.

1. Specifying the method for populating food intake data

Results

Checks for ensuring integrity of the output data
The checks below demonstrate the accuracy of the calculations in the ISNAPDS system using observation 1 of the pre-populated example data. To ensure the protocol is correctly adhered to when applying the system in analysis of actual survey data, it is recommended that users run each of these checks themselves for few different observations and output columns (errors in a given input spreadsheet may propagate additional errors in some output spreadshe.......

Discussion

The ISNAPDS system presented in this paper provides a convenient starting point for numerous analyses central to nutritional surveillance and epidemiology such as: estimating intake distributions of nutrients and food groups, determining the prevalence of nutrient inadequacy and excess, identifying key food sources of each nutrient, deriving food- or nutrient-based diet metrics or adherence to dietary guidelines, analyzing relationships between diet and health outcomes, and informing the design of nutrition programs. ISN.......

Materials

Name	Company	Catalog Number	Comments
Excel 365	Microsoft Corporation		The ISNAPDS system (Supplemental File 1)  is a Microsoft Excel Open XML (.xlsx) file originally developed in 2012. The published version was developed in 2022 using Excel 365.