{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T15:07:09Z","timestamp":1771859229509,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Science, and Technology","award":["23K02964"],"award-info":[{"award-number":["23K02964"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Evidence regarding the validity of digital dietary recordings in the family-based nutritional management of anorexia nervosa (AN) remains limited. This study evaluated the validity of an AI-assisted dietary recording application (app) used by the parents of young patients with AN, with total energy intake as the primary outcome and major nutrient intake as the secondary outcome. Methods: During hospital leave prior to discharge, one day of dietary intake was recorded by parents using the app based on meal photographs. The energy and nutrient intakes estimated by the app were compared with a registered dietitian using visual estimation of the photographs. Differences were examined using the Wilcoxon signed-rank test, associations were assessed using Spearman\u2019s correlation coefficients, and agreement was evaluated using Bland\u2013Altman analysis. Sensitivity analyses excluding extreme outliers were performed. Results: Thirty female inpatients with AN (mean age: 14.8 \u00b1 2.9 years) and their mothers participated. The median total energy intake did not differ significantly between the app and reference method (2462 vs. 2439 kcal\/day). Moderate to high correlations were observed for total energy (\u03c1 = 0.62) and major nutrient intakes. The app tended to overestimate these intakes; however, Bland\u2013Altman analyses indicated no systematic bias. Exclusion of two outliers strengthened correlations for total energy intake (\u03c1 = 0.74) and narrowed the limits of agreement. Conclusions: The app demonstrated an acceptable agreement for estimating energy and major nutrient intake in the therapeutic context of AN. Careful attention to dish type and portion size may further support its clinical use.<\/jats:p>","DOI":"10.3390\/nu18040708","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T14:05:11Z","timestamp":1771855511000},"page":"708","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validity of an AI-Assisted Dietary Recording Application for Family-Based Nutritional Management in Young Patients with Anorexia Nervosa"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4089-1816","authenticated-orcid":false,"given":"Nao","family":"Shiraishi","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rieko","family":"Kawase","sequence":"additional","affiliation":[{"name":"Clinical Nutritional Management Unit, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruka","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Akechi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/YCO.0000000000000818","article-title":"Worldwide prevalence of DSM-5 eating disorders among young people","volume":"35","year":"2022","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1186\/s40337-023-00882-0","article-title":"Systematic review of prospective studies assessing risk factors to predict anorexia nervosa onset","volume":"11","author":"Charrat","year":"2023","journal-title":"J. Eat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1093\/ajcn\/nqy342","article-title":"Prevalence of eating disorders over the 2000\u20132018 period: A systematic literature review","volume":"109","author":"Galmiche","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s40519-023-01547-2","article-title":"COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: A systematic review with frequentist and Bayesian meta-analyses","volume":"28","author":"Mutlu","year":"2023","journal-title":"Eat. Weight Disord.-Stud. Anorex. Bulim. Obes."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1001\/archgenpsychiatry.2011.74","article-title":"Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies","volume":"68","author":"Arcelus","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1002\/eat.23152","article-title":"Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist-guided smartphone app","volume":"52","author":"Neumayr","year":"2019","journal-title":"Int. J. Eat. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.brat.2011.12.003","article-title":"Does internet-based prevention reduce the risk of relapse for anorexia nervosa?","volume":"50","author":"Fichter","year":"2012","journal-title":"Behav. Res. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.appet.2012.12.016","article-title":"How much should I eat? Estimation of meal portions in anorexia nervosa","volume":"63","author":"Milos","year":"2013","journal-title":"Appetite"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/eat.24252","article-title":"Efficacy of Eating Disorder Focused Family Therapy for Adolescents With Anorexia Nervosa: A Systematic Review and Meta-Analysis","volume":"58","author":"Austin","year":"2025","journal-title":"Int. J. Eat. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/eat.23405","article-title":"Introduction of family-based treatment to Japan with adaptations to optimize the cultural acceptability and advance current traditional treatments of adolescent anorexia nervosa","volume":"54","author":"Iguchi","year":"2021","journal-title":"Int. J. Eat. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Matsuzaki, E., Michie, M., and Kawabata, T. (2017). Validity of Nutrient Intakes Derived from an Internet Website Dish-Based Dietary Record for Self-Management of Weight among Japanese Women. Nutrients, 9.","DOI":"10.3390\/nu9101058"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Shinozaki, N., and Murakami, K. (2020). Evaluation of the Ability of Diet-Tracking Mobile Applications to Estimate Energy and Nutrient Intake in Japan. Nutrients, 12.","DOI":"10.3390\/nu12113327"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s13300-019-0595-5","article-title":"Study Protocol for the Effects of Artificial Intelligence (AI)-Supported Automated Nutritional Intervention on Glycemic Control in Patients with Type 2 Diabetes Mellitus","volume":"10","author":"Oka","year":"2019","journal-title":"Diabetes Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e053453","DOI":"10.1136\/bmjopen-2021-053453","article-title":"Effects of artificial intelligence-SsupporTed Automated NutRiTional Intervention on LDL cholesterol Control in Patients with Familial Hypercholesterolaemia (iSTART-FH): Protocol for a randomised controlled trial","volume":"11","author":"Tada","year":"2021","journal-title":"BMJ Open"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Association Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_16","unstructured":"Kurita, D., and Takebayashi, A. (2023). Seishinka I mo Dekiru! Kyoshokush\u014d Shintai Chiryo Manual, Kinpodo. [2nd ed.]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/jhn.12014","article-title":"Measuring food intake with digital photography","volume":"27","author":"Martin","year":"2014","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_18","unstructured":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) (2020). Standard Tables of Food Composition in Japan\u20142020 (Eighth Revised Edition), MEXT. Available online: https:\/\/www.mext.go.jp\/a_menu\/syokuhinseibun\/mext_01110.html."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/oxfordjournals.aje.a114366","article-title":"Total energy intake: Implications for epidemiologic analyses","volume":"124","author":"Willett","year":"1986","journal-title":"Am. J. Epidemiol."},{"key":"ref_20","first-page":"69","article-title":"Statistics corner: A guide to appropriate use of correlation coefficient in medical research","volume":"24","author":"Mukaka","year":"2012","journal-title":"Malawi Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/1098-108X(200011)28:3<284::AID-EAT5>3.0.CO;2-G","article-title":"Assessment of macronutrient and micronutrient intake in women with anorexia nervosa","volume":"28","author":"Hadigan","year":"2000","journal-title":"Int. J. Eat. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1002\/eat.20973","article-title":"Accuracy of self-reported energy intake in weight-restored patients with anorexia nervosa compared with obese and normal weight individuals","volume":"45","author":"Schebendach","year":"2012","journal-title":"Int. J. Eat. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0005-7967(98)00102-8","article-title":"A cognitive behavioural theory of anorexia nervosa","volume":"37","author":"Fairburn","year":"1999","journal-title":"Behav. Res. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fischer, D., Berberich, G., Zaudig, M., Krauseneck, T., Weiss, S., and Pollatos, O. (2016). Interoceptive Processes in Anorexia Nervosa in the Time Course of Cognitive-Behavioral Therapy: A Pilot Study. Front. Psychiatry, 7.","DOI":"10.3389\/fpsyt.2016.00199"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s40337-024-01100-1","article-title":"A systematic scoping review of carer accommodation in eating disorders","volume":"12","author":"Kumar","year":"2024","journal-title":"J. Eat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1080\/10640266.2019.1652473","article-title":"Family accommodation in eating disorders: A preliminary examination of correlates with familial burden and cognitive-behavioral treatment outcome","volume":"29","author":"Anderson","year":"2021","journal-title":"Eat. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.psychres.2017.11.064","article-title":"Experience of caregiving and coping strategies in caregivers of adolescents with an eating disorder: A comparative study","volume":"260","author":"Parks","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1093\/advances\/nmaa114","article-title":"Within-Person Variation in Nutrient Intakes across Populations and Settings: Implications for the Use of External Estimates in Modeling Usual Nutrient Intake Distributions","volume":"12","author":"French","year":"2021","journal-title":"Adv. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/4\/708\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T14:12:04Z","timestamp":1771855924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/4\/708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["nu18040708"],"URL":"https:\/\/doi.org\/10.3390\/nu18040708","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]}}}