The Human Factor in Automated Image-Based Nutrition Apps: Analysis of Common Mistakes Using the goFOOD Lite App

Vasiloglou, Maria F; van der Horst, Klazine; Stathopoulou, Thomai; Jaeggi, Michael; Tedde, Giulia; Lu, Ya; Mougiakakou, Stavroula (2021). The Human Factor in Automated Image-Based Nutrition Apps: Analysis of Common Mistakes Using the goFOOD Lite App. JMIR mHealth and uHealth, 9(1), e24467. JMIR Publications 10.2196/24467

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Background: Technological advancements have enabled nutrient estimation by smartphone apps such as goFOOD. This is an artificial intelligence-based smartphone system, which uses food images or video captured by the user as input and then translates these into estimates of nutrient content. The quality of the data is highly dependent on the images the user records. This can lead to a major loss of data and impaired quality. Instead of removing these data from the study, in-depth analysis is needed to explore common mistakes and to use them for further improvement of automated apps for nutrition assessment.

Objective: The aim of this study is to analyze common mistakes made by participants using the goFOOD Lite app, a version of goFOOD, which was designed for food-logging, but without providing results to the users, to improve both the instructions provided and the automated functionalities of the app.

Methods: The 48 study participants were given face-to-face instructions for goFOOD Lite and were asked to record 2 pictures (1 recording) before and 2 pictures (1 recording) after the daily consumption of each food or beverage, using a reference card as a fiducial marker. All pictures that were discarded for processing due to mistakes were analyzed to record the main mistakes made by users.

Results: Of the 468 recordings of nonpackaged food items captured by the app, 60 (12.8%) had to be discarded due to errors in the capturing procedure. The principal problems were as follows: wrong fiducial marker or improper marker use (19 recordings), plate issues such as a noncompatible or nonvisible plate (8 recordings), a combination of various issues (17 recordings), and other reasons such as obstacles (hand) in front of the camera or matching recording pairs (16 recordings).

Conclusions: No other study has focused on the principal problems in the use of automatic apps for assessing nutritional intake. This study shows that it is important to provide study participants with detailed instructions if high-quality data are to be obtained. Future developments could focus on making it easier to recognize food on various plates from its color or shape and on exploring alternatives to using fiducial markers. It is also essential for future studies to understand the training needed by the participants as well as to enhance the app's user-friendliness and to develop automatic image checks based on participant feedback.

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