Technological tools for assessing children's food intake: a scoping review

**Background:** Conventional dietary assessment methods for children are prone to errors due to children's limited cognitive capacity and reliance on parent reporting. Technological innovations may standardize data collection and minimize reporting errors. This scoping review aimed to identify and characterize technological tools used to assess children's food intake, following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines.

**Methods:** The review searched five databases (MEDLINE via PubMed, Scopus, Web of Science, LILACS via BVS, Cochrane Library) and gray literature (OpenGrey) up to 26 October 2021. Studies were eligible if they assessed dietary intake of children aged 0–9 years using technology, including validation and calibration studies. Exclusion criteria included studies using only traditional methods, technology for non-dietary purposes (e.g., education, weight control), reviews, protocols, and non-English/Portuguese/Spanish articles. Three researchers independently screened titles/abstracts; full-text reading was performed in pairs with a fourth researcher resolving disagreements. Data extraction covered tool characteristics, technology details, and validation parameters. Qualitative synthesis with absolute and relative frequencies was performed using Microsoft Excel and R (version 4.2.0).

**Key Results:** From 15,119 retrieved studies, 10,919 remained after deduplication, 279 were read in full, and 93 met eligibility criteria. Forty-six technologies were identified. Most were developed in Europe (37%) and North America (32.6%), with 65.2% being self-administered and 37% web-based. The most common dietary assessment method was 24-hour dietary recall (24HR; 56.5%). Over 80% of studies involved children over 6 years. Data entry was primarily text-based (32.6%), image capture (17.4%), or free text (15.2%). Most tools were quantitative (87.0%), and 56.5% allowed estimation of energy and nutrient intake. Only 17.4% described assessment of supplement consumption. Approximately 54.6% of articles did not report whether the tool included a food composition database. Children were the informants in about 35% of tools, versus 26.1% for parents/guardians. The most studied tools were Web-DASC (9 articles), NDSR (7 articles), and EPIC-Soft and Web-CAAFE (5 articles each). Twenty-two tools (47.8%) were validated. The most common reference method was direct observation (38.7%), followed by 24HR (25.8%). Participant numbers in validation studies ranged from 21 to 834. Eighteen validation studies (58%) concluded results were satisfactory, 10 (32%) found tools required improvement, and 3 (10%) concluded the tool needed to be adequate for the study population. Only one technology was identified for Latin America (Web-CAAFE, Brazil) and one for Africa (Zambia Tablet-based 24h Recall Tool).

**Clinical Implications:** The review provides a comprehensive map of existing technological tools for assessing children's dietary intake, which is essential for nutritional status evaluation and predicting chronic disease risk. The predominance of tools for children over 6 years and the scarcity of validated tools for younger children highlight a gap. The lack of tools in low- and middle-income countries limits global applicability. Most tools do not report integrated food composition databases, which would facilitate real-time feedback. Few studies assessed intake in both home and school settings, limiting comprehensive 24-hour intake measurement. The findings support the need for funding to develop culturally and linguistically appropriate tools for under-served populations and for further validation studies, particularly for younger age groups.