Feasibility of Using an Electronic Calorie Counter to Monitor Energy Intake and Expenditure Among Young Adolescents

Interventions that incorporate behavioral techniques such as self-monitoring appear to be very effective at achieving and maintaining weight loss in both adults and adolescents. Electronic diaries (EDs) have been used for self-monitoring in dietary interventions involving adults and have been found to improve compliance to protocol. However, there are very few studies utilizing EDs in dietary interventions, including interventions targeting adolescents. The purpose of this study was to determine the extent to which a hand-held electronic device is a practical way of collecting self-monitored dietary and exercise data for adolescents. Forty middle school students recorded dietary and exercise habits for 21 days utilizing either a paper diary or an electronic calorie counter. Chi square analysis was used to determine which group was more compliant. Logistic regression analysis was used to determine what demographic factors influenced compliance. While overall compliance was fair, those utilizing paper dairies were significantly more compliant and recorded more days, meals and physical activities than those using the ED (P ≤ .05). Age was the only factor found to significantly influence completion of records. A summative evaluation using a focus group interview format and survey revealed barriers to using the ED, such as usability and portability. Students still preferred using an electronic tool over paper according to students responding to the summative evaluation. Participants indicated that adding an alarm and making the unit smaller would overcome these barriers and make the ED the preferred assessment tool. Future studies should determine the extent to which using an electronic diary could affect self-monitoring in adolescents attempting weight loss, as this is lacking in current research.