Study Protocol on the Development and Validation of a Sustainable Diet Index using Mobile Food Records

Nur Fadzlina Zulkefli , Moy Foong Ming
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur

Objective: Adopting a sustainable diet is an alternative to address the pandemics of obesity, undernutrition and climate change that are threatening human health. Sustainable diet takes into account the health aspect as well as the environmental impact of diets. There is a scarcity of research on sustainable diet and lack validated tools for its measurement in Malaysia. This study aimed to develop and validate a Sustainable Diet Index (SDI) to assess if the populations diet is sustainable and environmental friendly.

Methodology: The study participants will be young adults from a local university. The participants are required to capture all foods and beverages consumed daily, before and after eating, using an Android smartphone. A Mobile Food Record (MFR) application will be used by participants to upload a 3-day food and beverage images. The images will be assessed for serves of fruits and vegetables, meat, poultry, fish, legumes, food packaging and food waste.The components in the SDI were developed from the available dietary guidelines on sustainable diet. Internal validity of the SDI will be performed using exploratory and confirmatory factor analyses. Internal consistency and reliability will be checked using Cronbach's Alpha and test-retest respectively. The weightage of each component of the SDI will be determined using Structural Equation Modelling. Relative validity will be assessed by determining the agreement between the MFR and the traditional 24- hour diet recall method.

Results and Discussion: The SDI is expected to act as a valid tool for the measurement of sustainable diet among young adults and hence provide the opportunity for further monitoring and intervention by researchers. This study will also prove a wider use of food images for dietary assessment. The validated Sustainable Diet Index will provide a novel approach to evaluate sustainable diet among the Malaysian population.