ArticleFrontiers in nutrition2026
Dietary ecological momentary assessments: validation against food diaries and associations with health biomarkers.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03978052 (Prevention of Cognitive Decline in ApoE4 Carriers With Subjective Cognitive Decline After EGCG and a Multimodal Intervention), which is not on this map. Not yet cited in PubMed.
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Prevention of Cognitive Decline in ApoE4 Carriers With Subjective Cognitive Decline After EGCG and a Multimodal Intervention
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14 authors.
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Abstract
Background: Digital approaches that capture dietary behavior repeatedly in real-world settings may improve the monitoring of long-term lifestyle interventions while reducing participant burden and supporting self-awareness. This study developed and evaluated a low-burden dietary ecological momentary assessment (EMA) protocol to monitor Mediterranean diet adherence during the 12-month PENSA multimodal lifestyle trial in older adults at increased risk of cognitive decline. Methods: A total of 104 participants aged 60-80 years with subjective cognitive decline and APOE-ε4 carrier status were included. Daily mobile EMA prompts assessed key Mediterranean diet food groups through a rotating schedule, and participants received personalized feedback every 4 weeks. EMA-derived adherence indicators were evaluated against the Mediterranean Diet Adherence Screener, 3-day food diaries, nutrient profiles, usability data, and cardiometabolic and dementia-risk markers. Results: Mediterranean diet adherence improved over the intervention, with EMA scores increasing from 73.6 to 82.3% and capturing dynamic changes in dietary quality across the year. EMA-derived indicators showed increasing convergence with the Mediterranean Diet Adherence Screener over time ( Conclusion: These findings support dietary EMA as a feasible, scalable, and behaviorally meaningful approach for monitoring and promoting Mediterranean diet adherence in real-world lifestyle interventions, with potential value both as an assessment tool and as an active component to reinforce dietary change. The PENSA trial is registered at ClinicalTrials.gov (NCT03978052).
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