Developing in-country capacity to collect low-cost, high quality, granulated data on individual dietary intake across Africa and Asia

Global health challenge: Poor diet is an important preventable risk factor for worldwide morbidity and mortality [Global Burden of Disease Study, 2019]. The triple burden of malnutrition, the simultaneous occurrence of undernutrition, micronutrient deficiency and overnutrition, affects most lower and middle income countries (LMICs) due to a shift to western diets and lifestyle on a backdrop of malnutrition [Popkin, 2020]. LMICs experience the highest diet-related disease burden and lack critical data and real-time data collection tools on individual food intake needed to support evidence-based programs [Global Nutrition Report, 2018]. Traditional methods for measuring food intake are very costly, require a highly trained workforce and as a result, many countries rely on inaccurate survey methods. Ultimate aim: The primary aim of the partnership grant is to accelerate regional and in-country capacity in dietary assessment. This will be achieved through collaborative adaptation of the well established open-source, online 24-hour dietary recall system ‘Intake24’ in eight countries across Africa and Asia (South Africa, Ethiopia, Ghana, Uganda, Malaysia, Indonesia, Vietnam and Thailand). Guidance and mentorship will be provided across the research network through partners from the UK, Malaysia, Australia and an external expert panel to develop a community of practice which will encourage the sharing of experiences, knowledge and resources in localising Intake24. This will result in a well connected network of nutrition researchers relevant to the Global South, armed with feasible, cost-effective methods of collecting data relevant to the key public health issues facing LMIC populations. The teams will join the Intake24 Open Nutrition Network which includes members from the UK, Australia, Japan, Malaysia, Indonesia and Bangladesh who are working to share knowledge, resources and experience and to champion the use and further localisation of Intake24. Potential applications and benefits: As a result of this partnership grant, teams in each country will develop new skills in generation of food composition data and portion size assessment methods and will build regional capacity to conduct nutritional surveys and large-scale research studies. Localised versions of Intake24 will be deployed in each partner institution and software developers in South Africa and Malaysia will be trained in supporting the system. The use of Intake24 will be incorporated into undergraduate and postgraduate teaching as well as in service training or workshops that will promote the use of the system via each continent's Nutrition Leadership programme, dietetic associations and nutrition societies. An external panel of experts on dietary assessment will guide the partnership in developing the platform, and sustainability and uptake of the software in each setting will be supported by Ministries of Health and other various stakeholders. Resources developed in localisation of the system, such as food composition data and food photographs, will be made freely available and updated regularly via the FAO/INFOODS database [FAO/INFOODS, 2022], leading to an LMIC Open Nutrition Network of resources to enable the collection of high quality, granulated data on individual dietary intake at low cost. This repository of robust dietary assessment methods and food databases will aid future nutrition surveillance and cross-disciplinary research in the Global South, and will ultimately improve the capacity of the nutrition and health workforce to augment dietary assessment methods. Information on detailed dietary intakes will be invaluable in the development of targeted nutrition programs and policies required to address key public health problems in LMICs.