Nutrition 2
Nutrition 2
ABSTRACT In the mobile device market there is a large number of applications to help people monitor
intake or provide suggestions to lose weight and manage a healthy diet. However, the vast majority of
these apps consume a lot of time by having to introduce food one by one. This paper presents the work
to develop and pilot test a new Android application, FoodScan, aimed at people over 70, specially those
from rural environments or with limited technical knowledge, to manage their food from the items that
appear on their grocery receipts, avoiding the obligation to introduce one by one those foods, and generating
recommendations. To achieve this final objective, specific objectives have been completed as indicated in
the methods section. We conducted a review of current calorie control applications to learn about their
weaknesses and strengths. Different algorithms were tested to expedite the introduction of food into the
application and the most suitable for the FoodScan application was selected. Likewise, several options were
taken into account to create the knowledge base of food, taking into account dietary recommendations
for people over 70 years. Once developed, a pilot evaluation was carried out with a convenience sample
of 109 volunteers in rural areas of Caceres and Valladolid (Spain) and Alentejo (Portugal). They tested
FoodScan for a month after which they completed a user satisfaction survey. 93 % (101/109) believed that
the app was easy to download and install, 66 % (72/109) thought that it was easy to use, 47 % (51/109) noted
that the charts with the recommendations helped them with diet control and 49 % (53/109) indicated that
FoodScan helped them improve healthy eating habits. One-month pilot evaluation data suggested that most
users found the app somewhat helpful for monitoring food intake, easy to download and easy to use.
INDEX TERMS MHealth, android, food intake monitoring, elderly, automatic dietary assessment, Web
scraping, optical character recognition algorithm (OCR), user evaluation.
This work is licensed under a Creative Commons Attribution 4.0 License. For more information, see https://creativecommons.org/licenses/by/4.0/
VOLUME 8, 2020 227915
B. Sainz-de-Abajo et al.: FoodScan: Food Monitoring App by Scanning the Groceries Receipts
that many elderly people who live alone are suffering from
nutritional deficiencies that, in some cases, can cause signif-
icant damage to their physical condition. To determine the
health of the elderly population and avoid these problems,
we should have accurate information about their nutritional
patterns to predict their quality of life [5]–[7].
The objective the FoodScan application is to facilitate the
control of the elder diet, specially of those living in rural
areas. These people have limited technical knowledge and
prefer simple devices. In the development of the application,
it was taken into account that connectivity can also be a
problem. Sometimes the Internet connection does not arrive
in optimal conditions to certain rural areas or they do not
even have any signal. FoodScan is a simple application that
collects the information by scanning the purchase groceries
receipts and that does not require an Internet connection for
its management. We can store food in an integrated way with-
out having to do it one by one. It has been developed for the
FIGURE 1. Flow chart.
Android Operating System, since it has a higher penetration
rate than other operating systems.
The steps that we have carried out throughout the work
have been: (1) to review existing Calorie Control Apps; (2) III. METHODS
to analyse algorithms registering the purchased groceries A. WORK FLOW
and select a food collection to compare; (3) to develop the As a starting point, we carry out a review of mobile appli-
FoodScan App; and (4) to conduct a user evaluation. cations that offer characteristics similar to those we try to
implement in our app. After this comparative review, several
II. RELATED WORK algorithms were analysed to speed up the introduction of food
Technology can help people to maintain a healthy diet [8]. into the application. It was also very important to choose the
A large number of applications have been designed for this most appropriate food knowledge base, taking into account
purpose [9], [10]. Some manage sports activities or physical the food recommendations for people over 70 years old living
exercise plans [11]–[14]. Others focus on food control [15]. in rural areas. After achieving these objectives, we developed
Nevertheless, most of those applications unify both aspects: the application and finally carried out a satisfaction survey
control of food, caloric intake and sports activities. among end users. Figure 1 shows the flow chart followed in
Generally, applications for food control have the main this work.
function of registering and storing meals throughout the day.
The user must enter, one by one, the type of food ingested. B. REVIEW OF CURRENTLY AVAILABLE MOBILE APPS TO
This controls the calories ingested in a day and the specific CONTROL CALORIES
nutrients (proteins, carbohydrates, fats, vitamins), and allows A search was performed through Google, Scopus and Web of
comparisons with the data recorded from previous days. Science. The terms used were: ‘‘best calorie counter apps’’,
Applications can incorporate other functions such as: (1) set ‘‘apps to control calorie intake’’, ‘‘apps to control diet’’, and
goals to lose weight over a period of time; (2) store healthy ‘‘apps to control feeding’’. After an exhaustive examination
food recipes; or (3) include a step counter to complement the of mobile applications, we focused on the three that had
record of calories ingested with those that have been burned the higher number of downloads in order to analyse their
throughout the day doing physical exercises. functionalities and features: Lose It! [20], Fat Secret [21] and
Mobile applications have been developed to scan purchase My Fitness Pal [22]. Five people downloaded these three free
receipts [16], [17]. We found a study to measure the effects applications and tested them for a period of approximately
of front-of-pack interpretive nutrition labels on grocery shop- two months. They tested them simultaneously by entering the
ping using label scanning[18]. In another article, the authors same data in all three applications. It was decided that the
tried to know, by registering receipts, the behavior of buying evaluators would analyse characteristics of the applications
food in households [19]. In addition, that will be effective such as ease of downloading, user registration in the applica-
if there is a commitment by the user to scan the tickets. tion, graphical interface, simplicity of the food registration
However, we have not found any mobile application that process, possibility of scanning food barcodes, and using
photographs and records the groceries receipts to compare graphs and charts for providing the results. After this trial
them over a period of time, and based on that comparison period, opinions on the functionality of the applications were
show recommendations for a balanced diet. shared.
TABLE 1. User satisfaction survey. due to the high burden related to entering foods into apps.
Therefore, in order to increase the adherence, users need
applications registering the food intake without requiring
introducing these foods one by one.
B. LIMITATIONS
The implemented application and this study have some limi-
tation that should be highlighted:
1) The satisfaction survey do not ask for the demographics
FIGURE 15. Would you recommend it?. information of the participants. We did not consider
their inclusion because the only requirement for partic-
ipating in this study was to be over 50 years old. They
Only our application allows you to register the food all met the demand.
included in the ticket by scanning. 2) FoodScan tracks what is purchased, not what is con-
2) Analysis of algorithms registering purchased foods. sumed. Therefore, it cannot be used to estimate the
Three options were tested: (1) Web Scraping; (2) object daily nutritional intake, since some of the purchased
recognition and; (3) Optical Character Recognition groceries could be shared or thrown away. These
drawbacks were explained during the demonstration of and/or speed of the groceries receipt analysis, so that the user
the application and the users were given correct guide- does not have to wait a long time. Another improvement to be
lines. Also, consideration should be given to whether developed is the possibility of making the food analysis more
the person lives alone or not. complete by offering, a more specific study of nutrients and
3) The user should follow a good practice in using the calories ingested.
application, but if (s)he shares, throws away and buys
more than necessary, the results will not be realistic. REFERENCES
We are not able to specify what a person has eaten at a [1] S.-W. Chen, D.-L. Chiang, T.-S. Chen, H.-Y. Lin, Y.-F. Chung, and F. Lai,
certain time, but we get a general idea in a period of a ‘‘An implementation of interactive healthy eating index and healthcare
system on mobile platform in college student samples,’’ IEEE Access,
week or a month. vol. 6, pp. 71651–71661, 2018.
4) Further research is required to determine if users are [2] M. Chukwu, ‘‘Personalized mobile monitor for assisted healthy-living,’’ in
able to persist in app use over the long term and if Proc. IEEE Consum. Commun. Netw. Conf. (CCNC), Jan. 2011, pp. 18–22.
[3] Obesity: Preventing and Managing the Global Epidemic Report of a WHO
the app leads to improvement in dietary intake. We are Consultation., World Heal. Organ., Geneva, Switzerland, 2000.
also interested in knowing the lack of adherence to the [4] M. A. Subhi, S. H. Ali, and M. A. Mohammed, ‘‘Vision-based approaches
application. The responses obtained in a short period of for automatic food recognition and dietary assessment: A survey,’’ IEEE
use of the application cannot offer reliable data on the Access, vol. 7, pp. 35370–35381, 2019.
[5] E. Moguel, J. Berrocal, and J. García-Alonso, ‘‘Systematic literature
improvement in diet habits or weight loss. review of food-intake monitoring in an aging population,’’ Sensors, vol. 19,
no. 15, p. 3265, Jul. 2019.
C. CONCLUSION [6] A. A. Sayer and C. Cooper, ‘‘Early diet and growth: Impact on ageing,’’
Proc. Nutrition Soc., vol. 6, no. 1, pp. 79–85, 2002.
The elderly who are not used to new technologies may find it [7] I. Darnton-Hill, C. Nishida, and W. James, ‘‘A life course approach to diet,
difficult to use mobile applications to control their diet. The nutrition and the prevention of chronic diseases,’’ Public Health Nutrition,
disadvantage of many of these applications is that they require vol. 7, no. 1a, pp. 101–121, Feb. 2004.
[8] S. Pagoto, K. Schneider, M. Jojic, M. DeBiasse, and D. Mann, ‘‘Evidence-
a lot of time to introduce the food consumed throughout the based strategies in weight-loss mobile apps,’’ Amer. J. Preventive Med.,
day. From the user’s point of view, it is not practical and, vol. 45, no. 5, pp. 576–582, Nov. 2013.
in the long run, most of them will abandon this control. Our [9] B. Y. Laing, C. M. Mangione, C.-H. Tseng, M. Leng, E. Vaisberg,
M. Mahida, M. Bholat, E. Glazier, D. E. Morisky, and D. S. Bell, ‘‘Effec-
app is useful and easily manageable and avoids the obligation tiveness of a smartphone application for weight loss compared with usual
to introduce one by one those foods. The analysis of the care in overweight primary care patients,’’ Ann. Internal Med., vol. 161,
purchased food is offered through a bar graph with different no. 10, p. 5, Nov. 2014.
[10] J. Tang, C. Abraham, E. Stamp, and C. Greaves, ‘‘How can weight-loss
colors, so it is simple and intuitive. The elderly, or the people app designers’ best engage and support users? A qualitative investigation,’’
in their care, can control how they are eating or what food Brit. J. Health Psychol., vol. 20, no. 1, pp. 151–171, Feb. 2015.
deficiencies they may have. [11] J. Stephens and J. Allen, ‘‘Mobile phone interventions to increase phys-
ical activity and reduce weight: A systematic review,’’ J. Cardiovascular
It can be used by all kinds of public, regardless of their
Nursing, vol. 28, no. 4, pp. 320–329, 2013.
technical knowledge. Although it is geared towards serving [12] G. Flores Mateo, E. Granado-Font, C. Ferré-Grau, and
people over the age of 70, we hope that it will also be used X. Montaña-Carreras, ‘‘Mobile phone apps to promote weight loss
by anyone in their daily lives and that they will be loyal in the and increase physical activity: A systematic review and meta-analysis,’’
J. Med. Internet Res., vol. 17, no. 11, p. e253, Nov. 2015.
long term. Only by adopting healthy habits we can improve [13] G. Bleser, D. Steffen, M. Weber, G. Hendeby, D. Stricker, L. Fradet,
our quality of life. F. Marin, N. Ville, and F. Carré, ‘‘A personalized exercise trainer for the
FoodScan is an application that we have just developed and elderly,’’ J. Ambient Intell. Smart Environ., vol. 5, no. 6, pp. 547–562, 2013.
[14] P. K. Diwakar, Y. Keun Oh, S.-H. Park, and Y.-R. Yoon, ‘‘Personal digital
will continue to improve thanks to the contributions of users. exercise trainer for managing, monitoring and recording the exercise,’’ in
We will regularly monitor the 109 people who completed the Proc. IEEE Eng. Med. Biol. 27th Annu. Conf., 2005, pp. 3720–3723.
survey on the regular use of FoodScan to control their diet. [15] C. M. Wharton, C. S. Johnston, B. K. Cunningham, and D. Sterner,
‘‘Dietary self-monitoring, but not dietary quality, improves with use of
smartphone app technology in an 8-Week weight loss trial,’’ J. Nutrition
D. FUTURE LINES OF WORK Edu. Behav., vol. 46, no. 5, pp. 440–444, Sep. 2014.
One of the aspects of the application to consider in the future [16] A. Jäckle, J. Burton, M. P. Couper, and C. Lessof, ‘‘Participation in a
mobile app survey to collect expenditure data as part of a large-scale
is to extend it and implement a more complete ontology and probability household panel: Coverage and participation rates and biases,’’
a bigger food collection by adding more quantity and variety. Surv. Res. Methods, vol. 13, no. 1, 2019.
Furthermore, we are already working to expand the food [17] B. Read, ‘‘Respondent burden in a mobile app: Evidence from a shopping
receipt scanning study,’’ Surv. Res. Methods, vol. 13, no. 1, pp. 45–71 2019.
ontology and include users of a wider age range. Another [18] E. Volkova, B. Neal, M. Rayner, B. Swinburn, H. Eyles, Y. Jiang, J. Michie,
important point would be to improve the design of the appli- and C. N. Mhurchu, ‘‘Effects of interpretive front-of-pack nutrition labels
cation based on user ratings. This application is configured in on food purchases: Starlight randomised controlled trial,’’ Obesity Res.
Clin. Pract., vol. 8, pp. 110–111, Dec. 2014.
Spanish, Portuguese and English. It is planned to adapt it to
[19] S. A. French, S. T. Shimotsu, M. Wall, and A. F. Gerlach, ‘‘Capturing the
other languages to reach a greater number of users. spectrum of household food and beverage purchasing behavior: A review,’’
To make the application more powerful, artificial intelli- J. Amer. Dietetic Assoc., vol. 108, no. 12, pp. 2051–2058, Dec. 2008.
gence should be added, capable of learning what items refer to [20] Lose It. Accessed: Oct. 27, 2020. [Online]. Available: https://www.
loseit.com/
a specific food, since a direct comparison is currently made. [21] Fat Secret. Accessed: Oct. 27, 2020. [Online]. Available: https://www.
We will have to weigh that it does not affect the performance fatsecret.com/
[22] Myfitnesspal. Accessed: Oct. 27, 2020. [Online]. Available: JOSÉ MANUEL GARCÍA-ALONSO (Member,
https://www.myfitnesspal.com/ IEEE) received the Ph.D. degree in software
[23] O. Castrillo-Fernández, ‘‘Web scraping: Applications and tools,’’ Eur. engineering from the University of Extremadura,
Public Sector Inf. Platform (EPSI platform), Tech. Rep. 10, 2015, in 2014. He is currently an Associate Profes-
pp. 1–31. [Online]. Available: https://pdfslide.net/documents/web- sor with the University of Extremadura, and a
scrapingapplications-and-tools.html Co-Founder of Gloin, Software-Consulting Com-
[24] F. Polidoro, R. Giannini, R. Lo Conte, S. Mosca, and F. Rossetti, ‘‘Web pany. His research interests include software engi-
scraping techniques to collect data on consumer electronics and airfares
neering, mobile computing, pervasive computing,
for Italian HICP compilation,’’ Stat. J., vol. 31, no. 2, pp. 165–176, 2015.
eHealth, and gerontechnology.
[25] R. Penman, T. Baldwin, and D. Martinez, ‘‘Web scraping made simple
with SiteScraper,’’ Penman Web Scraping, pp. 1–10, May 2009. [Online].
Available: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.654.
745&rep=rep1&type=pdf
[26] J. R. R. Uijlings, K. E. A. Van De Sande, T. Gevers, and
A. W. M. Smeulders, ‘‘Selective search for object recognition,’’ Int.
J. Comput. Vis., vol. 104, no. 2, pp. 154–171, 2013.
[27] P. F. Felzenszwalb and D. P. Huttenlocher, ‘‘Pictorial structures for object
recognition,’’ Int. J. Comput. Vis., vol. 61, no. 1, pp. 55–79, 2005.
[28] D. G. Lowe, ‘‘Object recognition from local scale-invariant features,’’ in
Proc. 7th IEEE Int. Conf. Comput. Vis., vol. 2, Sep. 1999, pp. 1150–1157.
[29] A. Chaudhuri, K. Mandaviya, P. Badelia, and S. K. Ghosh, ‘‘Optical
JOSÉ JAVIER BERROCAL-OLMEDA (Member,
character recognition systems,’’ Stud. Fuzziness Soft Comput., vol. 352,
IEEE) received the Ph.D. degree in computer sci-
pp. 9–41, Dec. 2017.
[30] L. Converso and S. Hocek, ‘‘Optical character recognition,’’ J. Vis. Impair. ence from the University of Extremadura, Spain,
Blind., vol. 84, no. 10, pp. 507–509, Dec. 1990. in 2014. In 2016, he obtained an Associate posi-
[31] M. K. Ugale and M. S. Joshi, ‘‘Improving optical character recognition for tion at the University of Extremadura. He is cur-
low resolution images,’’ IJCSN Int. J. Comput. Sci. Netw., vol. 6, no. 25, rently a Co-Founder of company Gloin, which
pp. 18–20, 2017. is a Software-Consulting Company. His main
[32] A. Farooq, A. K. Khan, and G. Raja, ‘‘Implementation of a speech based research interests include mobile computing, con-
interface system for visually impaired persons,’’ Life Sci. J., vol. 10, no. text awareness, pervasive systems, crowd sensing,
SPEC. no. 9, pp. 398–400, 2013. the Internet of Things, and fog computing.
[33] R. M. Russell, H. Rasmussen, and A. H. Lichtenstein, ‘‘Modified Food
Guide Pyramid for People over Seventy Years of Age,’’ J. Nutr., vol. 129,
no. 3, pp. 751–753, Mar. 1999.
[34] Protégé. Accessed: Oct. 27, 2020. [Online]. Available: https://protege.
stanford.edu/
[35] P. Jahoda. (2016). MPAndroidChart. Accessed: Oct. 27, 2020. [Online].
Available: https://www.webci.tation.org/5mt5TH6pg
[36] C. Patel, A. Patel, and D. Patel, ‘‘Optical character recognition by open
source OCR tool tesseract: A case study,’’ Int. J. Comput. Appl., vol. 55,
no. 10, pp. 50–56, Oct. 2012.
[37] R. Hyam, ‘‘Automated image sampling and classification can be used to SERGIO LASO-MANGAS is currently pursu-
explore perceived naturalness of urban spaces,’’ PLoS ONE, vol. 12, no. 1, ing the Ph.D. degree with the University of
Jan. 2017, Art. no. e0169357. Extremadura, Spain. He is also working with the
[38] A. Bechmann, ‘‘Keeping it real: From faces and features to social Computing and Telematics Systems Department.
values in deep learning algorithms on social media images,’’ in Proc. His research interests include mobile computing,
50th Hawaii Int. Conf. Syst. Sci., 2017, pp. 1–9. [Online]. Available: pervasive systems, context-awareness, edge com-
https://scholarspace.manoa.hawaii.edu/bitstream/10125/41372/1/ puting, and the Internet of Things.
paper0223.pdf
[39] R. Arief, A. Benny, T. Maulana, and H., ‘‘Automated extraction of large
scale scanned document images using Google vision OCR in apache
Hadoop environment,’’ Int. J. Adv. Comput. Sci. Appl., vol. 9, no. 11,
pp. 112–116, 2018.
[40] UNESCO Thesaurus. Accessed: Oct. 27, 2020. [Online]. Available:
http://vocabularies.unesco.org/browser/thesaurus/es/?clang=en