Self-Assessment of the Daily Food Intake in ALS via an Application on a Mobile Device

In the course of the disease an undesirable weight loss is common in ALS patients. Nutritional status is an important prognostic factor for survival in ALS. The early detection of alterations in the food intake as well as changes in weight is essential for these patients. Commonly a nutrition consultation is performed after patients develop swallowing diffi culties or suffer from weight loss. The nutritionist anamnestically determines a retrospective dietary protocol by conducting a standardized interview to evaluate the daily oral food intake and the daily energy imbalance.

To examine the recording of the actual nutritional intake in ALS via a web-based application on a tablet computer.

In a prospective, controlled study, patients recorded the oral food intake via an Internet-based nutrition application by using a touchscreen tablet computer in their home care environment. The application requires internet connection to store the data on a server located in the virtual and physical secured environment of the research facility. Based on the established " quartered plate method " the web
application shows different options of meals, portions and durations. Patients assess the portion and duration of every single meal according to a full plate compared to their normal food intake. During the inclusion visit the nutritionist calculates the individual mean daily food intake of every participant and estimates individual portions. The self-assessment should be done at three predetermined days per week over a period of three months.

We already included 10 patients. Every patient is provided with a tablet computer with the installed application and a nutrition consultation was performed. The intuitive user interface and the simple usability improve the compliance especially in patients with manual defi cits.

Web applications on tablet computers or on smartphones are well known by a wide range of internet users. To our knowledge we present the fi rst web application for measuring the daily caloric intake in ALS. The study establishes
the methodical feasibility and clinical tolerability of a web application for monitoring the daily food intake in ALS patients. Based on this technique, patients are able to record the nutritional intake between the outpatient visits; we suggest that use in clinical practice enables the early detection of changes for nutritional intervention.