Determining skin-carotenoid scores (SCS) via reflectance spectroscopy (RS) has become a widely acceptable method to quantify children's fruit and vegetable consumption (FVC) in research and public health screening due to its ease of use, portability, and non-invasiveness. However, to date, no studies have systematically evaluated the field use of RS instruments in children.
Objectives are to summarize research use of RS-based SCS assessment in children (1-10-year-old) and its reliability and validity as a proxy for children's FVC and to identify areas and opportunities for future research.
Study Design, Settings, Participants
The research team performed a comprehensive literature search in eight databases in June 2021 yielding 4467 citations. Abstracts of peer-reviewed studies assessing SCS using RS instruments in children were identified. Studies were reviewed independently by two reviewers to determine eligibility for inclusion.
Eight articles (Intervention = 1; Cross-sectional=7) were included. Veggie Meter® was used in seven studies as an RS instrument. FVC was measured using 24-hour dietary recall, Pictorial Liking tool, Self-reported School Physical Activity and Nutrition (SPAN) survey, parent reported availability and accessibility survey, and electronic food photos. SCS was associated with total FVC; but not with orange and green vegetable consumption, fruit consumption, and liking. Age, gender, ethnicity, income, and seasonal variation were significant covariates. No study reported validity and reliability of RS-based SCS in children compared to other standardized carotenoid measures. Additionally, adherence to recommended RS-based SCS protocol for field use in children has not been fully reported in included studies.
While the RS has been established as a valid and reliable instrument to measure SCS in adults, present review found small correlation of SCS with total FVC and null relationship when considering only orange and green vegetables or fruit consumption. Therefore, further validation will be beneficial to evaluate reliability and validity of RS-based SCS as a proxy measure to assess children's FVC.
Buffett Early Childhood Institute Graduate Scholars Program