Intake24 Malaysia: Study Protocol to Develop and Validate a Digital Dietary Assessment Tool for a Multicultural Population (Preprint)

BACKGROUND Malaysia is a multicultural country with the main ethnic groups being Bumiputra, Chinese, and Indian. This creates a rich food culture with distinct dishes, cooking styles, and portion sizes, making dietary assessment challenging. Intake24 is a web-based 24-hour dietary recall system that automates data collection, reduces recall bias, and saves time. OBJECTIVE This paper describes a protocol for the development and relative validation of Intake24 Malaysia (Intake24-MY) for the Malaysian population. METHODS This paper describes two phases in adapting Intake24-MY: (1) the development process and (2) the validation study. Phase 1 consists of the following components: (1a) system translation, (1b) food list development, (1c) portion-size estimation, (1d) food-composition data, (1e) small-scale and pilot testing, and (1f) user guide development. Phase (2a) single-meal validation study that will be conducted among 100 adults, comparing Intake24-MY with observed intake. Phase 2b) cross-sectional study conducted among 482 Malaysian adults to compare 4 days of dietary intake using Intake24-MY against an interviewer-led 24-hour dietary recall. A structured questionnaire will be used to assess the feedback on the usability of Intake24-MY. The Bland-Altman method will be used to determine the agreement between these methods. RESULTS Recruitment for the pilot study began in September 2025. The single-meal validation study has been ongoing and is scheduled for completion by March 2026. Recruitment for the relative validation is scheduled to begin in May 2026, following institutional review board approval from the Monash University Human Research Ethics Committee (MUHREC ID: 41337). CONCLUSIONS Intake24-MY is a comprehensive digital dietary assessment tool for Malaysia and will contribute to improving dietary assessment for the multi-ethnic population in Malaysia. CLINICALTRIAL