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Background  Eating behavior has a high impact on the well-being of an individual. Such behavior involves not only when an individual is eating, but also various contextual factors such as with whom and where an individual is eating and what kind of food the individual is eating. Despite the relevance of such factors, most automated eating detection systems are not designed to capture contextual factors.    Objective  The aims of this study were to (1) design and build a smartwatch-based eating detection system that can detect meal episodes based on dominant hand movements, (2) design ecological momentary assessment (EMA) questions to capture meal contexts upon detection of a meal by the eating detection system, and (3) validate the meal detection system that triggers EMA questions upon passive detection of meal episodes.    Methods  The meal detection system was deployed among 28 college students at a US institution over a period of 3 weeks. The participants reported various contextual data through EMAs triggered when the eating detection system correctly detected a meal episode. The EMA questions were designed after conducting a survey study with 162 students from the same campus. Responses from EMAs were used to define exclusion criteria.    Results  Among the total consumed meals, 89.8% (264/294) of breakfast, 99.0% (406/410) of lunch, and 98.0% (589/601) of dinner episodes were detected by our novel meal detection system. The eating detection system showed a high accuracy by capturing 96.48% (1259/1305) of the meals consumed by the participants. The meal detection classifier showed a precision of 80%, recall of 96%, and F1 of 87.3%. We found that over 99% (1248/1259) of the detected meals were consumed with distractions. Such eating behavior is considered “unhealthy” and can lead to overeating and uncontrolled weight gain. A high proportion of meals was consumed alone (680/1259, 54.01%). Our participants self-reported 62.98% (793/1259) of their meals as healthy. Together, these results have implications for designing technologies to encourage healthy eating behavior.    Conclusions  The presented eating detection system is the first of its kind to leverage EMAs to capture the eating context, which has strong implications for well-being research. We reflected on the contextual data gathered by our system and discussed how these insights can be used to design individual-specific interventions.

jmir mhealth and uhealth

A Real-Time Eating Detection System for Capturing Eating Moments and Triggering Ecological Momentary Assessments to Obtain Further Context: System Development and Validation Study