A non-invasive assessment of skin carotenoid status through reflection spectroscopy is a feasible, reliable and potentially valid measure of fruit and vegetable consumption in a diverse community sample

Public Health Nutr. 2018 Jun;21(9):1664-1670. doi: 10.1017/S136898001700430X. Epub 2018 Feb 19.


Objective: To assess the feasibility, reliability and validity of reflection spectroscopy (RS) to assess skin carotenoids in a racially diverse sample.

Design: Study 1 was a cross-sectional study of corner store customers (n 479) who completed the National Cancer Institute Fruit and Vegetable Screener as well as RS measures. Feasibility was assessed by examining the time it took to complete three RS measures, reliability was assessed by examining the variation between three RS measures, and validity was examined by correlation with self-reported fruit and vegetable consumption. In Study 2, validity was assessed in a smaller sample (n 30) by examining associations between RS measures and dietary carotenoids, fruits and vegetables as calculated from a validated FFQ and plasma carotenoids.

Setting: Eastern North Carolina, USA.

Results: It took on average 94·0 s to complete three RS readings per person. The average variation between three readings for each participant was 6·8 %. In Study 2, in models adjusted for age, race and sex, there were statistically significant associations between RS measures and (i) FFQ-estimated carotenoid intake (P<0·0001); (ii) FFQ-estimated fruit and vegetable consumption (P<0·010); and (iii) plasma carotenoids (P<0·0001).

Conclusions: RS is a potentially improved method to approximate fruit and vegetable consumption among diverse participants. RS is portable and easy to use in field-based public health nutrition settings. More research is needed to investigate validity and sensitivity in diverse populations.

Keywords: Carotenoids; Fruit; Health promotion; Vegetables.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Carotenoids / analysis*
  • Carotenoids / blood
  • Cross-Sectional Studies
  • Diet Surveys / methods*
  • Feasibility Studies
  • Female
  • Fruit*
  • Humans
  • Male
  • North Carolina
  • Pilot Projects
  • Reproducibility of Results
  • Skin / chemistry*
  • Spectrum Analysis / methods*
  • Time Factors
  • Vegetables*


  • Carotenoids