Development and Evaluation of an Offline Vision-Language Model System for Estimating Nutrients from Meal Photographs on Personal Devices: The PLANS (Personal-device Local Assessment of Nutrients System) Study

Background: Estimating nutrient intake from meal photographs with vision-language models (VLMs) is now practical, but patient photographs often cannot leave the institution. We developed PLANS (Personal-device Local Assessment of Nutrients System), in which a small open VLM runs entirely on a personal device. Methods: Open VLMs were compared on two image sets with reference values (NutriImage, 887 Japanese meals; SNAPMe, 1,134 US meals), and the selected model (Qwen3-VL-4B, 4-bit) was run on an iPad Air without network access. Energy (primary outcome), protein, fat, carbohydrate and salt were

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