Effects of Dish Name, Visible Amount, Persona, and Explicit Instruction on Energy Estimates From Food Photographs by 26 Vision-Language Models: Comparative Evaluation Study

Background: Vision-language models (VLMs) are being considered for estimating energy intake from meal photographs. Prompt descriptions such as a Japanese-dietitian persona shift the estimates, suggesting their use for calibration; what the estimates rest on was unknown. Objective: We examined whether prompt descriptions can serve as calibration, at which training stage responses to a nationality persona and to an amount instruction arise, and whether estimates follow the visible amount or one associated with the identified dish. Methods: Eleven commercial and 15 open-weight models were evaluat

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