Does an Adolescent’s accuracy of recall improve with a second 24-h dietary recall?

The multiple-pass 24-h dietary recall is used in most national dietary surveys. Our purpose was to assess if adolescents’ accuracy of recall improved when a 5-step multiple-pass 24-h recall was repeated. Participants (n = 24), were Chinese-American youths aged between 11 and 15 years and lived in a supervised environment as part of a metabolic feeding study. The 24-h recalls were conducted on two occasions during the first five days of the study. The four steps (quick list; forgotten foods; time and eating occasion; detailed description of the food/beverage) of the 24-h recall were assessed for matches by category. Differences were observed in the matching for the time and occasion step (p < 0.01), detailed description (p < 0.05) and portion size matching (p < 0.05). Omission rates were higher for the second recall (p < 0.05 quick list; p < 0.01 forgotten foods). The adolescents over-estimated energy intake on the first (11.3% ± 22.5%; p < 0.05) and second recall (10.1% ± 20.8%) compared with the known food and beverage items. These results suggest that the adolescents’ accuracy to recall food items declined with a second 24-h recall when repeated over two non-consecutive days

Refinement and validation of an FFQ developed to estimate macro- and micronutrient intakes in a south Indian population

Objective: Potential error sources in nutrient estimation with the FFQ include inaccurate or biased recall and overestimation or underestimation of intake due to too many or too few items on the FFQ, respectively. Here we report the refinement of an FFQ that overestimated nutrient intake and its validation against multiple 24 h recalls. Study Design: Data on 2527 participants in south India (Trivandrum) were available for the original FFQ (OFFQ) that overestimated nutrient intake (132 food items). After excluding participants with implausible energy intake estimates (15.69 MJ/d (\u3e3750 kcal/d)) we ran stepwise regression analyses with selected nutrients as the outcomes and food intake (servings/d) as predictor variables (n 1867). From these results and expert consultation we refined the FFQ (RFFQ), and validated it by comparing intakes obtained with it and the mean of two 24 recalls among 100 participants. Results: The OFFQ overestimated usual daily nutrient intake before and after exclusions [for energy: 1339 (SD 5.46) MJ (3201 (SD 1305) kcal) and 1096 (sD 2.65) MJ (2619 (SD 634) kcal), respectively]. In stepwise analyses, fifty-seven food items explained 90% of the variance in nutrients, we retained thirteen food items because participants consumed them at least twice monthly and twelve food items that local nutritionists recommended. Mean energy intake estimated from the RFFQ (eighty-two food items) was 7.94 (SD 2.05) MJ (1897 (SD 489) kcal). The de-attenuated correlations between mean 24 h recall and RFFQ intakes ranged from 0.25 (vitamin A) to 0.82 (fat). Conclusion: We refined an FFQ that overestimated nutrient intake by shortening and redesigning, and validated it by comparisons with 24 h dietary recall data

Bias in protein and potassium intake collected with 24-h recalls (EPIC-Soft) is rather comparable across European populations

Purpose: We investigated whether group-level bias of a 24-h recall estimate of protein and potassium intake, as compared to biomarkers, varied across European centers and whether this was influenced by characteristics of individuals or centers. Methods: The combined data from EFCOVAL and EPIC studies included 14 centers from 9 countries (n = 1,841). Dietary data were collected using a computerized 24-h recall (EPIC-Soft). Nitrogen and potassium in 24-h urine collections were used as reference method. Multilevel linear regression analysis was performed, including individual-level (e.g., BMI) and center-level (e.g., food pattern index) variables. Results: For protein intake, no between-center variation in bias was observed in men while it was 5.7% in women. For potassium intake, the between-center variation in bias was 8.9% in men and null in women. BMI was an important factor influencing the biases across centers (p <0.01 in all analyses). In addition, mode of administration (p = 0.06 in women) and day of the week (p = 0.03 in men and p = 0.06 in women) may have influenced the bias in protein intake across centers. After inclusion of these individual variables, between-center variation in bias in protein intake disappeared for women, whereas for potassium, it increased slightly in men (to 9.5%). Center-level variables did not influence the results. Conclusion: The results suggest that group-level bias in protein and potassium (for women) collected with 24-h recalls does not vary across centers and to a certain extent varies for potassium in men. BMI and study design aspects, rather than center-level characteristics, affected the biases across center

Illustration of the Importance of Adjustment for within- and between-Person Variability in Dietary Intake Surveys for Assessment of Population Risk of Micronutrient Deficiency/Excess Using an Example Data Set

Nutrition intervention decisions should be evidence based. Single 24-h recalls are often used for measuring dietary intake in large dietary studies. However, this method does not consider the day-to-day variation in populations&rsquo; diets. We illustrate the importance of adjustment of single 24-h recall data to remove within-person variation using the National Cancer Institute method to calculate usual intake when estimating risk of deficiency/excess. We used an example data set comprising a single 24-h recall in a total sample of 1326 1&ndash;&lt;10-year-old children, and two additional recalls in a sub-sample of 11%, for these purposes. Results show that risk of deficiency was materially overestimated by the single unadjusted 24-h recall for vitamins B12, A, D, C and E, while risk of excess was overestimated for vitamin A and zinc, when compared to risks derived from usual intake. Food sources rich in particular micronutrients seemed to result in overestimation of deficiency risk when intra-individual variance is not removed. Our example illustrates that the application of the NCI method in dietary surveys would contribute to the formulation of more appropriate conclusions on risk of deficiency/excess in populations to advise public health nutrition initiatives when compared to those derived from a single unadjusted 24-h recall

Outcomes of a state-wide salt reduction initiative in adults living in Victoria, Australia

Purpose: To assess any effects of a state-wide sodium reduction intervention on sodium intake, sources of dietary sodium and discretionary salt use at a population level. Methods: Data (24-h urinary sodium excretion, self-report survey, a 24-h dietary recall) were collected cross-sectionally at baseline (2016/2017) and follow-up (2020) from adults in Victoria, Australia. Intervention activities included consumer awareness advertising campaign, public debate generation via mass media, strengthening existing policy initiatives and supporting food innovation with industry. Results: There were 339 participants at baseline and 211 at follow-up, with 144 and 90 of participants completing a 24-h dietary recall, respectively. There was no difference in adjusted 24-h urinary sodium excretion between baseline and follow-up (134 vs 131 mmol/24 h; p = 0.260). There were no differences in the percentage of participants adding salt during cooking (63% vs 68%; p = 0.244), adding salt at the table (34% vs 37%; p = 0.400) or regularly taking action to control salt/sodium intake (22% vs 21%; p = 0.793). There were large differences in the quantity of dietary sodium sourced from retail stores (57% vs 77%, p < 0.001), and less sodium was sourced from foods at fresh food markets (13% vs 2%; p ≤ 0.001) at follow-up. No large differences were apparent for foods with different levels of processing or for food groups. Conclusion: There was no clear population-level effect of the 4-year multi-component Victorian Salt Reduction Intervention on sodium intake with Victorian adults continuing to consume sodium above recommended levels. The findings indicate that more intensive and sustained efforts aiming at the retail and food industry with national level support are likely to be required to achieve a measurable improvement in sodium intake at a state level

5-a-day fruit and vegetable food product labels: reduced fruit and vegetable consumption following an exaggerated compared to a modest label.

BACKGROUND: Food product labels based on the WHO 5-a-day fruit and vegetable (FV) message are becoming increasingly common, but these labels may impact negatively on complementary or subsequent FV consumption. This study aimed to investigate the impact of a '3 of your 5-a-day' versus a '1 of your 5-a-day' smoothie product label on subsequent FV consumption. METHODS: Using an acute experimental design, 194 participants (90 males, 104 females) were randomised to consume a smoothie labelled as either '3 of your 5-a-day' (N = 97) or '1 of your 5-a-day' (N = 97) in full, following a usual breakfast. Subsequent FV consumption was measured for the rest of the day using 24-h recall. Usual FV consumption was also assessed via 24-h recall for the day before the study. RESULTS: Regression analyses revealed a significantly lower subsequent FV consumption following smoothies displaying the '3 of your 5-a-day' label compared to the '1 of your 5-a-day' label (Beta = - 0.15, p = 0.04). Secondary analyses revealed these effects to be driven mainly by changes to consumption in usual high FV consumers, in females and in vegetable as opposed to fruit consumption. CONCLUSIONS: These findings demonstrate a role for label information in food intake, and the potential negative impacts of an exaggerated food product label on healthy food consumption and healthy dietary profiles

Development and Validation of the Short Healthy Eating Index Survey with a College Population to Assess Dietary Quality and Intake

Because diet quality (DQ) is associated with risk of chronic disease and is a common construct assessed in health-related research, validated tools to assess DQ are needed that have low respondent and researcher burden. Thus, content experts develop the Short Healthy Eating Index (sHEI) tool and an associated scoring system. The sHEI scoring system was then refined using a classification and regression tree (CRT) algorithm methodology with an iterative feedback process with expert review and input. The sHEI scoring system was then validated using a concurrent criterion validation process that included the sHEI DQ scores (calculated from responses from 50 participants) being compared to the participants’ Healthy Eating Index scores derived from 24 h recalls. The total HEI score from the CRT algorithm highly correlated with the 24 h recall HEI score (0.79). For individual food group items, the correlation between the CRT algorithm scoring and the 24 h recall data scoring ranged from 0.44 for refined grains to 0.64 for whole fruits. The sHEI appears to be a valid tool for estimating overall dietary quality and individual items (with correlations \u3e 0.49) for fruits, vegetables, dairy, added sugar, sugar from sugar-sweetened beverages, and calcium

Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults.

Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455) completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010) scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02) and food-insecure (p \u3c 0.0001) pantry clients. Mean energy intake (p = 0.0003), number of eating occasions (p = 0.004), and HEI-2010 component scores for total fruit (p \u3c 0.001) and whole fruit (p \u3c 0.0003) increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients

Contribution of forest foods to dietary intake and their association with household food insecurity: a cross-sectional study in women from rural Cameroon

To determine the contribution of forest foods to dietary intake and estimate their association with household food insecurity. Cross-sectional survey conducted among 279 households. Using a 7 d recall questionnaire, information on household food consumption was collected from women and used to determine the household dietary diversity score, food variety score and forest food consumption score (FFCS). Household Food Insecurity Access Scale (HFIAS) score was determined and Spearman rank correlation was used to establish the relationship between consumption of forest foods and HFIAS score. Women’s dietary intake was estimated from two 24 h recalls. The contribution of forest foods to women’s nutrient intakes was calculated and women’s nutrient intakes were compared with estimated average nutrient requirements. Rural forest-dependent households in twelve villages in eastern and southern Cameroon. Household heads and their non-pregnant, non-lactating spouses. Forty-seven unique forest foods were identified; of these, seventeen were consumed by 98 % of respondents over the course of one week and by 17 % of women during the two 24 h recall periods. Although forest foods contributed approximately half of women’s total daily energy intake, considerably greater contributions were made to vitamin A (93 %), Na (100 %), Fe (85 %), Zn (88 %) and Ca (89 %) intakes. Despite a highly biodiverse pool of foods, most households (83 %) suffered from high food insecurity based on the HFIAS. A significant inverse correlation was observed between the HFIAS score and the FFCS (r2=−0·169, P=0·0006), demonstrating that forest foods play an important role in ensuring food security in these forest-dependent communities. Forest foods are widely consumed by forest-dependent communities. Given their rich nutrient content, they have potential to contribute to food and nutrition security

Food consumption in school-age children : a new web-based recall for dietary assessment in Portugal

Tese de doutoramento, Doenças Metabólicas e Comportamento Alimentar (Ciências e Tecnologias da Saúde) (Nutrição), Universidade de Lisboa, Faculdade de Medicina, 2016Accurate dietary assessment is critical for monitoring the nutritional status of children, examining associations between diet and health, and identifying dietary intake patterns and eating behaviours. The study of diets of children poses methodological problems relating to the accuracy of assessment. The 24-hour Dietary Recall (24-h DR) is among the most accurate methods to estimate total energy and nutrient intakes in school-age children. Traditional 24-h DR is expensive and impractical for large-scale studies. The application of technology to automate the more accurate 24-h DR is being conducted in multiple countries across the world, making them less expensive and easier to use. The objective of this study is to develop, validate and test a new web-based recall for dietary assessment in Portuguese school-age children: the Portuguese self-administered computerised 24-h DR (PAC24). The PAC24 is a self-administered web-based 24-h DR based on multiple pass method directed to second-, third- or fourth-grade Portuguese children (7-10 years old). In PAC24, children are first questioned about food and drink consumption on the previous day. Food entry is done via free text search, supported by a spell check application. For the majority of foods, amount consumed is estimated by selecting the closest portion size, served and leftover, if any, among seven different digital images. Data about time, place, television watching and computer use are assigned to each eating occasion. The food composition code and weight (g or mL) of selected items are automatically allocated and stored. A database of 380 food items is available. Food, energy and nutrient information is linked to a database that contains essentially information about Portuguese food composition table. The development of PAC24 was based on literature review, 21 focus groups (FG) developed in seven primary schools of the seven main regions of Portugal and input from national and international researchers with experience in computer-dietary assessment among children. A prototype of PAC24 was tested and its content was validated through an expert meeting. Accuracy was determined by comparison of PAC24 with lunch observations (‘gold standard’) in two schools in Lisbon and Tagus Valley (LTV) region. A pilot study was conducted to check the feasibility of PAC24 with respect to procedures, methods and data processing in one primary school in LTV region on two non-consecutive days with 15 days apart. The food consumption, particularly total energy and nutrient (protein, total fat, carbohydrate, fibre, calcium, sodium, potassium) intakes were studied. Wilcoxon signed-rank tests were used to compare the food consumption between the first and second measurement occasion. A p-value 0.05). In summary, PAC24 is a cost-effective, intuitive and an engaging method for Portuguese school-age children. The PAC24 could be used to estimate dietary intake on a group level, accurately. This method will provide useful information for epidemiological studies on the links between diet and health and contribute to the improvement of public health policies at national level