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

Image-based dietary assessment ability of dietetics students and interns

Image-based dietary assessment (IBDA) may improve the accuracy of dietary assessments, but no formalized training currently exists for skills relating to IBDA. This study investigated nutrition and dietetics students’ and interns’ IBDA abilities, the training and experience factors that may contribute to food identification and quantification accuracy, and the perceived challenges to performing IBDA. An online survey containing images of known foods and serving sizes representing common American foods was used to assess the ability to identify foods and serving sizes. Nutrition and dietetics students and interns from the United States and Australia (n = 114) accurately identified foods 79.5% of the time. Quantification accuracy was lower, with only 38% of estimates within ±10% of the actual weight. Foods of amorphous shape or higher energy density had the highest percent error. Students expressed general difficulty with perceiving serving sizes, making IBDA food quantification more difficult. Experience cooking at home from a recipe, frequent measuring of portions, and having a food preparation or cooking laboratory class were associated with enhanced accuracy in IBDA. Future training of dietetics students should incorporate more food-based serving size training to improve quantification accuracy while performing IBDA, while advances in IBDA technology are also needed. © 2017 by the authors; licensee MDPI, Basel, Switzerland

Feasibility of assessing diet with a mobile food record for adolescents and young adults with Down syndrome

Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome

A Qualitative Analysis of a Caregivers’ Experience of Complementary Feeding in a Population of Native Hawaiian, Other Pacific Islander and Filipino Infants: The Timing of the Introduction of Complementary Foods, and the Role of Transgenerational Experience

The aim of this study was to investigate caregivers’ experiences of complementary feeding (CF) among the Native Hawaiian and Other Pacific Islander (NHPI), and Filipino populations. Research focused on the timing of CF commencement, and the influence of transgenerational experience on feeding practices. The experiences and practices of those who fed human milk exclusively (HME), were compared to those who included infant formula (F&HM). Caregivers of a subset of 32 infants who were participating in a larger longitudinal study relating to CF and diet diversity, took part in voluntary in-depth interviews relating to CF practices. Interviews were recorded and transcribed. Two researchers analyzed interview transcripts. Interrater reliability and saturation were established. Institutional Review Board exemption was confirmed prior to study commencement. Interviews with 29 caregivers of infants were included in this study. Only infants of the F&HM group had an early introduction to complementary foods (age). Caregivers reported receiving conflicting advice from healthcare professionals (HCPs) in relation to timing of the introduction of complementary foods. Nonetheless, the majority of caregivers reported following the advice of HCPs. Extended family (including grandparents) played less of a role in infant feeding, compared to previous generations. While transgenerational practices were valued and included, ultimately, the perceived health and safety of the practice for infants influenced decisions

Food Security and Diet Quality in Native Hawaiian, Pacific Islander, and Filipino Infants 3 to 12 Months of Age

Food insecurity and other nutritional risks in infancy pose a lifelong risk to wellbeing; however, their effect on diet quality in Native Hawaiian, Pacific Islander, and Filipino (NHPIF) infants in Hawai‘i is unknown. In this cross-sectional analysis, the association between various indicators of food security and NHPIF infant diet quality were investigated in 70 NHPIF infants aged 3–12 months residing on O‘ahu, Hawai‘i. The dietary assessments of the infants were collected using a mobile food recordTM. Foods consumed across four days were categorized into seven food groups. Indicators for food security were examined through an adapted infant food security index and other indicators. Data were analyzed using chi-square tests, independent sample t-tests, multinomial logistic regression, and linear regression models. In models adjusting for age and sex, infants defined as food insecure by the adapted index were found to consume foods from more food groups and consume flesh foods on a greater proportion of days. Of the indicators examined, the adapted index was shown to be the best indicator for food group consumption. Further work is needed on a more representative sample of NHPIF infants to determine the impact that food security has on nutritional status and other indicators of health

Repeated dietary exposure to low levels of domoic acid and problems with everyday memory: Research to public health outreach

Domoic Acid (DA) is a marine-based neurotoxin. Dietary exposure to high levels of DA via shellfish consumption has been associated with Amnesic Shellfish Poisoning, with milder memory decrements found in Native Americans (NAs) with repetitive, lower level exposures. Despite its importance for protective action, the clinical relevance of these milder memory problems remains unknown. The purpose of this study was to determine whether repeated, lower-level exposures to DA impact everyday memory (EM), i.e., the frequency of memory failures in everyday life. A cross-sectional sample of 60 NA men and women from the Pacific NW was studied with measures of dietary exposure to DA via razor clam (RC) consumption and EM. Findings indicated an association between problems with EM and elevated consumption of RCs with low levels of DA throughout the previous week and past year after controlling for age, sex, and education. NAs who eat a lot of RCs with presumably safe levels of DA are at risk for clinically significant memory problems. Public health outreach to minimize repetitive exposures are now in place and were facilitated by the use of community-based participatory research methods, with active involvement of state regulatory agencies, tribe leaders, and local physicians

Testing the predictive validity of the healthy eating index-2015 in the multiethnic cohort: Is the score associated with a reduced risk of all-cause and cause-specific mortality?

The Healthy Eating Index-2015 (HEI-2015) was created to assess conformance of dietary intake with the Dietary Guidelines for Americans (DGA) 2015–2020. We assessed the association between the HEI-2015 and mortality from all-cause, cardiovascular disease (CVD), and cancer in the Multiethnic Cohort (MEC). White, African American, Native Hawaiian, Japanese American, and Latino adults (n > 215,000) from Hawaii and California completed a quantitative food-frequency questionnaire at study enrollment. HEI-2015 scores were divided into quintiles for men and women. Radar graphs were used to demonstrate how dietary components contributed to HEI-2015 scores. Mortality was documented over 17–22 years of follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox proportional hazards models. High HEI-2015 scores were inversely associated with risk of mortality from all-cause, CVD, and cancer for men and women (p-trend <0.0001 for all models). For men, the HRs (CIs) for all-cause, CVD, and cancer comparing the highest to the lowest quintile were 0.79 (0.76, 0.82), 0.76 (0.71, 0.82), and 0.80 (0.75, 0.87), respectively. For women, the HRs were 0.79 (0.76, 0.82), 0.75 (0.70, 0.81), and 0.84 (0.78, 0.91), respectively. These results, in a multiethnic population, demonstrate that following a diet aligned with the DGAs 2015–2020 recommendations is associated with lower risk of mortality from all-cause, CVD, and cancer