Comparison of a dietary record using reported portion size versus standard portion size for assessing nutrient intake

Objective: Because the percentage of missing portion sizes was large in the Aerobics Center Longitudinal Study (ACLS), careful consideration of the accuracy of standard portion sizes was necessary. The purpose of the present study was to investigate the consequences of using standard portion size instead of reported portion sizes on subjects\u27 nutrient intake. Methods: In 2307 men and 411 women, nutrient intake calculated from a 3-day dietary record using reported portion sizes was compared with nutrient intake calculated from the same record in which standard portion sizes were substituted for reported portion sizes. Results: The standard portion sizes provided significantly lower estimates (≥ 20%) of energy and nutrient intakes than the reported portion sizes. Spearman correlation coefficients obtained by the two methods were high, ranging from 0.67 to 0.93. Furthermore, the agreement between both methods was fairly good. Thus, in the ACLS the use of standard portion sizes rather than reported portion sizes did not appear to be suitable to assess the absolute intake at the group level, but appeared to lead to a good ranking of individuals according to nutrient intake. These results were confirmed by the Continuing Survey of Food Intake by Individuals (CSFII), in which the assessment of the portion size was optimal. When the standard portion sizes were adjusted using the correction factor, the ability of the standard portion sizes to assess the absolute nutrient intake at the group level was considerably improved. Conclusions: This study suggests that the adjusted standard portion sizes may be able to replace missing portion sizes in the ACLS database

The Provision of Assistance Does Not Substantially Impact the Accuracy of 24-Hour Dietary Recalls Completed Using the Automated Self-Administered 24-H Dietary Assessment Tool Among Women With Low Incomes

Background: Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income. Objective: This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance. Methods: Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes. Results: Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22). Conclusions: ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy

Perception of Sleep in Recovering Alcohol-Dependent Patients With Insomnia: Relationship With Future Drinking

Subjective and objective measures of poor sleep in alcoholic insomniacs predict relapse to drinking. Nonalcoholic insomniacs underestimate their total sleep time (TST) and overestimate their sleep onset latency (SOL) and wake time after sleep onset (WASO) compared with polysomnography (PSG). This study evaluated 3 hypotheses: (1) subjective SOL would predict frequency of future drinking; (2) participants would overestimate SOL and WASO and underestimate TST; and (3) higher amounts of over- and underestimates of sleep at baseline would predict worse drinking outcomes prospectively. Methods : Participants ( N =18), mean age 44.6 years (±13.2), underwent an adaptation night and then 2 nights of PSG 3 weeks apart. They also provided morning estimates of SOL, WASO, TST, and sleep efficiency (SE). Following the baseline PSG, participants were followed over 12 weeks. A 2-way ANOVA (night × method of measuring sleep) compared results and regression analyses predicted drinking. Drinking outcomes were defined as number of days drinking (DD) and number of heavy-drinking days (HDD) during 2 consecutive 6-week follow-up periods. Results : Most participants (72%) overestimated SOL by a mean of 21.3 (±36) minutes compared with PSG [ F (1, 14)=7.1, p <0.03]. Unexpectedly, 89% underestimated WASO by a mean difference of 48.7 (±49) minutes [ F (1, 14)=15.6, p <0.01]. Drinking during the first 6-week study period was predicted by both subjective estimates of WASO and their accuracy, whereas drinking during the second 6-week period was predicted by both subjective estimations of sleep and rapid eye movement sleep latency. Conclusion : Greater subjective accuracy of wakefulness at night provided by the patient predicted drinking during the study. Unlike nonalcoholic insomniacs, this alcoholic sample significantly underestimated WASO compared with PSG values. The predictive ability of sleep parameters depended on the selected measure of drinking outcomes and when outcomes were measured. Subjective sleep measures were better predictors of future drinking than corresponding PSG measures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65202/1/j.1530-0277.2006.00245.x.pd

Pilot Test of an Online ASA24 Training With EFNEP Educators

The purpose of this study was to evaluate the acceptability and usability of an online training to prepare Expanded Food and Nutrition Education Program (EFNEP) educators to collect 24-hr dietary recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24). Fifty-eight educators in 17 states were recruited to take the training; 29 completed the online training, assisted two individuals in completing a 24-hr recall using ASA24, and completed a survey about their experiences. The sample included 26 respondents. The majority (n = 16; 61.5%) of the sample was EFNEP educators with college education. The majority of the respondents indicated that they found the readings and videos acceptable for learning (n = 21; 80.7%). Half of the participants (n = 13) felt prepared to collect data using ASA24. The majority (n = 22; 84.6%) had positive feedback about the training content. The training may be acceptable for preparing EFNEP educators with at least some college education to collect 24-hr recalls using ASA24. Because of potential bias due to self-selection and nonresponse, the training has been revised and is now intended to be used to train trainers of EFNEP paraprofessionals