Overestimation of infant and toddler energy intake by 24-h recall compared with weighed food records

BACKGROUND: Twenty-four-hour dietary recalls have been used in large surveys of infant and toddler energy intake, but the accuracy of the method for young children is not well documented. OBJECTIVE: We aimed to determine the accuracy of infant and toddler energy intakes by a single, telephone-administered, multiple-pass 24-h recall as compared with 3-d weighed food records. DESIGN: A within-subjects design was used in which a 24-h recall and 3-d weighed food records were completed within 2 wk by 157 mothers (56 non-Hispanic white, 51 non-Hispanic black, and 50 Hispanic) of 7-11-mo-old infants or 12-24-mo-old toddlers. Child and caregiver anthropometrics, child eating patterns, and caregiver demographics and social desirability were evaluated as correlates of reporting bias. RESULTS: Intakes based on 3-d weighed food records were within 5% of estimated energy requirements. Compared with the 3-d weighed food records, the 24-h recall overestimated energy intake by 13% among infants (740 +/- 154 and 833 +/- 255 kcal, respectively) and by 29% among toddlers (885 +/- 197 and 1140 +/- 299 kcal, respectively). Eating patterns (ie, frequency and location) did not differ appreciably between methods. Macronutrient and micronutrient intakes were higher by 24-h recall than by 3-d weighed food record. Dairy and grains contributed the most energy to the diet and accounted for 74% and 54% of the overestimation seen in infants and toddlers, respectively. Greater overestimation was associated with a greater number of food items reported by the caregiver and lower child weight-for-length z scores. CONCLUSIONS: The use of a single, telephone-administered, multiple-pass 24-h recall may significantly overestimate infant or toddler energy and nutrient intakes because of portion size estimation errors.     

Minimizing random error in dietary intakes assessed by 24-h recall, in overweight and obese adults

OBJECTIVE: To determine the minimum number of days of dietary intake interviews required to reduce the effects of random error (day-to-day variability in dietary intake) when using the multiple-pass, multiple-day, 24-h recall method. DESIGN: Cross-sectional study. SETTING: University research department. SUBJECTS: A total of 50 healthy non-smoking overweight and obese (body mass index=26-40 kg/m2) adult men and women aged 39-45 years completed the study. Participants were randomly selected from volunteers for a larger unrelated study. INTERVENTIONS: Each participant completed 10, multiple-pass, 24-h recall interviews on randomly chosen days over 4 weeks. The minimum number of record days was determined for each macronutrient (carbohydrate, fat, protein) and energy, for each gender, to obtain a 'true' (unobservable) representative intake from reported (observed) dietary intakes. RESULTS: The greatest number of days required to obtain a 'true' representative intake was 8 days. Carbohydrate intakes required the greatest number of days of dietary record among males (7 days), whereas protein required the greatest number of days among females (8 days) in this cohort. Sunday was the day of the week that showed greatest variability in macronutrient intakes. Protein (P<0.05) and fat (P<0.001) intakes were significantly more variable than carbohydrate on Sundays compared with weekdays, for both men and women. CONCLUSION: A logistically achievable 8 days of dietary intake interviews was sufficient to minimize the effect of random error when using the multiple-pass, 24-h recall dietary intake method. Sunday should be included among the dietary interview days to ensure a 'true' representation of macronutrient intakes. This method can be confidently applied to small cohort studies in which dietary intakes from different groups are to be compared or to investigations of associations between nutrient intakes and disease.     

Development and testing of a computerised 24-h recall questionnaire measuring fruit and snack consumption among 9-11 year olds

OBJECTIVE: To evaluate the validity, reliability and sensitivity of a computerised single day 24-h recall questionnaire designed for the comparison of children's fruit and snack consumption at the group (school) level. DESIGN: Relative validity and reliability were assessed in relation to (i) intake at school and (ii) intake throughout the whole day, using diary-assisted 24-h recall interviews and a 7-day test-retest procedure. Sensitivity was assessed in relation to intake by comparing results from schools with differing food policies, and by sex. SUBJECTS AND SETTING: Eight schools took part in the validity and reliability assessments, with 78 children completing the 24-h recall interviews and 195 children completing the test-retest procedure. A total of 43 schools (1890 children) took part in the sensitivity analysis. All children were aged 9-11 y. All schools were in South Wales and South-west England. RESULTS: For fruit intake at school, the questionnaire showed fair levels of validity at the individual level (kappa = 0.29). At the group level, there were little or no differences in fruit intake at school between the two measures and two occasions. The questionnaire was sufficiently sensitive to identify statistically significant differences between girls and boys, and between schools with different food policies. For snack intake at school, validity at the individual level was slightly lower (kappa = 0.220.25), but the data remained of value in analyses at the group level. For fruit and snack intake throughout the whole day there was little agreement at the individual level (kappa = 0.00-0.06), and at the group level there tended to be substantial differences between the two measures and two occasions. CONCLUSIONS: The computerised questionnaire is a quick and cost-effective means of assessing children's consumption of fruit at school. While further development is required to improve validity and reliability, it has the potential to be particularly useful in randomised controlled trials of school-based dietary interventions.     

A 24-h recall does not provide a valid estimate of absolute nutrient intakes for rural women in southern Ethiopia

Objective

To investigate the relative validity of a multiple-pass interactive 24-h recall (24-HR) for assessing nutrient intakes of a group of rural Ethiopian women.

Methods

Dietary intakes from a 24-HR were compared with weighed record (WR) intakes collected on the same day for 58 women of child-bearing age from three subsistence farming communities in Sidama. The impact of memory lapses, use of average recipe data, and inaccurate portion size estimates on 24-HR intakes was also assessed.

Results

Median daily intakes of energy and most nutrients (except fat and phytate) were lower (P < 0.05) by the 24-HR versus the WR. Controlling for energy densities decreased the discrepancies to lower than ±6%, except for vitamin C. No significant differences between the two methods existed for the contribution of six food groups to energy intakes (percentages). Fewer than 40% of 24-HR intakes were ±10% of the WR. After classifying intakes (per day) into quartiles, Cohen’s κ values were poor (<4.0) for protein, iron, retinol, and dietary fiber and fair (≥0.40 to ≤0.75) for energy and other nutrients; all values per megajoule were mostly fair. Bland-Altman plots confirmed a negative bias for daily energy and nutrient intakes with the 24-HR versus WRs. Discrepancies were attributed mainly to inaccurate portion size estimates.

Conclusion

In this setting, the 24-HR cannot be substituted for the WR to assess absolute nutrient intakes for a group or the prevalence of inadequate intakes but could be used for energy-adjusted intakes. Prior training may improve the accuracy of the 24-HR.     

Neuroendocrine recovery after 2-week 12-h day and night shifts: an 11-day follow-up

Purpose

The study aimed to investigate the course and duration of neuroendocrine recovery after 2-week 12-h day and night shift working periods and to study whether there were differences in recovery between the shift groups.

Methods

Twenty-nine male offshore employees working 2-week 12-h shift tours participated in the study; 15 participated after a day shift tour and 14 after a night shift tour. Salivary cortisol was assessed at awakening, 30 min after awakening, and before bedtime on the 1st, 4th, 7th, and 11th day of the free period, with a reference day prior to the offshore tour. Differences were tested using generalised estimating equations analysis.

Results

Compared to the reference day, night shift workers had a significantly flatter cortisol profile on the 1st day off, significantly lower cortisol concentrations at 30 min after awakening on day 4 and at awakening on day 7, and a significantly smaller decline to evening concentration on days 4 and 11. Compared to the reference day, day shift workers only showed a significantly lower cortisol concentration at awakening on the 1st day off. Compared to day workers, night shift workers had a flatter profile on the 1st day off and a lower cortisol concentration at awakening on the 4th day.

Conclusions

Following 2-week 12-h night shift working periods, recovery was not fully complete up to day 11. Following 2-week 12-h day shift working periods, an indication of incomplete recovery was found on the 1st day off, with full recovery reached on day 4.

     

Predictors of reported consumption of low-nutrient-density foods in a 24-h recall by 8-16 year old US children and adolescents

The purpose of this study was to develop an explanatory model to predict the number of low-nutrient-density (LND) foods reported in a 24-h recall by US children and adolescents using data from the third National Health and Nutrition Examination Survey. The reported number of LND foods was estimated from 24-h dietary recall data for 8-16 year old respondents (n=4137; 2024 males and 2113 females). The LND foods included--baked and dairy desserts, sweeteners, salty snacks, visible/discretionary fat, and miscellaneous. The predictive ability of socio-demographic, family, weight/dieting related, life-style or food consumption related subject characteristics was determined using multiple linear regression analyses. The strongest independent negative predictor of the reported number of LND foods was the amount of nutrient-dense foods from the five major food groups. In addition, number of eating occasions reported was a significant independent positive predictor, and the weekly frequency of consuming a complete school lunch was a significant independent negative predictor of the reported number of LND foods. These models explained approximately 55% of the variance in LND food reporting in both males and females. Socio-demographic, family, body weight, or lifestyle characteristics contributed little to predicting the number of LND foods reported in a 24-h recall.     

Potential sources of carcinogenic heterocyclic amines in the Chinese diet: results from a 24-h dietary recall study in Singapore

OBJECTIVE: Heterocyclic amines (HCAs) from high-temperature cooking of meat have been linked to increased cancer incidence in Western populations, but data on the sources of HCAs in Asian diets are scarce. Our aim was to identify potential sources of HCAs in the Chinese diet, and to provide the basis for efforts to quantify dietary exposure to these compounds. DESIGN AND SETTING: We conducted 24-h dietary recall interviews among 986 Chinese men and women in Singapore, who were a randomly selected subpopulation of participants from the Singapore Chinese Health Study, a population-based cohort. Details of all foods and beverages consumed by each subject in the past 24 h were recorded, and information on meat type, cooking method and portion size were abstracted from all meat-containing dishes, and gram weight equivalents computed. RESULTS: The mean meat intake per person was 103.0 g/day (standard deviation 74.2), of which 97.2% was fresh meat. Fish (38.0%), pork (30.6%), and poultry (21.0%) accounted for 89.6% of meat consumed. Patterns of meat consumption and cooking methods differed markedly from Western populations. Documented high-temperature cooking methods, combined with stir-frying, accounted for 44.3% of fish, 35.1% of pork and 25.6% of poultry consumed. Specifically, potentially significant sources of HCAs were pan-fried fish and barbecued pork. CONCLUSIONS: Our results identify the potential sources of HCA in the Chinese diet, highlight aspects which are relevant to HCA formation and intake, and call for novel approaches to estimating individual exposure to dietary HCAs in this and similar populations.     

Obesity and type 2 diabetes

Summary  The rise in obesity – and specifically abdominal obesity – is driving the global increase in type 2 diabetes. Excess visceral fat, the causative factor behind abdominal obesity, is closely linked with β-cell dysfunction and insulin resistance, two of the key components of type 2 diabetes pathogenesis. Attempts to curb the current abdominal obesity and type 2 diabetes epidemics will require a government-led public health approach, in tandem with a personal approach aimed at helping abdominally obese individuals reduce their cardiovascular and metabolic (cardiometabolic) risk profile.     

Comparison of intakes of US Chinese women based on food frequency and 24-hour recall data

The objective of this cross-sectional study was to compare dietary reports from a food frequency questionnaire (FFQ) for US Chinese women with 24-hour recall estimates. The subjects were 56 women recruited through organizations in Philadelphia's Chinese community. Spearman correlations were used to describe FFQ estimates of food servings per month and nutrient intake per day vs estimates from three 24-hour recalls over 1 month. On average, women reported at least weekly consumption of 28 of 96 FFQ food items. The three most frequently consumed were rice (38 times/month), tea (29 times/month), and dark green, leafy vegetables (18 times/month). Comparing reported frequencies of the 28 foods to 24-hour recall estimates, the median Spearman correlation was 0.36. For nutrient estimates, correlations were high (r >0.5) for dietary fiber and calcium; moderate ( r =0.25 to 0.5) for energy, saturated fat, cholesterol, carbohydrates, protein, folic acid, and iron; but poor (r <0.25) for total fat, vitamin C, vitamin A, and carotene. These findings provide some assurance of the FFQ's adequacy for describing US Chinese women's intake of commonly consumed foods and selected nutrients. They also provide a basis for further improvements to, and evaluations of, the FFQ.