According to Dietary Assessment, a 2018 report from the Food and Agriculture Organization of the United Nations, “up-to-date and valid assessment of what people eat and drink will help to generate better information and evidence that will contribute to the formulation of effective agricultural and nutrition policies and programmes.” Unfortunately, assessing dietary intake isn’t as simple as it might seem. Studies have proven that individual dietary recall is often faulty, potentially leading to erroneous conclusions about the links between dietary intake and human health and nutrition.
ASN Journals have dealt with the issue of dietary assessment frequently, helping nutrition scientists understand the pros and cons of the various tools and methods available to assess dietary intake. Below are a sample of recent articles published in ASN Journals that address challenges and solutions to dietary assessment:
Comparison of Self-Reported Dietary Intakes from the Automated Self-Administered 24-h Recall, 4-d Food Records, and Food-Frequency Questionnaires against Recovery Biomarkers, The American Journal of Clinical Nutrition, January 2018
ASN member Yikyung Park et al. set out to test the accuracy of self-reported dietary intakes. To conduct their research, the authors recruited 530 men and 545 women, aged 50 to 74. Participants were asked to complete a series of self-administered 24-hour food intake recalls, 4-day food records, and food frequency questionnaires over a 12-month period. During this time, participants also provided two 24-hour urine collections, which were used to test for biomarkers of energy, protein, potassium, and sodium intake. Study results indicated that underreporting of energy, protein, potassium, and sodium intake was more common than overreporting. The prevalence of underreporting, however, differed by dietary assessment tool. Participants were 1.5 to 3 times more likely to underreport intake on food frequency questionnaires than on 24-hour recalls and 4-day food records. While the 24-hour recall and four-day food records may be more accurate, the authors pointed out that food frequency questionnaires, which report intake over longer periods of time, “provide important information about episodically consumed foods that can be missed in short-term instruments.” The authors recommend that “future nutrition studies should consider collecting multiple automated, self-administered 24-hour records or recalls over time as the primary dietary assessment instrument in conjunction with a food frequency questionnaire in epidemiologic and clinical research.”
Gender and Age Differences in Meal Structures, Food Away from Home, Chrono-Nutrition, and Nutrition Intakes among Adults and Children in Tanzania Using a Newly Developed Tablet-Based 24-Hour Recall Tool, Current Developments in Nutrition, February 2022
In low- and middle-income countries, little is known about meal structures, meal patterns, and nutrient intake because the collection of dietary intake data is often too expensive and labor intensive. In response, Ramya Ambikapathi et al. designed and tested a tablet-based Tanzania 24-hour recall tool, developed on an Android platform using the Open Data Kit. Among its features, the 24-hour recall tool enables researchers to quantify meals, portion sizes, breastfeeding frequency, and time between meals. Interviewers, all experienced in conducting public health surveys, were trained to use the 24-hour recall tool. They then gathered dietary intake data from 845 children, aged 0–18 months, enrolled in the Engaging Fathers for Effective Child Nutrition and Development in Tanzania trial as well as from 312 adult families participating in the Diet, Environment, and Choices of positive living (DECIDE) observational study. Following data collection and analysis, the authors concluded that their 24-hour recall tool was “field- and user-friendly,” with the ability to collect large samples of dietary intakes in low- and middle-income settings: “this tool could be used to examine transition in food systems, availability of food, or timing and location of meals.”
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, The Journal of Nutrition, January 2019
The Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) is a free, web-based system developed by the National Cancer Institute that enables self-administered, 24-hour dietary recalls; however, it has not been extensively tested among low-income populations. In response, Sharon I. Kirkpatrick et al. conducted a study among women with low incomes to evaluate the accuracy of ASA24 recalls completed both independently and with trained assistance. As part of the study, 302 women between the ages of 18 and 82 with incomes below the Supplemental Nutrition Assistance Program thresholds served themselves breakfast, lunch and dinner from a buffet over the course of one day. The following day, 148 of the women completed the ASA24 independently, and 154 completed the ASA24 with assistance from a trained paraprofessional. Study results indicated that food recall was 6 to 8% lower among the participants than previously observed among adults with a range of incomes. Offering assistance did not significantly impact accuracy. The authors believe, “innovation in dietary assessment is likely to continue to add to the possibilities for dietary assessment with diverse populations, including those with low incomes.”
Leveraging Observational Cohorts to Study Diet and Nutrition in Older Adults: Opportunities and Obstacles, Advances in Nutrition, April 2022
In the United States by 2060, the number of adults 65 and older is expected to double, and the number of adults over 85 is expected to triple. Despite a growing population of older adults, not enough is known about the dietary intakes among this age group. In response, ASN member M. Kyla Shea et al. identified 32 community-based longitudinal cohorts that collected information on the dietary intake of adults aged 65 and over in the United States. The authors summarized the cohorts’ designs, demographics, and dietary assessments. In addition, they identified key gaps in the existing databases such as the need to use recovery biomarkers to confirm the accuracy of dietary recall as well as the need for further research on how dietary patterns change from early old age to late old age. According to the authors, “most of the identified cohorts have collected and continue to collect detailed information about participants’ health and disease status.” Rather than establishing new cohorts focused on diet, the authors believe leveraging the existing cohort studies they identified “represents a cost- and time- effective strategy to fill research gaps about the diet in older adulthood.”
If you are conducting research that may improve our ability to assess dietary intake, please consider submitting your original research findings or review to an ASN Journal. Our editorial and marketing teams are committed to publishing your important findings as quickly as possible and disseminating them around the world as broadly as possible.