Fourth-Grade Children's Reporting Accuracy for Amounts Eaten at School-Provided Meals: Insight from a Reporting-Error-Sensitive Analytic Approach Applied to Validation Study Data

Validity of Interviewer-Administered 24-h Dietary Recalls in Older Korean Women: A Pilot Study

Despite the wide use of 24-h dietary recalls and differences in food culture between Western and Asian countries, limited studies validating 24-h dietary recalls have been performed in rice-based meals and in Asians. To determine the accuracy of 24-h dietary recalls in Koreans, 22 older women participating in a controlled-feeding study completed a single interviewer-administered 24-h dietary recall. The recalls of food items were classified as matches, exclusions, or intrusions. Portion size reports were categorized as corresponding (≤10% error), overreport, underreport, and missing. Recall accuracy was analyzed according to the type of dish, food group, or nutrients and compared by one-way analysis of variance or paired t-test. Participants reported 95% of the foods that they consumed. Sauces were most frequently missing. Corresponding portion sizes were 24%, while 43% were underreported. Kimchi was most frequently underreported. No difference was found among food groups. The recalled intakes of energy and most nutrients were similar to the actual intakes, with the exception of fat and sodium, which were underreported. The interviewer-administered 24-h dietary recall may be a reliable tool to assess food and nutrient intake in older Korean women. More accurate methods are necessary to assess sauce, kimchi, fat, and sodium intakes in the Korean diet.

Accuracy of Reporting Food Intakes among Primary School Children Aged 7-9 Years

BACKGROUND

Accurate measurement of dietary intake throughout childhood is important to monitor children's growth and development and for their long-term health. However, measuring dietary intake in children is challenging because of misreporting, difficulties in establishing portion size, and heavy reliance on proxy reporters.

OBJECTIVES

This study aimed to determine the accuracy of self-reported food intake by primary school children aged 7-9 y.

METHODS

A total of 105 children (51% boys), aged 8.0 ± 0.8 y, were recruited from three primary schools in Selangor, Malaysia. Individual meal intakes during a school break time were determined using a food photography method as the reference method. The children were then interviewed the following day to assess their recall of their meal intakes the previous day. ANOVA and Kruskal-Wallis tests were used to determine mean differences in the accuracy of reporting food items and amount by age and weight status, respectively.

RESULTS

On average, the children achieved 85.8% match rate, 14.2% omission rate, and 3.2% intrusion rate for accuracy in reporting food items. The children also achieved 85.9% correspondence rate and 6.8% inflation ratio for accuracy in reporting food amounts. Children living with obesity had notably higher intrusion rates compared with normal weight children (10.6% vs. 1.9%) (P < 0.05). Children aged >9 y had notably higher correspondence rates, compared with children aged 7 y (93.3% vs. 78.8%) (P < 0.05).

CONCLUSIONS

The low omission and intrusion rates and the high correspondence rate indicate that primary school children aged 7-9 y are capable of self-reporting food intake accurately for a lunch meal without proxy assistance. However, to confirm children's abilities to report their daily food intakes, further studies should be conducted to assess the accuracy of children in reporting their food intakes for more than one meal in a day.

A Qualitative Analysis of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for Assessing Children's Food Intake Reported by Parent Proxy

BACKGROUND

Accuracy and participant burden are two key considerations in the selection of a dietary assessment tool for assessing children's full-day dietary intake.

OBJECTIVE

The aim of this study was to identify barriers experienced by parents and burden when using two technology-based measures of dietary intake to report their child's intake: the Remote Food Photography Method (RFPM) and the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24).

DESIGN

Qualitative, semistructured, focus groups were conducted with parents who served as proxy reporters of their child's dietary intake using the two different dietary assessment methods (ie, RFPM and ASA24) 1 week apart.

PARTICIPANTS/SETTING

This study was conducted in 2019 and included 32 parents of children aged 7 to 8 years in Colorado and Louisiana.

MAIN OUTCOME MEASURES

Barriers adhering to the protocol and burden with the RFPM and ASA24.

QUALITATIVE ANALYSES

Qualitative content analysis and Atlas.ti software were used to analyze and interpret focus group data.

RESULTS

For the RFPM, parents described missing photos due to unobserved intake, forgetting to capture images, disruption of mealtimes, and child embarrassment when meals were photographed at school. For the ASA24, parents described the time commitment as the main source of burden and the need to expand the food database to include additional ethnic foods and restaurant items. The main strengths were ease of use for the RFPM and the consolidated workload for the ASA24.

CONCLUSIONS

The barriers experienced by parents and burden differed by method, highlighting the importance of considering the unique characteristics of each assessment tool when designing a pediatric dietary assessment study and interpreting findings.