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The Food Intake Recording Software System, version 4(FIRSSt4), is a web-based 24 hour dietary recall (24hdr) self-administered by children based on the Automated Self-Administered 24-hour recall (ASA24) (a self-administered 24hdr for adults). The food choices in FIRSST4 are abbreviated to include only those reported by children in U.S. national surveys; and detailed food probe questions are simplified to exclude those that children could not be expected to answer (for example questions regarding food preparation and added fats). ASA24 and FIRSSt4 incorporate 10,000+ food images with up to eight images per food to assist in portion size estimation. This paper reviews the formative research conducted during the development of FIRSSt4. When completed, FIRSSt4 will be hosted and maintained for investigator use on the National Cancer Institute’s ASA24 website.

Prospective epidemiologic data on the effects of different types of dietary sugars on cancer incidence have been limited. In this report, we investigated the association of total sugars, sucrose, fructose, added sugars, added sucrose and added fructose in the diet with risk of 24 malignancies. Participants (n = 435,674) aged 50-71 years from the NIH-AARP Diet and Health Study were followed for 7.2 years. The intake of individual sugars was assessed using a 124-item food frequency questionnaire (FFQ). Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) in multivariable models adjusted for confounding factors pertinent to individual cancers. We identified 29,099 cancer cases in men and 13,355 cases in women. In gender-combined analyses, added sugars were positively associated with risk of esophageal adenocarcinoma (HR(Q5 vs. Q1) : 1.62, 95% CI: 1.07-2.45; p(trend) = 0.01), added fructose was associated with risk of small intestine cancer (HR(Q5 vs. Q1) : 2.20, 95% CI: 1.16-4.16; p(trend) = 0.009) and all investigated sugars were associated with increased risk of pleural cancer. In women, all investigated sugars were inversely associated with ovarian cancer. We found no association between dietary sugars and risk of colorectal or any other major cancer. Measurement error in FFQ-reported dietary sugars may have limited our ability to obtain more conclusive findings. Statistically significant associations observed for the rare cancers are of interest and warrant further investigation.

We investigated the association of dietary alpha-tocopherol, gamma-tocopherol and supplemental vitamin E intake with the risk of esophageal squamous cell carcinoma (n = 158), esophageal adenocarcinoma (n = 382), gastric cardia adenocarcinoma (n = 320) and gastric noncardia adenocarcinoma (GNCA; n = 327) in the NIH-AARP Diet and Health Study, a cohort of approximately 500,000 people. Data on dietary and supplemental vitamin E intake were collected using a validated questionnaire at baseline and were analyzed using Cox regression models. Intakes were analyzed as continuous variables and as quartiles. For dietary alpha-tocopherol, we found some evidence of association with decreased esophageal squamous cell carcinoma and increased esophageal adenocarcinoma risk in the continuous analyses, with adjusted hazard ratios and 95% confidence intervals of 0.90 (0.81-0.99) and 1.05 (1.00-1.11), respectively, per 1.17 mg (half the interquartile range) increased intake. However, in quartile analyses, the p value for trend was nonsignificant for both these cancers. There was no association between dietary alpha-tocopherol and gastric cardia adenocarcinoma or GNCA. We observed no statistically significant associations with gamma-tocopherol. For supplemental vitamin E, the results were mainly null, except for a significantly lower risk of GNCA with higher doses of supplemental vitamin E. An increase of 71 mg/day (half the interquartile range) in supplemental vitamin E had an hazard ratio (95% confidence interval) of 0.92 (0.85-1.00) and the p value for trend in the quartile analysis was 0.015.

Dietary assessment of episodically consumed foods gives rise to nonnegative data that have excess zeros and measurement error. Tooze et al. (2006, Journal of the American Dietetic Association 106, 1575-1587) describe a general statistical approach (National Cancer Institute method) for modeling such food intakes reported on two or more 24-hour recalls (24HRs) and demonstrate its use to estimate the distribution of the food's usual intake in the general population. In this article, we propose an extension of this method to predict individual usual intake of such foods and to evaluate the relationships of usual intakes with health outcomes. Following the regression calibration approach for measurement error correction, individual usual intake is generally predicted as the conditional mean intake given 24HR-reported intake and other covariates in the health model. One feature of the proposed method is that additional covariates potentially related to usual intake may be used to increase the precision of estimates of usual intake and of diet-health outcome associations. Applying the method to data from the Eating at America's Table Study, we quantify the increased precision obtained from including reported frequency of intake on a food frequency questionnaire (FFQ) as a covariate in the calibration model. We then demonstrate the method in evaluating the linear relationship between log blood mercury levels and fish intake in women by using data from the National Health and Nutrition Examination Survey, and show increased precision when including the FFQ information. Finally, we present simulation results evaluating the performance of the proposed method in this context.

Objective: To describe the use of NCI's ASA24 in real-world studies. Methods: Descriptive statistics were generated to summarize usage characteristics across studies using 2014 versions of ASA24. Results: Since Feb. 2014, 319 studies had registered to use ASA24, 10% of which requested ASA24-Kids. The percentages of studies using the following setup options were: 88% - allowed unscheduled logins; 60% - completion of recalls from midnight-to-midnight vs. past 24-hrs; 73% - allowed multiple vs. single logins; 68% - completion time restricted to 24 vs. 32 hrs. The percentages of studies including optional questions were: 49% - dietary supplements; 82% - location of meals; 46% -whom meals were eaten with; 45% - use of TV/computer/mobile phone during meals; 35% - source of foods consumed. Nearly all recalls were completed after a single login; mean times to complete recalls with and without supplement questions was 32 and 23 minutes, respectively. Mean number of foods and beverages reported/day was 13. Mean and...

The efficacy of all dietary studies, whether aimed at monitoring a population's diet, understanding diet and health relationships, or evaluating the effect of an intervention, depends on appropriate assessment of intakes. Determining the most suitable dietary instrument for a particular study can be a challenge and is dependent upon a number of considerations, including the specific research question, dietary components of interest, study design, and target population. The National Cancer Institute has developed an online resource to provide guidance on the selection of appropriate dietary assessment methodologies for characterizing the intakes of a group or groups and to outline various considerations for the use of each. The Dietary Assessment Primer describes the major types of self-report instruments; provides guidance on using the instruments alone or in combination to address different research questions; compares key features of each instrument; explains validity, measurement error, and calibration...

Objective: To compare response rates, intake estimates, and preferences between ASA24 and interviewer-administered AMPM recalls. Methods: About 1200 participants were recruited from three integrated health systems using quota sampling to ensure representation of a range of ages and race/ethnicity groups. Participants were asked to complete two 24HRs, 4-7 weeks apart, and randomized into four study groups: 1) two ASA24s; 2) two AMPMs; 3) ASA24 first and AMPM second; and 4) AMPM first and ASA24 second. Results: Almost all enrolled participants (95%) completed at least one recall and 80% completed two; response rates did not differ by recall mode. Estimated intakes of energy, nutrients and food groups were comparable for ASA24 and AMPM; for example, energy, 2132 vs. 2126 kcal; fat, 84.9 vs. 82.8 g; saturated fat, 27.9 vs. 26.9 g; fiber, 18.4 vs. 18.4 g; and fruits and vegetables, 3.0 vs. 3.1 cup equivalents. Of participants completing one ASA24 and one AMPM, a greater percentage overall and by sex and site p...

OBJECTIVE: To assess the impact of editing data from the ASA24 on nutrient and food group estimates. METHODS: About 900 adults from 3 integrated health care systems completed recalls in an ASA24 ev...

Objective: To assess accuracy of portion size reporting in ASA24 compared to interviewer-administered recalls. Methods: True intake for three meals was ascertained among 81 adults by inconspicuously weighing foods and beverages offered at a buffet before and after each participant served him/herself, as well as plate waste. Participants were randomly assigned to complete ASA24 or an interviewer-administered Automated Multiple-Pass Method (AMPM) recall the following day. Differences between true and reported gram weights were calculated for each consumed item for which a match was reported by respondents and averaged. Results: For foods and drinks truly consumed for which respondents reported a match (80% for ASA24 and 83% for AMPM), mean differences between true and reported portion sizes were -3.7 grams for ASA24 and -11.8 grams for AMPM (absolute differences: 40.5 grams for ASA24 and 39.8 grams for AMPM (p=0.44)). Differences for primary foods and drinks were -5.1 grams for ASA24 and -14.4 grams for AMP...