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Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18–49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities’ divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17–45 % for macronutrients, 5–17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.

Redna analiza prehranskega vnosa hemodializnih bolnikov je pomembna za ohranjanje optimalnega prehranskega statusa. Ob pričetku zdravljenja s hemodializo se potrebe po beljakovinah povečajo, medtem ko se omejitve fosfata, kalija in natrija še vedno priporočajo z namenom preventive presnovnih zapletov. Cilj raziskave je bil ugotoviti, ali med pacienti s slabim in dobrim prehranskim statusom obstajajo razlike v prehranskem vnosu ter ali je prehranski vnos zadosten glede na priporočila. Klinično študijo smo izvedli v hemodializnem centru Univerzitetnega kliničnega centra v Ljubljani. Raziskava je potekala v dveh delih. Najprej smo 170 hemodializnim pacientom izmerili sestavo telesa in jim ocenili prehranski status z vidika podhranjenosti in vnetja z vprašalnikom MIS (ang. Malnutrition Inflammation Score). Nato smo izbrali po 28 pacientov z najboljšo in najslabšo oceno MIS in z njimi izvedli prehranski intervju ter ocenili telesno pripravljenost. Zanimal nas je vnos beljakovin, fosforja in kalija, saj so pri tej populaciji pogosto prisotne beljakovinsko energijska podhranjenost, hiperfosfatemija in hiperkalemija. Med skupinama pacientov s slabim in dobrim prehranskim statusom obstajajo statistično značilne razlike v prehranskem vnosu vseh preučevanih parametrov (makrohranila, mikrohranila – P, K, Ca, Na vnos soli, prehranske vlaknine, sadja in zelenjave). Povprečni vnos energije in beljakovin je v obeh skupinah nezadosten glede na priporočene vrednosti. Korelacije med zaužitim fosforjem s hrano in serumskim fosforjem v krvi ni. Korelacije med zaužitim kalijem s hrano in serumskim kalijem v krvi ni. Rezultati bioimpedančnih meritev, prehranske analize in nizke vrednosti serumskega albumina potrjujejo prisotnost beljakovinsko energijske podhranjenosti. Hemodializni pacienti nujno potrebujejo prehransko svetovanje, saj brez njega ne morejo doseči prehranskih ciljev potrebnih za podporo zdravljenja. Regular analysis of the nutritional intake of hemodialysis patients is important to maintain optimal nutritional status. At the start of hemodialysis treatment, protein requirements increase, while phosphate, potassium and sodium restrictions are still recommended to prevent metabolic complications. The aim of the research was to determine whether there are differences in dietary intake between patients with poor and good nutritional status and whether dietary intake is sufficient according to recommendations. The clinical study was conducted in the hemodialysis center of the University clinical center in Ljubljana. The research was conducted in two parts. First, we measured the body composition of 170 hemodialysis patients and assessed their nutritional status in terms of malnutrition and inflammation using the MIS (Malnutrition Inflammation Score) questionnaire. We then selected 28 patients with the lowest and highest MIS score and conducted a nutritional interview and assessed their physical fitness. We were interested in protein, phosphorus and potassium intake, as protein-energy malnutrition, hyperphosphatemia and hyperkalemia are often present in this population. Between the groups of patients with poor and good nutritional status, there are statistically significant differences in the dietary intake of all studied parameters (macronutrients, micronutrients – P, K, Ca, Na intake of salt, fiber, fruit and vegetables). The average intake of energy and protein in both groups is insufficient according to the recommended values. There is no correlation between dietary phosphorus intake and blood serum phosphorus or between dietary potassium intake and blood serum potassium. The results of bioimpedance measurements, nutritional analysis and low serum albumin values confirm the presence of protein-energy malnutrition. Hemodialysis patients urgently need nutritional counseling, because without it they cannot achieve the nutritional goals necessary to support the treatment.

Objective:To describe existing online, 24-h dietary recall (24-h DR) tools in terms of functionalities and ability to tackle challenges encountered during national dietary surveys, such as maximising response rates and collecting high-quality data from a representative sample of the population, while minimising the cost and response burden.Design:A search (from 2000 to 2019) was conducted in peer-reviewed and grey literature. For each tool, information on functionalities, validation and user usability studies, and potential adaptability for integration into a new context was collected.Setting:Not country-specificParticipants:General populationResults:Eighteen online 24-h DR tools were identified. Most were developed in Europe, for children ≥10 years old and/or for adults. Eight followed the five multiple-pass steps but used various methodologies and features. Almost all tools (except three) validated their nutrient intake estimates, but with high heterogeneity in methodologies. User usability was not always assessed, and rarely by applying real-time methods. For researchers, eight tools developed a web platform to manage the survey and five appeared to be easily adaptable to a new context.Conclusions:Among the eighteen online 24-h DR tools identified, the best candidates to be used in national dietary surveys should be those that were validated for their intake estimates, had confirmed user and researcher usability, and seemed sufficiently flexible to be adapted to new contexts. Regardless of the tool, adaptation to another context will still require time and funding, and this is probably the most challenging step.

Background The collection of weighed food records (WFR) is a gold standard for dietary assessment. We propose using the 24-h recall method combined with a portable camera and a food atlas (24hR-camera). This combination overcomes the disadvantages of the 24-h dietary recall method. Our study examined the validity of the 24hR-camera method against WFR by comparing the results. Methods Study subjects were 30 Japanese males, aged 31–58 years, who rarely cook and reside in the Tokyo metropolitan area. For validation, we compared the estimated food intake (24hR-camera method) and weighed food intake (WFR method). The 24hR-camera method uses digital photographs of all food consumed during a day, taken by the subjects, and a 24-h recall questionnaire conducted by a registered dietitian, who estimates food intake by comparing the participant’s photographs with food atlas photographs. The WFR method involves a registered dietitian weighing each food item prepared for the subject to consume and any leftovers. Food intake was calculated for each food group and nutrient using the 24hR-camera vs. weighed methods. Results Correlation coefficients between the estimated vs. weighed food intake were 0.7 or higher in most food groups but were low in food groups, such as oils, fats, condiments, and spices. The estimated intake of vegetables was significantly lower for the 24hR-camera method compared to the WFR method. For other food groups, the percentages of the mean difference between estimated vs. weighed food intake were -22.1% to 5.5%, with no significant differences between the methods (except for algae, which had a very low estimated intake). The correlation coefficients between the two methods were 0.774 for energy, and 0.855, 0.769, and 0.763 for the macronutrients, proteins, lipids, and carbohydrates, respectively, demonstrating high correlation coefficients: greater than 0.75. The correlation coefficients between the estimated vs. weighed for salt equivalents and potassium intake were 0.583 and 0.560, respectively, but no significant differences in intake were observed. Conclusions The 24hR-camera method satisfactorily estimated the intake of energy and macronutrients (except salt equivalents and potassium) in Japanese males and was confirmed as a useful method for dietary assessment.

Background Information on long-term dietary intake is often required for research or program planning, but surveys routinely use short-term assessments such as 24-h recalls (24HRs). Methods to reduce the impact of within-person variation in 24HRs, such as the National Cancer Institute (NCI) method, typically require extensive training and skill. Objectives We introduce the Simulating Intake of Micronutrients for Policy Learning and Engagement (SIMPLE) macro, a new tool to increase the accessibility of 24HR analysis. We explain the underlying theory behind the tool and provide examples of potential applications. Methods The SIMPLE macro connects the core NCI statistical code to estimate usual intake distributions and includes additional code to enable advanced analyses such as predictive modeling. The related SIMPLE-Iron macro applies the full probability method to estimate inadequate iron intake, and the SIMPLE-1D macro is used for descriptive or modeling analyses of data with a single 24HR per person. The macros and associated documentations are freely available. We analyzed data from the US National Health and Nutrition Examination Survey (NHANES) and the Cameroon National Micronutrient Survey to compare the SIMPLE macro to 1) the core NCI code using the Estimated Average Requirement cut point method, and 2) the IMAPP software for iron only, and to demonstrate the applications of the SIMPLE macro for estimating usual intake and predictive modeling. Results The SIMPLE macro generates identical results to the core NCI code. The SIMPLE-Iron macro also produces estimates of inadequate iron intake comparable to the IMAPP software. The examples demonstrate application of the SIMPLE macro to 1) descriptive analyses of nutrient intake from food and supplements (NHANES), and 2) analyses accounting for breast-milk nutrient intake and modeling fortification and supplementation programs (Cameroon). Conclusions The SIMPLE macros may facilitate the analysis and modeling of dietary data to inform nutrition research, programs, and policy.

OBJECTIVES: Dietary data are rarely collected in low- and middle-income countries due to complexity, cost, and time burden. To facilitate the collection and use of individual dietary data, the International Dietary Data Expansion (INDDEX) Project has developed INDDEX24, a novel dietary assessment platform to collect and analyze 24-hr dietary recall (24HR) data. This study assessed the cost and cost-efficiency (cost per respondent) of INDDEX24 compared to the traditional pen-and-paper interview (PAPI) approach to collecting and processing 24HR data. METHODS: Conducted alongside validation studies of the INDDEX24 platform in Viet Nam and Burkina Faso, we carried out activity-based costing studies to estimate and compare the cost of using INDDEX24 and PAPI to conduct a 24HR survey. We defined and costed a series of activities required to complete data collection and prepare the datasets, including development of dietary reference data, survey preparation, training, survey execution, data entry, and data cleaning and processing. RESULTS: In Viet Nam, the total economic cost of the 24HR was $111,004 ($755/respondent, n = 147) using INDDEX24 and $120,483 ($820/respondent, n = 147) using the PAPI modality. In Burkina Faso, the total cost of the 24HR using INDDEX24 was $78,043 ($538/respondent, n = 145) and $78,933 ($541/respondent, n = 146) using PAPI. The higher costs in Viet Nam were primarily driven by the preparation of dietary reference data, which was an extensive and nationally focused effort, whereas in Burkina it was regionally focused and benefited from previous development of relevant dietary data. In both countries, while INDDEX24 had higher costs associated with survey preparation (including purchasing tablets and a CommCare subscription), these costs were more than offset by the higher PAPI costs associated with data entry and data cleaning and processing. CONCLUSIONS: In two distinct contexts, the cost of conducting a 24HR was lower (Viet Nam) or approximately equivalent (Burkina Faso) using INDDEX24 than using PAPI. As the INDDEX24 dietary reference database is populated with reference data from which future users of INDDEX24 can draw, the cost of using INDDEX24 will likely decline further. FUNDING SOURCES: The INDDEX Project is implemented by the Tufts University Friedman School of Nutrition Science and Policy with funding from The Bill & Melinda Gates Foundation.

OBJECTIVES: The study assessed the relative accuracy of INDDEX24, a computer-assisted personal interview (CAPI) approach to conducting a 24-hour dietary recall (24HR), compared to the pen-and-paper interview (PAPI) approach against a full-day observed weighed food record (WFR) in northern Viet Nam where the diet is diverse and complex. METHODS: Women aged 18–49 from northern Viet Nam were randomly assigned to be interviewed with the CAPI or PAPI 24HR the day after other enumerators conducted a WFR. The Two One Sided T-test (TOST) assessed equivalence of each recall-benchmark method comparison using a 10% bound. A difference-in-differences approach compared the significance of differences between the CAPI vs. WFR and PAPI vs. WFR modalities. Nutrient intakes were logged to achieve a normal distribution. RESULTS: Both the PAPI and the CAPI were statistically equivalent to the WFR across indicators of average total food items, total grams of intake, energy intake, all macro- and micronutrients tested (except Vitamin A for both CAPI and PAPI). The difference-in-difference analysis showed that the CAPI diverged significantly less than PAPI from the WFR for iron (0.9 v. −1.3 mg) and PAPI diverged less from the WFR than CAPI for protein (−3.7 v. 7.9 grams). There were no other statistically significant differences and, for both PAPI and CAPI, average deviations from the WFR were small. Individual-level comparisons showed 56% of PAPI and 59% of CAPI respondents were within +/−20% of the WFR intakes, while 26% of respondents in the PAPI group and 32% of the CAPI group had energy intakes by 24HR within +/- 10% of the WFR intakes. CONCLUSIONS: INDDEX24 was an accurate method for assessing food and nutrient intake among women of reproductive age in northern Viet Nam, when compared to a WFR. INDDEX24 performed at least as well as the PAPI 24HR modality across several different group and individual level measures for energy and nutrients of interest. Digital data collection platforms facilitate standardization of data collection and may reduce survey time and costs. Given these advantages, the INDDEX24 Dietary Assessment Platform should be considered for implementing high quality, individual-level, quantitative dietary surveys in low- and middle-income countries. FUNDING SOURCES: Bill and Melinda Gates Foundation.

ObjectivesThe Nutrient-Rich Foods (NRF) Index is an important nutrient profiling model. Nutrition quality indices need to be tested and validated against the quality of the total diet and against health outcomes. A family of NRF indices was validated against the mean adequacy ratio (MAR), an overall measure of the nutrient adequacy. Besides, we examined the associations between the NRF index and obesity indicators. MethodsA total of 656 persons aged 18-75 years from Henan province of China since 2020 were studied. All foods consumed by participants were scored using NRFn.2 (where n= 6–11) indices based on unweighted sums, means, and ratios of percent Chinese Dietary Reference Intakes (DRIs) for beneficial nutrients (n) and nutrients to limit (2). NRF index scores in this study were calculated on 100 g, 100 kcal basis. The measure of index performance was the percentage of adjusted variation in MAR (R2). Multi-factor logistic regression models were used to examine the association between the NRF index scores and obesity indicators.ResultsThe NRF9.2 index, based on 9 beneficial nutrients and 2 nutrients to limit, using the algorithm based on sums and 100 kcal, was the best predicted model, with an adjusted R2 of 0.23 by multiple adjustments. The odds ratio (OR) for overweight (defined by BMI) in the 4th quartile (Q4) versus the 1st quartile (Q1) of the NRF9.2 index was 0.61 (95% CI=0.37, 0.98) after multiple adjustments. However, the NRF9.2 index score was not related to central obesity.Conclusion NRF9.2 index, using the algorithm based on sums and 100 kcal, was the best predicted model. NRF9.2 index scores were associated with BMI. These results revealed that the NRF9.2 index can be used as a validated tool to assess the overall diet quality among mid-eastern Chinese adults.

BACKGROUND: Collecting multiple 24-hour recalls (24HR) can be burdensome necessitating alternative methods to assess dietary intake in the research setting. METHODS: This cross-sectional study compared the use of the Diet ID™ online platform with three unannounced 24HR assessed via the Automated Self-Administered 24-Hour recall among participants in the Nutritious Eating with Soul (NEW Soul) study. NEW Soul participants (n=68; 100% African American, 79% female, mean age 50.7±9.6 years) were randomized to follow one of two healthy soul food diets: vegan or omnivorous. For the present study, data from both groups were combined. Energy intake, dietary quality (Healthy Eating Index), and macro-/micronutrients densities per 1,000 kcals, as assessed by either the averaged values of the three 24HR or the Diet ID. Descriptive statistics (means, standard deviations and Spearman rank correlations) summarized each nutrient as measured by the Diet ID and ASA24. Bland-Altman plots were used as the main method to assess agreement between the two measures. RESULTS: Nutrients from the Diet ID were generally higher than the 24HR except for the HEI score (69.6±12.2 ASA24 vs. 51.1±34.5 Diet ID). Diet ID reported 950 kcals higher energy intake than ASA24 with the difference being most pronounced at lower ASA24-reported energy intake. There were significant correlations between measures for HEI score, protein, carbohydrates, cholesterol, potassium, copper, thiamin, and vitamins B12 and E. Diet ID is a rapid way to assess dietary intake. There was higher reporting of nutrients using Diet ID compared to the 24HR. CONCLUSIONS: Future studies should consider comparing these two methods with objective assessments of energy and nutrient intake and using multiple instruments to ensure the strengths of all methods are included.

Salt is an essential mineral to our health that, in its sodium form, is involved in many functional processes in human body. Excessive salt consumption increases the risk of high blood pressure and cardiovascular disease (CVD). The World Health Organization (WHO) and the United Nations (UN) have identified salt reduction as one of the most cost-effective strategies to prevent the spread of non-communicable diseases. The objectives of the present study is to determine the salt status in the Moroccan population based on 24-hour dietary recall and food frequency. This descriptive cross-sectional study was conducted on 133 children and adolescents recruited from public schools in Rabat regions. The average total salt intake status was assessed by 24 h dietary recall. Food frequency questionnaire was used to evaluate children’s nutritional habits and the consumption of food rich in salt. The average total salt intake is 5264.5±2398.6mg/day. The knowledge of the study population on the health risks of excess salt, 81% of participants stated that high salt consumption is positively associated with health risks, while only 7% confirmed that there is no relationship between excess salt and health problems. For the use of iodized salt, about half (46.6%) of the study population uses iodized salt. For each variable, a significant difference is shown between the subgroups (p The current intake of salt is very high in both children and adults. Reducing salt intake is one of the most cost-effective measures to prevent CVD. A low-salt diet during childhood can prevent the development of CVD and hypertension later in life. However, there is no strategy to keep children and adults low in salt.

Background The collection of weighed food records (WFR) is a gold standard for dietary assessment. However, what a person eats changes every day, and it is practically difficult to weigh foods and drinks daily and calculate their nutrient contents. The validity of 24-hour dietary recall with the use of a portable camera (24hR-camera) was examined by comparison with the WFR.Methods The study subjects were recruited from 30 male adults who were fathers of university students and cooked rarely. For the validation of the 24hR-camera, we compared it and the WFR. The digital photographs were taken by the subjects of all food consumed during a day and a 24-h recall questionnaire was conducted by a registered dietitian who was trained on the survey methodology. An estimate of the amount of food consumed was made using a food atlas and the photographs taken by the subjects. For validation, comparison was made between the calculations, by both methods, of the levels of food group and nutrient. Results Correlation coefficients between the two methods were 0.7 or higher in most food groups but were low in food groups that are difficult to see, such as oils, fats, condiments, and spices. The intake of vegetables was significantly lower for the 24hR-camera method compared to the WFR method. For other food groups, except for algae, of which intake amount (in weight base) is very low, the percentages of mean difference between 24hR-camera and WFR s were -22.1% to 5.5%, with no significant differences between the methods. The correlation coefficients between the two methods were 0.774 for energy, and 0.855, 0.769, and 0.763 for the three major nutrients, proteins, lipids, and carbohydrates, respectively, demonstrating high correlation with coefficients greater than 0.75. The correlation coefficients between the two methods were 0.583 and 0.560 for salt and potassium intake, respectively, but no significant differences in intake were observed. Conclusions The method of 24-hR-canera satisfactorily estimated the intake of energy and major nutrients (except salt and potassium) in Japanese males, and was confirmed as a useful method for dietary assessment.

Background A food frequency questionnaire (FFQ) for South American children and adolescents was developed, but its validity for assessing dietary iron intake has not been evaluated. Objective To evaluate the validity of the FFQ and 24-hour dietary recalls (24h-DR) for assessing dietary iron intake in children and adolescents. Design The South American Youth/Child Cardiovascular and Environmental study is a multicenter observational study, conducted in five South American cities: Buenos Aires (Argentina), Lima (Peru), Medellin (Colombia), Sao Paulo, and Teresina (Brazil). The FFQ assessed dietary intake over the previous 3 months, and the 24h-DR was completed three times (2 weekdays and 1 weekend day) with a minimum 5-day interval between recalls. Blood samples were collected to assess serum iron, ferritin, and hemoglobin levels. Participants and setting Data of 99 children (aged 3 to 10 years) and 50 adolescents (aged 11 to 17 years) from public and private schools were collected during 2015 to 2017. Main outcome measures Dietary iron intake calculated from the FFQ (using the sum of daily iron intake in all food/food groups) and 24h-DR (mean of 3 days using the multiple source method). Statistical analyses performed Dietary iron intake in relation to blood biomarkers were assessed using Spearman rank correlations adjusted for sex, age, and total energy intake, and the quadratic weighted κ coefficients for agreement. Results Spearman correlations showed very good coefficients (range = 0.78 to 0.85) for the FFQ in both age groups; for the 24h-DR, the coefficients were weak in children and adolescents (range = 0.23 to 0.28). The agreement ranged from 59.9% to 72.9% for the FFQ and from 63.9% to 81.9% for the 24h-DR. Conclusion The South American Youth/Child Cardiovascular and Environmental study FFQ exhibited good validity to rank total dietary iron intake in children and adolescents, and as well as the 24h-DR, presented good strength of agreements when compared with serum iron and ferritin levels.

The nutritional status of 80 children (2-5years) in udaipur district was studied. Personal interviews consisting, 24 hour dietary recall of children was used. Amount of nutrients obtained per day from food consumed was calculated and compared with RDA for Indian children. Anthropometric measurements including weight and height were used to identify the physical condition of children. Waterlow’s, Gomez’s classification BMI-for-age determined the extent of mal-nutrition in children and were compared with IAP standards. The height, weight and BMI of all respondents were significantly (p

Background Obtaining valid and reliable estimates of usual dietary intake at a reasonable cost is a challenge in school-based nutrition research. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 version (ASA24 Kids-2014), a self-administered, computerized 24-hour dietary recall, offers improved feasibility over traditional interviewer-administered 24-hour recalls. Objective This mixed-methods study examined ASA24 Kids-2014′s validity for measuring dietary intake from National School Lunch Program lunches. Participants/setting After 24% attrition, 96 middle-school students from three urban schools in eastern Pennsylvania participated in the study. A subsample of 27 participants completed qualitative interviews. Data were collected in the spring of 2014. Main outcome measures Self-reported ASA24 Kids-2014 data were compared to direct observations of school lunch, which served as the criterion measure. Dependent variables included eight meal components selected from the National School Lunch Program guidelines (fruit, vegetables, grains, protein-rich foods, dairy, oils, solid fats, and added sugars). A supplemental interview collected qualitative data regarding students' perceptions of content and substantive validity. Statistical analyses The Wilcoxon signed rank test and Spearman's ρ examined criterion-related validity; qualitative content analysis examined content and substantive validity. Results Participants inaccurately recalled food items eaten at lunch, as 58% of foods were reported in error. However, among foods recalled correctly, no statistically significant differences emerged for estimates of portions consumed for six meal components (fruit, vegetables, grains, protein-rich foods, oils, and added sugars). In addition, statistically significant positive correlations emerged between ASA24 Kids-2014 and direct observation for all estimates. Qualitative data identified students' interest and motivation, comprehension, memory, and English-language fluency as relevant sources of error. Conclusions Middle school students have difficulty recalling food items eaten at school lunch; however, they are somewhat successful at estimating intake of accurately recalled foods using ASA24 Kids-2014. Like many self-administered computerized recalls, it remains limited by substantial error. Findings have implications for the development of ASA24 Kids-2014 among diverse youth in urban school settings.

Background Assessment of food intake is a cornerstone of nutritional research. However, the use of minimally validated dietary assessment methods is common and can generate misleading results. Thus, there is a need for valid, precise and cost-effective dietary assessment tools to be used in large cohort studies. The objective is to validate a newly developed automated self-administered web-based 24-h dietary recall (R24W), within a population of adults taking part in fully controlled feeding studies. Methods Sixty two adults completed the R24W twice while being fed by our research team. Actual intakes were precisely known, thereby allowing the analysis of the proportion of adequately self-reported items. Association between offered and reported portion sizes was assessed with correlation coefficients and agreement with the kappa score while systematics biases were illustrated with Bland-Altman Plot. Results Participants received an average of 16 food items per testing day. They reported 89.3% of the items they received. The more frequently omitted food categories were vegetables included in recipes (40.0%) as well as side vegetables (20.0%) and represented less than 5% of the actual daily energy intake. Offered and self-reported portion sizes were significantly correlated (r = 0.80 P

Made available in DSpace on 2021-06-25T10:33:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-05-01 Objectives: After dialysis initiation, a high protein diet is recommended due to significant nutrient losses through dialysate and increased risk of protein energy wasting. In peritoneal dialysis (PD) patients, protein intake can be assessed through different methods that have some advantages and limitations, which affect its use on routine care. The aim of this study is to evaluate the agreement between 2 different methods (24-hour dietary recall and PNA—protein equivalent of total nitrogen appearance) on estimating protein intake in PD patients. Design and Methods: Patients on PD for at least 3 months, aged 18 years old or more, were enrolled. To estimate protein intake, 24-hour dietary recall and PNA was used. PNA was calculated from 24-hour urine on the same day of the 24-hour dietary recall. Results: Fifty individuals on PD were included, mean age 55.7 ± 16.2 years, and body mass index 26.0 ± 4.5 kg/m2. The average energy consumption was 1788.79 ± 504.40 kcal/day, which corresponds to 26.81 ± 9.11 kcal/kg current body weight (BW)/day and 29.82 ± 8.39 kcal/kg ideal body weight (IBW)/day. The median of total daily and normalized protein intake estimated using dietary recall was 61.43 (45.28-87.40) g/day, 0.90 (0.58-1.22) g/kg current BW/day, and 1.04 (0.77-1.32) g/kg IBW/day, respectively. Daily protein intake estimated by PNA was 55.75 (48.27-67.74) g/day, protein intake normalized by current BW was 0.81 (0.72-0.99) g/kg and 0.92 (0.83-1.06) g/kg IBW/day. Bland-Altman analysis indicates no systematic bias for the assessment of total protein intake and normalized protein intake for current and ideal BW. Significant proportionality bias was observed for both evaluations, showing there is a dispersion of the values. Conclusions: Despite the absence of systematic bias in the Bland-Altman analysis, there is no agreement in the assessment of protein intake by dietary recall and PNA, due to the existence of proportionality bias. Thus, values can be influenced biased by the magnitude of the measures. Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP) Medical School Federal University of Uberlândia (UFU) Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP)

Eating foods high in added sugar has recently increased among people of all ages. This is expected to negatively affect health and life quality. This study was conducted to investigate the relationship between added sugar intake and sleep quality among university students. A total of 100 randomly selected female students (19-25 years old) from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, participated in the study after applying exclusion criteria. Sample size was calculated with expected correlation of −0.4 between sugar intake and sleep quality, a power of 90%, and a type 1 error of 5%. Participants completed the Food Frequency Questionnaire (FFQ), sleep quality questionnaire, and 24-hour dietary recall. Data were analyzed using IBM SPSS Statistics 25, and the χ2 test was used for measuring the association between added sugar intake and sleep quality, where P

Recent data on salt intake levels in India show consumption is around 11 g per day, higher than the World Health Organization&rsquo, s (WHO) recommended intake of 5 g per day. However, high-quality data on sources of salt in diets to inform a salt reduction strategy are mostly absent. A cross-sectional survey of 1283 participants was undertaken in rural, urban, and slum areas in North (n = 526) and South (n = 757) India using an age-, area-, and sex-stratified sampling strategy. Data from two 24-h dietary recall surveys were transcribed into a purpose-built nutrient database. Weighted salt intake was estimated from the average of the two recall surveys, and major contributors to salt intake were identified. Added salt contributed the most to total salt intake, with proportions of 87.7% in South India and 83.5% in North India (p &lt, 0.001). The main food sources of salt in the south were from meat, poultry, and eggs (6.3%), followed by dairy and dairy products (2.6%), and fish and seafood (1.6%). In the north, the main sources were dairy and dairy products (6.4%), followed by bread and bakery products (3.3%), and fruits and vegetables (2.1%). Salt intake in India is high, and this research confirms it comes mainly from added salt. Urgent action is needed to implement a program to achieve the WHO salt reduction target of a 30% reduction by 2025. The data here suggest the focus needs to be on changing consumer behavior combined with low sodium, salt substitution.

Malnutrition remains a major problem affecting millions of children in Africa. The objective of this study was to assess the nutritional status among primary school pupils in Olorunda Local government of Osogbo metropolis in South Western Nigeria. Semi-structured questionnaires were administered to respondents in11schools randomly selected. A cross sectional study design was used and multi-stage sampling technique was utilized in selecting participants for the study. Data was analyzed using Statistical Package for the Social Sciences. A total of 487 pupils were interviewed and their age range was 5–16years with a mean age of 8 years. More females (53.6%) than males (46.4%) were interviewed. Most fathers were skilled workers and while most mothers were in the unskilled labor force. Above half (50.2%) of the study population were found to have poor nutritional history based on the 24 hour dietary recall. Also using WHO standard measurements of z score with a standard deviation of

Aim To determine the relative validity of a 2-day 24-hour dietary recall (HR) designed to assess energy and nutrient intake among Chinese adults compared with a 2-day weighed dietary record (WD). Methods Data were obtained from an ongoing population-based, prospective cohort study of adults aged 18–65 years in South China. A total of 41 adults completing a HR and a WD within 14 days were included in the present analysis. Estimations of individual mean differences, Spearman's correlation coefficients, cross-classifications and Bland–Altman plots were used to assess the agreement between the intakes of energy and 18 nutrients obtained from the HR and the WD. Results With the exception of total fat, saturated fatty acids, thiamine, potassium and magnesium, the energy and nutrient intakes between the HR and WD showed no significant differences. All dietary intakes that were evaluated by the HR were correlated significantly with the dietary intake from the WD (de-attenuated correlation coefficients ranged from 0.10 to 0.87). The proportion of participants classified into quartiles correctly ranged from 61% for tocopherol intake to 90% for energy intake. The weighted k values ranking the participants ranged from 0.11 for tocopherol intake to 0.41 for the intakes of energy and calcium. The Bland–Altman plots showed moderate/good agreement among all the dietary intakes that were estimated from the HR and WD, except for total fat. Conclusions This study suggests that an HR could be a valid tool for estimating the energy and nutrient intakes among adults in South China at the group level.

Pregnancy is a period of considerable physiological and nutritional stress, during which the maternal requirements of almost all the nutrients are greatly increased. Pregnant women are considered as a vulnerable group because of increased physiological demands. Diet during pregnancy is one of the most important factors in achieving a successful outcome of pregnancy in terms of healthy baby and maintenance of her own health, as the overall development of child is determined to a great extent by the type of nourishment it receives right from the conception. By keeping in mind about the importance of nutritional diet the study was conducted with following objectives i.e. to study the knowledge about diet amongst pregnant women as well as diet taken by pregnant women (24 hour dietary recall) health problems among pregnant women as well as comparison between RDA and actual intake of nutrients. Results showed that near about 50% respondents has no idea about which nutrient rich diet should be taken during pregnancy. On the basis of 24 hour dietary recall it was found that more than 60%respondents do not gave importance to the inclusion of pulses, cereal, green leafy vegetables, fruits and milk in their diet. Besides this it was also found that 63.33 %respondents were having low hemoglobin level. There were 63.33% women having low blood pressure and 16.66% were having high blood pressure. In case of blood sugar level it was found that 60% were having low sugar level and 26.66 % were having high level.

OBJECTIVES: Self-reported dietary data suffer from high measurement error and findings that rely on them are of limited value. We determined the association of diet quality related biomarkers with associated measures from Block Food Frequency Questionnaire (FFQ) and Automated Self-Administered 24-hour dietary Assessment Tool (ASA24); and the association of FFQ and ASA24. METHODS: This cross-sectional single-visit study included 127 subjects (18–60 years, BMI ≥18.5 kg/m(2)). Diet quality related biomarkers were collected from pre-planned subsample (N = 33) to measure - plasma alkylresorcinol for whole grain, omega-3 index, serum fatty acid composition for dairy, serum carotenoids for fruit and vegetable, and serum selenium for seafood intake. Self-reported dietary intake data for whole grain, Omega-3 index, fatty acid, carotenoids, and selenium were calculated per instrument guidelines using FFQ and ASA24. Biomarkers were analyzed by Mass Spectrometry Facility, TTU. Outcomes with missing data were handled via multiple imputation with predictive mean matching. Spearman's correlation coefficient (using R statistical software) were used to assess the association of biomarkers with self-reported measures (N = 33), and the association between FFQ and ASA24 (N = 33, and N = 127). RESULTS: Diet quality related biomarkers were not associated with self-reported intake (all P > 0.07), except, omega-3 index was significantly correlated with reported intake in FFQ (P = 0.01). Significant associations were reported for whole grain, omega-3 index, and dairy intake between FFQ and ASA24 (P = 0.02, P = 0.01, P = 0.05 respectively; N = 33). After further analysis with N = 127 between FFQ and ASA24 significant association were reported in whole grain (P = 0.02), Omega-3 index (P = 4.90e-3), dairy (P = 1.79e-8), and seafood intake (P = 6.06e-4), but not carotenoid intake (P = 0.96). CONCLUSIONS: A significant association between measures via FFQ and ASA24 suggests consistency in self-reporting and also the likelihood these measures do not capture the time-frames they purport to – but rather a self-belief/representation of habitual intake patterns. Interestingly, the association of one of the biomarkers with self-reported intake suggests the necessity of including larger sample to better determine validity of self-reported data. FUNDING SOURCES: Texas Tech University.

Dietary assessment is important for monitoring and evaluating population intakes. Online tools can reduce the level of participant burden and the time taken to complete records, compared with other methods. The study aimed to field test an online dietary recall tool (Intake24) to test the suitability for collecting dietary information in Scottish national surveys and to develop the system based on feedback and emerging issues. Previous Scottish Health Survey participants, aged 11+ years, were invited to complete Intake24 and provide feedback about it. Of those who agreed to take part, 60% completed at least one recall. Intake24 was found to be user-friendly, enjoyable to use, and easy to follow and understand. Users agreed they would like to use Intake24 often, (44% compared with 15% who disagreed) and &gt, 75% felt the system accurately captured their dietary intakes. The main challenge reported was finding foods within the database. Of those completing fewer recalls than requested, the majority reported that they believed they had completed the required number or reported not receiving emails requesting they complete a further recall. Intake24 was found to be a user-friendly tool allowing dietary assessment without interviewer presence. Feedback indicated the method for recall reminders needs to be refined and tailored.

Objective To evaluate inter-coder (between-coder) and intra-coder (within-coder) reliability among trained data coders who enter 24-hour dietary recall data collected through Expanded Food and Nutrition Education Program operations in the state of Georgia. Design This study employed multiple cross-sectional evaluations of inter-coder reliability and a short-term longitudinal evaluation of intra-coder reliability. Participants/Setting Study participants consisted of trained data coders (n = 9) who were employed during the 12-month period of evaluation. Main Outcome Measures Primary outcome measures were inter-coder and intra-coder reliability across data entered into the Web-based Nutrition Education Evaluation and Reporting System. Statistical analyses were conducted using IBM SPSS 24. Descriptive statistics were generated and inter-coder and intra-coder reliability were assessed using 2-way mixed intraclass correlation coefficients. Results Results of this evaluation indicated good to excellent inter-coder reliability among all coders, and excellent intra-coder reliability among the majority of coders. However, some notable inconsistencies were identified within the intra-coder reliability analyses. Conclusions Future strategies to improve data quality within Expanded Food and Nutrition Education Program operations might include enhanced training for data coders, implementation of error detection protocols, expansion of the Web-based Nutrition Education Evaluation and Reporting System database, and exploration of automated, computer-assisted administration of 24-hour dietary recalls.

Maternal choline intake during the third trimester of human pregnancy can modify systemic and local epigenetic marks in fetal-derived tissues, promoting better pregnancy outcomes, increased immunity, as well as improved mental and physical work capacity with proper memory and cognitive development. 103 pregnant women presenting to the antenatal care of Azimpur Maternity Hospital of Dhaka, Bangladesh in their third trimester of pregnancy were randomly selected for this cross sectional study exploring dietary intake patterns of choline. A dietary recall form was administered to estimate frequency and amount of food consumption of foods for the previous 24 hours. Most women reported diets that delivered less than the recommended choline intake (mean ± SD; 189.5 ± 98.2) providing only 42.72% of total RDA value. The results of this study may indicate that dietary choline among pregnant, Bangladeshi women may not be adequate to meet the needs of both, the mother and fetus. Further studies are warranted to determine clinical implications.

Background Valid methods of diet assessment are important for nutrition research and practice, but can be difficult with children. Objective To validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites. Design Quasiexperimental. Participants/setting In one site, trained staff members observed and recorded foods and drinks consumed by children (n=38) during school lunch. The next day, the observed children completed both ASA24-Kids-2012 and an interviewer-administered 24hDR in a randomized order. Procedures in a second site (n=31) were similar, except observations occurred during dinner in a community location. Statistical analyses Foods were classified as matches (reported and consumed), intrusions (reported, but not consumed), or omissions (not reported, but consumed) for each participant. Rates of matches, intrusions, and omissions were calculated. Rates were compared between each recall method using repeated measures analysis of covariance. For matched foods, the authors determined correlation coefficients between observed and reported serving sizes. Results Match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes in Site 1 were 37%, 27%, and 35%, respectively. Comparable rates for interviewer-administered 24hDRs were 57%, 20%, and 23%, respectively. In Site 2, match, intrusion, and omission rates between ASA24-Kids-2012 and observed intakes were 53%, 12%, and 36%, respectively, vs 76% matches, 9% intrusions, and 15% omissions for interviewer-administered 24hDRs. The relationship strength between reported and observed serving sizes for matched foods was 0.18 in Site 1 and 0.09 in Site 2 for ASA24-Kids-2012, and 0.46 in Site 1 and 0.11 in Site 2 for interviewer-administered 24hDRs. Conclusions ASA24-Kids-2012 was less accurate than interviewer-administered 24hDRs when compared with observed intakes, but both performed poorly. Additional research should assess the age at which children can complete recalls without the help of a parent or guardian, as well as elucidate under which circumstances recalls can reasonably be used among children.

Adequate intake of calcium is important for skeletal growth. Low calcium intake during adolescence may lead to decreased bone mass accrual thereby increasing the risk of osteoporotic fractures in later stages of life. The aim of the present study was to assess dietary calcium and serum calcium of adolescent girls from different economic background. One eighty adolescent girls (10-15years) were selected from government and private schools. 24 hour dietary recall and food frequency questionnaire were used to evaluate intake of calcium and Calcium Arsenazo Reagent Kit was used to measure serum calcium. The mean calcium intake was significantly different in all three groups with maximum intake in girls from High Income Group (HIG) (1238.81 mg/day) and lowest in Low Income Group (LIG) girls (447.87 mg/day). Although the main source of calcium in all three groups was dairy products, the quantity of intake differed considerably. Despite low calcium intake,serum calcium was found normal in the subjects from LIG. Measures need to be taken to rectify low calcium intake in LIG. Bone mineral density is better indicator of calcium status than serum calcium.

Background: Household Consumption and Expenditures Surveys (HCES) are potential sources of data on dietary patterns for planning fortification programs, but they rarely have been compared with individual-level dietary assessment methods. Objective: To compare apparent consumption of fortifiable foods estimated from the Third Cameroon Household Survey (ECAM3) with the results of a national dietary survey using food frequency questionnaire (FFQ) and 24-hour recall (24HR) methods among women aged 15 to 49 years and children aged 12 to 59 months. Methods: We estimated coverage and frequency of consumption in the previous week (ECAM3 and FFQ) and coverage and amount consumed on the previous day (ECAM3 and 24HR) of refined vegetable oil, wheat flour, sugar, and bouillon cubes. Results: Coverage in the past week as measured by the ECAM3 and FFQ, respectively, was 64% vs. 54% for oil, 60% vs. 92% for flour, 69% vs. 78% for sugar, and 85% vs. 96% for bouillon cubes. The different methods identified similar patterns of coverage among subgroups for oil, but patterns for other foods were variable. Frequency of consumption and previous-day coverage were lower with the ECAM3 than with the FFQ and 24HR, likely reflecting infrequent acquisition relative to intake. For women, the mean amounts consumed on the previous day (among consumers) were 43 vs. 29 g of oil, 71 vs. 83 g of flour, 42 vs. 32 g of sugar, and 5.0 vs. 2.4 g of bouillon cubes (ECAM and 24HR, respectively). Conclusions: HCES provide useful information on patterns of food access but inadequate information on individual consumption amounts to estimate appropriate food fortification levels.

Dietary assessment has come under much criticism of late to the extent that it has been questioned whether self-reported methods of dietary assessment are worth doing at all. Widespread under-reporting of energy intake, limitations due to memory, changes to intake due to the burden of recording and social desirability bias all impact significantly on the accuracy of the dietary information collected. Under-reporting of energy intakes has long been recognized as a problem in dietary research with doubly labeled water measures of energy expenditure uncovering significant under-reporting of energy intakes across different populations and different dietary assessment methods. In this review we focus on dietary assessment with children with particular attention on the 24-hour dietary recall method. We look at the level of under-reporting of energy intakes and how this tends to change with age, gender and body mass index. We discuss potential alternatives to self-reported (or proxy-reported) dietary assessment methods with children, such as biomarkers, and how these do not enable the collection of information important to public health nutrition such as the cooking method, the mixture of foods eaten together or the context in which the food is consumed. We conclude that despite all of the challenges and flaws, the data collected using self-reported dietary assessment methods are extremely valuable. Research into dietary assessment methodology has resulted in significant increases in our understanding of the limitations of self-reported methods and progressive improvements in the accuracy of the data collected. Hence, future investment in dietary surveillance and in improving self-reported methods of intake can make vital contributions to our understanding of dietary intakes and are thus warranted.

Background: Current methods for assessing children's dietary intake, such as interviewer-administered 24-h dietary recall (24-h DR), are time consuming and resource intensive. Self-administered instruments offer a low-cost diet assessment method for use with children. The present study assessed the validity of the Portuguese self-administered, computerised, 24-h DR (PAC24) against the observation of school lunch. Methods: Forty-one, 7–10-year-old children from two elementary schools, in Lisbon, were observed during school lunch followed by completion of the PAC24 the next day. Accuracy for reporting items was measured in terms of matches, intrusions and omissions; accuracy for reporting amounts was measured in terms of arithmetic and absolute differences for matches and amounts for omissions and intrusions; and accuracy for reporting items and amounts combined was measured in terms of total inaccuracy. The ratio of the estimated weight of food consumed with the actual weight consumed was calculated along with the limits of agreement using the method of Bland and Altman. Results: Comparison of PAC24 against observations at the food level resulted in values of 67.0% for matches, 11.5% for intrusions and 21.5% for omissions. The mean for total inaccuracy was 3.44 servings. For amounts, accuracy was high for matches (−0.17 and 0.23 servings for arithmetic and absolute differences, respectively) and lower for omissions (0.61 servings) and intrusions (0.55 servings). PAC24 was found to under-estimate the weight of food on average by 32% of actual intake. Conclusions: PAC24 is a lower-burden procedure for both respondents and researchers and, with slight modification, comprises a promising method for assessing diet among children.

The children

Dietary intake data are crucial for developing or evaluating nutrition interventions to improve the nutritional status of populations. The collection of accurate and reliable dietary data in developing countries, however, remains challenging. The emergence of new technologies, which facilitate electronic data capture, might address some of these challenges. This paper aims to describe an application developed to collect a multiple-pass 24-h dietary recall, using electronic data capture, and compare the results to those estimated using a paper-based method. In this study, a tablet-based application was developed, in the CommCare platform, to evaluate the effectiveness, for improving dietary adequacy, of a package of behavior change interventions to reduce stunting and anemia among 6&ndash, 23-month-old children in East Java, Indonesia (Baduta project). Dietary intakes of energy and nutrients were estimated using electronic data capture in the cohort study of the Baduta project (n = 680). We compared these results with those estimated using paper-based data capture in the project&rsquo, s end-line cross-sectional study (n = 2740). We found a higher percentage of children classified as acceptable energy reporters (reported energy intake within the 95% CI of Total Energy Expenditure) with the electronic data capture compared with paper-based data capture (i.e., 60.8%, 72.4% and 80.7% for 6&ndash, 8-, 9&ndash, 11- and 12&ndash, 23-month-old children, respectively, vs. 40.9%, 56.9%, and 54.3%, respectively). The estimated mean energy and nutrient intakes were not significantly different between these dietary data capture methods. These results suggest dietary data collection, using a tablet-based application, is feasible and can improve the quality of dietary data collected in developing countries.

The method used for creating a database of approximately 20,000 digital images of multiple portion sizes of foods linked to the USDA's Food and Nutrient Database for Dietary Studies (FNDDS) is presented. The creation of this database began in 2002 and its development has spanned 10 years. Initially the images were intended to be used as a kid-friendly aid for estimating portion size in the context of a computerized 24-hour dietary recall for 8-15 year old children. In 2006, Baylor College of Medicine, Westat, and the National Cancer Institute initiated a collaboration that resulted in the expansion of this image database in preparation for the release of the web-based Automated Self- Administered 24 Hour Dietary Recall (ASA24) for adults (now also available for use by children – ASA24-Kids). Researchers in the US and overseas have capitalized on these digital images for purposes including, but not limited, to dietary assessment.

Introduction The National Cancer Institute’s 2014 Family Life, Activity, Sun, Health, and Eating Study utilized a 27-item Dietary Screener tailored to adolescent eating patterns that assessed the frequency of intake of several foods and beverages in parent–adolescent dyads. This study estimated intake of fruits and vegetables (FVs), dairy, added sugars, and whole grains for screener respondents using existing, nationally representative, 24-hour dietary recall data. Methods Dietary Screener items were converted from frequency responses to daily intake. Intake (dependent variable) was estimated using regression coefficients and portion sizes of foods and beverages (independent variables) generated from the 2003–2006 National Health and Nutrition Examination Survey 2-day 24-hour recall data set. Means (SDs) were used to examine daily dietary factor intake among parent and adolescents. Analysis was conducted in 2015–2016. The analytic sample consisted of 1,732 parents (aged ≥18 years) and their adolescent aged 12–17 years (n=1,632). Results Male parents consumed 3.6 cups of FVs, 1.8 cups of dairy, 22.6 teaspoons of added sugars, and 2.1 ounces of whole grains daily; female parents consumed 2.8 cups of FVs, 1.3 cups of dairy, 14.8 teaspoons of added sugars, and 1.4 ounces of whole grains daily. Male adolescents consumed 2.2 cups of FVs, 1.9 cups of dairy, 17.9 teaspoons of added sugars, and 1.0 ounces of whole grains daily; female adolescents consumed 2.2 cups FVs, 1.6 cups of dairy, 14.2 teaspoons of added sugars, and 0.8 ounces of whole grains daily. Conclusions Utilizing a dietary screener tailored to adolescent eating patterns in parent–adolescent dyads provided estimated dietary factor intake, underscoring existing 24-hour dietary recall data can be used to calibrate dietary habits.

Objective Identify practices for the collection of the 24-hour dietary recall (24HR) as used by the Expanded Food and Nutrition Education Program (EFNEP) to assess the fidelity with which dietary data are collected. Methods An electronic survey sent nationally to all 75 EFNEP coordinators to assess methodology for collection, staff training, and coding of 24HR. Results A total of 67 surveys were returned, 53 of which were usable: 57% of programs used multiple collection periods (previous day vs previous 24 hours), 36% did not use a consistent number of passes in recall collection; only 17% exclusively used the validated 5-pass method; 88% trained paraprofessionals for ≤8 hours on recall collection and >6 different training programs were used; and 86% of programs used multiple coders. Conclusions and Implications The wide variation in reported collection, training, and coding practices raises concerns about the validity of the recall data and the appropriateness of combining data from multiple programs. To improve consistency, EFNEP could establish standardized methods for training, data collection, and data entry for the 24HR. These results may encourage the national program office to establish programmatic change that will support the fidelity of collection methods across all programs.

With two-thirds of the U.S. population being either overweight or obese, accurate tools for self-monitoring eating behaviors are needed for both research and personal purposes. To increase user compliance, these tools should be easy to use and impose a minimal burden on the user. The present study compares user preferences and compliance with the Bite Counter, a wrist-worn device designed to monitor eating behavior by counting bites, to the Internet-based Automated Self-Administered 24-hour dietary recall (ASA24). Eighty-three participants used the Bite Counter and the ASA24 for two weeks. At the end of the two-week period, participants were asked to rate their preference, compliance, and the ease of use for the two tools. 76% of the participants preferred the Bite Counter to the ASA24. Participants consistently used both tools. The Bite Counter was significantly easier to use, according to subjective ratings. These results indicate that users may be more likely to use the Bite Counter consistently than 24-hour dietary recalls.

Extensive evidence has demonstrated that 24-hour dietary recalls (24HDRs) provide high-quality dietary intake data with minimal bias, making them the preferred tool for monitoring the diets of populations and, increasingly, for studying diet and disease associations (1-3). Traditional 24HDRs, however, are expensive and impractical for large-scale research because they rely on trained interviewers, and multiple administrations are needed to estimate usual intakes. To address these challenges, the National Cancer Institute (NCI), in collaboration with the research firm Westat (Rockville, MD), and with the support of other institutes and offices at the National Institutes of Health, developed the Automated Self-Administered 24-hour dietary recall (ASA24) (4-6). ASA24 is a public-access, freely available, web-based tool for researchers, clinicians and educators, modeled on the Automated Multiple Pass Method (AMPM) (7). Development of an automated self-administered 24HDR for adults began in 2006 and was informed by input from stakeholders participating in an External Working Group and small-scale cognitive and usability testing (4,5). A Beta version released in August 2009 has been used by over 175 researchers to collect over 40,000 recalls; Version 1, which offers improved usability and new features, was released in September 2011 (8). A modified version intended for self-administration by children is under development by researchers at the Baylor College of Medicine (Houston, TX) and is expected to be available mid-2012 (9,10). This paper describes the features of ASA24 and planned evaluations.

Previous studies have shown that underreporting of energy intake is common when assessing dietary intake, particularly in the overweight and obese. The aim of this study was to obtain an estimate of energy and macronutrient intake according to weight status and to investigate underreporting among Iraqi people living in the UK. Twenty eight adult volunteers (n = 16 males) were recruited. Dietary intake was estimated 3 times using the 24 hour dietary recall tech-nique. Portion size was estimated using household measures and the Photographic Atlas of Food Portion Sizes. Energy and macronutrients estimations were calculated, and weight and height were measured to calculate Body Mass Index (BMI). Energy intake was compared to estimated basal metabolic rate (BMR) and the Goldberg equation was used to assess underreporting. Of the overall sample, 57.1% (n = 16) and 21.4% (n = 6) subjects were overweight and obese, respectively. The mean energy intakes were low for males (1977 kcal/d) and females (1586 kcal/d). The percentage of under-reporters was high (57.1%) and this was higher in overweight and obese subjects (68.1%) compared to those of normal weight (4.5%). Overweight and obesity are common among well-educated Iraqi people. Underreporting of energy intake is common especially among overweight and obese Iraqi individuals.