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Background/Objectives: For low- and middle- income country (LMIC) settings, a global nutrition transition is rapidly emerging as diets shift, resulting in a dual burden of malnutrition. High quality dietary intake data for these populations is essential to understand dietary patterns contributing to these nutrition issues. New technology is emerging to address dietary assessment challenges; however, it is unknown how researchers conducting studies with LMIC populations or under-served groups in high-income countries adopt technology-assisted methods. This study aimed to describe the features of the dietary assessment methods used in these settings. Methods: A cross-sectional survey of members of an online international nutrition network was conducted. Participants completed an online questionnaire collecting data on dietary assessment method use, populations studied, and factors influencing method selection. Results: Of 45 participants (ranging from 27 to 60 years) who completed the questionnaire, 67% conducted dietary assessments in children aged 1–5 years, 60% in pregnant women and 60% in female adults. Dietary assessment was conducted predominantly in countries classified as LMIC (n = 50), compared to the assessment of vulnerable groups in high-income countries (n = 3). All participants reported using 24-h recalls, 80% used food frequency questionnaires, while 22% used image-based and 22% used image-assisted methods. Predominant modes were interviewer-administered, paper questionnaires and manual analysis; however, digital survey platforms were used by nearly half of participants. Conclusions: Although traditional dietary assessment methods continue to dominate in LMICs, evidence of technological-assisted method use is emerging. Technology-assisted methods, tailored to address challenges in collecting quality dietary intake data in LMICs, are becoming more accessible. [ABSTRACT FROM AUTHOR]

A priori dietary indices provide a standardized, reproducible way to evaluate adherence to dietary recommendations across different populations. Existing nutrient-based indices were developed to reflect food/beverage intake; however, given the high prevalence of dietary supplement (DS) use and its potentially large contribution to nutrient intakes for those that use them, exposure classification without accounting for DS is incomplete. The purpose of this article is to review existing nutrient-based indices and describe the development of the Total Nutrient Index (TNI), an index developed to capture usual intakes from all sources of under-consumed micronutrients among the U.S. population. The TNI assesses U.S. adults' total nutrient intakes relative to recommended nutrient standards for eight under-consumed micronutrients identified by the Dietary Guidelines for Americans: calcium, magnesium, potassium, choline, and vitamins A, C, D, E. The TNI is scored from 0 to 100 (truncated at 100). The mean TNI score of U.S. adults (≥19 y; n = 9,954) based on dietary data from NHANES 2011-2014, was 75.4; the mean score for the index ignoring DS contributions was only 69.0 (t-test; p < 0.001). The TNI extends existing measures of diet quality by including nutrient intakes from all sources and was developed for research, monitoring, and policy purposes. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1967872. [ABSTRACT FROM AUTHOR]

Background: Diet quality indexes, including the Healthy Eating Index, assess diets based on usual dietary intakes and a scoring function. Nearly all diet quality indexes use scoring functions that have floors and ceilings, thereby truncating the scores and losing information about intakes outside the scoring range. This score truncation has 2 important impacts: 1) the index does not reflect all intakes; and 2) the assumption that measurement error in intake reporting has a neutral impact on the diet quality score cannot be upheld.Objectives: Our main objective was to devise new diet quality scoring functions that eliminate truncation and its attendant problems.Methods: Seven desirable properties of a new scoring function were identified: 1) avoid truncations in component scoring to prevent information loss and to provide scoring sensitivity in the currently truncated regions; 2) reduce dependency on the accuracy of dietary standards; 3) minimize measurement error bias and subsequent misclassification; 4) relate plausibly to biological processes; 5) possess desirable mathematical and statistical properties; 6) have simple representations that are easy to calculate and add minimum artifacts of their own; and 7) otherwise closely mimic existing scoring functions.Results: The recommended replacement for piecewise-linear scoring is a family of scoring functions based on exponentials. For components where higher intakes are better, the function is a single exponential. For components where lower intakes are better, the function is a concave-convex mirrored pair of exponentials. The proposed exponential scoring functions have all 7 desired properties.Conclusions: The proposed exponential scoring functions will improve the usefulness of dietary scoring indexes by eliminating truncations. Compared to existing scoring functions, the use of exponentials makes the scores more inclusive of very high and very low intakes, reduces measurement error bias, and is less sensitive to the exact placement of the scoring standards. [ABSTRACT FROM AUTHOR]

Background: Intake24, a web-based 24-hour dietary recall tool developed in the United Kingdom, was adapted for use in New Zealand (Intake24-NZ) through the addition of a New Zealand food list, portion size images, and food composition database. Owing to the customizations made, a thorough evaluation of the tool's usability was required. Detailed qualitative usability studies are well suited to investigate any challenges encountered while completing a web-based 24-hour recall and provide meaningful data to inform enhancements to the tool., Objective: This study aims to evaluate the usability of Intake24-NZ and identify improvements to enhance both the user experience and the quality of dietary intake data collected., Methods: We used a mixed methods approach comprising two components: (1) completion of a single 24-hour dietary recall using Intake24-NZ with both screen observation recordings and collation of verbal participant feedback on their experience and (2) a survey., Results: A total of 37 participants aged ≥11 years self-completed the dietary recall and usability survey (men and boys: 14/37, 38% and women and girls: 23/37, 62%; Māori: 10/37, 27% and non-Māori: 27/37, 73%). Although most (31/37, 84%) reported that Intake24-NZ was easy to use and navigate, data from the recorded observations and usability survey revealed challenges related to the correct use of search terms, search results obtained (eg, type and order of foods displayed), portion size estimation, and associated food prompts (eg, did you add milk to your tea?)., Conclusions: This comprehensive usability study identified challenges experienced by users in completing a dietary recall in Intake24-NZ. The results informed a series of improvements to enhance user experience and the quality of dietary data collected with Intake24-NZ, including adding new foods to the food list, optimizing the search function and ordering of search results, creating new portion size images, and providing clearer instructions to the users., (©Berit Follong, Caitlin Haliburton, Sally Mackay, Maria Maiquez, Jacqueline Grey, Cliona Ni Mhurchu. Originally published in JMIR Formative Research (https://formative.jmir.org), 18.10.2024.)

The development of better and more robust measures of dietary intake in free living situations was identified as a priority for advancing nutrition research by the Office of Strategic Coordination for Health Research (OSCHR) Review of Nutrition and Human Health Research in 2017. The UK Nutrition Research Partnership (NRP) sponsored a workshop on Dietary Intake Assessment methodology alongside its series of 'Hot Topic' workshops designed to accelerate progress in nutrition research by bringing together people from a range of different disciplines. The workshop on Dietary Intake Assessment methodology took place via Zoom over two half‐days in January 2021 and included 50 scientists from a wide range of disciplines. The problems with current methods of dietary assessment and how emerging technologies might address them were set out in pre‐recorded presentations and explored in panel discussions. Participants then worked in breakout groups to discuss and prioritise the research questions that should be addressed to best further the field and lead to improvements in dietary assessment methodology. Five priority research questions were selected. Participants were asked to brainstorm potential approaches for addressing them and were then asked to focus on one approach and develop it further. At the end of these sessions, participants presented their project ideas to the rest of the workshop and these will be reported back to the Medical Research Council. It is hoped that potential collaborative projects arising from these discussions will be taken forward in response to future funding calls. [ABSTRACT FROM AUTHOR]

Background: In patients with type 2 diabetes mellitus (DM), an accurate assessment of food intake is essential for clinical nutritional management. Tools such as the food frequency questionnaire (FFQ) and 24‐h food record (24HR) identify dietary habits in support of dietary planning. However, it is possible that these tools have reporting errors with respect to assessing food intake, particularly energy intake (EI). Methods: A cross‐sectional study was conducted in patients with type 2 DM. EI was assessed by the FFQ and 24HR tools. Resting energy expenditure (REE) was measured by indirect calorimetry. Data were analysed using a kappa test, t‐test and Spearman's correlation coefficients. Under‐reporting was assessed using the EI/REE ratio. Patients with values <1.18 and <1.10 for FFQ and 24HR, respectively, were considered as under‐reporting. Results: We evaluated 55 patients [mean (SD) 62.7 (5.3) years old, duration of diabetes 11.2 (7.3) years, 52.7% female]. The mean (SD) EI assessed by FFQ was 1797.7 (641.3) and as assessed by 24HR was 1624 (484.8) kcal day–1. The mean (SD) REE was 1641.3 (322.3) kcal day–1. The mean (SD) ratios FFQ/REE and 24HR/REE were 1.11 (0.38) and 1.01 (0.30), respectively. The tools showed a moderate agreement for under‐reporting of EI (kappa = 0.404; P = 0.003). Moderate and positive correlations between REE were observed with FFQ (r = 0.321; P = 0.017) and 24HR (r = 0.364; P = 0.006). According to the tools, the under‐reporting was observed in approximately 65% of patients. Conclusions: The majority of patients with type 2 DM under‐reported their calorie intake, as assessed by FFQ and 24HR. REE showed a positive correlation with both tools. [ABSTRACT FROM AUTHOR]

Abstract Background Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report. Methods The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines. Results Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases. Conclusions The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org .

Metabolomics can be a tool to identify dietary biomarkers. However, reported food-metabolite associations have been inconsistent, and there is a need to explore further associations. Our aims were to confirm previously reported food-metabolite associations and to identify novel food-metabolite associations. We conducted a cross-sectional analysis of data from 849 participants (57% men) of the PopGen cohort. Dietary intake was obtained using FFQ and serum metabolites were profiled by an untargeted metabolomics approach. We conducted a systematic literature search to identify previously reported food-metabolite associations and analyzed these associations using linear regression. To identify potential novel food-metabolite associations, datasets were split into training and test datasets and linear regression models were fitted to the training datasets. Significant food-metabolite associations were evaluated in the test datasets. Models were adjusted for covariates. In the literature, we identified 82 food-metabolite associations. Of these, 44 associations were testable in our data and confirmed associations of coffee with 12 metabolites, of fish with five, of chocolate with two, of alcohol with four, and of butter, poultry and wine with one metabolite each. We did not identify novel food-metabolite associations; however, some associations were sex-specific. Potential use of some metabolites as biomarkers should consider sex differences in metabolism.

Background: The nitrate content of foods and water is highly variable, which has implications for the compilation of foodcomposition databases and assessment of dietary nitrate intake. Objective: A systematic review was conducted to ascertain the dietary assessment methods used and to provide estimates of daily nitrate intake in humans. Design: Relevant articles were identified by a systematic search of 3 electronic databases (PubMed,Web of Science, and Embase) from inception until February 2018. Observational studies conducted in adult populations and reporting information on dietary assessment methods and daily nitrate intake were included. Ecological analyses were conducted to explore the association of nitrate intake with indexes of economic development [Gross Domestic Product (GDP) and KOF Index of Globalization]. Results: A total of 55 articles were included. Forty-two studies investigated associations between nitrate intake and disease risk; 36 (87%) of these studies examined the association between nitrate intake and cancer risk, whereas only 6 studies explored the association of nitrate intake with the risk of diabetes, glaucoma, kidney failure, hypertension, and atherosclerotic vascular disease. The majority of studies used food-frequency questionnaires to assess nitrate intake (n = 43). The median daily nitrate intakes in healthy and patient populations were 108 and 110 mg/d, respectively. We found a significant inverse correlation of nitrate intake with GDP (r=−0.46, P < 0.001) and KOF index (r=−0.31, P = 0.002). Conclusions: The median estimated daily nitrate intakes by healthy and patient populations were similar, and these values were belowthe safe upper intake of daily intake (3.7 mg nitrate ion/kg body weight). However, there is considerable heterogeneity in the application of food-composition tables, which may have implications for the accuracy of estimated daily nitrate intake. The association between nitrate intake and risk of cardiometabolic diseases needs further investigation. [ABSTRACT FROM AUTHOR]

Background: Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report.Methods: The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines.Results: Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases.Conclusions: The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org . [ABSTRACT FROM AUTHOR]

A child's diet is an important determinant of growth and development. Because of this, the accurate assessment of dietary intake in young children remains a challenge. A systematic search of studies validating FFQ methodologies in children 12 to 36 months of age was completed. English-language articles published until March 2016 were searched using three electronic databases (MEDLINE, EMBASE and CINAHL). Quality assessment of the identified studies was carried out using The Reduced Summary Score and EURopean micronutrient RECommendations Aligned (EURRECA) scoring system. Seventeen studies were included and categorised according to whether they reflected long-term (≥7 d) or short-term (0·4). Of the nutrients with three or more studies available, FFQ validated using a reference method reflecting short-term intake had a good weighted correlation for Ca (0·51), and acceptable weighted correlations for vitamin C (0·31) and Fe (0·33). Semi-quantitative FFQ were shown to be valid and reproducible when estimating dietary intakes at a group level, and are an acceptable instruments for estimating intakes of Ca, vitamin C and Fe in children 12 to 36 months of age.

Abstract Objective: To investigate if the addition of an in‐depth interview focused on cultural dietary practices could improve the quality of dietary data from food records among South Asian women in New Zealand. Methods: Cross‐sectional data were collected from 134 South Asian women (≥20 years), living in Auckland. Dietary data were collected using four‐day food records. Nutritional analysis revealed 33.6% under‐reporting of energy intakes. All women were recalled for an in‐depth probing interview focused on culture‐specific foods and dietary practices. Results: The interview revealed extensive use of dairy products and plant oils. The nutrient content of the food record alone and the food record plus interview were compared; median energy intakes were 6,852 kJ vs 7,246 kJ (p

A child's diet is an important determinant of growth and development. Because of this, the accurate assessment of dietary intake in young children remains a challenge. A systematic search of studies validating FFQ methodologies in children 12 to 36 months of age was completed. English-language articles published until March 2016 were searched using three electronic databases (MEDLINE, EMBASE and CINAHL). Quality assessment of the identified studies was carried out using The Reduced Summary Score and EURopean micronutrient RECommendations Aligned (EURRECA) scoring system. Seventeen studies were included and categorised according to whether they reflected long-term (≥7 d) or short-term (<7 d) intake, or used a biomarker. A total score for each micronutrient was calculated from the mean of the correlation coefficients weighted by the study quality score. At least three validation studies per micronutrient were required for inclusion. Fifteen studies (83%) that considered validity of the FFQ in assessing nutrient intakes had quality scores from 2·5 to 6·0. Of those, ten (67%) studies found FFQ to have good correlations in assessing dietary intake (>0·4). Of the nutrients with three or more studies available, FFQ validated using a reference method reflecting short-term intake had a good weighted correlation for Ca (0·51), and acceptable weighted correlations for vitamin C (0·31) and Fe (0·33). Semi-quantitative FFQ were shown to be valid and reproducible when estimating dietary intakes at a group level, and are an acceptable instruments for estimating intakes of Ca, vitamin C and Fe in children 12 to 36 months of age. [ABSTRACT FROM AUTHOR]

The European Food Safety Authority’s 2010 scientific opinion on dietary reference values for total water intakes was partly based on observed intakes in population groups. Large variability was observed, and it is unlikely that these differences can be explained by differences in climate, activity level and/or culture. This suggests that there are uncertainties in the methodologies used to assess water intake from food and fluids, including all types of beverages. To determine current methods for recording and reporting total water, beverages and fluid intakes, twenty-one European countries were surveyed using an electronic questionnaire. In total, twelve countries responded and ten completed surveys were summarised. Countries reported that their survey was representative of the population in terms of age and socio-economic status. However, a variety of methods were used – that is, repeated 24-h recalls, estimated food diaries and FFQ. None of the methods were validated to assess water and fluid intakes. The methods used to record liquid foods – for example, soup and diluted drinks – were inconsistent. Clarity and consistency on definitions of categories of beverages to facilitate comparisons between countries are needed. Recommendations for a unified approach to surveying and quantifying intake of water from fluids and foods are proposed. [ABSTRACT FROM PUBLISHER]

Online dietary assessment tools offer a convenient, low cost alternative to traditional dietary assessment methods such as weighed records and face-to-face interviewer-led 24-h recalls. INTAKE24 is an online multiple pass 24-h recall tool developed for use with 11-24 year-old. The aim of the study was to undertake a comparison of INTAKE24 (the test method) with interviewer-led multiple pass 24-h recalls (the comparison method) in 180 people aged 11-24 years. Each participant completed both an INTAKE24 24-h recall and an interviewer-led 24-h recall on the same day on four occasions over a one-month period. The daily energy and nutrient intakes reported in INTAKE24 were compared to those reported in the interviewer-led recall. Mean intakes reported using INTAKE24 were similar to the intakes reported in the interviewer-led recall for energy and macronutrients. INTAKE24 was found to underestimate energy intake by 1% on average compared to the interviewer-led recall with the limits of agreement ranging from minus 49% to plus 93%. Mean intakes of all macronutrients and micronutrients (except non-milk extrinsic sugars) were within 4% of the interviewer-led recall. Dietary assessment that utilises technology may offer a viable alternative and be more engaging than paper based methods, particularly for children and young adults. [ABSTRACT FROM AUTHOR]

ObjectiveAnalysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized.DesignDuplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods.SettingHealthy Aging in Neighborhoods of Diversity across the Life Span study.SubjectsAfrican-American and White adults with two dietary recalls (n 2177).ResultsDifferences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls.ConclusionsUse of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet–health relationships. [ABSTRACT FROM PUBLISHER]

The Dutch Healthy Diet index (DHD-index) was developed using data from two 24 h recalls (24hR) and appeared useful to evaluate diet quality in Dutch adults. As many epidemiologic studies use FFQ, we now estimated the DHD-index score using FFQ data. We compared whether this score showed similar associations with participants' characteristics, micronutrient intakes, and biomarkers of intake and metabolism compared with the DHD-index using 24hR data. Data of 121 Dutch participants of the European Food Consumption Validation study were used. Dietary intake was assessed by two 24hR and a 180-item FFQ. Biomarkers measured were serum total cholesterol and carotenoids, EPA + DHA in plasma phospholipids and 24 h urinary Na. A correlation of 0·48 (95 % CI 0·33, 0·61) was observed between the DHD-index score based on 24hR data and on FFQ data. Classification of participants into the same tertiles of the DHD-index was achieved for 57 %. Women showed higher DHD-index scores. Energy intake was inversely associated with both DHD-index scores. Furthermore, age and intakes of folate, Fe, Mg, K, vitamin B6 and vitamin C were positively associated with both DHD-index scores. DHD-index scores showed acceptable correlations with the four combined biomarkers taking energy intake into account (r 24hR 0.55; r FFQ 0.51). In conclusion, the DHD-index score based on FFQ data shows similar associations with participants' characteristics, energy intake, micronutrient intake and biomarkers compared with the score based on 24hR data. Furthermore, ranking of participants was acceptable for both methods. FFQ data may therefore be used to assess diet quality using the DHD-index in Dutch populations.

Background:The health of subjects is not affected by the nutrients ingested in a particular day; it actually is influenced by the dietary habits over a long time. In the most commonly used methods, usual food components intakes would be estimated along with bias. Considering the initiating and developing of many chronic diseases in the middle-age and elderly, majority of them affected by nutrition, the aim of current research was to evaluate the distribution of usual intake of selected nutrients using a powerful statistical method i.e. NCI (National Cancer Institute) method in a general above 40-years-old population of central region of Iran. Methods: In this cross-sectional study, based on information obtained from the Isfahan Cohort Study in 2007, 1922 people aged 40 and over, were investigated. Subjects's dietary intakes were assessed with a 24-hour recalls and two food records. Distribution of usual nutrient intake was estimated using NCI method. The proportion of subjects at risk of nutrient intake deficiency or excess was estimated by comparing the estimated values with recommended standards, for men and women, separately. Findings: The prevalence of vitamin A inadequacy for men in different age groups was more substantial than women (58.3-96.7 percent for men vs 23.3-57.2 percent for women). The usual calcium and dietary fiber intakes for a low percentage of studied subjects were more than recommended standards (Maximum of 7 and 28 percent for dietary fiber and calcium, respectively). There was a significant difference between men and women, at the age of 40-70 years, in terms of compliance of recommended cholesterol level (P < 0.0001). Conclusion: The results of current research showed that intake of vitamin A, calcium and dietary fiber was not adequate, and somewhat there was excess intake of cholesterol in the studied population. Thus consuming of dairies, vegetables and fruits, as the main sources of micronutrients, should be increased in this population. Interventional population-based programs such as enriching food and training in order to adjusting the pattern of diet should be designed. [ABSTRACT FROM AUTHOR]

The Dutch Healthy Diet index (DHD-index) was developed using data from two 24 h recalls (24hR) and appeared useful to evaluate diet quality in Dutch adults. As many epidemiologic studies use FFQ, we now estimated the DHD-index score using FFQ data. We compared whether this score showed similar associations with participants' characteristics, micronutrient intakes, and biomarkers of intake and metabolism compared with the DHD-index using 24hR data. Data of 121 Dutch participants of the European Food Consumption Validation study were used. Dietary intake was assessed by two 24hR and a 180- item FFQ. Biomarkers measured were serum total cholesterol and carotenoids, EPA + DHA in plasma phospholipids and 24 h urinary Na. A correlation of 0·48 (95% CI 0·33, 0·61) was observed between the DHD-index score based on 24hR data and on FFQ data. Classification of participants into the same tertiles of the DHD-index was achieved for 57%. Women showed higher DHD-index scores. Energy intake was inversely associated with both DHD-index scores. Furthermore, age and intakes of folate, Fe, Mg, K, vitamin B6 and vitamin C were positively associated with both DHD-index scores. DHD-index scores showed acceptable correlations with the four combined biomarkers taking energy intake into account (r24hR 0.55; rFFQ 0.51). In conclusion, the DHD-index score based on FFQ data shows similar associations with participants' characteristics, energy intake, micronutrient intake and biomarkers compared with the score based on 24hR data. Furthermore, ranking of participants was acceptable for both methods. FFQ data may therefore be used to assess diet quality using the DHD-index in Dutch populations. [ABSTRACT FROM AUTHOR]

In the present medical context, the evaluation and the monitoring of factors other than mere physical symptoms are an urgent demand. In particular, the issue of quality of life (QoL) has become a relevant target in the treatment of cancer. However, the approach towards these aspects is not well standardized and the actual applications in a concrete setting are fragmented, left to personal or local initiative. If this is true for QoL in general, it is particularly relevant in the specific field of nutrition. Indeed, though the growing awareness of a correlation between chronic diseases and dietary habits has led to an increased interest in nutrition, both before and after cancer, very little is still known about the methods that measure this important variable of the QoL. Indeed, good nutrition may have a relevant impact on QoL, positively affecting both the physical and psychological well-being. Targeting this issue implies using proper instruments to both monitor and educate the patients. Hence, we argue that it is vital for oncologists to be able to individuate the best tool available in a specified context, so as to achieve an important goal with little effort, also adopting standardized strategies proved to be efficacious. In this framework, we briefly reviewed the tools more frequently reported in the scientific literature. We suggest that through a cognitive approach, it is possible to achieve important clinical targets, initially by understanding the patients' needs, values, and psychosocial factors involved in nutritional behaviour and food-related decisions, in order to develop a personalized approach. Hence, this is the only way to support concrete actions for promoting healthier diets, thus preventing recurrences, monitoring chronic conditions, and supporting a good QoL. [ABSTRACT FROM AUTHOR]

Dietary intake throughout childhood is a key determinant of growth and development and has an important role in both the prevention and treatment of childhood overweight and obesity. Although dietary intake assessment is fraught with challenges and limitations, reporting intake remains an important research outcome if dietary recommendations to promote healthy weight are to be refined. The aims of this paper are to review current dietary intake assessment methodologies for children, to identify their biases and provide guidance on how these can be addressed to improve reporting of dietary intakes of overweight children in the literature and to identify future research priorities. Knowledge of the methodological aspects of studies examining dietary intake a priori in the context of obesity will assist researchers in improving the quality of dietary data collected and reported and facilitate publication of both dietary intake and nutrition outcomes in the context of body weight. This will help to develop a strong evidence base against which to evaluate the effectiveness of nutrition interventions for both the prevention and treatment of pediatric obesity. [ABSTRACT FROM AUTHOR]

Aim: The aim of this review is to explore the validity and/or reproducibility of dietary assessment methods used to assess food and nutrient intakes of adolescents. Method: A detailed literature search was undertaken to trace articles reporting on the validity and/or reproducibility of food records, food frequency questionnaires (FFQs) and 24-hour recalls for the dietary assessment of adolescents, especially among South Africans, in the following databases: Medline, Science Direct, Academic Search Premier, Health Source, PubMed and the South African e-publications database (SAE). Original studies published between 1990 and 2009, and relevant original articles published before 1990, were included. Of these, only three were South African-based studies reporting testing for reproducibility and/or validity. Results: Results indicated that adolescents comply better with estimated food records than with weighed food records. However, energy intake was underestimated in adolescents (by 18-42%) when using food record methods. The relative validity of FFQs among adolescents was moderate, with correlation coefficients of > 0.3 for most measured nutrients and food items. Reproducibility was fair to good among female adolescents (0.3-0.83) for most nutrients and foods, but was lower in a South African Tswana-speaking group. The 24-hour recall method showed the least over- and underestimation of all the reviewed methods. When comparing the 24-hour recall method to an observed intake method among adolescents, < 11% underestimation of energy intake was found, while < 4% underestimation was found when the 24-hour recall method was tested against the doubly labelled water method. Conclusion: Based on these outcomes it was concluded that FFQs and 24-hour recalls are valid and reproducible dietary assessment methods that can be used when collecting dietary data from adolescents. Factors to consider when choosing the best suitable method should include the gender and ethnicity of the population as well as the time frame for the collection of dietary data. [ABSTRACT FROM AUTHOR]

Background/Objectives:We applied three dietary assessment methods and aimed at obtaining a set of physical, social and psychological variables that can discriminate those individuals who did not underreport (‘never under-reporters’), those who underreported in one dietary assessment method (‘occasional under-reporters’) and those who underreported in two or three dietary assessment methods (‘frequent under-reporters’).Participants/Methods:Sixty-five women aged 18–57 years were recruited for this study. Total energy expenditure was determined by doubly labelled water, and energy intake was estimated by three 24-h diet recalls, 3-day food records and a food frequency questionnaire. A multiple discriminant analysis was used to identify which of those variables better discriminated the three groups: body mass index (BMI), income, education, social desirability, nutritional knowledge, dietary restraint, physical activity practice, body dissatisfaction and binge-eating symptoms.Results:Twenty-three participants were ‘never under-reporters’. Twenty-four participants were ‘occasional under-reporters’ and 18 were ‘frequent under-reporters’. Four variables entered the discriminant model: income, BMI, social desirability and body dissatisfaction. According to potency indices, income contributed the most to the total discriminant power, followed in decreasing order by social desirability score, BMI and body dissatisfaction. Income, social desirability and BMI were the characteristics that mainly separated the ‘never under-reporters’ from the under-reporters (occasional or frequent). Body dissatisfaction better discriminated the ‘occasional under-reporters’ from the ‘frequent under-reporters’.Conclusions:‘Frequent under-reporters’ have a greater BMI, social desirability score, body dissatisfaction score and lower income. These four variables seemed to be able to discriminate individuals who are more prone to systematic under reporting. [ABSTRACT FROM AUTHOR]

Food records or 24-hour recalls are currently used to calibrate food frequency questionnaires (FFQs) and to correct disease risks for measurement error. The standard regression calibration approach requires that these reference measures contain only random within-person errors uncorrelated with errors in FFQs. Increasing evidence suggests that records/recalls are likely to be also flawed with systematic person-specific biases, so that for any individual the average of multiple replicate assessments may not converge to her/his true usual nutrient intake. The authors propose a new measurement error model to accommodate person-specific bias in the reference measure and its correlation with systematic error in the FFQ. Sensitivity analysis using calibration data from four studies demonstrates that failure to account for person-specific bias in the reference measure can often lead to substantial underestimation of the relative risk for a nutrient. These results indicate that in the absence of information on the extent of person-specific biases in reference instruments and their relation to biases in FFQs, the adequacy of the standard methods of correcting relative risks for measurement error is in question, as is the interpretation of negative findings from nutritional epidemiology such as failure to detect an important relation between fat intake and breast cancer. Am J Epidemiol 1999; 150: 642-51. [ABSTRACT FROM PUBLISHER]

Background. Easy-to-collect dietary indicators have been used increasingly for planning and evaluation of food security interventions. Various indicators have been employed, but rarely has a full set of indicators been compared using a common framework. Objective. This paper evaluates the performance of five dietary indicators for the assessment of household energy consumption using a common framework and recent data from Mozambique. Methods. Data were analyzed from a 2004 household survey, Current Vulnerability Analysis in Seven Provinces of Mozambique. Households (n = 4,358) were sampled from 42 rural districts using a two-stage design, and a quantitative 24-hour dietary recall was employed. Household energy intake ratios were calculated as the food energy consumed by household members divided by the sum of the members' recommended intakes. Five proxy indicators of household consumption in the previous day were developed: the number of meals, the number of food groups, the number of food items, a score based on a simple weighting of food groups consumed, and a predicted energy intake ratio based on weighting of food groups consumed with previously estimated regression coefficients. The performance of these indicators was assessed using correlations with energy intake, receiver operator characteristic analysis, efficiency of predictions, and prevalence estimate comparisons. Results. Although the predicted energy intake ratio performed best on all these performance criteria, and the simple food-group-weighted score performed second best, differences among the indicators on many of the criteria were relatively small. Conclusions. New assessment systems could take full advantage of easy-to-collect information by using one of these best-scoring indicators, although established systems could continue to use some of the other indicators explored here, such as the food item count, without much loss in accuracy. [ABSTRACT FROM AUTHOR]

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Background: Underreporting of energy intake is associated with self-reported diet measures and appears to be selective according to personal characteristics. Doubly labeled water is an unbiased reference biomarker for energy intake that may be used to assess under-reporting. Objective: Our objective was to determine which factors are associated with underreporting of energy intake on food-frequency questionnaires (FFQs) and 24-h dietary recalls (24HRs). Design: The study participants were 484 men and women aged 40-69 y who resided in Montgomery County, MD. Using the doubly labeled water method to measure total energy expenditure, we considered numerous psychosocial, lifestyle, and sociodemographic factors in multiple logistic regression models for prediction of the probability of underreporting on the FFQ and 24HR. Results: In the FFQ models, fear of negative evaluation, weight-loss history, and percentage of energy from fat were the best predictors of underreporting in women (R2=0.09); body mass index, comparison of activity level with that of others of the same sex and age, and eating frequency were the best predictors in men (R2=0.10). In the 24HR models, social desirability, fear of negative evaluation, body mass index, percentage of energy from fat, usual activity, and variability in number of meals per day were the best predictors of underreporting in women (R2=0.22); social desirability, dietary restraint, body mass index, eating frequency, dieting history, and education were the best predictors in men (R2 = 0.25). Conclusion: Although the final models were significantly related to underreporting on both the FFQ and the 24HR, the amount of variation explained by these models was relatively low, especially for the FFQ. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to analyse whether a qualitative method, in relation to traditional dietary assessment methods, was adequate to establish sufficient energy intake and energy content in separate meals in a population of elderly women. Methods: One hundred and thirty-five elderly women, aged 63–88 years, living at home from three communities in mid-eastern Sweden participated in the present study. The quantitative methods used were a combination of repeated 24-h recall and a 3-day estimated food diary. The qualitative method used was the Food-Based Classification of Eating episodes model (FBCE). Results: The mean intake of energy estimated by the 5-day registration was 6.8 ± 1.9 MJ. The total number of eating events was 5.22 ± 1.04 per day. On a group level, FBCE was useful to describe the diet among a group of elderly women; however, on an individual level, some complete meals were low or very low in energy, due to small portion sizes. Conclusion: The main conclusion was that a qualitative method, such as FBCE, must be supplemented with a dietary assessment method giving the energy intake to ensure that it is sufficient, especially when studying groups at risk for malnutrition. [ABSTRACT FROM AUTHOR]

Multiple-day food records or 24-hour recalls are currently used as “reference” instruments to calibrate food frequency questionnaires (FFQs) and to adjust findings from nutritional epidemiologic studies for measurement error. The common adjustment is based on the critical requirements that errors in the reference instrument be independent of those in the FFQ and of true intake. When data on urinary nitrogen level, a valid reference biomarker for nitrogen intake, are used, evidence suggests that a dietary report reference instrument does not meet these requirements. In this paper, the authors introduce a new model that includes, for both the FFQ and the dietary report reference instrument, group-specific biases related to true intake and correlated person-specific biases. Data were obtained from a dietary assessment validation study carried out among 160 women at the Dunn Clinical Nutrition Center, Cambridge, United Kingdom, in 1988–1990. Using the biomarker measurements and dietary report measurements from this study, the authors compare the new model with alternative measurement error models proposed in the literature and demonstrate that it provides the best fit to the data. The new model suggests that, for these data, measurement error in the FFQ could lead to a 51% greater attenuation of true nutrient effect and the need for a 2.3 times larger study than would be estimated by the standard approach. The implications of the results for the ability of FFQ-based epidemiologic studies to detect important diet-disease associations are discussed. Am J Epidemiol 2001;153:394–403. [ABSTRACT FROM PUBLISHER]

Results from analysis of 24 h urine collections, verified for completeness with para-amino benzoic acid, and blood samples collected over 1 year were compared with 16 d weighed records of all food consumed collected over the year, and with results from 24 h recalls, food-frequency questionnaires and estimated food records in 160 women. Using the weighed records, individuals were sorted into quintiles of the distribution of the urine N excretion: dietary N intake ratio (UN:DN). UN exceeded DN in the top quintile of this ratio; mean ratio UN:DN = 1·13 Individuals in this top quintile were heavier, had significantly greater body mass indices, were reportedly more restrained eaters, had significantly lower energy intake:basal metabolic rate ratios (EI:BMR), and had correlated ratios of UN:DN and EI:BMR (r - 0·62). Those in the top quintile reported lower intakes of energy and energy-yielding nutrients, Ca, fats, cakes, breakfast cereals, milk and sugars than individuals in the other quintiles but not lower intakes of non-starch polysaccharides, vitamin C, vegetables, potatoes or meat. Correlations between dietary intake from weighed records and 24 h urine K were 0·74 and 0·82, and between dietary vitamin C and β-carotene and plasma vitamin C and β-carotene 0·86 and 0·48. Correlations between dietary N intake from weighed records and 24 h urine excretion were high (0·78–0·87). Those between N from estimated food records and urine N were r 0·60–0·70. Correlations between urine N and 24 h recalls and food-frequency questionnaires were in the order of 0·01 to 0·5. Despite problems of underreporting in overweight individuals in 20% of this sample, weighed records remained the most accurate method of dietary assessment, and only an estimated 7 d diary was able to approach this accuracy. [ABSTRACT FROM PUBLISHER]

Women (n 160) aged 50 to 65 years were asked to weigh their food for 4 d on four occasions over the period of 1 year, using the PETRA (Portable Electronic Tape Recorded Automatic) scales. Throughout the year, they were asked to complete seven other dietary assessment methods: a simple 24 h recall, a structured 24 h recall with portion size assessments using photographs, two food-frequency questionnaires, a 7 d estimated record or open-ended food diary, a structured food-frequency (menu) record, and a structured food-frequency (menu) record with portion sizes assessed using photographs. Comparisons between the average of the 16 d weighed records and the first presentation of each method indicated that food-frequency questionnaires were not appreciably better at placing individuals in the distribution of habitual diet than 24 h recalls, due partly to inaccuracies in the estimation of frequency of food consumption. With a 7 d estimated record or open-ended food diary, however, individual values of nutrients were most closely associated with those obtained from 16 d weighed records, and there were no significant differences in average food or nutrient intakes. [ABSTRACT FROM PUBLISHER]

A list of research priorities related to dietary assessment methodology is presented. The priorities are based on a consensus of opinion by a multidisciplinary international group of experts who participated in the First International Conference on Dietary Assessment Methods. These experts included researchers in dietary assessment methodology, major users of dietary assessment methods, and policymakers involved in setting food and nutrition policies. The list of priorities may be used as a guide for planning future research in dietary assessment methods, for prioritizing the allocation of available research resources, and for planning subsequent conferences. A list of recommendations related to dietary assessment methodology is also presented. Procedures used by the conference planners to select the experts are described, and the need for developing objective criteria for ranking priorities is discussed. An ongoing function of the conference series will be to continue the process of revising the priorities and recommendations to reflect progress made and newly identified needs in dietary assessment methodology. [ABSTRACT FROM AUTHOR]

When collecting dietary data on children, confidence about responses is required. Children exist in multienvironments in their everyday lives, eg, the personal, school, home, peer, medical cane, media, food industry, and fast-food facility environments. These macroenvironments influence the format and type of data-collection methods used to interview today's youth. Researchers should identify the influence of each environment on the child's eating pattern and nutrient intake, explore the pros and cons of various data-collection methods amid these environments, and determine unresolved methodological issues to stimulate future research. Standardized protocols for interviewing children, exclusion criteria for surrogate responses, and currency of nutrient data for new food products available to children are needed. Redefining our methods by understanding the macroenvironments of youth can create a dietary methodology for the 21st century-an evolutionary method that builds on past research and incorporates current technology and societal changes. [ABSTRACT FROM AUTHOR]

Irregular dietary intakes impairs estimations from food records. Biomarkers and method combinations can be used to improve estimates. Our aim was to examine reproducibility from two assessment methods, compare them, and validate intakes against objective biomarkers. We used the Malmö Offspring Study (55% women, 18–71 y) with data from a 4-day food record (4DFR) and a short food frequency questionnaire (SFFQ) to compare (1) repeated intakes (n = 180), (2) intakes from 4DFR and SFFQ (n = 1601), and (3) intakes of fatty fish, fruits and vegetables, and citrus with plasma biomarkers (n = 1433) (3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid [CMPF], β-carotene and proline betaine). We also combined 4DFR and SFFQ estimates using principal component analysis (PCA). Moderate correlations were seen between repeated intakes (4DFR median ρ = 0.41, SFFQ median ρ = 0.59) although lower for specific 4DFR-items, especially fatty/lean fish (ρ ≤ 0.08). Between-method correlations (median ρ = 0.33) were higher for intakes of overall food groups compared to specific foods. PCA scores for citrus (proline betaine ρ = 0.53) and fruits and vegetables (β-carotene: ρ = 0.39) showed the highest biomarker correlations, whereas fatty fish intake from the SFFQ per se showed the highest correlation with CMPF (ρ = 0.46). To conclude, the reproducibility of SFFQ data was superior to 4DFR data regarding irregularly consumed foods. Method combination could slightly improve fruit and vegetable estimates, whereas SFFQ data gave most valid fatty fish intake. [ABSTRACT FROM AUTHOR]

Metabolomics can be a tool to identify dietary biomarkers. However, reported food-metabolite associations have been inconsistent, and there is a need to explore further associations. Our aims were to confirm previously reported food-metabolite associations and to identify novel food-metabolite associations. We conducted a cross-sectional analysis of data from 849 participants (57% men) of the PopGen cohort. Dietary intake was obtained using FFQ and serum metabolites were profiled by an untargeted metabolomics approach. We conducted a systematic literature search to identify previously reported food-metabolite associations and analyzed these associations using linear regression. To identify potential novel food-metabolite associations, datasets were split into training and test datasets and linear regression models were fitted to the training datasets. Significant food-metabolite associations were evaluated in the test datasets. Models were adjusted for covariates. In the literature, we identified 82 food-metabolite associations. Of these, 44 associations were testable in our data and confirmed associations of coffee with 12 metabolites, of fish with five, of chocolate with two, of alcohol with four, and of butter, poultry and wine with one metabolite each. We did not identify novel food-metabolite associations; however, some associations were sex-specific. Potential use of some metabolites as biomarkers should consider sex differences in metabolism. [ABSTRACT FROM AUTHOR]