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At least 19 recordsLinked to original sources

Comparison of dietary assessment methods in a southern French population: use of weighed records, estimated-diet records and a food-frequency questionnaire.

OBJECTIVE: The main objective of the study was to develop appropriate dietary assessment instruments for the French Mediterranean region and to validate the measurements they provide. SUBJECTS AND METHODS: Three different assessment methods were submitted to a sample of 150 male and female volunteers. 98 completed the protocol, which consisted of a 4 d weighed dietary record (PETRA) and a 7 d estimated-diet record (S7) based on a check list and a set of photographs, both these records being completed once in each season of the year, and a semi-quantitative (standard portion) food-frequency questionnaire (FFQ) including questions eliciting socio-demographic and anthropometric data, which was completed once only. The days when PETRA was used to evaluate food consumption coincided with the first 4 d of S7 (S4). RESULTS: Validation was based on nutrients and foods. Energy-adjusted Pearson correlation coefficients between S4 and PETRA ranged from 0.32 for vitamin E to 0.81 for vitamin C (mean: 0.65 for 21 nutrients). There was practically no misclassification in opposite extreme quartiles. Spearman correlation coefficients ranged from 0.63 for fish and sea-food to 0.90 for wine (mean: 0.76 for 16 food groups). There was practically no misclassification in opposite extreme quartiles. De-attenuated energy-adjusted Pearson correlation coefficients between FFQ and S7 ranged from 0.22 for proteins and monounsaturated fatty acids to 0.80 for iron (mean: 0.45). 10% or less of subjects were misclassified in opposite extreme quartiles (except for vitamin C, 12%). Spearman correlation coefficients ranged from 0.25 for green-yellow-red raw vegetables to 0.76 for wine (mean: 0.42). 8% or less of subjects were misclassified in opposite extreme quartiles (except for citrus fruit, 11%). CONCLUSIONS: Portion estimation using the set of photographs was validated by the correlation between S4 and PETRA for both nutrients and foods. The FFQ provides a reasonably reliable measure of macronutrient intake and a good measure of micronutrient intake when compared with the data in the literature. It performs less well for food intake. Better results can be achieved for FFQ: (i) by using the set of photographs instead of standard portions and (ii) by adding further questions on foods which are insufficiently covered.

Adult↗

Use of weighed diet records in the evaluation of diets with different protein contents in patients with type 2 diabetes.

Compliance with diets containing different amounts of protein was studied in 15 nonobese type 2 diabetes patients (13 males aged 38-69 y). A method based on interviews and training in the technique of weighed diet records was used. Protein intake recorded by the patients was evaluated on the basis of 24-h nitrogen output (criterion standard measurement). Three diets were prescribed in random order, each lasting 4 wk: usual diet (UD), chicken diet (CD) (both with 1.2-1.5 g protein/kg body wt), and low-protein diet (LPD; with 0.5-0.8 g protein/kg body wt). Diets were isoenergetic and similar in fat content. Nutritional status was not altered during the study according to anthropometric indexes (body mass index, triceps skinfold thickness, midupper arm muscle area, and waist-to-hip ratio) and laboratory data (serum albumin, hematocrit, and lymphocyte values). The correlation of protein intake recorded on the weighed diet records with that estimated by nitrogen output was 0.64 for the UD (P = 0.01), 0.79 for the CD (P < 0.001), and 0.66 for the LPD (P = 0.008). No difference was found in mean protein intake (g/kg body wt) calculated from the weighed diet records and nitrogen output for the UD (1.37 compared with 1.36 g/kg body wt) and CD (1.38 compared with 1.32 g/kg body wt). With the LPD, patients did not consume more protein than prescribed, but underreported their actual protein intake by 13% (0.68 compared with 0.78 g/kg body wt, P < 0.05) . In conclusion, the method of weighed diet records was sufficiently accurate for assessing protein intake in this sample of type 2 diabetes patients.

Administration, Oral↗

Standardised coding of diet records: experiences from INTERMAP UK.

Coding diet records is a basic element of most dietary surveys, yet it often receives little attention even though errors in coding can lead to flawed study results. In the INTERnational study of MAcro- and micronutrients and blood Pressure (INTERMAP study), efforts were made to minimise errors in coding the 18, 720 diet records. Staff were centrally trained and certified before being able to process study data and ongoing quality control checks were performed. This involved the senior (site) nutritionist re-coding randomly selected diet records. To facilitate standardisation of coding in the UK, a code book was designed; it included information about coding brand items, density and portion size information, and default codes to be assigned when limited information was available for food items. It was found that trainees, despite previous experience in coding elsewhere, made coding errors that resulted in errors in estimates of daily energy and nutrient intakes. As training proceeded, the number of errors decreased. Compilation of the code book was labour-intensive, as information from food manufacturers and retailers had to be collected. Strategies are required to avoid repetition of this effort by other research groups. While the methods used in INTERMAP to reduce coding errors were time consuming, the experiences suggest that such errors are important and that they can be reduced.

Diet↗

Comparison of a food frequency questionnaire with a diet record.

The associations between levels of nutrients derived from a 24-hour diet record and a food frequency questionnaire were assessed in a sample of 433 men and women. The food frequency questionnaire was administered three years after the completion of the diet record. Spearman correlations were all statistically significant; they varied from 0.36 for energy to 0.15 for vitamin A. Comparison of distributions into fifths showed few people grossly misclassified. A model was developed to assess the correlations which would be expected under various conditions of within and between subject variance for each nutrient, errors in measurements and drift in intake over time. The best possible correlation that could be obtained using the within and between subject variations in intake previously published, and with no measurement error or drift over time, was 0.60 for energy and 0.34 for vitamin A. Using a realistic measure of measurement error (standard deviation on log scale of 0.12 for diet record method, 0.06 for drift over time and 0.18 for food frequency method) the correlations obtained in the modelling were very similar to that observed. This study shows that it may be appropriate to use a food frequency questionnaire instead of a diet record to estimate intakes in population based epidemiological studies.

Adult↗

Disagreement of energy and macronutrient intakes estimated from a food frequency questionnaire and 3-day diet record in girls 4 to 9 years of age.

BACKGROUND: The Block98 food frequency questionnaire (FFQ) has been validated for dietary assessment of usual intakes in adults, but not in children. OBJECTIVE: To assess the agreement of the Block98 FFQ and 3-day diet records for measuring dietary intakes in young girls. SUBJECTS/SETTING: Healthy 4- to 9-year-old girls (N=61; 6.5+/-1.6 years) were recruited from the Athens/Clarke county area in Georgia. DESIGN: Dietary intakes were measured using the Block98 FFQ and 3-day diet records, with nutrient analysis of the 3-day diet records conducted using the Food Processor computer program (ESHA; version 7.21, 1998, ESHA Research, Salem, OR). The Block98 FFQ was completed by a trained interviewer and parent, with input from the child, if able. Food models and portion size pictures were used to increase reporting accuracy. STATISTICAL ANALYSIS: Paired sample t tests and simple regression were conducted to determine whether the two diet instruments reported similar values for energy and macronutrients. RESULTS: Block98 FFQ overestimated intakes from 3-day diet records for energy (2,180+/-692 vs 1,749+/-328 kcal), protein (68.3+/-25.9 vs 57.9+/-14.8 g/day), carbohydrate (298.7+/-97.0 vs 244.7+/-46.1 g/day) and fat (83.6+/-30.5 vs 62.3+/-14.7 g/day) (P<.05). Furthermore, the nutrients assessed using the two different methods were only moderately correlated (range: r=0.40 to 0.55). APPLICATIONS/CONCLUSIONS: The Block98 FFQ agreed weakly to moderately with the 3-day diet records, and resulted in consistently higher intakes of all nutrients. These findings suggest that additional work is needed to develop a FFQ that reflects young children's energy and macronutrient intakes.

Child↗

Comparison of measures of fatty acid intake by subcutaneous fat aspirate, food frequency questionnaire, and diet records in a free-living population of US men.

In 1986-1987, the authors assessed the fatty acid intake of 118 Boston-area men, aged 40-75 years, by a semiquantitative food frequency questionnaire administered twice, by two 7-day diet records, and by capillary gas chromatography of subcutaneous fat samples obtained by needle aspirate from the lateral buttock. Spearman correlation coefficients between diet record estimates of fatty acid intake (as a percentage of total fat) and fat aspirate measures (as a percentage of total peak area) were as follows: saturated fat, r = 0.16 (p = 0.09); monounsaturated fat, r = 0.22 (p = 0.01); and polyunsaturated fat, r = 0.49 (p = 0.0001). Spearman correlation coefficients between estimates derived from the food frequency questionnaire were as follows: saturated fat, r = 0.18 ( p = 0.05); monounsaturated fat, r = 0.14 (p = 0.14); polyunsaturated fat, r = 0.50 (p = 0.0001); and eicosapentaenoic acid, r = 0.47 (p = 0.0001). These data confirm that the polyunsaturated and eicosapentaenoic fatty acid content of subcutaneous fat is a measure of dietary intake of these fats. Although diet records are commonly thought to be the "gold standard" method of dietary assessment, the similar correlations observed between the fatty acid composition of adipose tissue and estimates of intake from the food frequency questionnaire and from diet records suggest that these two dietary assessment methods have similar validity in the measurement of polyunsaturated fatty acid intake.

Adipose Tissue↗

Validation of a self-administered diet history questionnaire using multiple diet records.

The validity of a self-administered diet history questionnaire has been estimated using as the reference data the mean of three 4-day diet records collected over the year prior to the administration of the questionnaire, in 1985-1986. Subjects were women ages 45-70 years, participants in the Women's Health Trial Feasibility Study, a multi-center clinical trial in which some women were randomized to be taught to adopt and maintain a low-fat diet, while others maintained their usual diet. The questionnaire produced group mean nutrient estimates closely approximating the values obtained by three 4-day records, e.g. in the usual-diet group, 37.7% of calories from fat by both food records and by questionnaire, and in the low-fat group, 21.3% of calories from fat by food records and 23.7% of calories from fat by questionnaire. Correlations between questionnaire and diet records for per cent of calories from fat were 0.67 and 0.65 respectively in the two groups; most correlations were in the 0.5-0.6 range, and were similar to those achievable by a single 4-day food record.

Aged↗

Comparison of energy expenditure measurements by diet records, energy intake balance, doubly labeled water and room calorimetry.

OBJECTIVES: The purpose of this study was to compare estimates of daily energy expenditure (EE) using energy intake from self reported diet records, metabolizable energy intake balance, doubly labeled water and room calorimetry methods. DESIGN: Cross sectional design. SETTING: Beltsville Human Nutrition Research Center, Beltsville, MD USA. INTERVENTIONS: Energy intake was measured using seven-day self reported diet records (EI), and metabolizable energy (ME) intake balance. EE was measured using doubly labeled water (TEE) and 24 h indirect room calorimetry (24 EE). Body composition was measured using stable isotope dilution and DEXA. RESULTS: EI measured by self reported diet records was 22% less than ME intake balance, 23% less than TEE by doubly labeled water and 8% less than 24 EE by room calorimetry. 24 EE was 16% less than TEE and 16% less than ME. TEE was not significantly greater than ME (0.3%). While mean ME, TEE and 24 EE measurements were significantly lower in female compared to male subjects, mean EI and the mean percent difference between measurement methods were not. CONCLUSIONS: Direct comparison of these methods indicate self reported diet records and room calorimetry underestimate daily energy expenditure. While EI balance accurately estimates energy expenditure, EE measured by doubly labeled water is a more direct approach.

Absorptiometry, Photon↗

Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women.

A self-administered diet history questionnaire has been developed for the use in health education in Japan. The relative validity of the test-version was examined using 3-day diet record (DR) as a reference method. Subjects were mildly hypercholesterolemic 47 women aged 38-69 years living in Hikone, Japan. The questionnaire provided close estimation of nutrients compared to the DR (mean of the 3-days), 1-25% differences between the two methods were observed for total energy and 17 nutrients examined. The differences were in general smaller for macronutrients, 1-3%, than for micronutrients, 1-25%. Pearson correlation coefficients between the questionnaire and the DR (mean of the 3-days) ranged from 0.16 for niacin to 0.60 for saturated fatty acid (mean = 0.41). The energy-adjustment using regression analysis and the correction of attenuation due to error from a limited number of days of DR slightly improved the results. The correlations ranged from 0.19 for niacin to 0.75 for saturated fatty acid (mean = 0.48). Average 37 and 6% subjects were classified into same quartile and opposite quartile respectively between the two methods. This questionnaire may be useful to assess individual nutrient intake level at least for the subjects examined.

Adult↗

Methods to assess relative reliability of diet records: minimum records for monitoring lipid and caloric intake.

A total of 252 diet records of 18 outpatients attending a lipid clinic were analyzed by a computer-assisted method to determine the minimum number of daily diet records that would be reliable for monitoring dietary adherence. Each subject recorded food intake in special diaries for 14 consecutive days between two clinic visits. All possible randomly selected combinations of 3, 4, 5, 7, 9, and 11 consecutive days of records in the 14-day period were analyzed for calories and lipids. Sets of records were said to be within a 95% confidence interval when the information yielded on any parameter differed by 5% or less from the mean values for the entire 14 days' records. All sets of records for 7, 9, and 11 days were in the 95% confidence range; therefore, 7 consecutive days of food recording were considered the minimum requirement for a 95% confidence limit. Out of 11 possible combinations of 4 consecutive day-sets of records, all but 3 sets were within 95% confidence limits. Consequently, 4 consecutive days of records were deemed acceptable as a reasonable compromise for minimal, reliable monitoring of diet compliance in outpatients for the nutrients studied.

Adult↗

The apparent validity of diet questionnaires is influenced by number of diet-record days used for comparison.

The effect of the number of diet records used as the reference data on the apparent validity of a diet history questionnaire was examined using data from 97 participants in the Women's Health Trial feasibility study. Pearson correlation coefficients were computed between the estimates of usual individual intake from the questionnaire and estimates from the mean of three 4-day records obtained over a 1-year period, the mean of the two most recent records, and the record obtained 1 year after the start of the study. The results illustrate that the apparent validity of a questionnaire increases when it is compared with a greater number of 4-day food records. The correlations increased for most nutrients when the baseline food record was included, despite the fact that it was completed at a time not targeted by the questionnaire. These findings suggest that greater effort should be given to obtaining more diet-record days when validating other dietary assessment instruments.

Aged↗

Estimating energy intake of urban women in Colombia: comparison of diet records and recalls.

As part of a larger study of energy-nutrition, we compared the performance of 24 h diet recalls with estimated diet records kept by trained observers. The subjects were economically disadvantaged women (n = 85) in the city of Cali, Colombia. A 24 h recall and an estimated diet record were collected for each woman at 0 and approximately 3 and 6 months. Energy intake obtained from the estimated dietary records was validated against energy expenditure and used as the reference method. Energy and macronutrient intake were calculated from published food composition tables and proximate analyses of common foods. The number of food items consumed per woman per day, total and in each of 16 food groups, was tabulated. Energy and macronutrient intakes were 11-13% lower in the 24 h recalls. The discrepancy energy could be largely accounted for by the lower number of food items in the recalls. The number of food items in eight of 16 food groups was significantly lower in the recalls compared to the records. Underreporting on the recalls was a general tendency in these subjects and not clearly related to average energy intake. We conclude that 24 h diet recalls underestimate energy and nutrient intake in this population and are not suitable for studies of human energetics.

Body Composition↗

Comparison of an Australian food-frequency questionnaire with diet records: implications for nutrition surveillance.

OBJECTIVES: To compare a widely used Australian food-frequency questionnaire (FFQ) with diet records and consider the results in relation to its use in nutrition surveillance. DESIGN: Inter-method reliability study. SETTING: A randomised trial in subjects with past asbestos exposure. SUBJECTS: Seventy-two adults living in Western Australia. METHODS: A semi-quantitative FFQ developed by the Commonwealth Scientific Industrial Research Organisation in South Australia was administered after the completion of four 7-day diet records (DRs). RESULTS: Mean agreement between methods was not significantly different from 100% for many nutrients, but the limits of agreement indicated that, at the individual level, the FFQ over- or underestimated the DR by at least 50%. Mean agreement between methods decreased significantly with increasing intakes for the majority of nutrients. Pearson's correlation coefficients were less informative indicators of agreement compared with the limits of agreement. CONCLUSIONS: These results indicate poor agreement between the FFQ and DR when estimating absolute intakes. Therefore, comparing intakes collected using this FFQ with specific cut-off points such as Recommended Dietary Intakes for nutrition surveillance may lead to seriously flawed conclusions about population intakes.

Australia↗

Validation of a semi-quantitative food frequency questionnaire: comparison with a 1-year diet record.

The validity of a self-administered semi-quantitative food frequency questionnaire was evaluated for a group of 27 men and women aged 20 to 54. Intakes of 18 nutrients computed from the questionnaire were compared with those derived from 1-year diet records completed approximately 18 months earlier. The questionnaire estimates of mean nutrient intake were within 10% of the mean diet record measurements for 11 of the 18 nutrients evaluated, and the difference was less than 25% for all but one nutrient (total vitamin A). Correlation coefficients comparing unadjusted nutrient intakes measured by the two methods ranged from 0.38 (vitamin C) to more than 0.65 (total calories, total fat, saturated fat, polyunsaturated fat, oleic acid, and cholesterol). The overall mean of correlation coefficients comparing intakes of the 18 nutrients measured by questionnaire and by diet record was 0.60. Coefficients for macronutrients decreased somewhat after adjustment for age and gender or caloric intake. The data provide further evidence that a simple and relatively inexpensive questionnaire can provide useful information on dietary intake over an extended period.

Adult↗

Helping elderly participants keep 3-day diet records in the New Mexico Aging Process Study.

Although verbal and written instructions on how to record dietary intake are commonly used in research, little information has been published describing instructional methods or materials. In the New Mexico Aging Process Study, a longitudinal study of nutrition and aging, participants keep a 3-day diet record each year. Classroom instruction and written materials are used in the study, and they were updated for use with Food Intake Analysis System (FIAS), version 2.3. This article describes the instructional methods and materials used to prepare elderly participants to keep accurate diet records; reports the development of a novel instructional tool, the food description flowcharts; and presents participants' opinions of the quality of the instruction and the usefulness of written materials. Included in the written materials were general instructions for recording food intake, examples of completed food intake and recipe forms, hints for eating out, and instructions for easy-to-use electronic scales. The flowcharts guide participants in accurately describing food intake while matching the coding requirements of FIAS. Fifty participants completed a written survey to evaluate the instructions and written materials. More than half of the respondents found the written materials to be very useful. All found the verbal instruction to be excellent or good. Nutritionists observed that records kept by participants who attended the class were generally complete and specific. The findings indicate that participants were satisfied with the instructions and written materials.

Aged↗

[A comparison between a food frequency and amount questionnaire and 7-day diet record with weighing].

A nutritional evaluation questionnaire to assess usual dietary intake was developed with the aim of achieving an accuracy level of a seven consecutive day diet record with weighing (DRW). With this questionnaire (FAQ), weekly frequencies and amounts for eleven food groups and three dishes per meal were assessed. The FAQ was conducted twice with 19 female students with a week interval (FAQ-1 and FAQ-2) in October or November of 1992. Concurrent with FAQ-2 each subjects' weekly diet was analyzed using the DRW for seven consecutive days. 1) The Spearman's correlation coefficient between the weekly frequencies obtained from FAQ-2 and those from DRW was more than 0.40 in thirty-seven of forty-one food items. 2) Nutrient intakes evaluated by DRW was highly correlated with food intake for several foods. Nutrient intake was estimated using multiple regression equations with food intake obtained from FAQ-2. 3) Compared to DRW derived values, mean values of most nutrient intakes estimated from FAQ-2 showed deviations within ten percent. Correlation coefficients between the nutrient intake estimated from FAQ-2 and those for DRW were high for calcium, vitamin C, retinol, sugar and vitamin B2, but rather low for total energy, protein and fat. 4) These results show that for some nutrient intakes, FAQ reflected those obtained from DRW for these subjects. The use of FAQ in population-based epidemiological studies should be the subject of future evaluation.

Adult↗

Total energy expenditure and physical activity as assessed by the doubly labeled water method in Swedish adolescents in whom energy intake was underestimated by 7-d diet records.

Swedish children and adolescents may be adopting a sedentary lifestyle with low energy expenditures and intakes, but no quantitative data are available. The purpose of the present study in 50 adolescents aged 15 y was to investigate whether assessment of total energy expenditure (TEE) and physical activity level (PAL) by the doubly labeled water method and indirect calorimetry and estimation of energy intake by a 7-d diet record would indicate physical inactivity. The boys' (n = 25) mean weight was 112% and the girls' (n = 25) was 109% of Swedish reference values from 1976; the mean height of both boys and girls was 102% of those reference values. Mean TEE in the boys and girls, 13.82 +/- 1.90 and 10.70 +/- 1.59 MJ/d, and mean PAL (TEE/basal metabolic rate), 1.89 +/- 0.16 and 1.79 +/- 0.22, respectively, were nonsignificantly higher than corresponding figures from other published studies. Mean energy intake as a percentage of TEE was 81.9 +/- 17.9% in the boys and 78.3 +/- 16.4% in the girls. Significant negative correlations were found both between energy intake as a percentage of TEE and percentage body fat and between energy intake as a percentage of TEE and body mass index. These results add to the evidence that 7-d diet records underestimate energy intake in adolescents, particularly those with a tendency for overweight and increased body fat. The results support indications of a trend of increasing body weight and height in Swedish adolescents, but conflict with the presumptions of low physical activity, low energy expenditure, and low energy intake. These results support the view that current recommendations for energy intake during adolescence are too low.

Adipose Tissue↗