Abstract

Citation

Ollberding NJ, Couch SC, Woo JG, Kalkwarf HJ. Within- and between-individual variation in nutrient intake in children and adolescents. J Acad Nutr Diet 2014 Nov;114(11):1749-58.e5. Epub 2014 May 10.

Abstract

BACKGROUND: Little is known regarding the number of 24-hour recalls required to rank-order children and adolescents on usual intake for diet-disease studies. OBJECTIVE: To determine the within- to between-individual variance ratios and number of 24-hour recalls required to rank-order individuals on usual intake for select macro- and micronutrients in a large, multiracial/ethnic sample of children and adolescents. DESIGN: Cross-sectional survey. PARTICIPANTS/SETTING: Children and adolescents ages 6 to 17 years participating in the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey (NHANES). MAIN OUTCOME MEASURES: Variance ratios for predefined sex, age (children age 6 to 11 years, adolescents age 12 to 17 years), and racial/ethnic groups (Mexican American/Hispanic, non-Hispanic black, and non-Hispanic white). STATISTICAL ANALYSIS: Mixed-effects linear regression models were used to estimate within- and between-individual variance components for selected nutrients. The number of 24-hour recalls required to rank-order participants on usual intake (absolute values and energy-adjusted) was obtained from the nutrient variance ratios for various levels of accuracy. RESULTS: Variance ratios were more than 1 for all nutrients examined. High values (variance ratio >3) were observed for protein, saturated and unsaturated fatty acids, cholesterol, and several micronutrients. Variance ratios for absolute nutrient intakes were similar for both sexes within age groups, but higher for children than for adolescents. A total of six to nine and three to six 24-hour recalls were typically sufficient to rank-order children and adolescents, respectively, on usual intake with an accuracy of r=0.8. Additional recalls were required to achieve the same accuracy for energy-adjusted nutrients. Variance ratios were similar for adolescents across racial/ethnic groups, but highly variable in children. CONCLUSIONS: A total of six to nine 24-hour recalls may represent a reasonable trade-off between accuracy and participant burden for rank-ordering nutrient intakes in children and adolescents. Additional research is required to determine whether this may be reduced using statistical modeling-based approaches and the number of recalls children and adolescents will reliably complete.

Full Text

The full text is available at https://dx.doi.org/10.1016/j.jand.2014.03.016

At A Glance

Individual Dietary Behavior Variables

Intake
Total Energy/Energy Density
Macronutrients, including Saturated Fat
Minerals/Vitamins

Domain(s)

Individual Dietary Behavior

Measure Type

24-hour dietary recall

Measure Availability

Not reported

Number of Items

Not applicable

Study location

Not Reported

Languages

Not reported

Information about Development of Measure

Multiple 24-hour diet recalls are commonly used to measure nutrient intake in children and adolescents, but have been used to a lesser extent for diet and disease research. Limitations of the 24-hour recall for such studies have been the high cost, logistics, participant burden, and cognitive challenges associated with administering multiple recalls. The within to between individual variance ratios for particular nutrients using 24 hour recalls have been shown to vary across populations. Few studies have specifically examined nutrient variance ratios for US children and adolescents.

Study Design

Study Participants

Age

6 - 11 Years

12 - 18 Years

Sex

Female

Male

Race/Ethnicity

Hispanic

White

Black/African American

Multiethnic/racial population (no further detail)

Predominantly Low-income/Low-SES

No

Sample Size

3473

Study Design

Design Type

Validation/Reliability

Health Outcomes Assessed

None

Obesity Measures

Not reported

BMI Measured or Self-reported

Not reported

Covariates

Not reported

Data Reported on Race/Ethnicity

Quantitative data on study sample

Data Reported on SES

Not applicable

SES-related Variables

Not applicable

How To Use

Administration

Who Administered

Researcher-administered

Third-party administered (e.g., parent/staff)

How Administered

In-person

Time Required

Not reported

Training Required

Not applicable

Instructions on Use

Instructions on instrument use included in article

Data Analysis

Data Collection/Analysis Costs

Not reported

Data Collection/Protocol

Two nonconsecutive 24-hour recalls were conducted as part of the dietary interview component of the 2007-2008 and 2009-2010 NHANES. The first recall was conducted in the mobile exam center. The second recall was conducted three to ten days later via telephone. Diet recalls for participants 6 to 11 years of age were conducted with the assistance of a parent or adult care provider.

Instructions on Data Analysis

Instructions on analysis included in article

Validity (0)

There are no validity tests reported for this measure.

Reliability (2)

Type of reliability Construct/subscale assessed Test/statistic used Result
Test-retest 24 hour recall. energy Within- to between-individual variance ratio (VR) VR = 2.8 (boys, 6 to 11 years) VR = 1.8 (boys, 12 to 17 years) VR = 2.8 (girls, 6 to 11 years) VR = 1.7 (girls, 12 to 17 years)
Test-retest 24 hour recall, nutrients Within- to between-individual variance ratio (VR) VR = 2.2 to 4.8 (boys, 6 to 11 years) VR = 1.8 to 3.4 (boys, 12 to 17 years) VR = 2.2 to 4.4 (girls, 6 to 11 years) VR = 1.7 to 3.8 (girls, 12 to 17 years)