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) |