St George SM, Van Horn ML, Lawman HG, Wilson DK. Reliability of 24-Hour Dietary Recalls as a Measure of Diet in African-American Youth. J Acad Nutr Diet 2016 Oct;116(10):1551-9. Epub 2016 Jul 6.
BACKGROUND: Although it is a common practice to estimate dietary intake using three random 24-hour dietary recalls, some studies have suggested up to nine may be necessary to reliably estimate usual intake in youth. Given the resulting increase in resources and participant burden, more research is needed to determine whether this method is reliable, particularly in African-American youth at increased risk for obesity and other chronic diseases. OBJECTIVE: This study estimated the reliability with which 24-hour dietary recalls measure energy, fat, fruit, and vegetable intake in African-American youth and examined how reliability changes as a function of the number of recalls. DESIGN: This study used cross-sectional data collection across three studies. PARTICIPANTS/SETTING: Participants were African-American youth (n=456, mean±standard deviation age 13.28±1.86 years, 64% were girls, mean±standard deviation body mass index [calculated as kg/m(2)] 31.45±7.94) who completed random 24-hour dietary recalls (67% completed three) conducted by research assistants using the Automated Self-Administered 24-Hour recall system (n=258) or registered dietitian nutritionists using the Nutrition Data System for Research (n=198). MAIN OUTCOME MEASURES/STATISTICAL ANALYSES: Estimates provided by multilevel models were used to calculate the proportion of variance accounted for between individuals and the reliability of means within individuals as a function of the number of recalls. RESULTS: Reliability estimates for assessing dietary outcomes using one to three recalls ranged from 11% to 62%. To achieve 80% reliability, the following number of recalls would need to be conducted: 8 for energy intake, 13 for fat intake, 21 to 32 for fruit intake, and 21 to 25 for vegetable intake. CONCLUSIONS: The common practice of assessing dietary intake with three recalls does so with low reliability in African-American youth. Until more objective methods for reliably estimating usual intake are developed, researchers who choose to use 24-hour dietary recalls are encouraged to include estimates of the measure's reliability in a priori power calculations for improved decision making regarding the number of observations and/or sample size.
The full text is available at https://dx.doi.org/10.1016/j.jand.2016.05.011
At A Glance
Individual Dietary Behavior Variables
|Total Energy/Energy Density|
|Macronutrients, including Saturated Fat|
Individual Dietary Behavior
24-hour dietary recall
Free. Access at https://epi.grants.cancer.gov/asa24/
Number of Items
South Carolina, USA
Information about Development of Measure
Twenty-four hour recalls (24HR) of food intake are typically collected by registered dietitians, or online. Regardless, low reliability of 24HRs is due to both variations in diet across days and inaccuracy in reporting. It is suggested that as many as six to nine 24HRs recalls might be needed to estimate the usual intake in youth with reasonably adequate reliability.
6 - 11 Years
12 - 18 Years
Health Outcomes Assessed
BMI for age
BMI Measured or Self-reported
Data Reported on Race/Ethnicity
Quantitative data on study sample
Data Reported on SES
Quantitative data on study sample
How To Use
Instructions on Use
Instructions on instrument use included in article
Data Collection/Analysis Costs
Participants were children and adolescents who completed twenty-four hour dietary recalls (24HR) as part of their participation in one of three studies: a cross-sectional health assessment study (study one); a family based, health-promotion intervention (study two); or a family-based, weight-loss efficacy trial (study three). Three 24HRs (either Modified Automated Self-Administered 24-Hour Protocol or registered dietitian administered) were completed for each participant on randomly assigned days determined by study staff and not scheduled with participants in advance.
Instructions on Data Analysis
Instructions on analysis included in article
There are no validity tests reported for this measure.
|Type of reliability||Construct/subscale assessed||Test/statistic used||Result|
|Internal Consistency||Modified Automated Self-Administered 24-Hour Protocols for three days of intake (studies one and two)||Intraclass correlation coefficients (ICC)||ICC = 0.35 for total energy; ICC = 0.24 for fat intake; ICC = 0.11 for fruit intake; ICC = 0.16 for vegetable intake|
|Internal Consistency||Registered dietitian-administered recalls for three days of intake (study three)||Intraclass correlation coefficients (ICC)||ICC = 0.33 for total energy; ICC = 0.23 for fat intake; ICC = 0.16 for fruit intake; ICC = 0.13 for vegetable intake|