Beaton E, Wright J, Devenish G, Do L, Scott J. Relative Validity of a 24-h Recall in Assessing Intake of Key Nutrients in a Cohort of Australian Toddlers. Nutrients 2018 Jan 12;10. (1).


There is limited information concerning the dietary intake of toddlers in Australia. Consequently, there is a need for studies investigating toddler intake that use dietary assessment measures that are valid and place a low participant burden on caregivers. The aim of this study was to determine the relative validity of a single 24-h dietary recall (24HR) in measuring the intake of five nutrients in a cohort of Australian toddlers compared to a combined 24HR and 2-day estimated food record (2DFR). A single 24HR and a 2DFR were collected from a cohort of Australian toddlers (n = 699) at approximately 12 months of age as part of the Study of Mothers' and Infants' Life Events affecting oral health (SMILE) project. Relative validity of one day of dietary data (24HR) in assessing intake of energy, protein, calcium, iron, and added sugars was tested against three days of dietary data (24HR + 2DFR) using paired t-tests, Bland-Altman analysis, cross-classification, and weighted Kappa statistic. Classification analysis found good agreement between the 24HR and 24HR + 2DFR for all nutrients with the percentage classified in the same tertile at 57.9% and above. The weighted Kappa statistic found acceptable agreement for all nutrients. This study suggests that a 24HR is a valid assessment tool for estimating the relative intake of energy, protein, calcium, iron, and added sugars among Australian toddlers at the individual level.

Full Text

The full text is available at https://dx.doi.org/10.3390/nu10010080

At A Glance

Individual Dietary Behavior Variables

Total Energy/Energy Density
Macronutrients, including Saturated Fat


Individual Dietary Behavior

Measure Type

24-hour dietary recall

Measure Availability

Not reported

Number of Items

Not applicable

Study location

Not Reported

South Australia, Australia


Not applicable

Information about Development of Measure

Within-subject variation of twenty-four hour dietary recalls (24HR) has been found to be lower than between-subject variation in children aged twelve months. To date, the validity of the 24HR in assessing the intake of young children has been the subject of only one study, and research on intakes of key nutrients (energy, protein, calcium, iron, and added sugars) is warranted.

Study Design

Study Participants


2 - 5 Years








Predominantly Low-income/Low-SES


Sample Size


Study Design

Design Type


Health Outcomes Assessed


Obesity Measures

Not reported

BMI Measured or Self-reported

Not applicable


Not available

Data Reported on Race/Ethnicity

Quantitative data on study sample

Data Reported on SES

Quantitative data on study sample

SES-related Variables

Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD)

How To Use


Who Administered


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

How Administered


Time Required

3 days

Training Required

Not reported

Instructions on Use

Instructions on instrument use included in article

Data Analysis

Data Collection/Analysis Costs

Not reported

Data Collection/Protocol

Dietary data were collected from mothers when children reached twelve months of age using a twenty-four hour dietary record (24HR) and a two day food record (2DFR). The three days of dietary collection were non-consecutive, within a ten day period and contained two weekdays and one weekend day. Prior to dietary data collection, participants were sent a food diary booklet containing instructions for completion, along with photos of food portion sizes and examples of household measures. The 24HR of their child’s intake was completed via telephone with a trained dietitian using the five-step multipass method. Mothers returned the completed 2DFR in a reply-paid envelope.

Instructions on Data Analysis

Instructions on analysis included in article

Validity (2)

Type of validity Construct/subscale assessed Criterion measure used Test/statistic used Result
Criterion Twenty-four hour dietary record (24HR), kilojoule and key nutrient intake twenty-four hour dietary record (24HR) plus two day food record (2DFR), kilojoule and key nutrient intake Bland–Altman statistics, mean difference (MD) MD = 65.6 kilojoules for energy MD = 0.6 grams for protein MD = 3.8 milligrams for calcium MD = 0.01 milligrams for iron MD = -0.18 grams for added sugars
Criterion Twenty-four hour dietary record (24HR), kilojoule and key nutrient intake twenty-four hour dietary record (24HR) plus two day food record (2DFR), kilojoule and key nutrient intake Bland–Altman statistics, limits of agreement (LOA) LOA = -1220.4, 1351.7 for energy LOA = -15.9, 17.0 for protein LOA = -268.3, 275.8 for calcium LOA = -0.56, 0.58 for iron LOA = -1.53, 1.17 for added sugar

Reliability (0)

There are no reliability tests reported for this measure.