van Horn LV, Stumbo P, Moag-Stahlberg A, Obarzanek E, Hartmuller VW, Farris RP, Kimm SY, Frederick M, Snetselaar L, Liu K. The Dietary Intervention Study in Children (DISC): dietary assessment methods for 8- to 10-year-olds. J Am Diet Assoc 1993 Dec;93(12):1396-403.


OBJECTIVES: The dietary assessment methods used in the Dietary Intervention Study in Children (DISC) are described and the rationale, validity, and/or general usefulness of each are discussed. DESIGN: DISC is the first multicenter, randomized, clinical trial to study the feasibility and long-term efficacy, safety, and acceptability of a fat-moderately diet in 8- to 10-year-old prepubescent children with moderately elevated plasma low-density lipoprotein cholesterol (LDL-C) levels. Final data collection for the original study (DISC I) occurred December 1, 1993; continued intervention and follow-up (DISC II) will extend beyond 1997. SETTING: Six clinical centers across the country participate in DISC. SUBJECTS: Preadolescent boys and girls with fasting LDL-C levels between the 80th and 98th age-specific and sex-specific percentiles established by the Lipid Research Clinics were eligible for the study. The feasibility phase included 140 children who were then enveloped into the full-scale trial. Baseline dietary data for 652 randomized children in the full-scale trial and 6-month results for the feasibility cohort are reported. INTERVENTIONS: Dietary assessment involved several elements: (a) determining eligibility based on consumption of more than 30% of energy from total fat, (b) monitoring adherence to and adequacy of the intervention diet, (c) evaluating acceptability of the diet in the intervention group, and (d) determining appropriate foods for the intervention diet. Methods are described for each purpose. MAIN OUTCOME MEASURES: LDL-C differences between the two groups and differences in total and saturated fat intakes as calculated from three 24-hour recalls were the primary outcome measures. Six-month dietary differences in the feasibility group are reported. STATISTICAL METHODS: Baseline group means and 6-month differences in dietary intake are reported for the full-scale trial and feasibility study, respectively. RESULTS: Baseline mean intake from three dietary recalls for the intervention (n = 328) and control (n = 324) groups, respectively, were as follows: energy = 1,759 kcal and 1,728 kcal; total energy from fat = 33.3% and 34.0%; total energy from saturated fat = 12.5% and 12.7%; and total dietary cholesterol = 209 mg and 195 mg. After 6 months of intervention, percentage of energy from total fat and saturated fat was reduced by 5.1% (P = .004) and 2.9% (P < .001), respectively, in this feasibility subset (n = 73) of the intervention group. Essentially no change in these parameters occurred in the control group (n = 67), which demonstrates a measurable difference in reporting between groups. APPLICATIONS/CONCLUSIONS: Results illustrate the feasibility of implementing a variety of dietary assessment methods among preadolescent children without relying primarily on parental reports.

Full Text

The full text is available at https://dx.doi.org/10.1016/0002-8223(93)92241-o

At A Glance

Individual Dietary Behavior Variables

Total Energy/Energy Density
Macronutrients, including Saturated Fat
Whole Grains/Fiber


Individual Dietary Behavior

Measure Type

24-hour dietary recall

Measure Availability

Not reported

Number of Items

Not applicable

Study location

Not Reported



Information about Development of Measure

Nothing to add

Study Design

Study Participants


6 - 11 Years





Not reported

Predominantly Low-income/Low-SES


Sample Size


Study Design

Design Type


Health Outcomes Assessed

Dietary intake/behavior

Obesity Measures

Not applicable

BMI Measured or Self-reported

Not applicable


Not reported

Data Reported on Race/Ethnicity

Not applicable

Data Reported on SES

Not applicable

SES-related Variables

Not applicable

How To Use


Who Administered


How Administered



Time Required

Not reported

Training Required

Yes, time not reported

Instructions on Use

Not reported

Data Analysis

Data Collection/Analysis Costs

Not available

Data Collection/Protocol

Children were taught how to provide recalled dietary data by using plastic models to illustrate estimation of portion sizes, and were given a 2D guide to help them recall their diet for the 2 telephone recalls.

Instructions on Data Analysis

Not reported

Validity (0)

There are no validity tests reported for this measure.

Reliability (0)

There are no reliability tests reported for this measure.