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Abstract: Results from a 2012 article showed a positive relationship between children''s body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated (1) whether the relationship differed by sex and race and (2) the relationship between BMI and 6 aspects of school-provided meals—amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from 4 studies conducted 1 per school year (1999-2000 to 2002-2003). Fourth-grade children (n = 328; 50% female; 54% black) from 13 schools total were observed eating school-provided breakfast and lunch on 1 to 3 days per child for 1178 total meals (50% breakfast). Children were weighed and measured. Marginal regression models were fit using BMI as the dependent variable. For purpose 1, independent variables were energy intake at school-provided meals, sex, race, age, and study; additional models included interaction terms involving energy intake and sex/race. For purpose 2, independent variables were the 6 aspects of school-provided meals, sex, race, age, and study. The relationship between BMI and energy intake at school-provided meals differed by sex (P < .0001; stronger for females) and race (P = .0063; stronger for black children). BMI was positively related to amounts eaten of standardized portions (P < .0001) and negatively related to energy content given in trades (P = .0052). Explaining the positive relationship between BMI and energy intake at school-provided meals may contribute to school-based obesity prevention efforts. [Copyright &y& Elsevier]

Data from four cross-sectional studies involving fourth-grade children were analyzed to investigate the relationship between participation in school-provided meals and body mass index (BMI), and the effect observed energy intake has on that relationship. Participation and BMI data were available on 1,535 children (51% black; 51% girls) for 4 school years (fall 1999 to spring 2003; one study per school year) at 13 schools total. Direct meal observations were available for a subset of 342 children (54% black; 50% girls) for one to three breakfasts and one to three lunches per child for a total of 1,264 school meals (50% breakfast). Participation in breakfast, lunch, and combined (both meals on the same day) was determined from nametag records compiled for meal observations for each study. Weight and height were measured. A marginal regression model was fit with BMI as the dependent variable; independent variables were breakfast participation, lunch participation, combined participation, sex, age, race, and study. For the subset of children, observed energy intake at breakfast, lunch, and combined was included in additional analyses. Participation in breakfast, lunch, and combined was not significantly associated with BMI regardless of whether analyses included observed energy intake (P values >0.181). The relationship between observed energy intake at breakfast and lunch, separately and combined, with BMI was positive (P values <0.01). In conclusion, these results do not support a relationship between school-meal participation and BMI but do support a relationship between observed energy intake at school meals and BMI during fourth grade. [Copyright &y& Elsevier]

Objective: To use data from a published validation study concerning retention interval and school food-service production records to examine intrusions (uneaten items reported eaten) in the school-meal parts of 24 h recalls. Design: For that study, children were observed eating two school meals (breakfast, lunch) and interviewed under one of six conditions from two target periods (previous day (PDTP), prior 24 h (24TP)) crossed with three interview times (morning, afternoon (AIT), evening). For the present article, a catalogue was constructed of foods available for that study's school meals. The study's intrusions were classified as stretches (on children's meal trays but uneaten), internal confabulations (in children's school food-service environments for that meal but not on children's trays) or external confabulations (not in children's school food-service environments for that meal). Occurrence, types and amounts of intrusions were investigated. Setting/subjects: Six schools; sixty fourth-grade children (ten per condition). Results: For breakfast, for the 24TP v. PDTP, reported items were less likely to be intrusions, internal confabulations and external confabulations; and intrusions were more likely to be stretches. For lunch, for the 24TP-AIT condition v. the other five conditions, reported items were less likely to be intrusions and external confabulations. Mean amounts reported eaten were smaller for stretches than for internal confabulations or external confabulations at breakfast, and for stretches than for internal confabulations at lunch. Conclusions: Accuracy was better for the 24TP (with fewer intrusions of which proportionally more were stretches which had smaller amounts reported eaten) than for the PDTP. Studies with 24 h recalls should minimize retention interval to improve accuracy. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether school-meal observations influenced children's 24-hour dietary recalls.Study Design and Setting: Over three school years, 555 randomly selected fourth-grade children were interviewed to obtain a 24-hour dietary recall; before being interviewed, 374 children were observed eating two school meals (breakfast, lunch), and 181 children were not observed. Within observation-status groups (observed, unobserved), children were randomized within sex to one of six combinations from two target periods (prior 24 hours, previous day) crossed with three interview times (morning, afternoon, evening).Results: For each of the five variables (interview length, meals/snacks, meal components, items, kilocalories), naïve and adjusted equivalence tests rejected that observation-status groups were different, indicating that school-meal observations did not influence children's 24-hour dietary recalls. There was a target-period effect on length (P<0.0001) (longer for prior-24-hour recalls), a school year effect on length (P=0.0002) (longer for third year), and a target period-interview time interaction on items (P=0.0110) and kilocalories (P=0.0047) (both smaller for previous-day recalls in the afternoon than prior-24-hour recalls in the afternoon and previous-day recalls in the evening), indicating that variables were sufficiently sensitive and psychometrically reliable.Conclusion: Conclusions about 24-hour dietary recalls by fourth-grade children observed eating school meals in validation studies are generalizable to 24-hour dietary recalls by comparable but unobserved children in nonvalidation studies. [ABSTRACT FROM AUTHOR]

Abstract: For school breakfast each day, many elementary schools offer a choice between a cold option that includes ready-to-eat (RTE) cereal and a hot option that includes a non-RTE-cereal entrée such as waffles. For breakfast reports, intrusions (reports of uneaten items) in correctly reported and misreported breakfast options were examined using data from five dietary-reporting validation studies. In each study, fourth-grade children were observed eating school breakfast and school lunch and then interviewed to obtain a dietary recall. A breakfast option was correctly reported in 240 breakfast reports for 203 intrusions total, and misreported in 97 breakfast reports for 189 intrusions total. Asymmetry was evident in misreported options; specifically, children observed eating a cold option almost never misreported a hot option, but children observed eating a hot option often misreported a cold option. Proportionately more breakfast reports were intrusion-free when a breakfast option was correctly reported than misreported. Linking of intrusions (i.e., multiple intrusions from the same option in a breakfast report) was especially evident with misreported breakfast options. Methodological aspects of dietary recalls such as target period (prior 24h; previous day), interview time (morning; afternoon; evening), and interview format (meal; open) had implications for intrusions and misreported breakfast options. [Copyright &y& Elsevier]

Validation-study data and foodservice production records were analyzed to test hypotheses concerning sources of intrusions (reports of uneaten items) in the school-meal parts of children's dietary recalls. Each child was observed eating school meals on two days, and interviewed the morning after each observation day; one interview used forward-order (morning-to-evening) and one used reverse-order (evening-to-morning) prompts. Lunch intrusions were likelier to have been available in the foodservice environment at lunch as day before the interview came closer, and on days before than after the interview. Temporal dating errors are contributing sources of intrusions in the school-lunch parts of children's recalls. [ABSTRACT FROM AUTHOR]

Objective: To compare reporting accuracy for breakfast and lunch in 2 studies. Design: Children were observed eating school meals and interviewed the following morning about the previous day. In Study 1, 104 children were each interviewed 1 to 3 times with ≥25 days separating any 2 interviews. In Study 2, 121 children were each interviewed once in forward (morning-to-evening) and once in reverse (evening-to-morning) order, with these interviews separated by ≥29 days. Setting: 12 schools. Participants: Fourth-grade children. Main Outcome Measures: For each meal, food-item variables (observed number, reported number, omission rate, intrusion rate, total inaccuracy) and kcal variables (observed, reported, correspondence rate, inflation ratio). Analysis: General linear mixed models. Results: For each study, observed and reported numbers of items and kcal, and correspondence rate (reporting accuracy), were greater for lunch than for breakfast; omission rate, intrusion rate, and inflation ratio (measures of reporting error) were greater for breakfast than for lunch. In Study 1, for each meal over interviews, total inaccuracy decreased and correspondence rate increased. In Study 2, for each meal for boys for reverse and for girls for forward order, omission rate was lower and correspondence rate was higher. Conclusions and Implications: Breakfast was reported less accurately than lunch. Despite improvement over interviews (Study 1) and differences for order x sex (Study 2), reporting accuracy was low for breakfast and lunch. [ABSTRACT FROM AUTHOR]

Abstract: This secondary analysis investigated the influences of body mass index (BMI) category and sex on reporting accuracy during multiple 24-hour dietary recalls. On 3 occasions, each of 79 children (40 girls; 39 boys) was observed eating school meals and then interviewed the next morning about the previous day''s intake, with 25 days or more between any 2 consecutive occasions for a child. Using age/sex BMI percentiles, we categorized 48 children as having a healthy weight (≥5th but <85th percentile), 14 as at risk of being overweight (≥85th but <95th percentile), and 17 as overweight (≥95th percentile). A repeated-measures analysis was conducted for each of 5 outcomes (number of items observed eaten, number of items reported eaten, omission rate, intrusion rate, and total inaccuracy). For items observed, the BMI Category × Trial interaction was marginally significant (P = .079); over trials, this outcome was stable for children with a healthy weight, decreased and stabilized for children at risk of being overweight, and stable and decreased for overweight children. This outcome was greatest for overweight children and least for children with a healthy weight (P = .015). For items reported, no significant effect was found. For omission rate (P = .028) and intrusion rate (P = .083), the BMI Category × Trial interaction was significant and marginally significant; over trials, both decreased for children with a healthy weight, decreased and stabilized for children at risk of being overweight, and increased and stabilized for overweight children. Total inaccuracy decreased slightly over trials (P = .076); this outcome was greater for boys than for girls (P = .049). The results suggest that children''s dietary reporting accuracy over multiple recalls varies by BMI category. Validation studies with adequate samples for each BMI category, sex, and race are needed. [Copyright &y& Elsevier]

We investigated telephone administration of the Children's Social Desirability (CSD) scale and our adaptation for children of the Social Desirability for Food scale (C-SDF). Each of 100 4th-graders completed 2 telephone interviews 28 days apart. CSD scores had adequate internal consistency and test-retest reliability, and a 14-item subset was identified that sufficiently measures the same construct. Our C-SDF scale performed less well in terms of internal consistency and test—retest reliability; factor analysis revealed 2 factors, 1 of which was moderately related to the CSD. The 14-item subset of the CSD scale may help researchers understand error in children's dietary reports. [ABSTRACT FROM AUTHOR]

: BackgroundDo children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order?: MethodsOne hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day’s intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts.: ResultsResults failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls.: ConclusionsPrompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children’s dietary recalls. [Copyright &y& Elsevier]

This retrospective analysis compared accuracy by meal component of fourth-graders’ school lunch recalls (Study 1) to the school lunch portion of 24-hour recalls (Study 2). For Study 1, 148 children were randomly selected, observed eating school lunch, and interviewed about lunch the previous day. For Study 2, 104 children were randomly selected, observed eating school breakfast and school lunch, and interviewed to obtain a 24-hour recall of the previous day. Results indicated that omission and intrusion rates for every meal component were greater for Study 2 than Study 1. The cognitive burden of recalling items eaten at school lunch as part of a 24-hour recall is greater than that of recalling school lunch items as a single meal and thus negatively impacts fourth-graders’ ability to report their intake. Validated studies are needed to guide the development of interview protocols which maximize the accuracy of children’s dietary recalls. [Copyright &y& Elsevier]