Search

Abstract: Background: Accurate information about children''s intake is crucial for national nutrition policy and for research and clinical activities. To analyze accuracy for reporting energy and nutrients, most validation studies utilize the “conventional approach,” which was not designed to capture errors of reported foods and amounts. The “reporting-error-sensitive approach” captures errors of reported foods and amounts. Objective: To extend results to energy and macronutrients for a validation study concerning retention interval (elapsed time between to-be-reported meals and the interview) and accuracy for reporting school-meal intake, the conventional and reporting-error-sensitive approaches were compared. Design and participants/setting: Fourth-grade children (n=374) were observed eating two school meals, and interviewed to obtain a 24-hour recall using one of six interview conditions from crossing two target periods (prior 24 hours and previous day) with three interview times (morning, afternoon, and evening). Data were collected in one district during three school years (2004-2005, 2005-2006, and 2006-2007). Main outcome measures: Report rates (reported/observed), correspondence rates (correctly reported/observed), and inflation ratios (intruded/observed) were calculated for energy and macronutrients. Statistical analyses performed: For each outcome measure, mixed-model analysis of variance was conducted with target period, interview time, their interaction, and sex in the model; results were adjusted for school year and interviewer. Results: With the conventional approach, report rates for energy and macronutrients did not differ by target period, interview time, their interaction, or sex. With the reporting-error-sensitive approach, correspondence rates for energy and macronutrients differed by target period (four P values <0.0001) and the target period by interview-time interaction (four P values <0.0001); inflation ratios for energy and macronutrients differed by target period (four P values <0.0001), and inflation ratios for energy and carbohydrate differed by the target period by interview-time interaction (both P values <0.005). Conclusions: Shortening the retention interval of dietary recalls increases accuracy for reporting energy and macronutrients. For validation studies, it is best to obtain reference information from a method that provides details about foods and amounts consumed and to use an analytic approach that captures errors of reported foods and amounts. [Copyright &y& Elsevier]

Background: Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria). Methods: Data were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age. Results: Breakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria. Conclusions: For fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated. [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: Background: For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy. Objective: The effects of target period and interview time on children''s accuracy for reporting school meals during 24-hour dietary recalls were investigated. Design and subjects/setting: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys). Main outcome measures: Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts. Statistical analyses performed: For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model. Results: There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third. Conclusions: To enhance children''s dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen. [Copyright &y& Elsevier]

Using previously collected data of fourth-grade children observed eating school meals and then interviewed, we categorized intrusions (food items reported but not observed eaten) as stretches (on the child's tray) or confabulations (not on the child's tray). We investigated intrusions, confabulations, and stretches and the role of liking, at different retention intervals (morning interviews about the previous day's intake; evening interviews about that day's intake) and under different reporting- order prompts (forward; reverse). As retention interval between consumption and report increased, the likelihood (1) increased that reported items were intrusions, that reported items were confabulations and that intrusions were confabulations; and (2) was constant that reported items were stretches. Results concerning reporting-order prompts were inconclusive. Liking ratings were higher for matches (reports of items observed eaten) than stretches, for confabulations than stretches, and for matches than omissions (unreported items observed eaten), but did not vary by retention interval or reporting-order prompts. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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]

Abstract: Background: Intrusions in dietary recalls may originate in confusion of episodic memories manifested as temporal dating errors. Objective: Data from a validation study (concerning reporting accuracy over multiple recalls) and school foodservice production records were used to investigate origins of intrusions in school meals in children''s 24-hour recalls. Design/subjects/setting: During the 1999-2000 school year, 104 fourth-grade children were observed eating school meals on 1 to 3 nonconsecutive days separated by ≥25 days, and interviewed about the previous day''s intake in the morning on the day after each observation day. Statistical analyses performed: For breakfast and lunch separately, logistic regression was used to investigate the effect of time (ie, days) before the interview day on the probability that intrusions referred to items available in the school foodservice environment. Exploratory analyses were conducted for breakfast options observed and/or reported eaten. Results: For interviews in which reported meals met criteria to be considered school meals and that contained intrusions, of 634 and 699 items reported eaten at breakfast and lunch, respectively, 394 and 331 were intrusions. Availability in the school foodservice environment of items referred to by intrusions in reports of lunch, but not breakfast, decreased as days increased before the interview day (P=0.031 and P=0.285, respectively). Concerning breakfast, children observed eating a cold option (ie, ready-to-eat cereal, milk, juice, crackers [graham or animal]) almost always reported a cold option, whereas children observed eating a hot option (ie, non–ready-to-eat cereal entrée [eg, sausage biscuit], milk, and fruit or juice) reported a cold option in approximately 50% of interviews. Conclusions: In children''s 24-hour recalls, confusion of episodic memories contributes to intrusions in school lunch, and generic dietary information (eg, cold option items available daily) or confusion of episodic memories may contribute to intrusions in school breakfast. Understanding the origins of intrusions may help in developing interview methods to decrease the occurrence of intrusions. [Copyright &y& Elsevier]

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: Objective: Validation study data are used to illustrate that conclusions about children’s reporting accuracy for energy and macronutrients over multiple interviews (ie, time) depend on the analytic approach for comparing reported and reference information—conventional, which disregards accuracy of reported items and amounts, or reporting-error-sensitive, which classifies reported items as matches (eaten) or intrusions (not eaten), and amounts as corresponding or overreported. Subjects and Design: Children were observed eating school meals on 1 day (n=12), or 2 (n=13) or 3 (n=79) nonconsecutive days separated by ≥25 days, and interviewed in the morning after each observation day about intake the previous day. Reference (observed) and reported information were transformed to energy and macronutrients (ie, protein, carbohydrate, and fat), and compared. Main Outcome Measures: For energy and each macronutrient: report rates (reported/reference), correspondence rates (genuine accuracy measures), and inflation ratios (error measures). Statistical Analyses: Mixed-model analyses. Results: Using the conventional approach for analyzing energy and macronutrients, report rates did not vary systematically over interviews (all four P values >0.61). Using the reporting-error-sensitive approach for analyzing energy and macronutrients, correspondence rates increased over interviews (all four P values <0.04), indicating that reporting accuracy improved over time; inflation ratios decreased, although not significantly, over interviews, also suggesting that reporting accuracy improved over time. Correspondence rates were lower than report rates, indicating that reporting accuracy was worse than implied by conventional measures. Conclusions: When analyzed using the reporting-error-sensitive approach, children’s dietary reporting accuracy for energy and macronutrients improved over time, but the conventional approach masked improvements and overestimated accuracy. The reporting-error-sensitive approach is recommended when analyzing data from validation studies of dietary reporting accuracy for energy and macronutrients. [Copyright &y& Elsevier]

Abstract: Objective.: Validation-study data are used to illustrate that conventional energy and macronutrient (protein, carbohydrate, fat) variables, which disregard accuracy of reported items and amounts, misrepresent reporting accuracy. Reporting-error-sensitive variables are proposed which classify reported items as matches or intrusions, and reported amounts as corresponding or overreported. Methods.: 58 girls and 63 boys were each observed eating school meals on 2 days separated by ≥4 weeks, and interviewed the morning after each observation day. One interview per child had forward-order (morning-to-evening) prompts; one had reverse-order prompts. Original food-item-level analyses found a sex-x-order prompt interaction for omission rates. Current analyses compared reference (observed) and reported information transformed to energy and macronutrients. Results.: Using conventional variables, reported amounts were less than reference amounts (ps<0.001; paired t-tests); report rates were higher for the first than second interview for energy, protein, and carbohydrate (ps≤0.049; mixed models). Using reporting-error-sensitive variables, correspondence rates were higher for girls with forward- but boys with reverse-order prompts (ps≤0.041; mixed models); inflation ratios were lower with reverse- than forward-order prompts for energy, carbohydrate, and fat (ps≤0.045; mixed models). Conclusions.: Conventional variables overestimated reporting accuracy and masked order prompt and sex effects. Reporting-error-sensitive variables are recommended when assessing accuracy for energy and macronutrients in validation studies. [Copyright &y& Elsevier]

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]

Abstract: This article (a) provides a general review of interobserver reliability (IOR) and (b) describes our method for assessing IOR for items and amounts consumed during school meals for a series of studies regarding the accuracy of fourth-grade children’s dietary recalls validated with direct observation of school meals. A widely used validation method for dietary assessment is direct observation of meals. Although many studies utilize several people to conduct direct observations, few published studies indicate whether IOR was assessed. Assessment of IOR is necessary to determine that the information collected does not depend on who conducted the observation. Two strengths of our method for assessing IOR are that IOR was assessed regularly throughout the data collection period and that IOR was assessed for foods at the item and amount level instead of at the nutrient level. Adequate agreement among observers is essential to the reasoning behind using observation as a validation tool. Readers are encouraged to question the results of studies that fail to mention and/or to include the results for assessment of IOR when multiple people have conducted observations. [Copyright &y& Elsevier]

Purpose: This study evaluated the effect of recency on accuracy of fourth-graders'' dietary reports.Methods: Each of 60 randomly selected children was observed eating school meals (breakfast, lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions generated by crossing two target periods (previous day, prior 24 hours) with three interview times (morning, afternoon, evening), with 10 children (5 males) per condition. Accuracy of the school meal portions of each recall was assessed by comparing reports to observations. Rates for omissions (items observed but not reported) and intrusions (items reported but not observed) were calculated to determine accuracy for reporting items. A measure of total inaccuracy combined errors for reporting items and amounts.Results: Using the prior 24 hours as the target period yielded better performance than did using the previous day: Omission rates were lower by about one-third, intrusion rates by about one-half, and total inaccuracy by about one-third (all p''s<0.01). A marginally significant interaction of target period by interview time was found for omission rate (p = 0.08), but not for intrusion rate (p = 0.15) or for total inaccuracy (p = 0.47).Conclusions: This provides evidence that recency influences children''s recall accuracy and demonstrates the importance of an awareness of principles of memory when designing what are essentially memory tests for epidemiologic studies. [Copyright &y& Elsevier]

Objective: To investigate the accuracy of children's dietary recalls of school breakfast and school lunch validated with observations and obtained during in-person versus telephone interviews. Design: Each child was observed eating school breakfast and school lunch and was interviewed that evening about that day's intake. Setting: Ten elementary schools. Participants: A sample of fourth-graders was randomly selected within race (black, white) and gender strata, observed, and interviewed in person (n = 33) or by telephone (n = 36). Main Outcomes Measured: Rates for omissions (items observed but not reported) and intrusions (items reported but not observed) were calculated to determine accuracy for reporting items. A measure of total inaccuracy was calculated to determine inaccuracy for reporting items and amounts combined. Analysis: Analysis of variance; chi-square. Results: Interview type (in person, telephone) did not significantly affect recall accuracy. For omission rate, intrusion rate, and total inaccuracy, means were 34%, 19%, and 4.6 servings for in-person recalls and 32%, 16%, and 4.3 servings for telephone recalls of school breakfast and school lunch. Conclusions and Implications: The accuracy of children's recalls of school breakfast and school lunch is not significantly different whether obtained in person or by telephone. Whether interviewed in person or by telephone, children reported only 67% of items observed; furthermore, 17% of items reported were not observed. [ABSTRACT FROM AUTHOR]

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]

Objective: To explore fourth-graders' school breakfast participation by gender and race (black, white) and examine the extent to which parents' responses to "Does this child usually eat school breakfast?" reflected their children's participation. Design: Parents answered "yes" or "no" to the questions printed on consent forms. Observers documented which children participated in school breakfast on 26 to 51 randomly selected days per school during 24 weeks in the 1999-2000 school year. Subjects: 357 children recruited from all 22 fourth-grade classes from 6 schools in 1 public school district. Variables Measured: Participation rate, participation rate grouping [usually participated (≥ 50% of days observed), did not usually participate (< 50% of days observed)]. Statistical Analyses Performed: Komolgorov-Smirnov tests, McNemar's test. Results: Median participation rate was 37.5% overall. Distribution of participation rates differed significantly by race (K-S test, P < .001) but not gender. There was a significant difference in the percentage of parents who said "yes" or "no" compared to children's usual participation grouping (McNemar test, P < .001). Of parents who said "yes," 66% of children usually participated; of parents who said "no," 92% of children did not usually participate. [ABSTRACT FROM AUTHOR]

Objective: To use data from observations and interviews to document fourth-graders' preferences for, and consumption of, fruits compared to vegetables available as part of school lunches. Design: Observations and interviews were conducted for studies regarding the impact of time interval between eating and reporting on the accuracy of children's school lunch recalls. Subjects/Settings: Children were recruited from up to 4 schools in one district during 3 school years; 63% agreed to participate. Randomly selected children (n = 237) were each observed eating school lunch once and were interviewed (regarding items eaten and preferences for items eaten) within 1½ hours or the next morning. Main Outcome Measures : Observed consumption of servings of items available as part of school lunch was recorded as none, taste, little bit, half, most, and all. Response options for preferences for items available as part of school lunch were liked not at all, a little, and a lot. Statistical Analyses Performed: Mixed-model analysis of variance. Results: Preferences were higher for fruits than vegetables. As preferences increased, consumption increased (P < .0001). Consumption of fruits compared to vegetables was similar after adjusting for preferences. Implications: Research is needed to understand how to increase children's preferences for vegetables as a means of increasing consumption. [ABSTRACT FROM AUTHOR]

Objective To determine the accuracy and consistency of fourth-graders’ school breakfast and school lunch recalls obtained during 24-hour recalls and compared with observed intake.Design Children were interviewed using a multiple-pass protocol at school the morning after being observed eating school breakfast and school lunch.Subjects 104 children stratified by ethnicity (African-American, white) and gender were randomly selected and interviewed up to 3 times each with 4 to 14 weeks between each interview.Statistical analysis Match, omission, and intrusion rates to determine accuracy of reporting items; arithmetic and/or absolute differences to determine accuracy for reporting amounts; total inaccuracy to determine inaccuracy for reporting items and amounts combined; intraclass correlation coefficients (ICC) to determine consistencyResults Means were 51% for omission rate, 39% for intrusion rate, and 7.1 servings for total inaccuracy. Total inaccuracy decreased significantly from the first to the third recall (P=0.006). The ICC was 0.29 for total inaccuracy and 0.15 for omission rate. For all meal components except bread/grain and beverage, there were more omissions than intrusions. Mean arithmetic and absolute differences per serving in amount reported for matches were -0.08 and 0.24, respectively. Mean amounts per serving of omissions and intrusions were 0.86 and 0.80, respectively.Applications/conclusions The low accuracy and low consistency of children''s recalls from this study raise concerns regarding the current uses of dietary recalls obtained from children. To improve the accuracy and consistency of children''s dietary recalls, validation studies are needed to determine the best way(s) to interview children. J Am Diet Assoc. 2002;102:386–395. [Copyright &y& Elsevier]

Presents a study which evaluated the feasibility of implementing specific prompting methods when obtaining school lunch recalls from first- and fourth-grade students. Methods; Results; Discussion.

Presents a study intended to validate fourth-graders' self-reports of school lunch, by comparing their reports to lunch observations, and to determine the impact on accuracy of gender, ethnicity, meal component, and time interval between eating and reporting. Methodology of the study; Details on the participants; Results and applications of the results.