Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 12, 2008
Publication Date: August 1, 2008
Citation: Moshfegh, A.J., Rhodes, D.G., Baer, D.J., Murayi, T., Clemens, J.C., Rumpler, W.V., Paul, D.R., Sebastian, R.S., Kuczynski, K.J., Ingwersen, L.A., Staples, R.C., Cleveland, L.E. 2008. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. American Journal of Clinical Nutrition. 88:324-332. Interpretive Summary: The USDA Automated Multiple Pass Method (AMPM) is a 5-step automated 24-hour recall interview that includes multiple passes during which respondents receive cues to help them remember and describe food they consumed. The AMPM has been used since 2002 to collect dietary data in What We Eat in America, National Health and Nutrition Examination Survey. This continuous national survey collects two days of dietary data on about 5,000 participants each year. Since data from this survey are used in developing nutrition and food-related regulations, programs, and policies as well as dietary standard recommendations, it is essential that the validity of the method be tested. The accuracy of dietary intake data has been questioned by researchers. An extensive research project, the AMPM Validation Study was undertaken using 524 healthy volunteers recruited from the Washington, DC area. Energy intake was collected from three 24-hour recalls using the AMPM and compared to energy expenditure measured by an independent biomarker, doubly labeled water. Results show that the USDA AMPM is a highly accurate method for collecting dietary intakes for the population.
Technical Abstract: The USDA Automated Multiple Pass Method (AMPM) is used for collecting 24-hour dietary recalls in What We Eat In America, National Health and Nutrition Examination Survey. Since the data have important program and policy applications, it is essential that the validity of the method be tested. The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) to total energy expenditure (TEE) using the doubly labeled water (DLW) technique. The 524 volunteers, aged 30-69 years, included an equal number of males and females recruited from the Washington, DC area. Each subject was dosed with DLW on the first day of their 2-week study period; three 24-hour recalls were collected using the AMPM during this same period. The first recall was conducted in person and subsequent recalls were over the telephone. Overall as a group, EI compared to TEE was under-reported by 11%. For normal weight subjects (BMI<25), EI was under-reported by less than 3%, for BMI>25, it was under-reported approximately 17%. Using a linear mixed model, 95%CI were determined for EI:TEE. Approximately 78% of males and 74% of females were classified as acceptable reporters (within 95%CI of EI:TEE). Both the percentage of energy under-reported and the percentage classified as low energy reporters (below 95%CI of EI:TEE) were highest in subjects classified as obese (BMI>30). Although the AMPM accurately reported energy intakes in normal weight subjects, research is warranted to enhance accuracy in overweight and obese individuals.