ACCURACY OF DIETARY RECALL USING THE USDA 5-STEP MULTIPLE PASS METHOD IN MEN: AN OBSERVATIONAL VALIDATION STUDY.

Authors: Conway, Joan; Ingwersen, Linda; Moshfegh, Alanna

Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/30/2004
Publication Date: 3/30/2004
Citation: Conway, J.M., Ingwersen, L.A., Moshfegh, A.J. 2004. Accuracy of dietary recall using the usda 5-step multiple pass method in men: an observational validation study. Journal Of The American Dietetic Association. 104:595-603.

Interpretive Summary: National food intake data is collected using the USDA multiple pass method for 24 hour food recall, therefore it is important to validate the methodology used. This study was conducted under controlled conditions to test the accuracy of food intake recall using the USDA 5-Step Multiple-Pass Method for dietary recall. Forty-men ranging in age from 21 to 65 years who lived in the metropolitan Washington DC area were studied. The subjects selected and consumed all meals and snacks, for one day, from a wide variety of foods. Actual and recalled energy, protein, carbohydrate, and fat intakes were determined by direct observation and a 24-h dietary recall respectively. Dietary recall was determined via telephone administration of the USDA 5-Step Multiple Pass Method the following day. Analysis of variance and covariance tested the overall accuracy of recall and the effect of body fatness on dietary recall. Statistical plots were used to assess bias in recall of food intake. There was no significant difference between recalled and actual intakes of energy, protein, carbohydrate, or fat in this population of men. Accuracy of recall was not related to body size. The energy intake of these men was highly correlated to their estimated energy requirement. Significant inter-individual variation in accuracy of recall was found. The USDA 5-Step multiple pass method can accurately assess intakes of energy, protein, carbohydrate, and fat in a population of men regardless of their body fatness. This data will be useful to all federal agencies dependent on national food intake data, educators, and clinical dietitians. Researchers and clinical dietitians need to continue to examine factors that influence under- and over-reporting of food intake by the multiple pass 24-hour recall method.

Technical Abstract: This observational validation study was conducted under controlled conditions to test the accuracy of dietary recall in normal weight, overweight, and obese men using the USDA 5-Step Multiple-Pass Method for dietary recall. This was a Cross-sectional analysis of actual and recalled intake of food during one day. Forty-two men ranging in age from 21 to 65y and in Body Mass Index (BMI)from 21 to 39 kg per meters squared who lived in the Washington DC area were studied. The subjects selected and consumed all meals and snacks, for one day, from a wide variety of foods. Actual and recalled energy, protein, carbohydrate, and fat intakes were determined by direct observation and a 24-h dietary recall respectively. Dietary recall was determined via telephone administration of the USDA 5-Step Multiple Pass Method the following day. Analysis of variance and covariance tested the overall accuracy of recall and the effect of BMI on dietary recall. Bland-Altman plots were used to assess bias in recall of food intake. There was no significant difference between recalled and actual intakes of energy, protein, carbohydrate, or fat in this population of men. Accuracy of recall was not related to BMI. The energy intake of these men was highly correlated to their estimated energy requirement. Significant inter-individual variation in accuracy of recall was found. The USDA 5-Step multiple pass method can accurately assess intakes of energy, protein, carbohydrate, and fat in a population of men regardless of their BMI. Researchers and clinical dietitians need to continue to examine factors that influence under- and over-reporting of food intake by the multiple pass 24-hour recall method.