Fourth-grade children's dietary reporting accuracy by meal component: Results from a validation study that manipulated retention interval and prompts

Abstract

We examined reporting accuracy by meal component (beverage, bread, breakfast meat, combination entrée, condiment, dessert, entrée, fruit, vegetable) with validation-study data on 455 fourth-grade children (mean age = 9.92 ± 0.41 years) observed eating school meals and randomized to one of eight dietary recall conditions (two retention intervals [short, long] crossed with four prompts [forward, meal-name, open, reverse]). Accuracy category (match [observed and reported], omission [observed but unreported], intrusion [unobserved but reported]) was a polytomous nominal item response variable. We fit a multilevel cumulative logit model with item variables meal component and serving period (breakfast, lunch) and child variables retention interval, prompt and sex. Significant accuracy category predictors were meal component (p < 0.0003), retention interval (p < 0.0003), meal-component × serving-period (p < 0.0003) and meal-component × retention-interval (p = 0.001). The relationship of meal component and accuracy category was much stronger for lunch than breakfast. For lunch, beverages were matches more often, omissions much less often and intrusions more often than expected under independence; fruits and desserts were omissions more often. For the meal-component × retention-interval interaction, for the short retention interval, beverages were intrusions much more often but combination entrées and condiments were intrusions less often; for the long retention interval, beverages were matches more often and omissions less often but fruits were matches less often. Accuracy for each meal component appeared better with the short than long retention interval. For lunch and for the short retention interval, children’s reporting was most accurate for entrée and combination entrée meal components, whereas it was least accurate for vegetable and fruit meal components. Results have implications for conclusions of studies and interventions assessed with dietary recalls obtained from children.

Validation of a Web-Based, Time-Use Application to Assess Children’s School Meal Intakes: My E-Diary for Activities and Lifestyle (MEDAL)

“…Compared to studies where retention periods were either shorter (recalled immediately after meal, omission rate 28%) [22] or slightly longer (recalled meal the next day, omission rate 28-36%) [10,11] than the present study, omission rates in the present study were slightly lower (24.6%). For participants without access to computers or the internet at home, completing their entries the next school day using the school computers may have increased the retention interval, thus affecting their ability to report accurately [2,34]. However, our sensitivity analyses suggest that accessibility to the internet at home did not significantly influence reporting accuracy in the present study.…”

“…Another factor leading to misreporting is the information retention period. Among children aged 8-11-years-old, retention period was associated with dietary reporting accuracy; reporting accuracy was higher when children recalled their breakfast and lunch meals in school directly after lunch (short retention period), compared to after breakfast the next morning (long retention period) [2,34]. In the present study, the participants were reminded to report their diet and activities at the end of each day.…”

“…Certain foods that are less commonly eaten or that were side dishes or additions to their meals (e.g., condiments) might thus be less salient during recalls and are expectedly more prone to being omitted in self-reports. These factors have previously been identified to account for misreporting of dietary information among children in western populations [2,19,32], and even adults [33].…”

“…1 Categories arranged in descending order of total match rates. 2 Strict matches occurred when a food item reported in MEDAL exactly matched the item in the meal photo. 3 Loose matches occurred when a food item reported in MEDAL was not identical to the item in the meal photo but belonged to the same food group.…”

“…However, assessing schoolchildren's food intake can be challenging. Parents often lack first-hand knowledge of their child's out-of-home food intake, thus limiting the accuracy of proxy-food reporting [2]. On the other hand, traditional pen-and-paper dietary assessment methods such as 24-h recall, food diaries and food frequency questionnaires involve lengthy and extensive interviews or completion of questionnaires, which can be burdensome for children [3] and affect their motivation to complete the assessment, resulting in low compliance.…”