Intrusions in Children's Dietary Recalls: The Roles of BMI, Sex, Race, Interview Protocol, and Social Desirability

Abstract

Dietary-reporting validation study data and school foodservice production records were used to examine intrusions (reports of uneaten items) in school meals in 24-h recalls. Fourth-grade children [20 low-BMI (≥5th and <50th percentiles); 20 high-BMI (≥85th percentile); 50% boys; 75% black] were each observed eating two school meals (breakfast, lunch) and interviewed about the prior 24 h that evening (24E) or the previous day the next morning (PDM). Social desirability was assessed. Intrusions were classified as stretches (on meal tray), internal confabulations (in school foodservice environment but not on meal tray), and external confabulations (not in school foodservice environment). For breakfast, reported items were less likely to be intrusions for black than white children, and for low-BMI boys than the other BMI-×-sex groups, and to be external confabulations for high-BMI girls than high-BMI boys. For lunch, reported items and intrusions were more likely to be stretches for 24E than PDM interviews. As social desirability increased, fewer items were reported for breakfast, and reported items and intrusions were more likely to be internal confabulations for lunch. For breakfast, compared to low-BMI girls, as social desirability increased, intruded amounts were larger for high-BMI boys and smaller for high-BMI girls. For lunch, intruded amounts were smaller for high-BMI girls than the other BMI-×-sex groups. Amounts reported were smaller for stretches than internal confabulations and external confabulations for breakfast, and external confabulations for lunch. To better understand intrusions, dietary-reporting validation studies are needed with larger samples by BMI-group, sex, and race.

Fourth-grade children’s dietary recall accuracy for energy intake at school meals differs by social desirability and body mass index percentile in a study concerning retention interval

“…Also, secondary analyses (Guinn et al, 2008) from that study found that, for school breakfast, items reported eaten were less likely to be intrusions for boys with low BMI%s (≥5 th and <50 th percentiles) than for boys with high BMI%s (≥85 th percentile), girls with high BMI%s, and girls with low BMI%s. Additionally, for school breakfast, for amounts reported eaten for intrusions, there was an interaction of BMI%-group and sex, and an interaction of BMI%-group, sex, and SDS; compared to girls with low BMI%s, as SDS increased, amounts reported eaten for intrusions increased for boys with high BMI%s and decreased for girls with high BMI%s.…”

“…Assessment of social desirability in studies in which children self-report dietary intake has been recommended (Livingstone & Robson, 2000). In the one dietary-reporting validation study of which we know that examined children’s social desirability (Baxter, Smith, Litaker et al, 2006), SDS was not a significant covariate for any accuracy variable concerning energy, although subsequent analyses found that SDS correlated negatively with number of school-breakfast items reported eaten (Guinn et al, 2008). …”

Need for Technological Innovation in Dietary Assessment

“…The main challenges to accuracy with the 24HR are attention and memory. Many respondents are challenged with distinguishing between what they usually eat and what they ate yesterday, opening the possibility for omissions and intrusions (foods reported, but not actually eaten) (12). Actual memory of distinct events decays with time (7,13), which has been documented to start within an hour of the meal (14).…”

Relationship of socio-economic factors and parental eating habits with children's food intake in a population-based study in a metropolitan area of Brazil

“…The estimated consumption of energy and nutrients in infancy is particularly challenging due to the greater number of errors in measuring the diet, which compromises the accuracy of the methods for assessing food intake in this age group (37) . However, the 24 h recall is the main method used to evaluate children's food intake (38) . According to Salles-Costa et al (39) , the use of two 24 h recalls among children is appropriate for evaluating the intakes of energy, carbohydrates, protein, lipids and other micronutrients (Ca, Fe, vitamin C).…”