Measuring dietary intake in children and adolescents in the context of overweight and obesity

Abstract

Dietary intake throughout childhood is a key determinant of growth and development and has an important role in both the prevention and treatment of childhood overweight and obesity. Although dietary intake assessment is fraught with challenges and limitations, reporting intake remains an important research outcome if dietary recommendations to promote healthy weight are to be refined. The aims of this paper are to review current dietary intake assessment methodologies for children, to identify their biases and provide guidance on how these can be addressed to improve reporting of dietary intakes of overweight children in the literature and to identify future research priorities. Knowledge of the methodological aspects of studies examining dietary intake a priori in the context of obesity will assist researchers in improving the quality of dietary data collected and reported and facilitate publication of both dietary intake and nutrition outcomes in the context of body weight. This will help to develop a strong evidence base against which to evaluate the effectiveness of nutrition interventions for both the prevention and treatment of pediatric obesity.

Self-Reported Energy Intake by Age in Overweight and Healthy-Weight Children in NHANES, 2001–2008

“…Studies of the accuracy of dietary reporting by children have found conflicting results, though those found to beinaccuratehavetypicallyuseddifferent methods of assessment than the AMPM used in NHANES. [28][29][30] Overall precision of reporting is less important to our findings than whether precision is influenced by weight status, which must be considered a possibility. There is limited validation of the AMPM in children, but it has demonstrated better accuracy than other methods, 15 although a bias previously noted of underreporting among overweight women was specifically not seen in trials involving children.…”

Diet and body fat in adolescence and early adulthood: a systematic review of longitudinal studies

“…The duration of follow up is another important aspect. Short periods do not allow exposure to establish its effect upon the outcome, whereas long periods can allow the ef-fect to be influenced by other factors or even lose magnitude for not corresponding to the period of life in which the exposure would have been meaningful 33,34 .…”

I did eat my vegetables. Agreement between parent and child food intake diaries

“…While younger children may encounter some difficulties in completing food diaries, several studies have shown that for children older than 8 years of age, validity is higher when the diaries are completed by the child rather than by a proxy (5,9) . Further, a validation study conducted among children aged 9-11 years found that mixed foods had lower agreement scores than well-defined foods and foods consumed less frequently (13) .…”

“…Another study found overall weaker associations of parent-child diet similarity when using FFQ than with food diaries (12) . Children can face difficulty in recalling the foods that they consumed when the time gap between reporting and food consumption is long (5,9,13,14) . Additionally, in the age range from 6 to 10 years, their reading abilities can differ extensively and portion size estimation represents a common challenge (5,9,13,15) .…”