Measuring energy, macro and micronutrient intake in UK children and adolescents: a comparison of validated dietary assessment tools

Abstract

Background: Measuring dietary intake in children and adolescents can be challenging due to misreporting, difficulties in establishing portion size and reliance on recording dietary data via proxy reporters. The aim of this review was to present results from a recent systematic review of reviews reporting and comparing validated dietary assessment tools used in younger populations in the UK. Methods: Validation data for dietary assessment tools used in younger populations (≤18 years) were extracted and summarised using results from a systematic review of reviews of validated dietary assessment tools. Mean differences and Bland-Altman limits of agreement (LOA) between the test and reference tool were extracted or calculated and compared for energy, macronutrients and micronutrients.Results: Seventeen studies which reported validation of 14 dietary assessment tools (DATs) were identified with relevant nutrition information. The most commonly validated nutrients were energy, carbohydrate, protein, fat, calcium, iron, folate and vitamin C. There were no validated DATs reporting assessment of zinc, iodine or selenium intake. The most frequently used reference method was the weighed food diary, followed by doubly labelled water and 24 h recall. Summary plots were created to facilitate comparison between tools. On average, the test tools reported higher mean intakes than the reference methods with some studies consistently reporting wide LOA. Out of the 14 DATs, absolute values for LOA and mean difference were obtained for 11 DATs for EI. From the 24 validation results assessing EI, 16 (67%) reported higher mean intakes than the reference. Of the seven (29%) validation studies using doubly labelled water (DLW) as the reference, results for the test DATs were not substantially better or worse than those using other reference measures. Further information on the studies from this review is available on the www.nutritools.org website.Conclusions: Validated dietary assessment tools for use with children and adolescents in the UK have been identified and compared. Whilst tools are generally validated for macronutrient intakes, micronutrients are poorly evaluated. Validation studies that include estimates of zinc, selenium, dietary fibre, sugars and sodium are needed.

Prospective association between a Mediterranean-style dietary score in childhood and cardiometabolic risk in young adults from the ALSPAC birth cohort

“…Therefore, caution should be taken when interpreting the size of the association observed. The use of self-reported diet diaries to assess children’s dietary intake inevitably introduces some reporting error and bias, although diet diaries are generally less prone to misreporting than food frequency questionnaires [ 66 ]. In addition, we did not have 3 days of diet diary records for all the children (a maximum of 1 or 2 days of diet diaries were available for 11.6, 13.6 and 17.4% of the children at 7, 10 and 13 years, respectively).…”

The relationship between dietary intakes and plasma concentrations of PUFA in school-age children from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

“…The strengths include the large number of children with both dietary and biomarker data, making this one of the largest correlation studies of this type in children. The majority of studies validating dietary assessment tools in children in the UK have a sample size of <50 (60) .…”

“…The strengths include the large number of children with both dietary and biomarker data, making this one of the largest correlation studies of this type in children. The majority of studies validating dietary assessment tools in children in the UK have a sample size of <50 (60) . The use of a parental-completed FFQ specially designed for this age group enabled us to capture habitual dietary intakes, which is particularly advantageous when collecting information on foods such as fish and seafood, which are typically eaten less frequently in this population.…”

Failure to Thrive in the Outpatient Clinic: A New Insight

“…Beside caloric intake, attention should be paid to daily intakes of each macro-and micronutrient, comparing them to recommended intakes as indicated by country-specific guidelines, e.g., Dietary Reference Intake in the U.S. [106] and LARN Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana in Italy [107]. Unlike macronutrients, micronutrient intakes are difficult to assess, and the need for validation studies of tools estimating zinc, selenium, dietary fiber, sugars, and sodium has been highlighted [100].…”

“…To define the deficit, patients’ caloric intake should be compared to requirements. Caloric intake can be calculated thanks to a 24-h food recall or 3-day food diary [ 99 , 100 ], eventually with support of image-assisted approaches [ 101 ]. This analysis should preferably be carried out by a trained professional, such as a dietician or a nutritionist, especially for patients where a pathologic condition is suspected [ 102 ].…”