Research
Original Research
Reliability of 24-Hour Dietary Recalls as a Measure of Diet in African-American Youth

https://doi.org/10.1016/j.jand.2016.05.011Get rights and content

Abstract

Background

Although it is a common practice to estimate dietary intake using three random 24-hour dietary recalls, some studies have suggested up to nine may be necessary to reliably estimate usual intake in youth. Given the resulting increase in resources and participant burden, more research is needed to determine whether this method is reliable, particularly in African-American youth at increased risk for obesity and other chronic diseases.

Objective

This study estimated the reliability with which 24-hour dietary recalls measure energy, fat, fruit, and vegetable intake in African-American youth and examined how reliability changes as a function of the number of recalls.

Design

This study used cross-sectional data collection across three studies.

Participants/setting

Participants were African-American youth (n=456, mean±standard deviation age 13.28±1.86 years, 64% were girls, mean±standard deviation body mass index [calculated as kg/m2] 31.45±7.94) who completed random 24-hour dietary recalls (67% completed three) conducted by research assistants using the Automated Self-Administered 24-Hour recall system (n=258) or registered dietitian nutritionists using the Nutrition Data System for Research (n=198).

Main outcome measures/statistical analyses

Estimates provided by multilevel models were used to calculate the proportion of variance accounted for between individuals and the reliability of means within individuals as a function of the number of recalls.

Results

Reliability estimates for assessing dietary outcomes using one to three recalls ranged from 11% to 62%. To achieve 80% reliability, the following number of recalls would need to be conducted: 8 for energy intake, 13 for fat intake, 21 to 32 for fruit intake, and 21 to 25 for vegetable intake.

Conclusions

The common practice of assessing dietary intake with three recalls does so with low reliability in African-American youth. Until more objective methods for reliably estimating usual intake are developed, researchers who choose to use 24-hour dietary recalls are encouraged to include estimates of the measure’s reliability in a priori power calculations for improved decision making regarding the number of observations and/or sample size.

Section snippets

Participants

Participants (n=456) were children and adolescents between the ages of 10 and 17 years who completed 24-hour dietary recalls as part of their participation in one of three studies: a cross-sectional health assessment study (study 1)20; a family-based, health-promotion intervention (study 2)21; or a family-based, weight-loss efficacy trial (study 3).22 All studies were conducted in South Carolina. Participants across the three studies were recruited using numerous strategies, including printed

Participant Demographic Characteristics

Participant demographic characteristics are summarized in Table 1. Participants were predominantly female (64%), mean±standard deviation (SD) age was 13.28±1.86 years and mean±SD body mass index was 31.45±7.94. Annual household income for 63% of participants was <$40,000. Most participants completed three dietary recalls (67%), with mean±SD spread of 4.57±5.60 days between the first and second recall and 9.49±7.84 days between the first and third recall. On average, participants reported

Discussion

The goals of this study were to estimate the reliability with which 24-hour dietary recalls measure dietary outcomes frequently assessed within randomized controlled trials (ie, total energy, fat, vegetable, and fruit intake) in African-American youth and to examine change in reliability as a function of the number of recall days. Results indicated that reliability estimates for assessing dietary outcomes for African-American youth using three recalls, or the number commonly collected in the

Conclusions

Overall, findings from the present study demonstrate that current standards for assessing usual dietary intake in youth using only three random 24-hour dietary recalls are associated with low reliability. Low reliability, in turn, results in lower power and might help explain the marginal or null results often observed in youth dietary intervention studies. Researchers should include reliability estimates in a priori power calculations to make the most informed decisions regarding the use of

S. M. St. George is a postdoctoral fellow, Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL.

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    S. M. St. George is a postdoctoral fellow, Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL.

    M. L. Van Horn is a professor, Department of Individual, Family, and Community Education, College of Education, University of New Mexico, Albuquerque.

    H. G. Lawman is director of research and evaluation, Division of Chronic Disease Prevention, Philadelphia Department of Health, Philadelphia, PA.

    D. K. Wilson is a professor, Department of Psychology, University of South Carolina, Columbia.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT This research was supported by three grants (F31 HD066944 to S. M. St. George, F31 DK086358 to H. G. Lawman, and R01 HD072153 to D. K. Wilson) funded by the National Institutes of Health. The study sponsor had no role in study design, data collection, analysis, interpretation, writing of the paper or decision to submit the paper for publication.

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