Repeated 24-hour recalls versus dietary records for estimating nutrient intakes in a national food consumption survey

This study was presented at the 7th International Conference on Diet and Activity Methods, Washington DC, USA, June 2009.

Figures & data

Table 1. Characteristics of the participants

	Total (n=127)				Women (n=71)				Men (n=56)
	Mean	SD	Min	Max	Mean	SD	Min	Max	Mean	SD	Min	Max
Age (years)	50.2	24.7	15.1	91.1	51.7	25.3	15.2	84.7	48.3	23.9	15.1	91.1
Weight (kg)	71.6	13.4	44.0	119.0	65.9	11.2	44.0	98.0	78.9	12.5	55.0	119.0
Height (cm)	170.4	9.1	152.0	190.0	165.3	6.5	152.0	182.0	176.9	7.7	160.0	190.0
BMI (kg/m2)	21.0	3.6	13.3	33.1	19.9	3.3	13.3	30.1	22.4	3.4	16.0	33.1

Fig. 1.  Percentage of participants (n=76) classified as underreporter, acceptable reporter and overreporter by the ratio energy intake over total energy expenditure (EI/TEE) clustered by gender and method (estimated dietary record; EDR (a), 24-hour recall; 24HR (b). The lower and upper ratio cut-offs for EDR and 24HR are 0.80 and 1.20; and 0.72 and 1.28, respectively. *Number of underreporters in men was significantly lower compared to women (χ22= 6.361, p = 0.042)).

Table 2. Mean usual intakes, p-values for t-tests, ratios and Spearman correlations of macronutrients by both methods. All data are adjusted for day of week and age (in years). Figures representing total sample are additionally adjusted for gender

	EDR						24HR
	All (n = 127)		Women (n=71)		Men (n=56)		All (n=127)		Women (n=71)		Men (n=56)		p^a				Ratio 24HR/EDR			r^b
Macronutrient	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	All	?	?		All	?	?	All	?	?
Energy (MJ/d)	8.1	1.5	6.9	1.1	9.7	1.9	9.0	2.1	7.8	1.8	10.7	2.1	<0.01	<0.01	0.01		1.12	1.12	1.11	0.56**	0.28*	0.63**
Energy including alcohol (MJ/d)	8.4	1.5	7.0	1.1	10.3	2.0	9.4	2.2	7.9	1.8	11.5	2.5	<0.01	<0.01	0.01		1.12	1.12	1.12	0.59**	0.29*	0.63**
Protein (g/d)	76.0	12.0	66.9	9.6	87.3	14.1	78.7	15.6	66.0	11.8	96.5	18.3	0.12	0.61	<0.01		1.04	0.99	1.10	0.47**	0.26**	0.41**
Fat (g/d)	76.7	17.4	64.0	13.9	94.2	21.8	96.6	28.4	84.4	24.3	113.0	29.9	<0.01	<0.01	<0.01		1.26	1.32	1.20	0.50**	0.33**	0.58**
SFA (g/d)	31.0	7.8	27.2	6.2	35.9	9.7	38.6	13.1	33.4	10.1	45.5	16.2	<0.01	<0.01	<0.01		1.24	1.23	1.27	0.45**	0.28**	0.52**
MUFA (g/d)	29.5	6.8	23.9	5.3	37.7	8.4	34.7	9.9	30.1	7.7	40.9	10.8	<0.01	<0.01	0.08		1.18	1.26	1.09	0.50**	0.34**	0.57**
PUFA (g/d)	12.9	3.5	10.4	3.1	16.7	3.9	19.1	6.2	17.5	5.6	21.1	5.9	<0.01	<0.01	<0.01		1.48	1.68	1.26	0.46**	0.37**	0.46**
LA (g/d)	10.1	3.3	8.0	2.9	13.5	3.8	11.4	3.6	9.7	2.9	13.7	4.0	<0.01	<0.01	0.73		1.12	1.22	1.02	0.35**	0.30**	0.27*
Cholesterol (mg/d)	275.7	54.1	244.1	43.8	316.5	67.9	296.5	87.1	256.6	96.7	350.7	54.9	0.02	0.32	<0.01		1.08	1.05	1.11	0.39**	0.17**	0.50**
Carbohydrates (g/d)	233.4	56.0	202.6	42.9	277.1	73.7	239.5	57.9	206.5	46.3	287.3	74.4	0.39	0.60	0.47		1.03	1.02	1.04	0.62**	0.49**	0.68**
Starch (g/d)	126.3	28.0	113.1	25.8	145.2	31.6	131.0	39.3	112.6	37.5	157.1	41.7	0.27	0.93	0.09		1.04	1.00	1.08	0.61**	0.57**	0.55**
Simple sugars (g/d)	104.1	38.8	85.8	27.6	130.0	51.9	107.1	35.8	91.6	19.9	126.5	49.4	0.52	0.15	0.71		1.03	1.07	0.97	0.58**	0.38**	0.72**
Fibre (g/d)	22.5	5.6	21.5	5.5	23.9	5.9	21.3	4.9	19.8	4.1	23.2	6.0	0.06	0.05	0.56		0.95	0.92	0.97	0.47**	0.50**	0.39**
Alcohol (g/d)	12.6	13.1	5.0	6.3	22.1	17.5	15.1	15.3	5.9	6.6	26.9	25.4	0.17	0.44	0.25		1.20	1.17	1.22	0.60**	0.45**	0.67**
Alcohol (g/d)^c	34.1	16.1	19.1	11.5	44.2	16.3	38.7	17.1	19.8	8.1	53.1	29.8	0.03	0.68	0.05		1.13	1.04	1.20	0.55**	0.14	0.61**
Water (ml/d)	2235.1	583.8	2128.2	583.7	2359.8	576.4	2180.2	501.4	2005.5	436.5	2408.3	562.7	0.42	0.16	0.65		0.98	0.94	1.02	0.70**	0.66**	0.73**
	Nob = 236/Nind = 90^c		Nob = 95/Nind = 44^c		Nob = 141/Nind = 46^?c		Nob = 99/Nind = 66^c		Nob = 42/Nind = 30^c		Nob = 57/Nind = 33^?c									Nind = 56^d	Nind = 23^d	Nind = 33^d

Note: EDR, 5-day estimated dietary record; 24HR, 2-day 24-hour recall.

^a Student's t-test.

^b Spearman correlation coefficient.

^cOn consumption days only (Nob, number of observations, Nind, number of individuals).

^dPositive alcohol consumption in both methods only.

^*Significant at the 0.05 level (2-sided).

^**Significant at the 0.001 level (2-sided).

Table 3. Mean usual intakes, p-values for t-tests, ratios and Spearman correlations of micronutrients by both methods. All data are adjusted for day of week and age (in years). Figures representing total sample are additionally adjusted for gender

	EDR						24HR
	All (n=127)		Women (n=71)		Men (n=56)		All (n=127)		Women (n=71)		Men (n=56)		p^a			ratio 24HR/EDR			r^b
Micronutrient	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	Mean	SD	All	?	?	All	?	?	All	?	?
Vitamin C (mg/d)	79.4	32.0	92.9	41.0	63.2	23.4	98.8	34.8	90.3	31.5	110.7	39.6	<0.01	0.67	<0.01	1.2	1.0	1.8	0.42**	0.38**	0.48**
Thiamin (mg/d)	1.4	0.4	1.3	0.3	1.5	0.3	4.0	2.1	3.9	2.2	4.1	1.7	<0.01	<0.01	<0.01	2.9	3.0	2.8	0.16	0.19	-0.03
Riboflavin (mg/d)	1.5	0.5	1.4	0.4	1.7	0.5	1.7	0.4	1.5	0.4	1.9	0.2	<0.01	0.12	<0.01	1.1	1.1	1.1	0.43**	0.35**	0.41**
Potassium (mg/d)	3,252.8	569.3	2,959.9	495.7	3,628.5	640.5	3,130.0	681.1	2,683.5	597.2	3,755.7	718.8	0.12	<0.01	0.32	1.0	0.9	1.0	0.47**	0.32**	0.48**
Calcium (mg/d)	807.7	217.8	746.1	179.4	871.7	251.1	814.5	250.3	755.6	231.7	891.8	268.9	0.82	0.79	0.68	1.0	1.0	1.0	0.26**	0.19	0.34**
Iron (mg/d)	10.9	2.5	9.4	2.3	13.0	2.6	11.8	2.2	10.1	1.9	14.0	2.1	<0.01	0.06	0.02	1.1	1.1	1.1	0.56**	0.44**	0.47**

EDR, 5-day estimated dietary record; 24HR, 2-day 24-hour recall.

^a Student's t-test.

^bSpearman correlation coefficient.

^*Significant at the 0.05 level (2-sided).

^**Significant at the 0.001 level (2-sided).

Table 4. Agreement between EDR and 24HR by ranking of participants in tertiles expressed as weighted Kappa coefficients with 95% confidence intervals

	Weighted Kappa (95% CI)
Nutrient	All	?	?
Energy (MJ/d)	0.31 (0.19–0.43)	0.17 (0.01–0.34)	0.45 (0.26–0.63) ^a
Energy including alcohol. (MJ/d)	0.40 (0.28–0.52)	0.24 (0.07–0.40)	0.39 (0.21–0.58) ^a
Protein (g/d)	0.29 (0.17–0.42)	0.14 (−0.02–0.31)	0.23 (0.05–0.42)
Fat (g/d)	0.36 (0.24–0.49)	0.30 (0.14–0.46)	0.35 (0.17–0.54)
SFA (g/d)	0.33 (0.21–0.45)	0.11 (−0.06–0.27)	0.27 (0.09–0.46)
MUFA (g/d)	0.33 (0.21–0.45)	0.24 (0.07–0.40)	0.48 (0.29–0.66)
PUFA (g/d)	0.31 (0.19–0.43)	0.33 (0.17–0.50)	0.31 (0.13–0.50)
LA (g/d)	0.20 (0.08–0.33)	0.17 (0.01–0.34)	0.11 −0.07–0.30)
Cholesterol (mg/d)	0.27 (0.15–0.40)	0.14 (−0.02–031)	0.27 (0.09–0.46)
Carbohydrates (g/d)	0.42 (0.29–0.54)	0.30 (0.14–0.46)	0.56 (0.37–0.74) ^a
Starch (g/d)	0.43 (0.31–0.56)	0.36 (0.20–0.53)	0.35 (0.17–0.54)
Simple sugars (g/d)	0.42 (0.29–0.54)	0.24 (0.07–0.40)	0.52 (0.33–0.70) ^a
Fibre (g/d)	0.27 (0.15–0.40)	0.33 (0.17–0.50)	0.31 (0.13–0.50)
Alcohol (g/d)^b	0.31 (0.13–0.50)	0.01 (−0.28–0.30)	0.37 (0.09–0.64) ^a
Water (ml/d)	0.54 (0.42–0.66)	0.52 (0.36–0.69)	0.60 (0.41–0.78)
Vitamin C (mg/d)	0.29 (0.17–0.42)	0.20 (0.04–0.37)	0.31 (0.13–0.50)
Thiamin (mg/d)	0.06 (−0.06–0.19)	0.11 (−0.06–0.27)	0.00 (−0.19–0.18)
Riboflavin (mg/d)	0.33 (0.21–0.45)	0.33 (0.17–0.50)	0.27 (0.09–0.46)
Potassium (mg/d)	0.33 (0.21–0.45)	0.20 (0.04–0.37)	0.31 (0.13–0.50)
Calcium (mg/d)	0.17 (0.05–0.29)	0.14 (−0.02–0.31)	0.19 (0.01–0.38)
Iron (mg/d)	0.43 (0.31–0.56)	0.24 (0.07–0.40)	0.35 (0.17–0.54)
	Nind = 56^b	Nind = 23^b	Nind = 33^b

Note: EDR, 5-day estimated dietary record; 24HR, 2-day 24-hour recall.

^aKappa correlation coefficient significantly different from women (Fisher r-to-Z test, 1-sided).

^bPositive alcohol consumption in both methods only (Nind: number of individuals).

Abbreviations: 24HR, 24-hour recall; CV, coefficient of variation; DLW, doubly labelled water; EDR, estimated dietary record; EI, energy intake; FCDB, food composition database; MET, metabolic equivalent, TEE, total energy expenditure.