The number of 24 h dietary recalls using the US Department of Agriculture's automated multiple-pass method required to estimate nutrient intake in overweight and obese adults.

OBJECTIVE: To determine the number of 24 h dietary recalls required to adequately estimate nutrient intake in overweight and obese adults using the US Department of Agriculture's (USDA) automated multiple-pass method (AMPM). In addition, the study quantified sources of variation in dietary intake, such as day of the week, season, sequence of diet interviews (training effect), diet interviewer, body weight and within- and between-subject variances in the intake of selected nutrients. DESIGN: Adults having a BMI of ≥ 28 but <38 kg/m2 were included in the study. The USDA's AMPM was used to obtain 24 h dietary recalls every 10 d for 6 months. Dietary intake data were analysed to adequately estimate the number of 24 h recalls necessary to assess nutrient intake. Variance component estimates were made by using a mixed-model procedure. SETTING: The greater Washington, DC, metropolitan area. SUBJECTS: Adults (34 men and 39 women) aged 35-65 years. RESULTS: Overweight and obese adults completed fourteen 24 h dietary recalls. Utilizing within- and between-subject variances requires 5-10 and 12-15 d of 24 h dietary recalls in men and women, respectively, to estimate energy and macronutrient intakes in a 6-month period. Within- and between-subject variances were the major contributors to variance in nutrient intakes. Day of the week, season, sequence, diet interviewer and body weight had little impact on variance. CONCLUSIONS: This information is valuable for researchers planning to conduct studies on free-living individuals that include the collection of dietary intake data.

The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes.

BACKGROUND: The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. OBJECTIVE: The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. DESIGN: The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. RESULTS: Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) < 25] underreported EI by <3%. By using a linear mixed model, 95% CIs were determined for the ratio of EI to TEE. Approximately 78% of men and 74% of women were classified as acceptable energy reporters (within 95% CI of EI:TEE). Both the percentage by which energy was underreported and the percentage of subjects classified as low energy reporters (<95% CI of EI:TEE) were highest for subjects classified as obese (body mass index > 30). CONCLUSIONS: Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.

Accuracy of dietary recall using the USDA five-step multiple-pass method in men: an observational validation study.

OBJECTIVE: This observational validation study was conducted under controlled conditions to test the accuracy of dietary recall in normal weight, overweight, and obese men using the USDA five-step multiple-pass method for dietary recall. DESIGN: Cross-sectional analysis of actual and recalled intake of food during 1 day. SUBJECTS/SETTING: Forty-two men ranging in age from 21 to 65 years and in body mass index from 21 to 39 kg/m(2) who lived in the metropolitan Washington DC area were studied. INTERVENTION: The subjects selected and consumed all meals and snacks, for 1 day, from a wide variety of foods provided at a human study facility. MAIN OUTCOME MEASURES: Actual and recalled energy, protein, carbohydrate, and fat intakes were determined by direct observation and by a 24-hour dietary recall, respectively. Dietary recall was determined via telephone administration of the USDA five-step multiple-pass method the following day. STATISTICAL ANALYSES PERFORMED: Analysis of variance and covariance tested the overall accuracy of recall and the effect of body mass index on dietary recall. Bland-Altman plots were used to assess bias in recall of food intake. RESULTS: In this population of men, there were no significant differences between actual and recalled intakes of energy (3,294+/-111 and 3,541+/-124 kcal/day), protein (117+/-5 and 126+/-5 g/day), carbohydrate (414+/-16 and 449+/-16 g/day), or fat (136+/-7 and 146+/-8 g/day), respectively. Accuracy of recall was not related to body mass index in that the obese men recalled food intake as accurately as the nonobese men. The energy intake of these men was significantly correlated (r=0.57, P<.05) with their estimated energy requirements. Significant interindividual variation in accuracy of recall was found. CONCLUSIONS: Under controlled conditions, the USDA five-step multiple-pass method can accurately assess intakes of energy, protein, carbohydrate, and fat in a population of men regardless of their body mass index. Researchers and clinical dietitians need to continue to examine factors that influence underreporting and overreporting of food intake by the multiple-pass 24-hour recall method.

Effectiveness of the US Department of Agriculture 5-step multiple-pass method in assessing food intake in obese and nonobese women.

BACKGROUND: National surveys of food intake rely on the 24-h dietary recall method for assessing the nutrient intakes of Americans. OBJECTIVES: This observational validation study was conducted under controlled conditions to test the effectiveness of the US Department of Agriculture (USDA) 5-step multiple-pass method for dietary recall; to test the ability of normal weight, overweight, and obese women to recall food intake; and to test the accuracy of macronutrient recall. DESIGN: Women (n = 49) aged 21-65 y with a body mass index (in kg/m(2)) of 20-45 selected all meals and snacks for 1 d from a wide variety of foods. A 24-h dietary recall with the use of the USDA 5-step multiple-pass method was administered by telephone the following day. Analysis of variance and covariance tested the overall accuracy of recall and the effect of BMI on dietary recall. RESULTS: As a population, the women overestimated their energy and carbohydrate intakes by 8-10%. No significant differences between mean actual and recalled intakes of energy and the macronutrients were observed in the obese women. Normal-weight and overweight women significantly (P < 0.01) overestimated their energy, protein, and carbohydrate intakes. Recalled fat intake was not significantly different from actual intake in women across the BMI range studied. CONCLUSIONS: The USDA 5-step multiple-pass method effectively assessed mean energy intake within 10% of mean actual intake on the previous day. Obese women more accurately recalled food intake than did overweight and normal-weight women despite undereating on the day of the study.