Dietary assessment in children using electronic methods: telephones and tape recorders.

Selection of dietary assessment methodology is important in dietary intervention studies. Few studies have reported the relative merits of various assessment methods or the feasibility of electronic methods in pediatric populations. Parent-child dyads performed telephone recalls (no. = 32) and tape recorded dietary records (no. = 33). Traditional recalls were first conducted to familiarize parents and children with the telephone recall procedure, to introduce two-dimensional food models, and to instruct on the use of the tape recorder. Parents monitored and documented as unobtrusively as possible the child's intake on the day before the telephone recall and also on the day of the taped record. Children were called at random to reduce bias. Simple correlation coefficients (r) were calculated for nine nutrients and calories for both methods. For telephone recalls, values ranged from a low of r = .64 for saturated and polyunsaturated fat to r = .85 for cholesterol and r = .93 for iron. Tape-recorded data yielded r = .80 or above, except calories with r = .68 (p less than .001 for all values, 1-tail tests). Mean nutrient values were within expected ranges, e.g., 1,800 kcal +/- 500, with saturated fat about 14% of calories per day. Comparisons between parents and childrens reports of food frequencies and portion sizes revealed the best correlations for beverages, bread-cereals-crackers, meat-fish-poultry, and mixed dishes. We conclude that preadolescent children are able to provide dietary intake data using electronic methods in a manner that compares favorably with their parents' written records.

Freedom from fat: a contemporary multi-component weight loss program for the general population of obese adults.

This report summarizes results for the first 2,037 participants in the Freedom from Fat (FFF) weight loss program. FFF combined nutrition education, a low-fat dietary pattern, exercise, behavioral self-management, and social support in a program designed to serve the general population of overweight and obese adults. Participants ranged in age from 18 to 84 and from ideal weight to massively obese. After enrolling, program participants attended professionally led weekly meetings as long as they wished. Participants were encouraged to keep daily food diaries, to reduce the proportion of calories from fat to 30% or less, to exercise at moderate intensity for 30 minutes a day 5 days a week, to keep graphic records of weight change and exercise, and to display their graphs at each weekly group meeting. Attrition rates were comparatively low for a large-scale program, with half of the participants still active in the fifth month and 22% still active after 1 year. Mean weight loss for obese participants (BMI 30 or greater) at 6 months was 7.3 kg (16.2 lb) for men and 5.3 kg (11.6 lb) for women. The best predictors of weight loss at 6 months were number of days per week in which food diaries were kept, baseline body mass index, number of minutes of exercise per week, and age.

Validity and usefulness of medical chart weights in the long-term evaluation of weight loss programs.

The high rate of delayed recidivism seen in behavioral weight loss studies makes follow-up over a number of years essential. Unfortunately, these data are both expensive and difficult to collect. This report examines the validity of body weights routinely recorded in medical charts and their usefulness in the long-term evaluation of weight control programs. Comparison of 123 pairs of chart weights and research clinic weights recorded within 30 days of each other showed a mean difference of .06 lb (.03 kg) and a standard deviation of 2.38 lb (1.08 kg). This measurement error is considerably less than that seen in self-reported weights of obese adults. The accuracy, economy and relative ease of collection make the use of medical chart weights well suited for long-term evaluations of weight loss studies and other research purposes.