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

Linda A. Bush; Jayne Hutchinson; Jozef Hooson; Marisol Warthon-Medina; Neil Hancock; Katharine Greathead; Bethany Knowles; Elisa J. Vargas-Garcia; Lauren E. Gibson; Barrie Margetts; Sian Robinson; Andy Ness; Nisreen A. Alwan; Petra A. Wark; Mark Roe; Paul Finglas; Toni Steer; Polly Page; Laura Johnson; Katharine Roberts; Birdem Amoutzopoulos; Darren C. Greenwood; Janet E. Cade

doi:10.1186/s40795-019-0312-9

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

Linda A. Bush, Jayne Hutchinson, Jozef Hooson, Marisol Warthon-Medina, Neil Hancock, Katharine Greathead, Bethany Knowles, Elisa J. Vargas-Garcia, Lauren E. Gibson, Barrie Margetts, Sian Robinson, Andy Ness, Nisreen A. Alwan, Petra A. Wark, Mark Roe, Paul Finglas, Toni Steer, Polly Page, Laura Johnson, Katharine RobertsBirdem Amoutzopoulos, Darren C. Greenwood, Janet E. Cade

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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.

Original language	English
Article number	53
Journal	BMC Nutrition
Volume	5
Issue number	1
DOIs	https://doi.org/10.1186/s40795-019-0312-9
Publication status	Published - 21 Nov 2019
Externally published	Yes

Bibliographical note

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Funder

UK Medical Research Council [Grant number MR/L02019X/1]

Keywords

Dietary assessment
Macronutrients
Mean difference, limits of agreement
Micronutrients
Validation

ASJC Scopus subject areas

Nutrition and Dietetics
Public Health, Environmental and Occupational Health
Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Bush, L. A., Hutchinson, J., Hooson, J., Warthon-Medina, M., Hancock, N., Greathead, K., Knowles, B., Vargas-Garcia, E. J., Gibson, L. E., Margetts, B., Robinson, S., Ness, A., Alwan, N. A., Wark, P. A., Roe, M., Finglas, P., Steer, T., Page, P., Johnson, L., ... Cade, J. E. (2019). Measuring energy, macro and micronutrient intake in UK children and adolescents: A comparison of validated dietary assessment tools. BMC Nutrition, 5(1), Article 53. https://doi.org/10.1186/s40795-019-0312-9

Bush, LA, Hutchinson, J, Hooson, J, Warthon-Medina, M, Hancock, N, Greathead, K, Knowles, B, Vargas-Garcia, EJ, Gibson, LE, Margetts, B, Robinson, S, Ness, A, Alwan, NA, Wark, PA, Roe, M, Finglas, P, Steer, T, Page, P, Johnson, L, Roberts, K, Amoutzopoulos, B, Greenwood, DC & Cade, JE 2019, 'Measuring energy, macro and micronutrient intake in UK children and adolescents: A comparison of validated dietary assessment tools', BMC Nutrition, vol. 5, no. 1, 53. https://doi.org/10.1186/s40795-019-0312-9

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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.",

keywords = "Dietary assessment, Macronutrients, Mean difference, limits of agreement, Micronutrients, Validation",

author = "Bush, {Linda A.} and Jayne Hutchinson and Jozef Hooson and Marisol Warthon-Medina and Neil Hancock and Katharine Greathead and Bethany Knowles and Vargas-Garcia, {Elisa J.} and Gibson, {Lauren E.} and Barrie Margetts and Sian Robinson and Andy Ness and Alwan, {Nisreen A.} and Wark, {Petra A.} and Mark Roe and Paul Finglas and Toni Steer and Polly Page and Laura Johnson and Katharine Roberts and Birdem Amoutzopoulos and Greenwood, {Darren C.} and Cade, {Janet E.}",

note = "Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.",

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TY - JOUR

T1 - Measuring energy, macro and micronutrient intake in UK children and adolescents

T2 - A comparison of validated dietary assessment tools

AU - Bush, Linda A.

AU - Hutchinson, Jayne

AU - Hooson, Jozef

AU - Warthon-Medina, Marisol

AU - Hancock, Neil

AU - Greathead, Katharine

AU - Knowles, Bethany

AU - Vargas-Garcia, Elisa J.

AU - Gibson, Lauren E.

AU - Margetts, Barrie

AU - Robinson, Sian

AU - Ness, Andy

AU - Alwan, Nisreen A.

AU - Wark, Petra A.

AU - Roe, Mark

AU - Finglas, Paul

AU - Steer, Toni

AU - Page, Polly

AU - Johnson, Laura

AU - Roberts, Katharine

AU - Amoutzopoulos, Birdem

AU - Greenwood, Darren C.

AU - Cade, Janet E.

N1 - Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

PY - 2019/11/21

Y1 - 2019/11/21

N2 - 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.

AB - 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.

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KW - Macronutrients

KW - Mean difference, limits of agreement

KW - Micronutrients

KW - Validation

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

Abstract

Bibliographical note

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Keywords

ASJC Scopus subject areas

UN SDGs

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