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

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
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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 languageEnglish
Article number53
JournalBMC Nutrition
Volume5
Issue number1
DOIs
Publication statusPublished - 21 Nov 2019
Externally publishedYes

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

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