24-Hour Dietary Recall

and
Food Record Method
Chapter 4: Short-term dietary recall and
recording methods by Jelia C Witschi
In Nutritional epidemiology
By WALTER WILLETT

Introduction
24-Hour dietary recall and food record method
Based on foods and amounts actually consumed by a
n individual on one or more specific days

Food frequency questionnaires (FFQ) and diet h

istories
Based on an individuals perceptions of usual intake
over a less precisely defined period of time

Data collection methods for 24-h recall

An in-depth interview conducted by a traine
d dietary interviewer
Intervieweessubjects, parent, caretake
The dietary interviewer solicits detailed info
rmation about everything the subject had to
eat and drink from midnight to midnight of t
he previous day or over the 24-hour period,
either backward or forward
The importance of a skilled interviewer
Dependent on short term memory and coop
eration

 Food preparation methods, recipe ingredient

s, brand name of commercial products, use of
dietary supplements
Interviewer (important factors in obtaining co
mplete and accurate information)
Use open-ended questions
Nonjudgmental manner/a neutral attitude /avoid
asking questions in a manner that might influenc
e the subjects responses
Use key questions and memory aids

 Accurate quantification of amounts of foods

Amount estimation tool
Food containers
Photographs
Geometric shapes
Number

Using computer software

The Minnesoda Nutrition Data System (NDS) /
Currently the most commonly used method for
dietary surveys in the U.S.
DAC designed by Academia Sinica

Face to face, telephone interview

Saving traveling time
Surprise effect

Data collection methods for Food record

Food intake is recorded by the subject (or o
bserver) at the time the foods are eaten to m
inimize reliance on memory
Intensive training for the subjects
The fields worker weighs the raw ingredient
s, as well as the individual portions of the c
ook dishesdetermine individual food inta
kes
Food quantifying tools
Carefully reviewed by a trained nutritionist

Strengths and limitations of the 24-hour

dietary recall and food record methods
Strength (both methods)
Based on actual intake to estimate absolute amo
unt rather than relative amount of nutrients
Open endedhigh level of specificity
Interviews should be sensitive to cultural differ
ence

Limitation (both method)

Day to day variation

 Strength (recall vs. food record)

Recall does not need literacy
Recall is less likely to alter eating behavior
Relatively minimal respondent burden

Limitation (recall vs. food record)

Reliance on memory
The need for a highly trained interviewer

Limitation (food record)

High level of subject motivation

Number of days and which days

For group means
Single day

For the distribution of individual intake within the

group, or relationship between individual intake a
nd other variables
More than one day
The number of days is dependent on the studied nutrien
t

Work days vs. Weekend days

Combination of days of the week and not consecutive d
ays

Estimate of long term intake

Seasonal effect

For micronutrients such as vitamin A, C

Food frequency questionnaire

Reducing error in data collection

Factors affecting data from dietary recall : A
ge, gender, intelligence, mood, attention, co
nsistency of eating pattern
Comparison of mean energy intake (Recall
vs. food record) Table 4-1

Reducing error from dietary recall

1. Considerable training and practice of the intervie
wers.
2. Providing a relaxed and unhurried atmosphere fo
r the subject.
3. Asking about the previous days activities to help
jog the subjects memory
4. Providing a list of foods
5. To use an automated system for collecting the dat
a in which the computer provides all of the prom
pts for describing foods at the appropriate level o
f detail.

-Back-

Reducing error from food record

1. Subjects motivation
2. Careful training of subjects in methods of keeping
accurate records
3. Emphasizing the importance of the subjects contri
bution to the research
4. Stressing the need for timely recording of food int
ake
5. Encouraging subjects to maintain usual eating hab
its during the recording period (They may changer
for ease of recording, social desirability).
6. Providing written examples
7. To review the food records by trained nutritionist
ASAP.

Reducing error from both methods

1. Between meals snacks
2. Eating-out details
3. Quantification of portion sizes:
Food weighing devices, photographs or food mod
els of more than one portion size, models of geo
metric shapes, training of subjects in the use of f
ood models (Table 4-2),
4. For telephone interview, tools (ex: ruler, standard
measuring cups or spoons, or a notebook of phot
ographs of different portion sizes for selected fo
ods) can be provided to each subjects to keep at
home.

5. Improvement of tools: two-dimensional vis

uals portraying various sizes of geometric
shapes, mounds, and beverage containers t
o facilitate amount estimation.
6. Inducing motivation:
a. convincing participants the importance of
the research and the critical role they play
b. Monetary or other types of incentives

-Back-

Analysis of food intake data

At individual level, by food group, by meal
pattern (the investigation of the effects of fo
ods when eating together)
Calculation of nutrient intakes (database of
food composition)
The degree of specificity of food descriptio
n detail required at the data collection level
forcoding and nutrient calculation.

Sources of error in nutrient calculation

Inaccuracies in the coding of food intake da
ta
data entry check of the computer system, intens
ive training and certification of coders/intervie
wer, 10% or 20% duplicate coding.

Accuracy and representativeness of the nutr

ient values in food composition databases.
The use of outdated nutrient data
Analytical methodology

Validation of 24-hour recalls and

food records
Reporting accuracy
Accuracy of nutrient calculations
Accuracy of assessing usual intake
how well the selected days of intake represent u
sual individual intake

Reporting accuracy
1. Omissions of food items are more common than
additions

Side dishes or add-ons (Figure4-1)

2. Overestimation appears to be more frequent than u

nderestimation for portion sizes (Table 4-4).

Beverages: best estimation

Add-ons: poorest estimation

3. The under-reporting of energy intake observed in v

alidation studies of records and recalls is more likel
y due to omissions in reporting foods than to under
estimate of portion sizes
4. The greatest difficulty in estimating amounts was a
ssociated with items that could not be separately vi
sualized.

5. Overall, recalls tend to underestimate intake b

y about 10% compared with observed intake
(vary considerably among individuals).
6. Flat slope syndrome:
Over-estimaton of portion sizes tended to be g
reater among those who ate smaller portions a
nd under-estimation among those who ate larg
er portions.

-Back-

-Back-

Accuracy of nutrient calculations

1. (Table 4-5) Calculated values tend to be hi
gher or lower than the analyzed values
Nutrient dependent

Accuracy of assessing usual intake

1. The use of biochemical indicator for validation
(Ch 9)
2. Under-reporting /underestimation

Obesity, athlete, education, motivation, age (adolesce

nt, elderly)
Nutrient intakes expressed as a percentage of total en
ergy intake have not been found to be biased, even w
hen energy intake itself was under-reported

3. Reproducibility

Day-to-day variation, seasonal difference

Reproducible at the group level
Reproducible when averaging of multiple days of inta
ke at the individual level

 There are limitations and potential sources o

f error for dietary recalls and food records.
Be careful when using these methods to vali
date food-frequency questionnaires or diet h
istories designed for estimating long term us
ual dietary intake (CH 6).

-Back-

Summary
Foods records and 24-hour recalls
1. Consist of specific foods consumed by an individu
al on one or more days
2. Greater specificity for describing foods and food p
reparation methods, greater flexibility for analyzin
g the data
3. Seldom used as the primary method for estimating
usual intake in large scale epidemiologic research
4. Important in describing mean values for groups an
d in validating food frequency questionnaires (mo
st commonly used method)