Comparison of Multiple-Pass 24-Hour Recall Estimates of Energy Intake With Total Energy Expenditure Determined By the Doubly Labeled Water Method in Young Children

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Abstract

Objective This study determined the accuracy of the multiple-pass 24-hour recall method for estimating energy intake in young children by comparing it with measurements of total energy expenditure made using the doubly labeled water method.

Design Three multiple-pass 24-hour recalls were obtained over a 14-day period to estimate mean energy intake. Total energy expenditure was measured over the same 14-day period under free-living conditions using the doubly labeled water technique.

Subjects/setting Twenty-four children between the ages of 4 and 7 years were tested at the General Clinical Research Center/Sims Obesity Nutrition Research Center at the University of Vermont.

Statistical analysist Tests, paired t tests, Pearson product-moment correlation coefficients, pairwise comparison to show relative bias and limits of agreement, and regression analysis were used to test the relationships among study variables.

Results No difference was found between 3-day mean energy intake and total energy expenditure for the group (t=2.07, P=.65). The correlation between individual measures of energy intake and total energy expenditure was not statistically significant (r=.25, P=.24).

Conclusions Data from 3 days of multiple-pass 24-hour recalls were sufficient to make valid group estimates of energy intake. The method was not precise for individual measurements of energy intake. J Am Diet Assoc. 1996; 96:1140-1144.

Section snippets

Sample

Data from 24 white children (12 boys, 12 girls) between the ages of 4 and 7 years who volunteered for our ongoing studies on energy requirements in young children were used for this study. The children were recruited by newspaper advertisement and word of mouth from Burlington, Vt, and the surrounding rural areas. The study procedures were approved by the Committee on Human Research for the Medical Sciences at the University of Vermont, and written informed consent was obtained from the parents

Results

(Table 1) presents a summary of the physical characteristics of the subjects and their parents. The girls were significantly older (P=.01) and had a higher percent body fat (P=.03) than the boys. There were no significant differences between the boys and girls in any of the other variables listed in (Table 1). The children's mean BMI was slightly higher than the norm for their age group (average BMI for 5-year-old girls=15; average BMI for 5-year-old boys–16) (17).

Mean 3-day energy intake as

Discussion

The use of the doubly labeled water methodology as a reference technique for the validation of energy intake measurement methods depends on the premise of energy balance; that is, energy intake equals energy expenditure when subjects are in energy balance (5). During normal growth and development young children increase their total body mass; thus, they are not in energy balance over extended periods. The average 5-year-old child gains 2.7 kg/year (17). If we assume that 75% of this gain in

Applications

Basiotis et al (18) state that to achieve the desired statistical precision in intake estimates for groups, investigators can either increase the number of days of food intake records for a set number of subjects or increase the number of subjects with a set number of food intake records. In this cohort of 24 children aged 4 to 7 years old, collecting 3 days of multiple-pass 24-hour recalls was sufficient to make a valid group estimate. The multiple-pass 24-hour recall method was more accurate,

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    Copyright © 1996 American Dietetic Association. Published by Elsevier Inc. All rights reserved.