The Assessment and Monitoring of Dietary Intake

Friday, July 15, 2011: 8:30 AM

Leigh Small, PhD, RN, CPNP-PC, FNAP
Center for Improving Health Outcomes for Children, Teens, and Families, Arizona State University, Phoenix, AZ

Intervention researchers and clinical practitioners interested in weight reduction/maintenance continue to search for a method to quantify the dietary intake of children. Currently available methods include: a) direct observation with weighed food records, b) 24-hour dietary recall, c) in-depth diet histories, d) food frequency questionnaires, e) biomarker measurements of targeted nutrients, and f) estimated food records. Key qualities of such dietary measures include accuracy, ease of use, and low participant/patient burden.

The purpose of this presentation is to delineate the process of the photographic diet diary which can be used with preschool children, outline the data obtained with this diet assessment method, discuss recent concurrent reliability findings, and present research and clinical applications of this assessment tool.

The photographic diet diary, has been used since 1983 with increasing success and its use is now supported with psychometric data. Most recently, concurrent validity was established with the Block Food Frequency (BFF) Questionnaire. In this study, 33 parents of preschool children, 4-5 years, were asked to complete a 48 hour Photographic Diet Diary and the BFF Questionnaire for preschoolers. Strong correlations were found between the actual (gms/day) macronutrients (e.g., protein, carbohydrates, fats, and saturated fats). A noteworthy finding was the correlations were strongest between the BFF macronutrient values and the macronutrient values of the food that was served to the children rather than the BFF macronutrient values and the actual macronutrient eaten by the children.

These findings support the convergent validity of the photographic diet diary for preschool children. The in-depth comparisons suggest that the BFF may be more reflective of a parent’s recollection of the food that they served to their young child more so than the actual dietary intake of the child. Therefore, it may be that a photographic diet diary is better assessment of a child’s true dietary intake.