Comparison of Three Dietary Assessment Methods to Estimate Meat Intake as Part of a Meat Reduction Intervention among Adults in the UK.

Cristina Stewart,Kerstin Frie,Filippo Bianchi,Susan A Jebb

doi:10.3390/nu14030411

Abstract

Food diaries are used to estimate meat intake at an individual level but it is unclear whether simpler methods would provide similar results. This study assessed the agreement between 7 day food diaries in which composite dishes were disaggregated to assess meat content (reference method), and two simpler methods: (1) frequency meal counts from 7 day food diaries; and (2) 7 day dietary recalls, each using standard estimated portion sizes. We compared data from a randomized controlled trial testing a meat reduction intervention. We used Bland-Altman plots to assess the level of agreement between methods at baseline and linear mixed-effects models to compare estimates of intervention effectiveness. At baseline, participants consumed 132 g/d (±75) of total meat; frequency meal counts and dietary recalls underestimated this by an average of 30 and 34 g/day, respectively. This was partially explained by an underestimation of the assumed portion size. The two simpler methods also underestimated the effect of the intervention, relative to control, though the significant effect of the intervention was unchanged. Simpler methods underestimated absolute meat intake but may be suitable for use in studies to measure the change in meat intake in individuals over time.

Highlights

Meat intake, red and processed meat, negatively affects human health, and meat production negatively impacts the environment [1,2]
Dietary data were obtained from 115 participants who took part in RE-MAP (Replacing Meat with Alternative Plant-based Products), an randomized controlled trial (RCT) evaluating the impact of a four-week behavioural intervention to reduce meat consumption [14]
Looking at specific meat types, we found that the average portion sizes attributed to each eating occasion for red and processed meat was 19.7 g lower for dietary recalls and frequency meal counts than food diaries, while that of unprocessed white meat was 21.2 g lower (Supplementary Table S1)

Summary

Introduction

Red and processed meat, negatively affects human health, and meat production negatively impacts the environment [1,2]. Most diet assessments of free-living participants rely on self-reported measures (e.g., food diaries, dietary recalls and food frequency questionnaires (FFQs)), with each method having its own strengths, limitations and level of investigator and participant burden [3,4]. Food diaries, both weighed and un-weighed (estimated), have been the mainstay of dietary assessment for many years, including in the UK National Diet and Nutrition Survey (NDNS) [5], the EPIC Norfolk Study [6], the Avon Longitudinal Study of Parents and Children cohort [7] and the MRC National Survey of Health and Development (1946 British Birth Cohort) [8]. In 2008, the NDNS moved to a 4 day estimated diary to reduce participant burden after previously using 7 day weighed diaries [5]

Methods

Discussion

Conclusion