Abstract
Traditional dietary assessment methods, used in the UK, such as weighed food diaries impose a large participant burden, often resulting in difficulty recruiting representative samples and underreporting of energy intakes. One approach to reducing the burden placed on the participant is to use portion size assessment tools to obtain an estimate of the amount of food consumed, removing the need to weigh all foods. An age range specific food atlas was developed for use in assessing children’s dietary intakes. The foods selected and portion sizes depicted were derived from intakes recorded during the UK National Diet and Nutrition Surveys of children aged 1.5 to 16 years. Estimates of food portion sizes using the food atlas were compared against 4-day weighed intakes along with in-school / nursery observations, by the research team. Interviews were conducted with parents the day after completion of the diary, and for children aged 4 to 16 years, also with the child. Mean estimates of portion size consumed were within 7% of the weight of food recorded in the weighed food diary. The limits of agreement were wide indicating high variability of estimates at the individual level but the precision increased with increasing age. For children 11 years and over, agreement with weighed food diaries, was as good as that of their parents in terms of total weight of food consumed and of intake of energy and key nutrients. The age appropriate food photographs offer an alternative to weighed intakes for dietary assessment with children.
Highlights
Accurate information on the dietary intake of children is essential to inform nutrition related health policies and evaluate interventions
This paper describes the further development of the age appropriate photographs and testing in a real life-setting, during a nutritionist administered interview following the completion of a 4-day weighed food diary
The original food photographs used in the pilot study were supplemented by additional images in order to cover the top 100 foods based on frequency of consumption, weight of food consumed and contribution to energy intake of foods consumed by children in the National Diet and Nutrition Surveys (NDNS) of children aged 1.5–4.5 years, and young people aged 4–18 years
Summary
Accurate information on the dietary intake of children is essential to inform nutrition related health policies and evaluate interventions. Obtaining information on food intake presents many challenges. There tends to be a trade-off between the accuracy of a method and the burden it places on the study participant. More accurate methods such as duplicate diet and PLOS ONE | DOI:10.1371/journal.pone.0169084. Development of the Young Person’s Food Atlas for Health Research, Research Professorship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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