Abstract
Background
Little is known regarding the number of 24-hour recalls required to rank-order children
and adolescents on usual intake for diet–disease studies.
Objective
To determine the within- to between-individual variance ratios and number of 24-hour
recalls required to rank-order individuals on usual intake for select macro- and micronutrients
in a large, multiracial/ethnic sample of children and adolescents.
Design
Cross-sectional survey.
Participants/setting
Children and adolescents ages 6 to 17 years participating in the 2007-2008 and 2009-2010
National Health and Nutrition Examination Survey (NHANES).
Main outcome measures
Variance ratios for predefined sex, age (children age 6 to 11 years, adolescents age
12 to 17 years), and racial/ethnic groups (Mexican American/Hispanic, non-Hispanic
black, and non-Hispanic white).
Statistical analysis
Mixed-effects linear regression models were used to estimate within- and between-individual
variance components for selected nutrients. The number of 24-hour recalls required
to rank-order participants on usual intake (absolute values and energy-adjusted) was
obtained from the nutrient variance ratios for various levels of accuracy.
Results
Variance ratios were more than 1 for all nutrients examined. High values (variance
ratio >3) were observed for protein, saturated and unsaturated fatty acids, cholesterol,
and several micronutrients. Variance ratios for absolute nutrient intakes were similar
for both sexes within age groups, but higher for children than for adolescents. A
total of six to nine and three to six 24-hour recalls were typically sufficient to
rank-order children and adolescents, respectively, on usual intake with an accuracy
of r=0.8. Additional recalls were required to achieve the same accuracy for energy-adjusted
nutrients. Variance ratios were similar for adolescents across racial/ethnic groups,
but highly variable in children.
Conclusions
A total of six to nine 24-hour recalls may represent a reasonable trade-off between
accuracy and participant burden for rank-ordering nutrient intakes in children and
adolescents. Additional research is required to determine whether this may be reduced
using statistical modeling–based approaches and the number of recalls children and
adolescents will reliably complete.
Keywords
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Biography
N. J. Ollberding is an assistant professor, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Biography
J. G. Woo is an associate professor, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Biography
H. J. Kalkwarf is a professor, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Biography
S. C. Couch is a professor, Department of Nutritional Sciences, College of Allied Health, University of Cincinnati, Cincinnati, OH.
Article info
Publication history
Published online: May 10, 2014
Accepted:
March 7,
2014
Footnotes
Supplementary materials: Tables 1, 4, 5, 9, and 10 are available online at www.andjrnl.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT No funding was obtained for the current research.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
