Abstract
Background
Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) is a self-administered
web-based tool designed to collect detailed dietary data at low cost in observational
studies.
Objective
The objectives of this study were to describe, overall and by demographic groups,
the performance and feasibility of ASA24-2011 recalls and compare Healthy Eating Index-2015
(HEI-2015) total and component scores to 4-day food records (4DFRs) and food frequency
questionnaires (FFQs).
Design
Over 12 months, participants completed up to 6 ASA24 recalls, 2 web-based FFQs, and
2 unweighed paper-and-pencil 4DFRs. Up to 3 attempts were made to obtain each ASA24
recall. Participants were administered doubly-labeled water to provide a measure of
total energy expenditure and collected two 24-hour urine samples to assess concentrations
of nitrogen, sodium, and potassium.
Participants/setting
From January through September 2012, 1,110 adult members of AARP, 50 to 74 years of
age, were recruited from the Pittsburgh, PA, area to participate in the Interactive
Diet and Activity Tracking in AARP (IDATA) study. After excluding 33 participants
who had not completed any dietary assessments, 531 men and 546 women remained.
Main outcome measures
Response rates, nutrient intakes compared to recovery biomarkers across each ASA24
administration day, and HEI-2015 total and component scores were measured.
Statistical analyses performed
Means, medians, standard deviations, interquartile ranges, and HEI-2015 total and
component scores computed using a multivariate measurement error model are presented.
Results
Ninety-one percent of men and 86% of women completed 3 ASA24 recalls. Approximately
three-quarters completed 5 or more, higher than the completion rates for 2 4DFRs and
2 FFQs. Approximately, three-quarters of men and 70% of women completed ASA24 on the
first attempt; 1 in 5 completed it on the second. Completion rates varied slightly
by age and body mass index. Median time to complete ASA24-2011 (current version: ASA24-2020)
declined with subsequent recalls from 55 to 41 minutes in men and from 58 to 42 minutes
in women and was lowest in those younger than 60 years. Mean nutrient intakes were
similar across recalls. For each recording day, energy intakes estimated by ASA24
were lower than energy expenditure. Reported intakes for protein, potassium, and sodium
were closer to recovery biomarkers for women, but not for men. Geometric means of
reported intakes of these nutrients did not systematically vary across ASA24 administrations,
but differences between reported intakes and biomarkers differed by nutrient. Of 100
possible points, HEI-2015 total scores were nearly identical for 4DFRs and ASA24 recalls
and higher for FFQs (men: 61, 60, and 68; women: 64, 64, and 72, respectively).
Conclusions
ASA24, a freely available dietary assessment tool for use in large-scale nutrition
research, was found to be highly feasible. Similar to previously reported data for
nutrient intakes, HEI-2015 total and component scores for ASA24 recalls were comparable
to those for 4DFRs, but not FFQs.
Trial registration
ClinicalTrials.gov identifier: NCT03268577 (http://www.clinicaltrials.gov).
Keywords
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Biography
A. F. Subar is a nutritionist and program director, Division of Cancer Control and Population Sciences, Bethesda, MD.
Biography
F. E. Thompson is an epidemiologist and special volunteer, Division of Cancer Control and Population Sciences, Bethesda, MD.
Biography
K. W. Dodd is mathematical statisticians, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
Biography
D. Midthune is mathematical statisticians, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
Biography
V. Kipnis is mathematical statisticians, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
Biography
H. R. Bowles is an epidemiologist, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
Biography
N. Potischman is director, Population Studies Program, Office of Dietary Supplements, National Institutes of Health, Bethesda, MD.
Biography
D. J. Baer is a research physiologist, US Department of Agriculture, Agricultural Research Service, Beltsville, MD.
Biography
D. A. Schoeller is director, Isotope Ratio Core, Biotech Center and Nutritional Sciences, Universtiy of Wisconsin, Madison.
Biography
S. I. Kirkpatrick is a nutritionist and associate professor, University of Waterloo, Waterloo, Ontario, Canada.
Biography
B. Mittl is a project director, is nutritionists, Westat, Rockville, MD.
Biography
T. P. Zimmerman is nutritionists, Westat, Rockville, MD.
Biography
D. Douglass is nutritionists, Westat, Rockville, MD.
Biography
Y. Park is an epidemiologist and associate professor, Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO.
Article info
Publication history
Published online: August 17, 2020
Accepted:
June 9,
2020
Received:
June 25,
2019
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study and ASA24 development were funded by the NCI via contracts HHSN261201000087I, HHSN26100003, N02-PC-64406 with contributions from the Office of Dietary Supplements, the National Heart, Lung and Blood Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the Office of Behavioral and Social Science Research, the National Institute of Child Health and Human Development, and National Institute on Alcohol Abuse and Alcoholism, and via shared instrumentation grant RR020915 to University of Wisconsin for purchase of the isotope ratio mass spectrometer used in the urine analysis.
The study is registered at ClinicalTrials.gov (https://clinicaltrials.gov), identifier: NCT03268577.
AUTHOR CONTRIBUTIONS A. F Subar, N. Potischman, K. W. Dodd, F. E. Thompson, D. Midthune, V. Kipnis, H. R. Bowles, S. I. Kirkpatrick, and Y. Park designed the study. YP, H. R. Bowles, B. Mittl, T. P. Zimmerman, and D. Douglass conducted the study and collected the data. D. J. Baer and D. A. Schoeller conducted laboratory analyses. A. F Subar, B. Mittl, T. P. Zimmerman, D. Douglass, K. W. Dodd, D. Midthune, V. Kipnis and Y. Park analyzed the data. Y. Park and A. F Subar drafted the paper and had primary responsibility for the final content. All authors participated in data interpretation, provided critical review, and commentary on the draft of the manuscript, and read and approved the final manuscript.
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© 2020 by the Academy of Nutrition and Dietetics.
