The Accuracy of Portion Size Reporting on Self-Administered Online 24-Hour Dietary Recalls Among Women With Low Incomes

Published:April 04, 2022DOI:



      Accurately estimating portion sizes remains a challenge in dietary assessment. Digital images used in online 24-hour dietary recalls may be conducive to accuracy.


      The current analyses were conducted to examine the accuracy of portion size estimation by women with low incomes who completed 24-hour dietary recalls using the online Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24) in the Food and Eating Assessment Study II.


      True dietary intake was observed for 3 meals on 1 day through a controlled feeding study conducted from May through July 2016. The following day, participants completed an unannounced 24-hour dietary recall using ASA24, independently or with assistance in a small-group setting.


      Participants included 302 women aged 18 to 82 years living in the Washington, DC, area who met the income thresholds for the Supplemental Nutrition Assistance Program.

      Main outcome measures

      The accuracy of portion size estimation was assessed by comparing the weight truly consumed (observed) and the weight reported for predetermined categories of foods and beverages.

      Statistical analyses performed

      The differences between observed and reported portions were examined and linear regression tested differences by recall condition. Analyses were conducted by condition and repeated with stratification by racial/ethnic identity, education, and body mass index.


      On average across foods and beverages, reported portion sizes were 7.4 g (95% CI, 4.3-10.5) and 6.4 g (95% CI, 2.8-10.0) higher than observed portion sizes in the independent and assisted conditions, respectively. Portion sizes were overestimated for small pieces and shaped foods in both conditions, as well as for amorphous/soft foods in the assisted condition and underestimated for single-unit foods in both conditions. Misestimation was fairly consistent by participants’ race/ethnicity, education, and body mass index, to varying magnitudes.


      Women with low incomes overestimated the amounts of foods and beverages consumed across several categories using online 24-hour dietary recalls with digital images to support portion size estimation. Assistance with ASA24 had little impact on accuracy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Beaton G.H.
        • Burema J.
        • Ritenbaugh C.
        Errors in the interpretation of dietary assessments.
        Am J Clin Nutr. 1997; 65: 1100S-1107S
        • Kipnis V.
        • Subar A.F.
        • Midthune D.
        • et al.
        Structure of dietary measurement error: Results of the OPEN biomarker study.
        Am J Epidemiol. 2003; 158: 14-16
        • Prentice R.L.
        • Mossavar-Rahmani Y.
        • Huang Y.
        • et al.
        Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers.
        Am J Epidemiol. 2011; 174: 591-603
        • Gibson R.S.
        • Charrondiere U.R.
        • Bell W.
        Measurement errors in dietary assessment using self-reported 24-hour recalls in low-income countries and strategies for their prevention.
        Adv Nutr. 2017; 8: 980-991
        • Freedman L.S.
        • Commins J.M.
        • Moler J.E.
        • et al.
        Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake.
        Am J Epidemiol. 2014; 180: 172-188
        • Freedman L.S.
        • Commins J.M.
        • Moler J.E.
        • et al.
        Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for potassium and sodium intake.
        Am J Epidemiol. 2015; 181: 473-487
        • Baranowski T.
        • Islam N.
        • Douglass D.
        • et al.
        Food Intake Recording Software System, version 4 (FIRSSt4): A self-completed 24-h dietary recall for children.
        J Hum Nutr Diet. 2014; 27: 66-71
        • Subar A.F.
        • Kirkpatrick S.I.
        • Mittl B.
        • et al.
        The Automated Self-Administered 24-hour dietary recall (ASA24): A resource for researchers, clinicians, and educators from the National Cancer Institute.
        J Acad Nutr Diet. 2012; 112: 1134-1137
        • Carter M.C.
        • Albar S.A.
        • Morris M.A.
        • et al.
        Development of a UK online 24-h dietary assessment tool: myfood24.
        Nutrients. 2015; 7: 4016-4032
        • Jacques S.
        • Lemieux S.
        • Lamarche B.
        • et al.
        Development of a web-based 24-h dietary recall for a French-Canadian population.
        Nutrients. 2016; 8: 724
        • Simpson E.
        • Bradley J.
        • Poliakov I.
        • et al.
        Iterative development of an online dietary recall tool: INTAKE24.
        Nutrients. 2017; 9: 118
        • Islam N.G.
        • Dadabhoy H.
        • Gillum A.
        • et al.
        Digital food photography: Dietary surveillance and beyond.
        Proc Food Sci. 2013; 2: 122-128
        • Cypel Y.S.
        • Guenther P.M.
        • Petot G.J.
        Validity of portion-size measurement aids: A review.
        J Am Diet Assoc. 1997; 97: 289-292
        • Subar A.F.
        • Crafts J.
        • Zimmerman T.P.
        • et al.
        Assessment of the accuracy of portion size reports using computer-based food photographs aids in the development of an automated self-administered 24-hour recall.
        J Am Diet Assoc. 2010; 110: 55-64
        • Nelson M.
        • Atkinson M.
        • Darbyshire S.
        Food photography I: The perception of food portion size from photographs.
        Br J Nutr. 1994; 72: 649-663
        • Amoutzopoulos B.
        • Page P.
        • Roberts C.
        • et al.
        Portion size estimation in dietary assessment: A systematic review of existing tools, their strengths and limitations.
        Nutr Rev. 2020; 78: 885-900
        • Hernández T.
        • Wilder L.
        • Kuehn D.
        • et al.
        Portion size estimation and expectation of accuracy.
        J Food Compost Anal. 2006; 19: S14-S21
        • Robson P.J.
        • Livingstone M.B.
        An evaluation of food photographs as a tool for quantifying food and nutrient intakes.
        Public Health Nutr. 2000; 3: 183-192
        • Salvesen L.
        • Engeset D.
        • Øverby N.C.
        • Medin A.C.
        Development and evaluation of image-series for portion size estimation in dietary assessment among adults.
        J Nutr Sci. 2021; 10: e3
        • Almiron-Roig E.
        • Aitken A.
        • Galloway C.
        • Ellahi B.
        Dietary assessment in minority ethnic groups: A systematic review of instruments for portion-size estimation in the United Kingdom.
        Nutr Rev. 2017; 75: 188-213
        • Kirkpatrick S.I.
        • Potischman N.
        • Dodd K.W.
        • et al.
        The use of digital images in 24-hour recalls may lead to less misestimation of portion size compared with traditional interviewer-administered recalls.
        J Nutr. 2016; 146: 2567-2573
        • Kirkpatrick S.I.
        • Baranowski T.
        • Subar A.F.
        • Tooze J.A.
        • Frongillo E.A.
        Best practices for conducting and interpreting studies to validate self-report dietary assessment methods.
        J Acad Nutr Diet. 2019; 119: 1801-1816
        • Blanton C.A.
        • Moshfegh A.J.
        • Baer D.J.
        • Kretsch M.J.
        The USDA Automated Multiple-Pass Method accurately estimates group total energy and nutrient intake.
        J Nutr. 2006; 136: 2594-2599
        • Timon C.M.
        • Cooper S.E.
        • Barker M.E.
        • et al.
        A comparison of food portion size estimation by older adults, young adults and nutritionists.
        J Nutr Health Aging. 2018; 22: 230-236
        • Kirkpatrick S.I.
        • Guenther P.M.
        • Douglass D.
        • et al.
        The provision of assistance does not substantially impact the accuracy of 24-hour dietary recalls completed using the automated self-administered 24-h Dietary Assessment Tool among women with low incomes.
        J Nutr. 2019; 149: 114-122
        • United States Department of Agriculture
        Assistance for people of all ages.
        • Kirkpatrick S.I.
        • Subar A.F.
        • Douglass D.
        • et al.
        Performance of the automated self-administered 24-hour recall relative to a measure of true intakes and to an interviewer-administered 24-h recall.
        Am Jour Clin Nutr. 2014; 100: 233-240
        • Kretsch M.J.
        • Fong A.K.
        Validation of a new computerized technique for quantitating individual dietary intake: The Nutrition Evaluation Scale System (NESSy) vs the weighed food record.
        Am J Clin Nutr. 1990; 51: 477-484
        • United States Department of Agriculture
        The Expanded Food and Nutrition Education Program Policies.
        (Published 2015)
        • Centers for Disease Control and Prevention
        Behavioral risk factor surveillance system.
        (Published 2014)
        Date accessed: July 22, 2021
        • Centers for Disease Control and Prevention
        Body mass index (BMI).
        (Published 2021)
      1. Version 9.4. SAS Institute, 2013
        • United States Department of Agriculture
        Special Supplemental Nutrition Program for Women, Infants, and Children.
        Date accessed: July 22, 2021
        • Korn E.L.
        • Graubard B.I.
        Analysis of Health Surveys.
        John Wiley & Sons, 2011
        • Kirkpatrick S.I.
        • Gilsing A.M.
        • Hobin E.
        • et al.
        Lessons from studies to evaluate an online 24-hour recall for use with children and adults in Canada.
        Nutrients. 2017; 9: 100


      S. I. Kirkpatrick is an associate professor, School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.


      P. M. Guenther is a research professor, Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City.


      C. Durward is an associate professor, Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan.


      D. Douglass is a research nutritionist, Westat, Rockville, MD.


      T. P. Zimmerman is a research nutritionist, Westat, Rockville, MD.


      L. L. Kahle is a programmer, Information Management Services, Inc, Rockville, MD.


      A. T. Atoloye is a postdoctoral research associate, Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford.


      M. L. Marcinow is a research associate, Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.


      M. R. Savoie-Roskos is an associate professor, Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan.


      K. A. Herrick is a program director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.


      K. W. Dodd is a mathematical statistician, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.