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XNB151 Week 3 Measuring dietary intake
Food and
 Food        Food        Physical    Nutritional
Supply   purchasing &     Activity    Status
          acquisition   Behaviours
XNB151 Week 3 Measuring dietary intake
Food intake data

Prospective (current)
  •Food diaries
      • Household measures or weighed
  •Chemical analysis
      •Duplicate meals




 Retrospective (past)
 • Actual
     • 24-hour recall
     • Food Frequency Questionnaires
 • Usual
     • Dietary Histories
Food Diaries
 Using     household measures
     Set time period for recording (minimum 3 days)
     Record all food consumed & drink over there days in
      diary
     Include a non-working day
 Using     weights
     Similar recording to above but use a set procedure for
      weighing using scales & measuring utensils


   What are the advantages?
   What are the limitations?

                                    Musicians Daily Diet
                                    Credit: PETER MENZEL/SCIENCE PHOTO LIBRARY
Page from a food diary example




            http://www.srl.cam.ac.uk/epic/images/7dfd.jpg
Chemical analysis (duplicate
meals)
           Collection of an identical
            meal/food from client for
            analysis
               useful for analysing food
               composition

             Limitations
               expensive & time consuming
               impractical outside confined
               setting
24-hour recall (current
                intake)
   Ask individual to remember what food &
    drinks they have consumed in previous
    24 hours or day
     usually performed by trained interviewer


 What are the advantages?
 What are the limitations?




                                      Tea farmers daily diet, Kenya
24-hr Recall example




           http://www.srl.cam.ac.uk/epic/images/7dfd.jpg
Food frequency questionnaire
             (current intake)

 Qualitative      & semi-quantitative survey of:
     how often foods are eaten +/- how much
     usually self administered, can be interview
     general or specific FFQ


 What are the advantages?
 What are the limitations?
Diet history
    Assess typical intake
                                    Bakers Daily Diet, Iran
         Original Adaptation - 3 components

1.   a usual 24-hour recall
        usual takes away atypical errors
        food amounts enhanced by using food models

2.   a checklist

3.   a short (3 days) diary
Construction Workers
Diet History                  Daily Diet, USA



 An investigation of habitual intake over a
specified period of time – usually 1 mo to 1 yr
 24 hour recall + variations
 Details on types (e.g. low fat), quantities, brands)
 Indicates patterns of eating
 Able to estimate energy, macro & micro nutrients
 Able to estimate food groups
 Can be targeted to particular nutrients e.g.
  carbohydrate in diabetes
 Administered by a trained health professional
Diet History Example
Limitations of food intake data – diet history

   honesty, memory & frankness of client
   need highly skilled interviewer
   expensive & time consuming
   may underestimate intake


  Most useful information for
  assessment
Photographic dietary records
 Relatively novel method of assessing intake.
 Require the individual to photograph food before eating
  (prospective method). Any food left over is also
  photographed. A reference object (e.g. card, coin) is often
  included in the photograph. Additional information to
  indentify items (i.e. description) is often necessary.
 Analysis of records can be either manual (by dietitian or
  other trained person) or automatic using image analysis
  software. Manual analysis should include the use of aids
  to reduce portion size estimation error.
 Stand-alone camera or mobile phone with camera
  function can be used.



Megan Rollo, QUT PhD Student
Example: recording intake using
                 Nutricam


     1. Mobile phone with Nutricam software.

                                                           2. Capturing an image of items for consumption.




 “At home...
black coffee,
one sugar...
   orange
   juice…
 cornflakes,
 reduced fat
    milk.”



                                                          4. Image and voice file sent to website for analysis.
   3. Describing items in image (recording voice file).


   Megan Rollo, QUT PhD Student
XNB151 Week 3 Measuring dietary intake
How do we investigate food
         intakes over time?
Reliable trends in food intake over time can only be
 established from data collected using the same
     survey design & food intake methodology.

  Can achieve this via the aid of national dietary
  surveys (of intakes)– to provide information on
           average intake of population



 1995 National Nutrition       National Health
        Survey                     Survey
2007 Australian National Children's
Nutrition & Physical Activity Survey
  More than 4000 children across Australia
 Collected data on food and nutrient
   intake, physical activity levels and
   physical measurements (height, weight
   and waist measurements) of children
   aged 2-16 years.
 24-hr recall + follow-up survey
 Purpose: “to provide the information
   needed for public and private sectors to
   work together to develop targeted
   strategies to address a range of health
   concerns in children”
http://www.health.gov.au/internet/main/publis
   hing.nsf/Content/health-pubhlth-strateg-
   food-monitoring.htm
2011/13 Australian Health Survey
   Australian Bureau of Statistics and Department
    of Ageing
   Expands upon previous surveys
   Involves ~ 50,000 adults and children across
    Australia.
   Will be conducted in homes
   Topics include demographics, risk
    factors, health status, medications, chronic
    diseases, use of health services, and nutrition
    and physical activity habits.
   Voluntary blood and urine sample
Purpose of Dietary
                     Surveys
Provide information on:
      Likely impact of changes to food regulation
      Levels of additives & contaminants in the food supply
      Proportion of population complying with recommendations
      Need for targeted population level interventions
      Need for, & impact of, fortification of foods

Australian Health Survey 2011/13 Objectives
 assess the level and distribution of the health of populations
 measure the level, distribution and influence of health
  determinants
 quantify the inputs to the health system
 monitor and appraise health interventions
 increase knowledge through research and statistics
 evaluate the performance of the health system
 understand the interrelationships of all the above.
References Cont
   Commonwealth Scientific Industrial Research
    Organisation (CSIRO ) Preventative Health National
    Research Flagship, and the University of South Australia,
    2007 Australian National Children’s Nutrition and
    Physical Activity Survey Main Findings, Commonwealth
    of Australia, Canberra.

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XNB151 Week 3 Measuring dietary intake

  • 2. Food and Food Food Physical Nutritional Supply purchasing & Activity Status acquisition Behaviours
  • 4. Food intake data Prospective (current) •Food diaries • Household measures or weighed •Chemical analysis •Duplicate meals Retrospective (past) • Actual • 24-hour recall • Food Frequency Questionnaires • Usual • Dietary Histories
  • 5. Food Diaries  Using household measures  Set time period for recording (minimum 3 days)  Record all food consumed & drink over there days in diary  Include a non-working day  Using weights  Similar recording to above but use a set procedure for weighing using scales & measuring utensils  What are the advantages?  What are the limitations? Musicians Daily Diet Credit: PETER MENZEL/SCIENCE PHOTO LIBRARY
  • 6. Page from a food diary example http://www.srl.cam.ac.uk/epic/images/7dfd.jpg
  • 7. Chemical analysis (duplicate meals)  Collection of an identical meal/food from client for analysis  useful for analysing food composition  Limitations  expensive & time consuming  impractical outside confined setting
  • 8. 24-hour recall (current intake)  Ask individual to remember what food & drinks they have consumed in previous 24 hours or day  usually performed by trained interviewer  What are the advantages?  What are the limitations? Tea farmers daily diet, Kenya
  • 9. 24-hr Recall example http://www.srl.cam.ac.uk/epic/images/7dfd.jpg
  • 10. Food frequency questionnaire (current intake)  Qualitative & semi-quantitative survey of:  how often foods are eaten +/- how much  usually self administered, can be interview  general or specific FFQ  What are the advantages?  What are the limitations?
  • 11. Diet history  Assess typical intake Bakers Daily Diet, Iran Original Adaptation - 3 components 1. a usual 24-hour recall  usual takes away atypical errors  food amounts enhanced by using food models 2. a checklist 3. a short (3 days) diary
  • 12. Construction Workers Diet History Daily Diet, USA  An investigation of habitual intake over a specified period of time – usually 1 mo to 1 yr  24 hour recall + variations  Details on types (e.g. low fat), quantities, brands)  Indicates patterns of eating  Able to estimate energy, macro & micro nutrients  Able to estimate food groups  Can be targeted to particular nutrients e.g. carbohydrate in diabetes  Administered by a trained health professional
  • 14. Limitations of food intake data – diet history  honesty, memory & frankness of client  need highly skilled interviewer  expensive & time consuming  may underestimate intake Most useful information for assessment
  • 15. Photographic dietary records  Relatively novel method of assessing intake.  Require the individual to photograph food before eating (prospective method). Any food left over is also photographed. A reference object (e.g. card, coin) is often included in the photograph. Additional information to indentify items (i.e. description) is often necessary.  Analysis of records can be either manual (by dietitian or other trained person) or automatic using image analysis software. Manual analysis should include the use of aids to reduce portion size estimation error.  Stand-alone camera or mobile phone with camera function can be used. Megan Rollo, QUT PhD Student
  • 16. Example: recording intake using Nutricam 1. Mobile phone with Nutricam software. 2. Capturing an image of items for consumption. “At home... black coffee, one sugar... orange juice… cornflakes, reduced fat milk.” 4. Image and voice file sent to website for analysis. 3. Describing items in image (recording voice file). Megan Rollo, QUT PhD Student
  • 18. How do we investigate food intakes over time? Reliable trends in food intake over time can only be established from data collected using the same survey design & food intake methodology. Can achieve this via the aid of national dietary surveys (of intakes)– to provide information on average intake of population 1995 National Nutrition National Health Survey Survey
  • 19. 2007 Australian National Children's Nutrition & Physical Activity Survey  More than 4000 children across Australia  Collected data on food and nutrient intake, physical activity levels and physical measurements (height, weight and waist measurements) of children aged 2-16 years.  24-hr recall + follow-up survey  Purpose: “to provide the information needed for public and private sectors to work together to develop targeted strategies to address a range of health concerns in children” http://www.health.gov.au/internet/main/publis hing.nsf/Content/health-pubhlth-strateg- food-monitoring.htm
  • 20. 2011/13 Australian Health Survey  Australian Bureau of Statistics and Department of Ageing  Expands upon previous surveys  Involves ~ 50,000 adults and children across Australia.  Will be conducted in homes  Topics include demographics, risk factors, health status, medications, chronic diseases, use of health services, and nutrition and physical activity habits.  Voluntary blood and urine sample
  • 21. Purpose of Dietary Surveys Provide information on:  Likely impact of changes to food regulation  Levels of additives & contaminants in the food supply  Proportion of population complying with recommendations  Need for targeted population level interventions  Need for, & impact of, fortification of foods Australian Health Survey 2011/13 Objectives  assess the level and distribution of the health of populations  measure the level, distribution and influence of health determinants  quantify the inputs to the health system  monitor and appraise health interventions  increase knowledge through research and statistics  evaluate the performance of the health system  understand the interrelationships of all the above.
  • 22. References Cont  Commonwealth Scientific Industrial Research Organisation (CSIRO ) Preventative Health National Research Flagship, and the University of South Australia, 2007 Australian National Children’s Nutrition and Physical Activity Survey Main Findings, Commonwealth of Australia, Canberra.

Notes de l'éditeur

  1. Last week we we discussed how we assess or monitor the food supply, using food balance sheets to assess food available for use and consumption, as well as food purchasing and acquisition data. This week we will investigate how we measure actual food intake and consumption.
  2. So how do we measure the diets of individuals?Measuring food intake is one of the most difficult tasks undertaken by health professionals for several reasons. Food supply is extremely variedIndividuals eat widely varying amounts and combinations from day to dayVariations exist in recipes and nutrient content of different versions of the same foodTask of recording foods in detail is time consuming and requires a lot of co-operation from respondents
  3. There are two overarching categories under which dietary data collection methods fall, prospective and retrospective. Prospective methods investigate current intakes, so they essentially look at the ‘here and now’. These strategies include food diaries or journals, duplicate meals, and novel approaches such as photographic dietary records.Retrospective methods investigate previous, or past, dietary intakes. Retrospective diet methodologies may include 24-hour recalls (in which people are asked what they ate or drank in the last 24 hours), food frequency questionnaires, and ‘diet histories’ which may include a variety of data collection methods and aim to ascertain what people ‘usually’ eat.
  4. Diet histories are most commonly used in clinical dietetic practice. There are multiple variations of the ‘diet history’. Undertaking a typical diet history traditionally involves a ‘usual’ 24-recall, in which participants reported on the previous days intake and whether this represents their typical diet, a checklist to jog the clients memory, and further validation through the inclusion of a 3 day food diary.
  5. The national health survey is a 3 yearly survey of approximately 26,000 participants, and assesses a wide range of health conditions, as well as a small number of dietary intakes via short-answer questions. These include ‘how many servings of fruits or vegetables do you consume per day’ and ‘what type of milk do you usually consume’ which is used as a proxy measure for fat.The NNS 1995 was a more detailed investigation of diet undertaken among 13 858 Australians > 2 years of age who participated in the NHSConducted using 24hr recalls in the homeThis method allowed a large number of people to be included The decision was made to use this method to allow comparison with other studies (1983 & 1986 NNS(Most recent National Nutrition Survey to date