ns 210 – unit 3 seminar measuring diets and interview techniques jennifer neily, ms, rd, cssd, ld...
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NS 210 – Unit 3 Seminar
Measuring Diets and Interview Techniques
Jennifer Neily, MS, RD, CSSD, LDRegistered/Licensed DietitianKaplan University
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Reasons for Measuring Diet
• “TO IMPROVE HUMAN HEALTH”
• 4 Major Uses Of Dietary Intake Data– Assessing and monitoring
intake– Formulating and evaluating
government and agricultural policy
– Epidemiologic research– Commercial purposes
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Assessing and Monitoring Food and Nutrient Intake• Ensuring adequacy of the food
supply
• Estimating the adequacy of dietary intakes of individuals and groups
• Monitoring trends in food and nutrient consumption
• Estimating exposure to food additives and contaminants
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Figure 1
Source: Journal of the American Dietetic Association 2010; 110:1638-1645 (DOI:10.1016/j.jada.2010.08.018 )
Copyright © 2010 American Dietetic
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Figure 3
Source: Journal of the American Dietetic Association 2010; 110:1638-1645 (DOI:10.1016/j.jada.2010.08.018 )
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Formulating and Evaluating Government Health & Agricultural Policy
• Planning food production and distribution
• Establishing food production and distribution
• Establishing programs for nutrition education and disease risk reduction
• Evaluating the success and cost-effectiveness of nutrition education and disease risk reduction programs
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Conducting Epidemiologic Research
• Studying the relationships between diet and health
• Identifying groups at risk of developing diseases because of their diet and/or nutrient intake
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Commercial Purposes
• Data from national nutrition surveys are used by the food manufacturers to develop advertising campaigns or new food products
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Measuring Diet
• Most widely used indirect indicator of nutritional status
• Estimating intake can be difficult– Weakness of data-gathering
techniques– Human behavior– Natural tendency of intake– Limitations of nutrient
composition tables and databases
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Methods for Measuring Intake• 24-hour recall• Food Record or Diary• Food Frequency
Questionnaires (FFQs)• Diet History• Duplicate Food Collections• Food Accounts• Food Balance Sheets• Photographic and Digital
Video Methods
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24-Hour Recall• Strengths
– Requires less than 20 minutes
– Inexpensive– Easy to administer– Low respondent
burden– Can provide detail info
on types of food consumed
– Probability sampling possible
– More objective than dietary history
– Does not alter usual diet
• Limitations– One recall is seldom
representative of a person’s usually intake
– Underreporting/ overrreporting occurs
– Relies on memory– Omissions of dressings,
sauces, and beverages can lead to low estimates of energy intake
– May be a tendency to overreport intake at low levels and overreport intake at high levels of consumption
– Data entry can be very labor intensive
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Food Record or Food Diary
• An extensive record of log including brands and portions of all foods eaten over the course of several days or weeks.
• A diary may include more information like when, where, and with whom.
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One month “Billy C” client food record
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Food Record or Diary
• Strengths– Does not depend
on memory– Can provide
detailed intake data
– Can provide data about eating habits
– Multiple-day data more representative of usually intake
– Reasonably valid up to 5 days
• Limitations– Requires high degree
of cooperation– Response burden can
result in low response rates when used in large national surveys
– Subject must be literate
– Takes more time to obtain data
– Act of recording may alter diet
– Analysis is labor intensive and expensive.
– Must know portions and be able to estimate
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Food Frequency Questionnaires (FFQ)
• Assess energy and/or nutrient intake by determining frequency of intake
• Usually 150 foods or less. What food and how often
• May take 7 – 60 minutes depending on complexity of FFQ
• May provide visual pictures/graphics to help assess portion
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Food Frequency Questionniares
• Strengths– Usually self
administered– Computer read– Modest demand on
respondents– Relatively inexpensive
for large sample sizes– May be more
representative of usual intake than food diary
– Design can be based on large population data
– Considered by some as the method of choice for research on diet-disease relationships
• Limitations– May not
represent usual foods or portion sizes chosen
– Intake data can be compromised when multiple foods are grouped within single listings
– Depend on ability of subject to describe diet
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Block Questionnaires
• Very popular in research setting
• Solid history of validatoin• Evidence based results
used in hundreds of research studies.
• Multiple versions: long, short, fruits/veggies, meat, soy, nutrients, adults, children, physical activity
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Diet History
• Strengths– Assesses
usually nutrient intake
– Can detect seasonal changes
– Data on all nutrients can be obtained
– Can correlate well with biochemical means
• Limitations– Lengthy
interview process
– Requires highly trained interviewers
– Difficult and expensive to code
– May tend to overestimate nutrient intake
– Requires cooperative respondent with ability to recall usual diet
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Food Accounts
• Strengths– Suitable for use
with large sample size
– Can be used over relatively long periods
– Gives data on dietary patterns and habits of families and other groups
– Less likely to lead to alterations in diet than some other methods
– Relatively economical
• Limitations– Does not
account for food losses
– Respondent literacy and cooperation necessary
– Not appropriate for measuring individual food consumption
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Food Balance Sheet• Strengths
– Can give a total view of a country’s food supplies
– Indicates food habits and dietary trends
– Sued to plan international nutrition policies and food programs
– May be the only data available on a country’s food consumption practices
• Limitations– Accuracy of
data may be questionable
– Only represents food available for consumption
– Does not represent food actually consumed
– Does not indicate how food was distributed
– Does not account for wasted food
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Other Interview Techniques
• Duplicate Food Collection Method
• Photographic and Video Records
• Computerized Techniques
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p. 294
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Issues in Dietary Measurement
• Validity– Ability of an instrument to
measure what it is intended to measure
• Reproducibility– The ability of a method to
produce the same estimate on two or more occasions
• How Many Days?– It is important to know how long
a dietary intake must be measure before a sufficiently reliable estimate of usual intake is obtained
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Estimating Portion Sizes
• Photographs of food• Geometric Shapes• Measuring Devices• Lifelike plastic food
models
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Estimating Portion Sizes…
Portion Distortion!
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FRENCH FRIES 20 Years Ago
Today
210 Calories
2.4 ounces
How many calories are intoday’s portion of fries?
National Heart Lung and Blood Institute
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FRENCH FRIES 20 Years Ago
Today
210 Calories
2.4 ounces
National Heart Lung and Blood Institute
610 Calories6.9 ounces
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How long will you have to walk leisurely in order to burn those extra 400 calories?*
*Based on 160-pound person
Maintaining a Healthy Weight is a Balancing ActCalories In = Calories Out
National Heart Lung and Blood Institute
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*Based on 160-pound person
If you walk leisurely for 1 hour and 10 minutes you will burn approximately 400 calories.*
Calories In = Calories Out
National Heart Lung and Blood Institute
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320 calories
How many calories are in today’s turkey sandwich?
TURKEY SANDWICH 20 Years Ago
Today
National Heart Lung and Blood Institute
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320 calories
TURKEY SANDWICH 20 Years Ago
Today
National Heart Lung and Blood Institute
820 calories
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*Based on 160-pound person
If you ride a bike for 1 hour and 25 minutes,you will burn approximately 500 calories.*
Calories In = Calories Out
National Heart Lung and Blood Institute
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CHICKEN CAESAR SALAD
20 Years Ago Today
390 calories 1 ½ cups
How many calories are in today’s chicken
Caesar salad?
National Heart Lung and Blood Institute
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CHICKEN CAESAR SALAD
20 Years Ago Today
390 calories 1 ½ cups
National Heart Lung and Blood Institute
790 calories
3 ½ cups
Calorie Difference: 400 calories
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Bagel
Calorie difference: 210
• 25 years ago:– 140 calories– 2 inch diameter
• Today:– 350 - 400 calories– 6 inch diameter
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Blueberry Muffin
Calorie difference: 290
• 25 years ago:– 210 calories– 1.5 ounces
• Today:– 500 calories– 4 ounces
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Chocolate Chip Cookie
Calorie difference: 220+++
• 25 years ago:– 55 calories– 1.5 inch diameter
• Today:– 275 - 600 calories– 3.5 - 4 inch diameter
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Overview of Chapter 3
• Research Design Considerations– Correlation Studies– Case Control Studies– Cohort studies
• Factors that influence selection of dietary methods
• Different Techniques in Measuring diet– Strengths and Limitations
• Validating Dietary Methods
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Stuff you need to know!
• Always check announcements and your email.
• Unit 5 midterm coming up. Information posted in Doc Sharing. It’s worth 140 points – 14% of your grade!
• New sections in Doc Sharing: – APA info, samples and formatting– Turnitin.com and plagiarism