ASSIGNMENT NO 3:
NAME: SAHAR AMAN-ULLAH
ROLL NO: UBF23LBHND052
SUBJECT: ASSESSMENT OF NUTRITION STATUS
TOPIC: DIETARY ASSESSMENT METHODS COMPARISON
DEPARTMENT : NUTRITION AND DIETETICS
SEMESTER : IV
SUBMITTED TO: MR. HAMMAD TAHIR
DATE OF SUBMISSION :12- JUNE-2025
FACULTY OF FOOD TECHNOLOGY AND NUTRITION
SCIENCES
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Introduction Of Dietary Assessment Methods:
• Accurate dietary assessment is foundational to understanding
nutrient intake, evaluating dietary habits, and designing
interventions for various population groups.
3 Commonly Used Dietary Assessment
Methods:
1. 24-hour recall
2. Food Frequency Questionnaire (FFQ),
3. Food diary in terms of accuracy, practicality, and bias, using
adolescents and pregnant women as comparative case studies.
Overview Of Dietary Assessment Methods:
1. 24-Hour Dietary Recall:
The 24-hour recall involves an interviewer asking participants to detail
all food and beverages consumed in the previous 24 hours, often using a
standardized multiple-pass approach to enhance recall accuracy.
Method: Trained interviewers ask participants to recall all foods and
beverages consumed in the past 24 hours, often using multiple passes
(e.g., USDA’s Automated Multiple-Pass Method).
Strengths:
• Does not alter eating behaviour (unlike diaries).
• Suitable for diverse populations with low literacy.
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Limitations:
• Relies on memory, leading to recall bias (underreporting snacks,
portion misestimation).
• A single day may not reflect habitual intake.
2. Food Frequency Questionnaire
(FFQ):
The FFQ captures usual intake by asking respondents how often they
consume various food items over a specified period, such as a month or
a year.
Method: A predefined list of foods with frequency options (e.g., "per
day/week/month") and sometimes portion sizes.
Strengths:
• Captures long-term dietary patterns (useful for chronic disease
research).
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• Cost-effective for large-scale studies.
Limitations:
• Fixed food lists may miss culturally specific or new foods.
• Overestimates/underestimates intake due to portion size assumptions.
3. Food Diary (Food Record)
Participants document all food and beverage consumption in real time,
typically over three to seven days. Entries may include preparation
methods, brand names, and portion sizes.
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Method: Participants record all consumed foods and beverages in real-
time over several days (typically 3-7 days).
Strengths:
• Minimizes recall bias.
• Provides detailed data (timing, portion sizes, meal context).
Limitations:
• High participant burden, leading to non-compliance.
• May alter eating habits (reactivity bias).
Case Study 1: Adolescents
•
• Adolescents face increased risk for nutritional deficiencies, including
calcium, iron, and Fiber. Simultaneously, they engage in inconsistent
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eating patterns, often influenced by peers, media, and autonomy-
seeking behaviour.
• Research by Livingstone et al. (2004) found that adolescents
underreport energy intake by as much as 25%, particularly in food
diaries.
• Digital approaches, such as smartphone apps for food diaries or
voice-assisted 24-hour recalls, have shown promise in improving
accuracy and engagement (Ngo et al., 2009). However, for
population-level monitoring, a modified FFQ with adolescent-
friendly language and visuals may be the most scalable approach.
• Best approach for adolescents:
Use multiple 24-hour recalls with visual aids and parental input for
younger teens. In large-scale surveys, a simplified, validated
adolescent-specific FFQ is effective.
1.Dietary Challenges in Adolescents
• Irregular eating patterns (skipping meals, snacking).
• High consumption of fast food and sugar-sweetened beverages.
• Social influences (peer pressure, underreporting unhealthy foods).
2.Accuracy Comparison:
Method Validity Reliability
Moderate (underreports Low (day-to-day
24-hour recall
snacks) variability)
Low (misses-irregular Moderate (depends on
FFQ
eating) memory)
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Method Validity Reliability
Moderate (compliance
Food diary High (real-time recording)
issues)
3.Practicality
24-hour recall: Easy to administer in schools but requires trained
interviewers.
FFQ: Best for large surveys but may not capture adolescent-specific
eating habits.
Food diary: High dropout rates; tech-assisted tools (apps) improve
compliance.
Bias Analysis
• Recall bias: Adolescents forget snacks or misreport portion sizes.
• Social desirability bias: Overreporting "healthy" foods,
underreporting junk food.
• Reactivity bias: Diaries may lead to temporary healthier eating.
Case Study 2: Pregnant Women
• Pregnancy increases demand for nutrients like folate, iron, and DHA.
Accurate dietary assessment is critical for monitoring these intakes
and guiding supplementation.
• Pregnant women are typically more motivated to engage in dietary
monitoring, especially during second and third trimesters (Erkkola et
al., 2001).
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• FFQs customized for pregnancy (e.g., capturing supplement intake,
morning sickness, and aversions) have shown high correlation with
biomarkers (e.g., serum folate). Food diaries also work well but are
more resource-intensive.
• Best approach for pregnant women:
Use a pregnancy-specific FFQ to assess nutrient intake over time,
complemented by short-term food diaries (3–4 days) to track
current behaviours. 24-hour recall is a useful alternative in clinical
settings with time constraints.
1.Dietary Challenges in Pregnancy
• Increased nutritional needs (iron, folate, protein).
• Nausea, cravings, and aversions alter intake.
• Cognitive changes may affect memory.
Accuracy Comparison
Method Validity Reliability
24-hour Moderate (affected by
Low (varies by trimester)
recall pregnancy fatigue)
Moderate (good for long- Moderate (depends on
FFQ
term trends) trimester)
High (detailed but Moderate (fatigue reduces
Food diary
burdensome) compliance)
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2.Practicality
• 24-hour recall: Clinically feasible but may be affected by memory
lapses.
• FFQ: Efficient for prenatal studies but may miss recent dietary shifts.
• Food diary: Accurate but challenging due to pregnancy fatigue.
3.Bias Analysis
• Recall bias: Pregnancy "brain fog" may lead to omissions.
• Reporting bias: Overreporting nutrient-dense foods to align with
prenatal advice.
• Reactivity bias: Diaries may cause stress, reducing compliance.
Discussion & Recommendations:
Adolescents
• Best for accuracy: Food diary (if compliance is ensured via apps).
• Best for large studies: FFQ (with adolescent-specific food lists).
• Balanced option: Multiple 24-hour recalls (weekday + weekend).
Pregnant Women
• Best for accuracy: Food diary (short-term, e.g., 3 days).
• Best for longitudinal studies: FFQ (adjusted for pregnancy
cravings).
• Clinical use: 24-hour recall (quick but requires multiple
assessments).
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Conclusion
Dietary assessment methods vary in accuracy, practicality, and bias,
especially when applied to adolescents and pregnant women.
Adolescents benefit from engaging, simplified tools, while pregnant
women prefer structured, low-burden methods. The best outcomes
emerge when tools are adapted and combined to meet the needs of
specific populations and research objectives.
References (APA
Style)
• Livingstone, M. B. E., Robson, P. J., & Wallace, J. M. W. (2004).
Issues in dietary intake assessment of children and adolescents.
British Journal of Nutrition, 92(S2), S213–S222.
https://doi.org/10.1079/BJN20041169
• Ngo, J., Engelen, A., Molag, M., Roesle, J., García-Segovia, P., &
Serra-Majem, L. (2009). A review of the use of information and
communication technologies for dietary assessment. British
Journal of Nutrition, 101(S2), S102–S112.
https://doi.org/10.1017/S0007114509990629
• Rockett, H. R., Breitenbach, M., Frazier, A. L., Witschi, J., Wolf, A.
M., Field, A. E., & Colditz, G. A. (1997). Validation of a
youth/adolescent food frequency questionnaire. Preventive
Medicine, 26(6), 808–816. https://doi.org/10.1006/pmed.1997.0200
• Burrows, T. L., et al. (2014). "A systematic review of the validity of
dietary assessment methods in children compared with doubly
labelled water." Journal of the Academy of Nutrition and Dietetics,
114(9), 1377-1392.
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