Conclusions about Children’s Reporting Accuracy for Energy and Macronutrients Over Multiple Interviews Depend on the Analytic Approach for Comparing Reported Information to Reference Information
Abstract
Objective
Validation study data are used to illustrate that conclusions about children’s reporting accuracy for energy and macronutrients over multiple interviews (ie, time) depend on the analytic approach for comparing reported and reference information—conventional, which disregards accuracy of reported items and amounts, or reporting-error-sensitive, which classifies reported items as matches (eaten) or intrusions (not eaten), and amounts as corresponding or overreported.
Subjects and Design
Children were observed eating school meals on 1 day (n=12), or 2 (n=13) or 3 (n=79) nonconsecutive days separated by ≥25 days, and interviewed in the morning after each observation day about intake the previous day. Reference (observed) and reported information were transformed to energy and macronutrients (ie, protein, carbohydrate, and fat), and compared.
Main Outcome Measures
For energy and each macronutrient: report rates (reported/reference), correspondence rates (genuine accuracy measures), and inflation ratios (error measures).
Statistical Analyses
Mixed-model analyses.
Results
Using the conventional approach for analyzing energy and macronutrients, report rates did not vary systematically over interviews (all four P values >0.61). Using the reporting-error-sensitive approach for analyzing energy and macronutrients, correspondence rates increased over interviews (all four P values <0.04), indicating that reporting accuracy improved over time; inflation ratios decreased, although not significantly, over interviews, also suggesting that reporting accuracy improved over time. Correspondence rates were lower than report rates, indicating that reporting accuracy was worse than implied by conventional measures.
Conclusions
When analyzed using the reporting-error-sensitive approach, children’s dietary reporting accuracy for energy and macronutrients improved over time, but the conventional approach masked improvements and overestimated accuracy. The reporting-error-sensitive approach is recommended when analyzing data from validation studies of dietary reporting accuracy for energy and macronutrients.
ABSTRACT