Food Diary, Food Frequency Questionnaire, and 24-Hour Dietary Recall
Diet and nutrition have an essential connection to human health. Dietary data provide valuable information about specific associations between exposure to dietary components and health, disease, or mortality. Due to the high daily variability of diet, the accurate assessment of dietary intake in the free-living human population is more challenging than the measurement of other environmental exposures. For most epidemiological studies, exposure to a long-term diet is more relevant than intake on a specific day or a reduced number of days. It is essential to choose a suitable method for assessing diet and interpreting data collected. Dietary intake can be assessed using subjective or objective methods. Subjective methods are based on people’s memory, who must answer a self-reporting form, or can be carried out by a trained interviewer, recalling food and food preparations consumed at the previous mealtime, the day before, or for a specified period. Subjective dietary assessment methods include the food frequency questionnaire, 24-hour dietary recall, food record, and weight food record. In recent years, technological innovations have improved data collection methods and subsequent analysis, but the problem of misreporting dietary intake, whether voluntary or involuntary, persists and contributes to data inaccuracy and misinterpretation. Objective dietary assessment methods appeal to nutritional biomarkers to estimate dietary exposures. These markers highly correlated with dietary intake, regardless of the subject’s memory and ability to describe the type and quantity of food consumed. These methods are usually expensive and invasive, so their use in large epidemiological studies can be difficult to implement. Some biomarkers have been used to validate dietary questionnaires, which are frequently used in large epidemiological studies; for example, the case of doubly labeled water as a marker of dietary energy. The human validation of this technique included different ages and conditions. Most of the studies show lower values for reported energy intake compared with measured total energy expenditure. This underreporting is usually higher in people with obesity. Biomarkers are also used to measure intake or exposure to a food component; for example, urinary sodium excretion is used as an objective marker of sodium intake or urinary nitrogen, which provides an objective measurement of dietary protein intake. Biomarkers can also be used to assess nutritional status by measuring body fluids like urine, blood, saliva, or tissues or even provide accurate information of dietary intake and new insights into the biological effect of dietary patterns and lifestyle and their impact on health/disease risk. In recent years, omics technologies have been integrated into nutritional epidemiological research to identify novel biomarkers. These scientific advances will help researchers obtain more accurate data and will allow for a better calibration of traditional methods when assessing dietary intake.
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Authors and Affiliations
- Centro de Posgrado, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay Luisa Saravia
- Departamento de Nutrición Clínica, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay Paula Moliterno & Estela Skapino
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain Luis A. Moreno
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Luis A. Moreno
- Luisa Saravia