24-Hour Dietary Recall
A 24-hour dietary recall is used in nutrition and dietetics to assess an individual’s food and beverage intake over the past 24 hours. It is a retrospective and interviewer-administered technique that relies on the participant’s ability to recall and report all the foods and drinks consumed in the preceding day. The goal is to obtain a comprehensive snapshot of the individual’s dietary habits.
Multiple Pass recall Technique (MPR)
It is recommended that the interviewer conduct the 24-hour recall through the Multiple Pass Recall (MPR) approach, which consists of open-ended detailed questions, such as asking about the Time of the meals consumed, food items consumed in each meal, location of consumption, quantities consumed, and, finally, reviewing information that had been reported. The interviewer may ask probing questions that may refresh the respondent’s memory, such as anything consumed between the meal or any snacks taken. This often helps the respondent remember additional foods that could have been missed. The interviewer identifies the foods reported by the respondent such that an appropriate entry can be selected from the standard food database to calculate the nutrient intake based on the portion size.
Advantages of the 24-Hour Dietary Recall (24hDR)
Retrospective Nature Preserves Usual Consumption
The 24hDR, being a retrospective method, does not alter the subject's usual consumption patterns. This feature ensures that individuals can recall their typical dietary habits without the method itself influencing their behaviour.
Estimating Usual Intake at Individual and Community Levels
Serial recalls offer a unique advantage by enabling the estimation of usual intake not only at the individual level but also at the broader community level. This makes the 24hDR a versatile tool for assessing dietary patterns across different population segments.
Time-Efficient Administration
The administration of the 24hDR is relatively time-efficient compared to other dietary assessment methods. Its streamlined process facilitates data collection without imposing significant time burdens on subjects or researchers.
High Precision and Improved Accuracy with Serial Administration
The method exhibits high precision, showcasing its capacity to produce consistent measures when repeatedly administered in the same context. Precision improves with an increased number of 24hDRs conducted on the same study subject, typically 2-3 times, enhancing the reliability of the data.
Elevated Response Rate
The 24hDR demonstrates an elevated response rate, making it a practical choice for studies with large sample sizes. This characteristic contributes to the method's feasibility for widespread use in research.
Applicability to Low Literacy Populations
The flexibility of administering the 24hDR via direct interviews makes it suitable for low-literacy populations. This adaptability ensures inclusivity in data collection, regardless of the literacy levels of the study subjects.
Validity for Assessing Energy and Nutrients
The 24hDR is considered a valid instrument for assessing energy and nutrient intake. Complementary methods such as food records, direct observation, and biochemical parameters may enhance validation.
Elevated Response Rate
The 24hDR demonstrates an elevated response rate, making it a practical choice for studies with large sample sizes. This characteristic contributes to the method's feasibility for widespread use in research.
Applicability to Low Literacy Populations
The flexibility of administering the 24hDR via direct interviews makes it suitable for low-literacy populations. This adaptability ensures inclusivity in data collection, regardless of the literacy levels of the study subjects.
Limitations of the 24-Hour Dietary Recall (24hDR)
Reliance on Recent Memory and Age Considerations
The 24hDR relies extensively on the recent memory of study subjects, making it less recommended for the elderly or individuals less than 12 years of age. The limitations of memory recall may compromise the accuracy of reported dietary information.
Dependency on Interviewer Skills
Effective administration of the 24hDR is contingent on the interviewer's capacity to describe ingredients, food preparation, and dishes accurately. This dependence underscores the importance of well-trained interviewers for both face-to-face and telephone-administered interviews.
Complications with Single Recall and Field Work
A single 24hDR may not provide an accurate estimate of usual intake, necessitating the planning of 2 or more recalls. This complicates fieldwork logistics and may pose challenges in terms of resource allocation.
Difficulty in Estimating "What, How, and How Much"
The method faces challenges in precisely estimating the details of "What, How, and How Much" consumed, introducing potential inaccuracies in the reported dietary data.
Underestimation, "Flat Slope Syndrome," and Database Limitations
In general, the 24hDR tends to underestimate intake, particularly in the elderly and children. The "Flat Slope Syndrome" may lead to overestimating low and underestimating high intakes. Additionally, data quality is often limited by the availability and adequacy of food composition databases. These limitations highlight the need for careful consideration and validation when utilising the 24hDR in dietary assessment studies.
The Importance of Multiple 24-Hour Dietary Recalls in Assessing Habitual Diet
The adequacy and accuracy of dietary assessments play a pivotal role in understanding an individual's habitual diet. Recognising the limitations of a single 24-hour dietary recall, researchers have explored the efficacy of repeated recalls to offer a more representative insight into long-term dietary patterns.
Insights from Studies:
In a study conducted by Holmes et al. in 2008, titled “A comparison of four dietary assessment methods in materially deprived households in England,” it was concluded that a sole 24-hour recall does not adequately represent an individual’s habitual diet. The study advocates for the use of repeated 24-hour recalls, termed as multiple recalls, to provide a more comprehensive understanding.
Holmes et al. specifically recommended four instances of 24-hour recalls to gather sufficient information for the data to be truly representative. This approach acknowledges the variability in dietary habits and aims to capture a more nuanced picture of an individual’s usual food and beverage consumption.
In a parallel study conducted in Australia by Jackson et al. in 2008, titled “Minimizing random error in dietary intakes assessed by 24-h recall, in overweight and obese adults,” the recommendation was even more extensive. The study suggested eight repeat 24-hour recalls as a strategy to capture the intricacies of variation in macro-nutrient intake.
Implications for Dietary Research:
These findings underscore the importance of employing multiple 24-hour dietary recalls in research endeavours seeking to comprehend habitual dietary patterns. The variation in recommendations emphasises the need to consider specific study objectives, populations under investigation, and the desired level of granularity in dietary data.
References
Castell GS, Serra-Majem L, Ribas-Barba L. What and how much do we eat? 24-hour dietary recall method. Nutricion hospitalaria. 2015;31(3):46-8.
Holmes B, Dick K, Nelson M. A comparison of four dietary assessment methods in materially deprived households in England. Public health nutrition. 2008 May;11(5):444-56.
Jackson KA, Byrne NM, Magarey AM, Hills AP. Minimising random error in dietary intakes assessed by 24-hour recall in overweight and obese adults. European journal of clinical nutrition. 2008 Apr;62(4):537-43.