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      Limitations of 24-hour Recall Method: Micronutrient Intake and the Presence of the Metabolic Syndrome

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      North American Journal of Medical Sciences
      Medknow Publications & Media Pvt Ltd

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          Abstract

          Dear Editor, Congratulations to authors’ effort on the article entitled “Micronutrient intake and the presence of the metabolic syndrome,”[1] which was recently published in North American Journal of Medical Sciences. However, I have some concerns with the use of 24-hour recall method to assess dietary intake (as done by the authors). This is because, the data generated by using this method may not represent the long-term dietary habits of the patient. So, finding an association between metabolic syndrome (a chronic condition) and micronutrient intake based on 24-hour recall may not be appropriate. Twenty-four hour recall is basically a retrospective method of diet assessment, where an individual is interviewed about their food and beverage consumption during the previous day or the preceding 24 hours. However, a single 24-hour recall is not considered to be representative of habitual diet at an individual level. This methodology is adequate for surveying intake in a large group and estimating group mean intakes of diet. This has been highlighted in a study that was conducted to decide on the methods for conducting dietary assessment in the UK Low Income Diet and Nutrition Survey (LIDNS).[2] Four repeat 24-hour recalls were recommended as the most appropriate method of dietary assessment, according to this study.[2] Furthermore, in a recent Australian study in adults, eight repeat 24-hour recalls were recommended to capture the variation that is usually present in diet.[3]

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          Most cited references3

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          A comparison of four dietary assessment methods in materially deprived households in England.

          Low-income households in the UK concentrate factors associated with poor record-keeping such as lower literacy, numeracy and English language skills. The present study aimed to (1) compare the validity and acceptability of three dietary survey methods against appropriate reference measures and (2) identify a method which was both valid and acceptable in low-income households. Cross-sectional design comparing three 4-day dietary survey methods (multiple-pass 24-hour recall, food checklist and semi-weighed method) against a 4-day weighed inventory and other reference measures within subjects. London, UK, 2001. Low-income households were selected using a doorstep screening questionnaire in 18 of the 60 most deprived neighbourhoods in London. Results are based on 384 respondents (159 males, 225 females) aged 2-90 years in 240 households. Respondents were mainly White (48%), Black or Black British (31%) or Asian or Asian British (9%). The dietary survey method preferred by interviewers was the 24-hour recall. Most respondents preferred the food checklist. Compared with the weighed inventory, repeat 24-hour recalls and the food checklist yielded higher estimates of energy and nutrient intakes. The semi-weighed method was least liked and yielded the lowest estimates of intake. Based partly on evidence presented here and partly on evidence to be presented in later publications, four multiple-pass 24-hour recalls were recommended as the most appropriate method for a national study of diet and nutrition in low-income households in the UK.
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            Minimizing random error in dietary intakes assessed by 24-h recall, in overweight and obese adults.

            To determine the minimum number of days of dietary intake interviews required to reduce the effects of random error (day-to-day variability in dietary intake) when using the multiple-pass, multiple-day, 24-h recall method. Cross-sectional study. University research department. A total of 50 healthy non-smoking overweight and obese (body mass index=26-40 kg/m2) adult men and women aged 39-45 years completed the study. Participants were randomly selected from volunteers for a larger unrelated study. Each participant completed 10, multiple-pass, 24-h recall interviews on randomly chosen days over 4 weeks. The minimum number of record days was determined for each macronutrient (carbohydrate, fat, protein) and energy, for each gender, to obtain a 'true' (unobservable) representative intake from reported (observed) dietary intakes. The greatest number of days required to obtain a 'true' representative intake was 8 days. Carbohydrate intakes required the greatest number of days of dietary record among males (7 days), whereas protein required the greatest number of days among females (8 days) in this cohort. Sunday was the day of the week that showed greatest variability in macronutrient intakes. Protein (P<0.05) and fat (P<0.001) intakes were significantly more variable than carbohydrate on Sundays compared with weekdays, for both men and women. A logistically achievable 8 days of dietary intake interviews was sufficient to minimize the effect of random error when using the multiple-pass, 24-h recall dietary intake method. Sunday should be included among the dietary interview days to ensure a 'true' representation of macronutrient intakes. This method can be confidently applied to small cohort studies in which dietary intakes from different groups are to be compared or to investigations of associations between nutrient intakes and disease.
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              Micronutrient Intake and the Presence of the Metabolic Syndrome

              Background: Dietary micronutrients have been proposed to protect against oxidative damage and related clinical complications. Aims: We aimed to compare the micronutrient intake between individuals with and without metabolic syndrome (MS). Materials and Methods: This cross-sectional study included 3800 men and women who were aged between 35 and 65 years. The diagnosis of the MS was based on International Diabetes Federation criteria. Dietary intake of participants was assessed using a questionnaire for 24 h dietary recall. Student's t-test and Mann–Whitney U-tests were used for comparing the micronutrient intake of subjects with or without the MS and the odds ratio for the presence of the MS was calculated for each micronutrient by control for total energy intake adjusted by the residue method. Results: The mean age of MS subjects and the control group was 48.8 ± 7.9 years and 47.6 ± 7.6 years, respectively. Energy-adjusted intake of vitamin E (P < 0.05), B2 (P < 0.01), and B12 (P < 0.05) was higher in normal women compared with women with MS. Energy-adjusted intake of vitamin B1 was significantly higher in women with MS. After logistic regression analysis, no significant association between micronutrient intake and MS was shown. Conclusion: We found no significant association between micronutrient intake and MS.
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                Author and article information

                Journal
                N Am J Med Sci
                N Am J Med Sci
                NAJMS
                North American Journal of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                2250-1541
                1947-2714
                August 2013
                : 5
                : 8
                : 498
                Affiliations
                [1]Department of Community Medicine, Dr. RPGMC, Tanda, Himachal Pradesh, India ojasrainasunil@ 123456yahoo.co.in
                Article
                NAJMS-5-498
                10.4103/1947-2714.117329
                3784931
                24083229
                7b032f91-3916-4d76-9543-fc1653f74944
                Copyright: © North American Journal of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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