Some studies have suggested that eating patterns, which describe eating frequency, the temporal distribution of eating events across the day, breakfast skipping, and the frequency of eating meals away from home, may be related to obesity. Data from the Seasonal Variation of Blood Cholesterol Study (1994-1998) were used to evaluate the relation between eating patterns and obesity. Three 24-hour dietary recalls and a body weight measurement were collected at five equally spaced time points over a 1-year period from 499 participants. Data were averaged for five time periods, and a cross-sectional analysis was conducted. Odds ratios were adjusted for other obesity risk factors including age, sex, physical activity, and total energy intake. Results indicate that a greater number of eating episodes each day was associated with a lower risk of obesity (odds ratio for four or more eating episodes vs. three or fewer = 0.55, 95% confidence interval: 0.33, 0.91). In contrast, skipping breakfast was associated with increased prevalence of obesity (odds ratio = 4.5, 95% confidence interval: 1.57, 12.90), as was greater frequency of eating breakfast or dinner away from home. Further investigation of these associations in prospective studies is warranted.

Social desirability (the tendency to respond in such a way as to avoid criticism) and social approval (the tendency to seek praise) are two prominent response set biases evident in answers on structured questionnaires. These biases were tested by comparing nutrient intakes as estimated from a single 24-hour diet recall interview (24 HR) and a 7-day dietary recall (7DDR). Data were collected as part of the Worcester Area Trial for Counseling in Hyperlipidemia, a randomized, physician-delivered nutrition intervention trial for hypercholesterolemic patients conducted in Worcester, Massachusetts, from 1991 to 1995. Of the 1,278 total study subjects, 759 had complete data for analysis. Men overestimated their fat and energy intakes on the 7DDR as compared with the 24HR according to social approval: One unit increase in the social approval score was associated with an overestimate of 21.5 kcal/day in total energy intake and 1.2 g/day in total fat intake. Women, however, underestimated their dietary intakes on the 7DDR relative to the 24HR according to social desirability: One unit increase in the social desirability score was associated with an underestimate of 19.2 kcal/day in energy intake and 0.8 g/day in total fat. The results from the present study indicate that social desirability and social approval biases appear to vary by gender. Such biases may lead to misclassification of dietary exposure estimates resulting in a distortion in the perceived relation between health-related outcomes and exposure to specific foods or nutrients. Because these biases may vary according to the perceived demands of research subjects, it is important that they be assessed in a variety of potential research study populations.

We developed an inexpensive, culturally sensitive diabetes prevention program that resulted in weight loss, improved HbA1c, and improved insulin resistance in a high-risk Latino population.

Purpose-Twenty-four-hour diet recall interviews (24HRs) are used to assess diet and to validate other diet assessment instruments. Therefore it is important to know how many 24HRs are required to describe an individual's intake.Method-Seventy-nine middle-aged white women completed seven 24HRs over a 14-day period, during which energy expenditure (EE) was determined by the doubly labeled water method (DLW). Mean daily intakes were compared to DLW-derived EE using paired t tests. Linear mixed models were used to evaluate the effect of call sequence and day of the week on 24HR-derived energy intake while adjusting for education, relative body weight, social desirability, and an interaction between call sequence and social desirability.Results-Mean EE from DLW was 2115 kcal/day. Adjusted 24HR-derived energy intake was lowest at call 1 (1501 kcal/day); significantly higher energy intake was observed at calls 2 and 3 (2246 and 2315 kcal/day, respectively). Energy intake on Friday was significantly lower than on Sunday. Averaging energy intake from the first two calls better approximated true energy expenditure than did the first call, and averaging the first three calls further improved the estimate (p = 0.02 for both comparisons). Additional calls did not improve estimation.Conclusions-Energy intake is underreported on the first 24HR. Three 24HRs appear optimal for estimating energy intake.