A Systematic Review of Methods to Assess Children's Diets in the School Context

Abstract

To evaluate the impact of school-based nutrition interventions, accurate and reliable methods are needed to assess what children eat at school. The primary objective of this study was to systematically review methodological evidence on the relative accuracy and reliability of dietary assessment methods used in the school context. The secondary objective was to assess the frequency of methods and analytical approaches used in studies reporting in-school dietary outcomes. Three health databases were searched for full-text English-language studies. Twenty-two methodological studies were reviewed. For school meal recalls, the majority of studies (n = 8 of 12) reported poor accuracy when accuracy was measured by using frequencies of misreported foods. However, when energy report rates were used as a measure of accuracy, studies suggested that children were able to accurately report energy intake as a group. Results regarding the accuracy of food-frequency questionnaires (FFQs) and food records (FRs) were promising but limited to a single study each. Meal observations offered consistently good interrater reliability across all studies reviewed (n = 11). Studies reporting in-school dietary outcomes (n = 47) used a broad range of methods, but the most frequently used methods included weighed FRs (n = 12), school meal recalls (n = 10), meal observations by trained raters (n = 8), and estimated FRs (n = 7). The range of dietary components was greater among studies relying on school meal recalls and FRs than among studies using FFQs. Overall, few studies have measured the accuracy of dietary assessment methods in the school context. Understanding the methodological characteristics associated with dietary instruments is vital for improving the quality of the evidence used to inform and evaluate the impact of school-based nutrition policies and programs.

Validation of 24‐h dietary recall for estimating nutrient intakes and adequacy in adolescents in Burkina Faso

“…One small validation study that compared recall to whole day OWRs among 11-to 15-year-old adolescents in the United States found that recalls overestimated energy intakes by about 10% (Kerr et al, 2015). makes it difficult to surmise how accurately children can report recall overall a 24-h period and make comparisons to the present study (McPherson et al, 2000;Tabacchi et al, 2013;Tugault-Lafleur et al, 2017).…”

Examining school-day dietary intakes among Canadian children

“…Another limitation was the use of self-reported data. The accuracy of dietary recall methods among children can vary widely depending on children's age and interview conditions (e.g., the retention period, type of prompting, and use (or not) of parental assistance) (Sharman et al 2016;Tugault-Lafleur et al 2017). Studies conducted among children have also confirmed substantial under-reporting of energy intake (McPherson et al 2000;Burrows et al 2010).…”

Teachers as Healthy Beverage Role Models: Relationship of Student and Teacher Beverage Choices in Elementary Schools

“…The beverage recall survey used in this study, while modified from a validated survey and pilot tested in this setting, has not been validated. Moreover, self-reported dietary information is less comprehensive as compared to observation or plate waste methods [22]. Additionally, while the San Francisco Bay Area and California as a whole have had wellestablished healthy beverage standards since 2005, findings may not reflect other regions of the country.…”