Objective-We propose a new statistical method that uses information from two 24-hour recalls (24HRs) to estimate usual intake of episodically-consumed foods.Statistical Analyses Performed-The method developed at the National Cancer Institute (NCI) accommodates the large number of non-consumption days that arise with foods by separating the probability of consumption from the consumption-day amount, using a two-part model. Covariates, such as sex, age, race, or information from a food frequency questionnaire (FFQ), may supplement the information from two or more 24HRs using correlated mixed model regression. The model allows for correlation between the probability of consuming a food on a single day and the consumptionday amount. Percentiles of the distribution of usual intake are computed from the estimated model parameters.
Results-TheEating at America's Table Study (EATS) data are used to illustrate the method to estimate the distribution of usual intake for whole grains and dark green vegetables for men and women and the distribution of usual intakes of whole grains by educational level among men. A simulation study indicates that the NCI method leads to substantial improvement over existing methods for estimating the distribution of usual intake of foods.Applications/Conclusions-The NCI method provides distinct advantages over previously proposed methods by accounting for the correlation between probability of consumption and amount consumed and by incorporating covariate information. Researchers interested in estimating the distribution of usual intakes of foods for a population or subpopulation are advised to work with a statistician and incorporate the NCI method in analyses.
KeywordsUsual intake; Episodically-consumed foods; statistical methods When using dietary assessment among populations or individuals, investigators are often interested in capturing usual intakes -that is, long-term averages. The 24-hour dietary recall (24HR) provides rich details about dietary intake for a given day, but collecting more than two 24HRs per individual is impractical in large surveys such as the National Health and Nutrition Examination Survey (NHANES). Therefore, it is necessary to employ statistical methods to estimate usual dietary intake.Researchers are interested in estimating the usual intake of foods to assess compliance with food-based dietary recommendations and to relate food intake to health parameters. Unlike most nutrients, which are consumed daily, estimating usual intake of episodically-consumed foods presents the following unique challenges for statistical modeling (see the Glossary for a definition of "statistical modeling" and related terms):A. accounting for days without consumption of a particular food or food group; B. allowing for consumption-day amount data that are generally positively skewed and have extreme values in the upper tail of the intake distribution;C. distinguishing within-person variability, which consists of day-to-day variation in intake and random reporting errors, from between-...