Fruit and Vegetable Intake Assessed by Repeat 24 h Recalls, but Not by A Dietary Screener, Is Associated with Skin Carotenoid Measurements in Children

Abstract

Accurate measurement of fruit and vegetable (FV) intake is important for nutrition surveillance and evaluation of dietary interventions. We compared two tools for reporting FV intake to objective measurement of skin carotenoids among children. FV cups/day was assessed by repeated 24 h dietary recalls (24H FV) and the National Cancer Institute’s All-Day Fruit and Vegetable Screener (NCI FV). Skin carotenoids were measured by repeated resonance Raman spectroscopy (RRS) of the palm. FV cups were regressed on RRS scores in unadjusted, field-based, and research-setting models with covariates feasible in each scenario. Data were baseline values from children aged 2–12 years in low-income households enrolled in a healthy eating randomized trial in four U.S. states (n = 177). Twenty-four-hour FV cups were associated with skin carotenoids in all models (p < 0.001) but NCI FV cups were not. Predicted RRS scores for discrete 24H FV cups provide a guide to interpretation of RRS in children (2 cups FV intake ~36,000 RRS units), with the research-setting scenario generally providing the narrowest prediction range (+/−1924). When self-reported data are required, 24 h recalls are more accurate than NCI FV screener data; and, when limited time, resources, or literacy must be considered, RRS scores can be quickly obtained and easily interpreted.

Systematic Review of Reflection Spectroscopy-Based Skin Carotenoid Assessment in Children

“…Such information is currently available for RRS but not RS. For example, for RRS, one study demonstrates that 30,489.8 (±4667.1) RRS units of SCS in children translates into 0.5 cups of FV/day consumption [ 35 ]. Therefore, future randomized control trials are recommended to establish reference points for using RS-based SCS to estimate children’s daily FVC, similar to RRS.…”

“…A newer and advanced alternative method to RRS for SC assessment includes pressure-mediated reflection spectroscopy (RS) [ 32 , 33 , 34 ]. RS has been validated with plasma carotenoid status in adults [ 32 , 34 , 35 , 36 ] but not in children. RS uses a broader band of LED light from 350 to 850 nm of the spectral range [ 33 ].…”

Evaluating the Association of the Increase in the WIC Cash Value Benefit on the Diversity of MyPlate Fruits and Vegetables Redeemed and Consumed By Children in Low-Income Households

“…Total FVI included legumes, 100% fruit juice, and fried potatoes [ 31 ]. This method has been validated for use in studies with limited data [ 32 ] to evaluate child FVI [ [33] , [34] , [35] ].…”

Assessment of Fruit and Vegetables Intake with Biomarkers in Children and Adolescents and Their Level of Validation: A Systematic Review

“…Correspondingly, they were compared with FV consumptions, which were assessed by various tools, for example, 24 h recalls, fruit and vegetable intake frequency questionnaire, food frequency screener, and liking survey. Skin carotenoids measured by RRS were positively associated (r > 0.35, p < 0.05) with total FV consumption [24][25][26][27][28], except in a study in which FV intake was assessed by the National Cancer Institute's All-Day Fruit and Vegetable (NCI FV) Screener [26]. In this study, the authors used two tools to assess FV intake-NCI FV and 24 h dietary recall (24H FV)-and they suggested that the NCI FV screener is not a valid tool for FV intake assessment [26].…”

“…Skin carotenoids measured by RRS were positively associated (r > 0.35, p < 0.05) with total FV consumption [24][25][26][27][28], except in a study in which FV intake was assessed by the National Cancer Institute's All-Day Fruit and Vegetable (NCI FV) Screener [26]. In this study, the authors used two tools to assess FV intake-NCI FV and 24 h dietary recall (24H FV)-and they suggested that the NCI FV screener is not a valid tool for FV intake assessment [26]. RRS scores were also verified by serum and plasma carotenoid concentrations separately in two studies [24,27], in which blood carotenoids were measured by high-performance liquid chromatography.…”