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Community-specific modifications are essential for objective assessment of maternal dietary intake--Pune Maternal
1Biometry and Nutrition Group, Agharkar Research Institute, G.G. Agarkar Road, Pune 411 004, India. raoari@yahoo.com
Objective:
To introduce community-specific modifications in the conventional 24 h recall method for objectively estimating maternal dietary intake and validate it with a reference method.
Design:
A modified 24 h recall method was developed with the visit of trained local girls at the subject's home to weigh portion sizes at each mealtime over the 24 h recall period. This was validated with the reference method in which weighed records of the foods consumed were obtained and their laboratory analysis was done to obtain nutrient intakes.
Setting:
Rural areas located 40-50 km from Pune City, India.
Subjects:
Forty-one pregnant women participated willingly.
Results:
The estimates of intake obtained from the reference method were comparable to those obtained from the modified 24 h recall method for energy (7795 (sd 1841) kJ (1863 (sd 440) kcal) v. 7615 (sd 1824) kJ (1820 (sd 436) kcal), respectively), protein (48.6 (sd 12.9) g v. 45.3 (sd 12.6) g, respectively) and fat (35.3 (sd 16.6) g v. 36.0 (sd 14.2) g, respectively). Significant correlation was observed between the estimates obtained by the two methods for energy (0.75, P < 0.001), protein (0.71, P < 0.001) and fat (0.56, P < 0.001) and differences in nutrient intake did not reveal any systematic bias. When compared with the reference method, the modified method showed >80% sensitivity and specificity for identifying inadequate maternal energy intakes.
Conclusions:
Simple modifications to conventional methods backed by understanding of community specifics and nutritional peculiarities are of immense importance in obtaining objective estimates of daily nutritional intakes of individuals in free-living populations. The approach would be adaptable in similar settings in other developing countries.
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