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'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake
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Published on: September 18, 2018

A program needs-driven approach to selecting dietary assessment methods for decision-making in food fortification

Jennifer Coates1, Brooke Colaiezzi, John L Fiedler

  • 1Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave., Room 126, Boston, MA 02111, USA. Jennifer.coates@tufts.edu

Food and Nutrition Bulletin
|December 1, 2012
PubMed
Summary

Choosing the right dietary assessment method is crucial for food fortification programs. Household Consumption and Expenditures Surveys (HCES) are best for needs assessment, while 24-hour recalls are ideal for impact evaluation.

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Area of Science:

  • Nutrition Science
  • Public Health
  • Food Policy

Background:

  • Dietary assessment data are vital for planning, monitoring, and evaluating food fortification and nutrition programs.
  • Understanding the validity, usefulness, and cost of different dietary assessment methods is critical for program success.
  • Limited guidance exists for selecting appropriate dietary assessment methods for fortification programs.

Purpose of the Study:

  • To establish criteria for evaluating the tradeoffs of various dietary assessment methods.
  • To assess the suitability of alternative dietary assessment methods for fortification programming needs.
  • To rank four common dietary assessment methods based on program stage-specific information requirements.

Main Methods:

  • Conducted 25 semistructured expert interviews and reviewed literature on four dietary assessment methods: 24-hour recalls, Food Frequency Questionnaires/Fortification Rapid Assessment Tool (FFQ/FRAT), Food Balance Sheets (FBS), and Household Consumption and Expenditures Surveys (HCES).
  • Developed and applied criteria to assess validity, usefulness, and cost for each method.
  • Ranked the methods based on their suitability for different stages of fortification programs.

Main Results:

  • For needs assessment, Household Consumption and Expenditures Surveys (HCES) offer high suitability and low cost for estimating inadequate intake risk, though with some validity compromise compared to 24-hour recalls.
  • HCES are recommended for identifying fortification vehicles and estimating coverage/impact due to cost-effectiveness and moderate-to-high validity.
  • For monitoring coverage, a simple, low-cost FFQ is suitable. For impact evaluation, 24-hour recalls are recommended for assessing nutrient intake changes.
  • Food Balance Sheets (FBS) demonstrated low validity across all programmatic uses compared to other methods.

Conclusions:

  • No single dietary assessment method is universally superior; strengths and weaknesses are context- and purpose-dependent.
  • Method selection must align with specific program data requirements and suitability.
  • A thorough understanding of the tradeoffs between validity, usefulness, and cost is essential for informed decision-making in dietary assessment for fortification programs.