Methodological considerations and future insights for 24-hour dietary recall assessment in children

Dietary assessment has come under much criticism of late to the extent that it has been questioned whether self-reported methods of dietary assessment are worth doing at all. Widespread under-reporting of energy intake, limitations due to memory, changes to intake due to the burden of recording and social desirability bias all impact significantly on the accuracy of the dietary information collected. Under-reporting of energy intakes has long been recognized as a problem in dietary research with doubly labeled water measures of energy expenditure uncovering significant under-reporting of energy intakes across different populations and different dietary assessment methods. In this review we focus on dietary assessment with children with particular attention on the 24-hour dietary recall method. We look at the level of under-reporting of energy intakes and how this tends to change with age, gender and body mass index. We discuss potential alternatives to self-reported (or proxy-reported) dietary assessment methods with children, such as biomarkers, and how these do not enable the collection of information important to public health nutrition such as the cooking method, the mixture of foods eaten together or the context in which the food is consumed. We conclude that despite all of the challenges and flaws, the data collected using self-reported dietary assessment methods are extremely valuable. Research into dietary assessment methodology has resulted in significant increases in our understanding of the limitations of self-reported methods and progressive improvements in the accuracy of the data collected. Hence, future investment in dietary surveillance and in improving self-reported methods of intake can make vital contributions to our understanding of dietary intakes and are thus warranted.