A comparison of four dietary assessment methods in materially deprived households in England

Objectives: Low-income households in the UK concentrate factors associated with poor record-keeping such as lower literacy, numeracy and English language skills. The present study aimed to (1) compare the validity and acceptability of three dietary survey methods against appropriate reference measures and (2) identify a method which was both valid and acceptable in low-income households.

Design: Cross-sectional design comparing three 4-day dietary survey methods (multiple-pass 24-hour recall, food checklist and semi-weighed method) against a 4-day weighed inventory and other reference measures within subjects.

Setting: London, UK, 2001.

Subjects: Low-income households were selected using a doorstep screening questionnaire in 18 of the 60 most deprived neighbourhoods in London. Results are based on 384 respondents (159 males, 225 females) aged 2-90 years in 240 households. Respondents were mainly White (48%), Black or Black British (31%) or Asian or Asian British (9%).

Results: The dietary survey method preferred by interviewers was the 24-hour recall. Most respondents preferred the food checklist. Compared with the weighed inventory, repeat 24-hour recalls and the food checklist yielded higher estimates of energy and nutrient intakes. The semi-weighed method was least liked and yielded the lowest estimates of intake.

Conclusions: Based partly on evidence presented here and partly on evidence to be presented in later publications, four multiple-pass 24-hour recalls were recommended as the most appropriate method for a national study of diet and nutrition in low-income households in the UK.

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