Julie A. Royer

Fourth-Grade Children's Dietary Recall Accuracy Is Influenced by Retention Interval (Target Period and Interview Time)

BACKGROUND For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy. OBJECTIVE The effects of target period and interview time on childrens accuracy for reporting school meals during 24-hour dietary recalls were investigated. DESIGN AND SUBJECTS/SETTING: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys). MAIN OUTCOME MEASURES Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts. STATISTICAL ANALYSES PERFORMED For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model. RESULTS There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third. CONCLUSIONS To enhance childrens dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen.

The Relationship of School Absenteeism with Body Mass Index, Academic Achievement, and Socioeconomic Status among Fourth-Grade Children.

BACKGROUND Data from a school-based study concerning fourth-grade childrens dietary recall accuracy were linked with data from the South Carolina Department of Education (SCDE) through the South Carolina Budget and Control Board Office of Research and Statistics (ORS) to investigate the relationships of childrens school absenteeism with body mass index (BMI), academic achievement, and socioeconomic status (SES). METHODS Data for all variables were available for 920 fourth-grade children during 2 school years (2005-2006, 2006-2007). Number of school days absent for each child and eligibility for free/reduced-price school meals (SES measure) were provided to ORS by SCDE. Childrens weight and height were measured by research staff; age/sex-specific BMI percentile was calculated and grouped into categories. For academic achievement, Palmetto Achievement Challenge Tests scores were provided by the school district. The associations of absenteeism with BMI, academic achievement, SES, and school year were investigated with logistic binomial models using the modified sandwich variance estimator to adjust for multiple outcomes within schools. RESULTS The relationships between absenteeism and each of BMI percentile category and SES were not significant (all coefficient p values > .118). The relationship between absenteeism and academic achievement was inversely significant (p value < .0001; coefficient = -.087). CONCLUSIONS These results support the inverse relationship between absenteeism and academic achievement that was expected and has been found by other researchers. The lack of significant results concerning the relationships between absenteeism and both BMI and SES differs from earlier, limited research. More research to investigate these relationships is needed.

Children's body mass index, participation in school meals, and observed energy intake at school meals

BackgroundData from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria).MethodsData were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age.ResultsBreakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria.ConclusionsFor fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.

Twenty-four hour dietary recalls by fourth-grade children were not influenced by observations of school meals

OBJECTIVE To investigate whether school-meal observations influenced childrens 24-hour dietary recalls. STUDY DESIGN AND SETTING Over three school years, 555 randomly selected fourth-grade children were interviewed to obtain a 24-hour dietary recall; before being interviewed, 374 children were observed eating two school meals (breakfast, lunch), and 181 children were not observed. Within observation-status groups (observed, unobserved), children were randomized within sex to one of six combinations from two target periods (prior 24 hours, previous day) crossed with three interview times (morning, afternoon, evening). RESULTS For each of the five variables (interview length, meals/snacks, meal components, items, kilocalories), naïve and adjusted equivalence tests rejected that observation-status groups were different, indicating that school-meal observations did not influence childrens 24-hour dietary recalls. There was a target-period effect on length (P<0.0001) (longer for prior-24-hour recalls), a school year effect on length (P=0.0002) (longer for third year), and a target period-interview time interaction on items (P=0.0110) and kilocalories (P=0.0047) (both smaller for previous-day recalls in the afternoon than prior-24-hour recalls in the afternoon and previous-day recalls in the evening), indicating that variables were sufficiently sensitive and psychometrically reliable. CONCLUSION Conclusions about 24-hour dietary recalls by fourth-grade children observed eating school meals in validation studies are generalizable to 24-hour dietary recalls by comparable but unobserved children in nonvalidation studies.

Validation-study conclusions from dietary reports by fourth-grade children observed eating school meals are generalisable to dietary reports by comparable children not observed.

OBJECTIVE To investigate the effect of observing school meals on childrens dietary reports. SUBJECTS AND SETTING One hundred and twenty children randomly selected, but with half girls, from usual school-meal eaters among 312 volunteers (from all 443 fourth-grade children in six schools in one district). DESIGN Children were assigned randomly to one of 12 conditions yielded by crossing observation status (observed; not observed), target period (previous day; prior 24 hours), and interview time (morning; afternoon; evening). RESULTS Response variables included interview length, number of meals and snacks reported for the target period, and, for two school meals, number of meal components reported, importance-weighted number of items reported and kilocalories reported. These variables were transformed to principal components; two were retained (1, the school meal variables; 2, interview length and number of meals and snacks). Analyses of variance on principal component scores tested effects of observation status, target period, interview time and all interactions. Observation status did not affect scores on either retained principal component. Scores on Component 2 showed that more intake was reported in prior-24-hours interviews than in previous-day interviews. CONCLUSIONS The effect of target period on reported intake indicates that the response variables were sufficiently reliable to detect manipulations. This, together with the finding that response variables did not depend on observation status, suggests that observation of school meals does not affect fourth-grade childrens dietary reports, and that conclusions about dietary reports by fourth-grade children observed eating school meals in validation studies may be generalised to dietary reports by comparable children not observed.

Relation of Children's Dietary Reporting Accuracy to Cognitive Ability

A validation study of childrens dietary reporting provided an opportunity to investigate whether cognitive ability is a source of systematic error in dietary recalls. From the fall of 2004 through the spring of 2007, fourth-grade children (n = 374) in Columbia, South Carolina, were observed eating school meals and interviewed to obtain 24-hour dietary recalls; subsequently, measures of dietary reporting error were calculated. The common factor extracted from 4 subject-area achievement tests (scores on which were provided by the school district for 362 children) was used as a measure of cognitive ability. For the 325 children who reported school meals that met the criteria to be reports about school meals, as cognitive ability increased, dietary reporting error decreased; the relation between cognitive ability and dietary reporting performance was stronger among girls than among boys. The mean cognitive ability for 37 children who reported no meals that satisfied the criteria for being reports about school meals was significantly lower than that for the 325 children who reported meals that satisfied these criteria. These findings indicate that cognitive ability is a source of systematic error in childrens dietary recalls. More generally, the quality of epidemiologic survey data may depend systematically on the cognitive ability of respondents.

Fourth-grade children’s dietary recall accuracy for energy intake at school meals differs by social desirability and body mass index percentile in a study concerning retention interval

Data from a study concerning retention interval and school-meal observation on children’s dietary recalls were used to investigate relationships of social desirability score (SDS) and body mass index percentile (BMI%) to recall accuracy for energy for observed (n = 327) children, and to reported energy for observed and unobserved (n = 152) children. Report rates (reported/observed) correlated negatively with SDS and BMI%. Correspondence rates (correctly reported/observed) correlated negatively with SDS. Inflation ratios (overreported/observed) correlated negatively with BMI%. The relationship between reported energy and each of SDS and BMI% did not depend on observation status. Studies utilizing children’s dietary recalls should assess SDS and BMI%.

There Is No Relationship between Academic Achievement and Body Mass Index among Fourth-Grade, Predominantly African-American Children

School-based initiatives to combat childhood obesity may use academic performance to measure success. This cross-sectional study investigated the relationship between academic achievement and body mass index percentile, socioeconomic status (SES), and race by linking existing datasets that are not routinely linked. Data from a school-based project (with National Institutes of Health funding) concerning dietary recall accuracy were linked with data from the states Department of Education through the states Office of Research and Statistics. Data were available on 1,504 fourth-grade, predominantly African-American children from 18 schools total in one district in South Carolina during the 2004-2005, 2005-2006, and 2006-2007 school years. School staff administered standardized tests in English, math, social studies, and science. Researchers measured childrens weight and height. Children were categorized as low-SES, medium-SES, or high-SES based on eligibility for free, reduced-price, or full-price school meals, respectively. Results from marginal regression analyses for each sex for the four academic subjects, separately and combined, showed that test scores were not related to body mass index percentile, but were positively related to SES (P values <0.0001), and were related to race, with lower scores for African-American children than children of other races (P values <0.0039). Cost-efficient opportunities exist to create longitudinal data sets to investigate relationships between academic performance and obesity across kindergarten through 12th-grade children. State agencies can house body mass index data in state-based central repositories where staff can use globally unique identifiers and link data across agencies. Results from such studies could potentially change the way school administrators view nutrition and physical education.

A Validation Study Concerning the Effects of Interview Content, Retention Interval, and Grade on Children's Recall Accuracy for Dietary Intake and/or Physical Activity

BACKGROUND Practitioners and researchers are interested in assessing childrens dietary intake and physical activity together to maximize resources and minimize subject burden. OBJECTIVE Our aim was to investigate differences in dietary and/or physical activity recall accuracy by content (diet only; physical activity only; diet and physical activity), retention interval (same-day recalls in the afternoon; previous-day recalls in the morning), and grade (third; fifth). DESIGN Children (n=144; 66% African American, 13% white, 12% Hispanic, 9% other; 50% girls) from four schools were randomly selected for interviews about one of three contents. Each content group was equally divided by retention interval, each equally divided by grade, each equally divided by sex. Information concerning diet and physical activity at school was validated with school-provided breakfast and lunch observations, and accelerometry, respectively. Dietary accuracy measures were food-item omission and intrusion rates, and kilocalorie correspondence rate and inflation ratio. Physical activity accuracy measures were absolute and arithmetic differences for moderate to vigorous physical activity minutes. STATISTICAL ANALYSES PERFORMED For each accuracy measure, linear models determined effects of content, retention interval, grade, and their two-way and three-way interactions; ethnicity and sex were control variables. RESULTS Content was significant within four interactions: intrusion rate (content×retention-interval×grade; P=0.0004), correspondence rate (content×grade; P=0.0004), inflation ratio (content×grade; P=0.0104), and arithmetic difference (content×retention-interval×grade; P=0.0070). Retention interval was significant for correspondence rate (P=0.0004), inflation ratio (P=0.0014), and three interactions: omission rate (retention-interval×grade; P=0.0095), intrusion rate, and arithmetic difference (both already mentioned). Grade was significant for absolute difference (P=0.0233) and five interactions mentioned. Content effects depended on other factors. Grade effects were mixed. Dietary accuracy was better with same-day than previous-day retention interval. CONCLUSIONS Results do not support integrating dietary intake and physical activity in childrens recalls, but do support using shorter rather than longer retention intervals to yield more accurate dietary recalls. Additional validation studies need to clarify age effects and identify evidence-based practices to improve childrens accuracy for recalling dietary intake and/or physical activity.

A Pilot Study of the Effects of Interview Content, Retention Interval, and Grade on Accuracy of Dietary Information From Children

OBJECTIVE Investigate differences in dietary recall accuracy by interview content (diet only or diet and physical activity), retention interval (same day or previous day), and grade (third or fifth). METHODS Thirty-two children observed eating school-provided meals and interviewed once each; interview content and retention interval randomly assigned. Multivariate analysis of variance on rates for omissions (foods observed but unreported) and intrusions (foods reported but unobserved); independent variables: interview content, retention interval, grade. RESULTS Accuracy differed by retention interval (P = .05; better for same day [omission rate, intrusion rate: 28%, 20%] than previous day [54%, 45%]) but not interview content (P > .48; diet only: 41%, 33%; diet and physical activity: 41%, 33%) or grade (P > .27; third: 48%, 42%; fifth: 34%, 24%). CONCLUSIONS AND IMPLICATIONS Although the small sample limits firm conclusions, results provide evidence-based direction to enhance accuracy: specifically, to shorten the retention interval. Larger validation studies need to investigate the combined effect of interview content, retention interval, and grade on accuracy.