Performance and feasibility of recalls completed using the automated self-administered 24-h dietary assessment tool in relation to other self-report tools and biomarkers in the interactive diet and activity tracking in AARP

Authors: SUBAR, AMY - National Cancer Institute (NCI, NIH); POTISCHMAN, NANCY - National Institutes Of Health (NIH); DODD, KEVIN - National Cancer Institute (NCI, NIH); THOMPSON, FRANCES - National Cancer Institute (NCI, NIH); Baer, David; SCHOELLER, DALE - University Of Wisconsin; MIDTHUNE, DOUGLAS - National Cancer Institute (NCI, NIH); KIPNIS, VICTOR - National Cancer Institute (NCI, NIH); KIRKPATRICK, SHARON - University Of Waterloo; MITTL, BETH - Westat Inc; ZIMMERMAN, THEA - Westat Inc; DOUGLASS, DEIRDRE - Westat Inc; BOWLES, HEATHER - National Cancer Institute (NCI, NIH); PARK, YIKYUNG - Washington University School Of Medicine

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/9/2020
Publication Date: 11/1/2020
Citation: Subar, A.F., Potischman, N., Dodd, K.W., Thompson, F.E., Baer, D.J., Schoeller, D.A., Midthune, D., Kipnis, V., Kirkpatrick, S.I., Mittl, B., Zimmerman, T.P., Douglass, D., Bowles, H., Park, Y. 2020. Performance and feasibility of recalls completed using the automated self-administered 24-h dietary assessment tool in relation to other self-report tools and biomarkers in the interactive diet and activity tracking in AARP (IDATA) study. Journal of the Academy of Nutrition and Dietetics. 120:1805-1820. https://doi.org/10.1016/j.jand.2020.06.015.
DOI: https://doi.org/10.1016/j.jand.2020.06.015

Interpretive Summary: Accurately and precisely determining food intake (specific foods, nutrients and energy) is crucial to understanding dietary patterns in a population. The Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) is a self-administered web-based method that has been developed collect detailed dietary intake data. This method is low cost and well-suited for use in observational studies. Other methods for dietary assessment include food records and food frequency questionnaires. A validation study was conducted to describe the performance and feasibility of using dietary recalls captured with ASA24 (using the 2011 version) and to compare dietary intakes with four-day food records (4DFRs) and food frequency questionnaires (FFQs). Over a year period of time, over 1000 adult volunteers completed up to six ASA24 recalls, two web-based FFQs, and two unweighed paper-and-pencil 4DFRs. In addition, intake of energy, protein, potassium, and sodium was measured as recovery biomarkers. The outcomes were response rates, intakes compared to recovery biomarkers, and Healthy Eating Index-2015 (HEI-2015) scores. Completion rate of ASA24 was higher than the completion rates for 4DFRs and FFQs. Average absolute intakes of energy, protein, potassium, and sodium based on ASA24 were lower compared to recovery biomarkers, particularly in men. In summary, ASA24, is a freely-available dietary assessment tool that can be used in large-scale nutrition research. This information is of interest to scientists interested in assessing food intake in a large population.

Technical Abstract: Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) is a self-administered web-based tool designed to collect detailed dietary data at low cost in observational studies. The objectives of this study were to describe, overall and by demographic groups, the performance and feasibility of ASA24-2011 recalls and compare Healthy Eating Index-2015 (HEI-2015) total and component scores to 4-day food records (4DFRs) and food frequency questionnaires (FFQs). Over 12 months, participants completed up to 6 ASA24 recalls, 2 web-based FFQs, and 2 unweighed paper-and-pencil 4DFRs. Up to 3 attempts were made to obtain each ASA24 recall. Participants were administered doubly-labeled water to provide a measure of total energy expenditure and collected two 24-hour urine samples to assess concentrations of nitrogen, sodium, and potassium. From January through September 2012, 1,110 adult members of AARP, 50 to 74 years of age, were recruited from the Pittsburgh, PA, area to participate in the Interactive Diet and Activity Tracking in AARP (IDATA) study. After excluding 33 participants who had not completed any dietary assessments, 531 men and 546 women remained. Response rates, nutrient intakes compared to recovery biomarkers across each ASA24 administration day, and HEI-2015 total and component scores were measured. Means, medians, standard deviations, interquartile ranges, and HEI-2015 total and component scores computed using a multivariate measurement error model are presented. Ninety-one percent of men and 86% of women completed 3 ASA24 recalls. Approximately three-quarters completed 5 or more, higher than the completion rates for 2 4DFRs and 2 FFQs. Approximately, three-quarters of men and 70% of women completed ASA24 on the first attempt; 1 in 5 completed it on the second. Completion rates varied slightly by age and body mass index. Median time to complete ASA24-2011 (current version: ASA24-2020) declined with subsequent recalls from 55 to 41 minutes in men and from 58 to 42 minutes in women and was lowest in those younger than 60 years. Mean nutrient intakes were similar across recalls. For each recording day, energy intakes estimated by ASA24 were lower than energy expenditure. Reported intakes for protein, potassium, and sodium were closer to recovery biomarkers for women, but not for men. Geometric means of reported intakes of these nutrients did not systematically vary across ASA24 administrations, but differences between reported intakes and biomarkers differed by nutrient. Of 100 possible points, HEI-2015 total scores were nearly identical for 4DFRs and ASA24 recalls and higher for FFQs (men: 61, 60, and 68; women: 64, 64, and 72, respectively). ASA24, a freely available dietary assessment tool for use in large-scale nutrition research, was found to be highly feasible. Similar to previously reported data for nutrient intakes, HEI-2015 total and component scores for ASA24 recalls were comparable to those for 4DFRs, but not FFQs.