Repeat 24-hour recalls and locally developed food composition databases: a feasible method to estimate dietary adequacy in a multi-site preconception maternal nutrition RCT

  • Rebecca L. Lander
  • K. Michael Hambidge
  • Nancy F. Krebs
  • Jamie E. Westcott
  • Ana Garces
  • Lester Figueroa
  • Gabriela Tejeda
  • Adrien Lokangaka
  • Tshilenge S. Diba
  • Manjunath S. Somannavar
  • Ranjitha Honnayya
  • Sumera A. Alie
  • Umber S. Khan
  • Elizabeth M. McClure
  • Vanessa R. Thorsten
  • Kristen B. Stolka
  • for the Women First Preconception Nutrition Trial Group
Keywords: Dietary assessment, nutrition, pregnant women, low- and middle-income countries

Abstract

Background : Our aim was to utilize a feasible quantitative methodology to estimate the dietary adequacy of >900 first-trimester pregnant women in poor rural areas of the Democratic Republic of the Congo, Guatemala, India and Pakistan. This paper outlines the dietary methods used.

Methods : Local nutritionists were trained at the sites by the lead study nutritionist and received ongoing mentoring throughout the study. Training topics focused on the standardized conduct of repeat multiple-pass 24-hr dietary recalls, including interview techniques, estimation of portion sizes, and construction of a unique site-specific food composition database (FCDB). Each FCDB was based on 13 food groups and included values for moisture, energy, 20 nutrients (i.e. macro- and micronutrients), and phytate (an anti-nutrient). Nutrient values for individual foods or beverages were taken from recently developed FAO-supported regional food composition tables or the USDA national nutrient database. Appropriate adjustments for differences in moisture and application of nutrient retention and yield factors after cooking were applied, as needed. Generic recipes for mixed dishes consumed by the study population were compiled at each site, followed by calculation of a median recipe per 100 g. Each recipe’s nutrient values were included in the FCDB. Final site FCDB checks were planned according to FAO/INFOODS guidelines.

Discussion : This dietary strategy provides the opportunity to assess estimated mean group usual energy and nutrient intakes and estimated prevalence of the population ‘at risk’ of inadequate intakes in first-trimester pregnant women living in four low- and middle-income countries. While challenges and limitations exist, this methodology demonstrates the practical application of a quantitative dietary strategy for a large international multi-site nutrition trial, providing within- and between-site comparisons. Moreover, it provides an excellent opportunity for local capacity building and each site FCDB can be easily modified for additional research activities conducted in other populations living in the same area.

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Published
2017-04-11
How to Cite
1.
Lander R, Hambidge KM, Krebs N, Westcott J, Garces A, Figueroa L, Tejeda G, Lokangaka A, Diba T, Somannavar M, Honnayya R, Alie S, Khan U, McClure E, Thorsten V, Stolka K, Group for the WF. Repeat 24-hour recalls and locally developed food composition databases: a feasible method to estimate dietary adequacy in a multi-site preconception maternal nutrition RCT. Food & Nutrition Research [Internet]. 11Apr.2017 [cited 17Jul.2018];61. Available from: https://foodandnutritionresearch.net/index.php/fnr/article/view/1182
Section
Original Articles