School-Age Children Can Recall Some Foods and Beverages Consumed the Prior Day Using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) without Assistance.

BACKGROUND: Technological innovations allow for collection of 24-h recalls (24HRs) in a broader range of studies than previously possible. The web-based Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) has been shown to be feasible and to perform well in capturing true intake among adults. However, data to inform use with children are limited. OBJECTIVE: This observational feeding study was conducted to evaluate children's ability to accurately report a lunchtime meal using ASA24 without assistance. METHODS: The study was conducted among children (n = 100) aged 10-13 y within a school setting. Students were served an individual cheese pizza, baby carrots, ranch dip, yogurt, a cookie, and 1 choice of water, juice, or milk. Plate waste was collected and weighed. The next day, participants completed ASA24 and a sociodemographic questionnaire. Descriptive statistics were generated to determine match rates by food item and age, and linear regression analyses were conducted to examine associations between sociodemographic characteristics and accuracy of reported energy and nutrient intake. Associations between true and reported energy and nutrient intakes and portion sizes were assessed with use of t tests. RESULTS: Just under half (49%) of children fully completed ASA24 (median time, 41 min). Children reported an exact, close, or far match for 58% of all foods and beverages consumed, ranging from 29% for dip to 76% for pizza, but also reported some items not consumed as part of the study meal. Older children completed the recall in a shorter time than younger children (mean 31 among 13 y compared with 52 min among 10 y). Intakes of energy (39%), protein (33%), and sodium (78%) were significantly overestimated, whereas portion sizes for cookies (53%) and juice (69%) were underestimated. CONCLUSIONS: Children can report some foods and drinks consumed using ASA24, but our findings suggest challenges with independent completion, necessitating research to examine strategies, such as training and resources, to support data quality.

Lessons from Studies to Evaluate an Online 24-Hour Recall for Use with Children and Adults in Canada.

With technological innovation, comprehensive dietary intake data can be collected in a wide range of studies and settings. The Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool is a web-based system that guides respondents through 24-h recalls. The purpose of this paper is to describe lessons learned from five studies that assessed the feasibility and validity of ASA24 for capturing recall data among several population subgroups in Canada. These studies were conducted within a childcare setting (preschool children with reporting by parents), in public schools (children in grades 5-8; aged 10-13 years), and with community-based samples drawn from existing cohorts of adults and older adults. Themes emerged across studies regarding receptivity to completing ASA24, user experiences with the interface, and practical considerations for different populations. Overall, we found high acceptance of ASA24 among these diverse samples. However, the ASA24 interface was not intuitive for some participants, particularly young children and older adults. As well, technological challenges were encountered. These observations underscore the importance of piloting protocols using online tools, as well as consideration of the potential need for tailored resources to support study participants. Lessons gleaned can inform the effective use of technology-enabled dietary assessment tools in research.

Front-of-package references to fiber on foods in Canadian supermarkets highlight the need for increased nutrition knowledge among consumers.

OBJECTIVE: To assess the nature of the guidance on fiber, a nutrient for which many Canadians' intakes are suboptimal, provided by manufacturers' use of front-of-package references on food in Canadian supermarkets. DESIGN/SETTING: Survey of all prepackaged food sold in 3 large supermarkets in Toronto. VARIABLES MEASURED: Front-of-package references to fiber and other forms of nutrition-related marketing were recorded from all products. For a subsample of breads, Nutrition Facts table information was also collected. ANALYSIS: Descriptive statistics; t test. RESULTS: Front-of-package references to fiber were found on 6% of all foods, but large proportions of high fiber foods bore no front-of-package references to fiber. Many foods making a reference to fiber (17%) are "foods to limit," according to Canada's Food Guide. Front-of-package references to fiber were declared in at least 30 different ways, and 31% used unregulated language. Among breads, use of regulated language was associated with higher fiber content. CONCLUSIONS AND IMPLICATIONS: Consumers may be faced with challenges in seeking out healthful sources of fiber in the grocery store, given the complexity of existing front-of-package nutrition-related marketing and limited references to fiber in some categories. This work suggests that current nutrition-related marketing cannot function as a substitute for nutrition education.

Health Canada's proposed discretionary fortification policy is misaligned with the nutritional needs of Canadians.

Health Canada has proposed new fortification policies that will allow manufacturers to add vitamins and minerals to a wide variety of foods at their discretion and increase nutrient additions to breakfast cereals. Our objective was to examine the potential impact of these policies on nutrient inadequacies and excesses in the Canadian population. Using dietary intake data from the Canadian Community Health Survey, Cycle 2.2 (2004), usual intake distributions from food were estimated for vitamins A and C, folate, niacin, calcium, and magnesium for all age/sex groups. The prevalence of individuals with inadequate nutrient intake and the proportion of individuals with intakes above the tolerable upper intake level (UL) were assessed where possible, assuming full implementation of the proposed policies. To approximate a "mature market" scenario, consumption patterns of fortified foods in the United States were estimated and applied to Canadian intake data. Full implementation resulted in marked reductions in inadequate intakes of vitamin A, vitamin C, magnesium, and folate, and improvements in calcium intakes for some age/sex groups. However, it caused intakes of folate, niacin, vitamin A, and calcium to rise above the UL, particularly among younger age groups. Although increased food fortification may reduce the apparent prevalence of inadequate intakes for some nutrients, there is no evidence of inadequacies for niacin or several other nutrients slated for addition. Our modeling suggests that Health Canada's proposed policies are misaligned with the nutritional needs of the population, because they are not rooted in an assessment of current nutrient intake patterns.