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Twenty-Four-Hour Recall Overestimates the Dietary Intake of Malnourished Children^1,2,

Department of Social Medicine ^* Department of Nutrition, Universidade Federal de Pelotas, CP 464-96100 Pelotas, RS, Brazil

Food intake and morbidity are the two main proximal determinants of childhood malnutrition. Intake is usually assessed through the 24-h recall method. Few studies, however, have evaluated the accuracy of this method; in particular, it is not known whether accuracy varies according to the child's nutritional status. The intake of 50 children (<2 y old), of whom 25 were underweight (weight-for-age more than 2 SD below the National Center for Health Statistics reference), as evaluated through weighing of all foods (gold standard) and through recall. The overall intakes of energy, fat and protein were significantly greater according to the recall method than by weighing. The trend towards overestimation was more marked for malnourished children than for well-nourished children. The possibility of such bias should be taken into account in future studies.

KEY WORDS: • dietary intake • infant feeding • protein energy malnutrition • 24-h recall • humans

¹ Study financed by the Fundaço de Amparo à Pesquisa do Rio Grande do Sul, the Programme for the Control of Diarrhoeal Diseases of the World Health Organization, and the International Development Research Centre (Canada).

² The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

³ To whom correspondence should be addressed.

Manuscript received 28 October 1993. Revision accepted 17 August 1994.

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