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Nutritional Epidemiology

The USDA Automated Multiple-Pass Method Accurately Estimates Group Total Energy and Nutrient Intake^1,2

³ USDA, Agricultural Research Service, Western Human Nutrition Research Center, University of California, Davis, CA 95616; ⁴ USDA, Agricultural Research Service, Food Surveys Research Group, Beltsville, MD 20705-2350; ⁵ USDA, Agricultural Research Service, Diet and Human Performance Laboratory, Beltsville, MD 20705-2350; ⁶ USDA, Agricultural Research Service, National Program Staff, Beltsville, MD 20705-5138

^* To whom correspondence should be addressed. E-mail: molly.kretsch{at}ars.usda.gov.

The imperative to address the national obesity epidemic has stimulated efforts to develop accurate dietary assessment methods suitable for large-scale applications. This study evaluated the performance of the USDA Automated Multiple-Pass Method (AMPM), the computerized dietary recall designed for the National Health and Nutrition Examination Survey dietary survey, and 2 epidemiological methods [the Block food-frequency questionnaire (Block) and National Cancer Institute's Diet History Questionnaire (DHQ)] using doubly labeled water (DLW) total energy expenditure (TEE) and 14-d estimated food record (FR) absolute nutrient intake as criterion measures. Twenty highly motivated, normal-weight-stable, premenopausal women participated in a free-living study that included 2 unannounced AMPM recalls and completion of the Block and DHQ. AMPM and FR total energy intake (TEI) did not differ significantly from DLW TEE [AMPM: 8982 ± 2625 kJ; FR: 8416 ± 2217; DLW: 8905 ± 1881 (mean ± SD)]. Conversely, the questionnaires underestimated TEI by 28% (Block: 6365 ± 2193; DHQ: 6215 ± 1976; P < 0.0001 vs. DLW). Pearson correlation coefficients for DLW TEE with each dietary method TEI showed a stronger linear relation for AMPM (r = 0.53; P = 0.02) and FR (r = 0.41; P = 0.07) than for the Block (r = 0.25; P = 0.29) and DHQ (r = 0.15; P = 0.53). Most mean absolute FR nutrient intakes were closely approximated by the AMPM but were significantly underestimated by the questionnaires. In highly motivated premenopausal women, the AMPM provides valid measures of group total energy and nutrient intake whereas the Block and DHQ yield underestimations.

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