Measuring Food Intake 261
of dietary intake, both during and after dietary study
periods. Measurements suitable for this purpose
will be discussed further in the context of validity.
Response bias can probably best be minimized by
providing the respondents with clear and well-
presented instructions, adequate support, and
appropriate incentives. Such incentives may include
relevant dietary feedback where this is appropriate or
monetary or other rewards provided that these are
within ethical principles.
In dietary studies that involve more than one inter-
viewer, the training of interviewers and the use of
standard procedures for interviewing is one way
of reducing unnecessary random variation (error)
that might otherwise arise because different inter-
viewers conduct interviews in different ways. The use
of standard procedures, however, can also introduce
systematic error; for example, if one interviewer is
assigned to interview all respondents in areas of low
socioeconomic status and another to interview all
respondents in areas of high socioeconomic status. It
is important to recognize also that standard interview
procedures do not necessarily “standardize” respon-
dent response. To date, relatively little work has
focused on the respondent response aspect of dietary
assessment.
Since all dietary methods engage the cognitive
processes of respondents, an appreciation of the
properties of human cognition and its limitations is
fundamental to improving the accuracy of dietary
assessments. Recently, research into the cognitive
aspects of dietary assessment has been undertaken in
an attempt to increase the understanding of how
respondents process dietary intake data (Domel,
1997; Thompson et al., 2002; Vuckovic et al., 2002;
Matt et al., 2006).
Some of the important issues in this area that are
relevant to improving the quality of dietary data
include identifi cation of:
● factors that improve communication between
respondent and investigator
● the most effective cues for recall over different
periods
Inadequate
communication/
descriptions
Behavior and interactions
Messages from researcher
Attitudes to food
Socioeconomic status
Image management
Poor memory Inability to “summarize” dietary patterns
False perception of own diet
Altered food
choice
Report RECORD RECALL HISTORY FFQ
Weighing errors
Poor estimations
Identify food Subject’s choice
from questionnaire
Underreporting
Overreporting
Poor quantification:
- Questionnaire choices
- Subject’s perceptions
Quantify Weighed/ Estimated
estimated
Average portion
or small/medium/large
Frequency As reported Subject’s
estimate
Subject’s choice
from questionnaire
Food table values
differ from actual
composition
Calculate
intake
Food code
x Portion weight
x Nutrient content/g
Researcher’s choice
from food tables
Food code
x Portion weight
x Frequency
x Nutrient content/g
Figure 10.6 The process of dietary assessment showing the different sources of error (shown in italics) and the stages at which they operate
in different dietary methods. FFQ, food frequency questionnaire.