Performance and Feasibility of Recalls Completed Using the Automated Self-Administered 24-Hour Dietary Assessment Tool in Relation to Other Self-Report Tools and Biomarkers in the Interactive Diet and Activity Tracking in AARP (IDATA) Study

Abstract

Background: Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) is a self-administered web-based tool designed to collect detailed dietary data at low cost in observational studies.

Objective: The objectives of this study were to describe, overall and by demographic groups, the performance and feasibility of ASA24-2011 recalls and compare Healthy Eating Index-2015 (HEI-2015) total and component scores to 4-day food records (4DFRs) and food frequency questionnaires (FFQs).

Design: Over 12 months, participants completed up to 6 ASA24 recalls, 2 web-based FFQs, and 2 unweighed paper-and-pencil 4DFRs. Up to 3 attempts were made to obtain each ASA24 recall. Participants were administered doubly-labeled water to provide a measure of total energy expenditure and collected two 24-hour urine samples to assess concentrations of nitrogen, sodium, and potassium.

Participants/setting: From January through September 2012, 1,110 adult members of AARP, 50 to 74 years of age, were recruited from the Pittsburgh, PA, area to participate in the Interactive Diet and Activity Tracking in AARP (IDATA) study. After excluding 33 participants who had not completed any dietary assessments, 531 men and 546 women remained.

Main outcome measures: Response rates, nutrient intakes compared to recovery biomarkers across each ASA24 administration day, and HEI-2015 total and component scores were measured.

Statistical analyses performed: Means, medians, standard deviations, interquartile ranges, and HEI-2015 total and component scores computed using a multivariate measurement error model are presented.

Results: Ninety-one percent of men and 86% of women completed 3 ASA24 recalls. Approximately three-quarters completed 5 or more, higher than the completion rates for 2 4DFRs and 2 FFQs. Approximately, three-quarters of men and 70% of women completed ASA24 on the first attempt; 1 in 5 completed it on the second. Completion rates varied slightly by age and body mass index. Median time to complete ASA24-2011 (current version: ASA24-2020) declined with subsequent recalls from 55 to 41 minutes in men and from 58 to 42 minutes in women and was lowest in those younger than 60 years. Mean nutrient intakes were similar across recalls. For each recording day, energy intakes estimated by ASA24 were lower than energy expenditure. Reported intakes for protein, potassium, and sodium were closer to recovery biomarkers for women, but not for men. Geometric means of reported intakes of these nutrients did not systematically vary across ASA24 administrations, but differences between reported intakes and biomarkers differed by nutrient. Of 100 possible points, HEI-2015 total scores were nearly identical for 4DFRs and ASA24 recalls and higher for FFQs (men: 61, 60, and 68; women: 64, 64, and 72, respectively).

Conclusions: ASA24, a freely available dietary assessment tool for use in large-scale nutrition research, was found to be highly feasible. Similar to previously reported data for nutrient intakes, HEI-2015 total and component scores for ASA24 recalls were comparable to those for 4DFRs, but not FFQs.

Trial registration: ClinicalTrials.gov identifier: NCT03268577 (http://www.clinicaltrials.gov).

Keywords: 4-day food record; ASA24; Feasibility; Food frequency questionnaire.

Figure 1:

Timeline of dietary assessments and biomarker measurements in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 - October 2013 ^a FFQ = food frequency questionnaire ^b FC = food checklist ^c ASA24 = Automated Self-administered 24-hour Dietary Assessment Tool (2011 version) ^d 4DFR = 4-day food record ^e Urine = 24-hr urine ^f DLW = doubly labeled water ^g DLW-s = doubly labeled water repeated in a subset of participants

Figure 2.

Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) administration in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 - October 2013

Figure 3.

Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) completion pattern per attempt^a by sex, age, and body mass index (BMI) group in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 - October 2013 ^a Total number of ASA24 recalls competed: 2,740 in men and 2,626 in women ^b Normal (BMI 18.5-24.9); overweight (BMI 25-29.9); obese (BMI≥30)

Figure 3.

Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) completion pattern per attempt^a by sex, age, and body mass index (BMI) group in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 - October 2013 ^a Total number of ASA24 recalls competed: 2,740 in men and 2,626 in women ^b Normal (BMI 18.5-24.9); overweight (BMI 25-29.9); obese (BMI≥30)

Figure 4.

Median time (interquartile range)^a to complete the Automated self-administered 24-hour Dietary Assessment Tool (ASA24) by sex, attempt, and age group in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 –October 2013 ^aBased on 2,602 ASA24 recalls completed in men and 2,484 ASA24 recalls competed in women.

Figure 4.

Median time (interquartile range)^a to complete the Automated self-administered 24-hour Dietary Assessment Tool (ASA24) by sex, attempt, and age group in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US, March 2012 –October 2013 ^aBased on 2,602 ASA24 recalls completed in men and 2,484 ASA24 recalls competed in women.

Figure 5.

Geometric mean energy, protein, potasium, and sodium intake based on the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) administration compared to recovery biomarkers^a in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US in March 2012 –October 2013 ^aRecovery biomarkers: doubly labeled water for total energy (n=347 men and 356 women); urinary protein, sodium and potassium from 24-hour urine collections (protein calculated from nitrogen values, n=431 men and 439 women)

Figure 5.

Geometric mean energy, protein, potasium, and sodium intake based on the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) administration compared to recovery biomarkers^a in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US in March 2012 –October 2013 ^aRecovery biomarkers: doubly labeled water for total energy (n=347 men and 356 women); urinary protein, sodium and potassium from 24-hour urine collections (protein calculated from nitrogen values, n=431 men and 439 women)

Figure 5.

Geometric mean energy, protein, potasium, and sodium intake based on the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) administration compared to recovery biomarkers^a in the Interactive Diet and Activity Tracking in AARP (IDATA) Study conducted in the US in March 2012 –October 2013 ^aRecovery biomarkers: doubly labeled water for total energy (n=347 men and 356 women); urinary protein, sodium and potassium from 24-hour urine collections (protein calculated from nitrogen values, n=431 men and 439 women)