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Br J Nutr. 2018 Dec;120(11):1262-1271. doi: 10.1017/S0007114518002374. Epub 2018 Oct 23.

Comparison of an interactive 24-h recall and weighed food record for measuring energy and nutrient intakes from complementary foods among 9-10-month-old Malawian infants consuming lipid-based nutrient supplements.

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1Department of Population Health,London School of Hygiene and Tropical Medicine,London WC1E 7HT,UK.
2Intake - Centre for Dietary Assessment,FHI 360,Washington,DC 20009,USA.
3Centre for Child Health Research,School of Medicine and Life Sciences,University of Tampere,Tampere FI-33014,Finland and Tampere University Hospital,FI-33521 Tampere,Finland.
4Department of Infectious Disease Epidemiology,London School of Hygiene and Tropical Medicine,London WC1E 7HT,UK.
5Department of Public Health,School of Public Health and Family Medicine,University of Malawi,College of Medicine, Private Bag 360, Blantyre 3,Malawi.
6Department of Medical Statistics,London School of Hygiene and Tropical Medicine,London WC1E 7HT,UK.


Fortifying complementary foods with lipid-based nutrient supplements (LNS) may improve energy and nutrient intakes of infants at risk for undernutrition. We aimed to determine the relative validity of an interactive 24-h recall (i-24-HR) for assessing the impact of an LNS intervention on dietary intakes of energy and nutrients among rural Malawian 9-10-month-old infants (n 132) participating in the International Lipid-Based Nutrient Supplements Dose (iLiNS-DOSE) trial. Dietary data were collected for the same day via i-24-HR and weighed food records. Inter-method agreements were estimated overall and by intervention group, using Bland-Altman plots and paired t tests; measurement error models (differential error); and percentage of food omissions and intrusions were estimated. Overall, inter-method differences in mean intakes of energy and most nutrients were not significant. When stratified by group, recalled energy intakes were under-estimated (-368 kJ; P=0·01) in the control but not in the intervention group (-42 kJ; P=0·6). This differential reporting error was related to an over-estimation of recalled LNS (8·1 v. 4·5 g; P30 % eating occasions) omissions were milk/fish/eggs, starchy roots/vegetables and sweetened snacks. Common intrusions were milk/yogurt. Starchy staples and LNS were recalled when consumed (>85 %) (i.e. matched). These results emphasise the importance of considering differential error when interpreting dietary results in LNS trials.


LNS lipid–based nutrient supplements; LOA limits of agreement; WFR weighed food records; i-24-HR interactive 24-h recall; iLiNS-DOSE International Lipid–based Nutrient Supplements Dose; 24-h Recall; Dietary assessment; Infants; Lipid-based nutrient supplements; Weighed records

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