The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal

Background: Recall bias or memory error is a known limitation of recall-based dietary assessment methods and can lead to substantial misrepresentation of diets. Pictorial recall aids have been used by various studies to mitigate recall bias, but their effect on quantitative, 4-pass 24-h dietary reca...

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Main Authors: Anna Vanderkooy, Elaine L Ferguson, Nisha Sharma, Ndèye Yaga Sy, Rosenette Kane, Alissa M Pries
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Current Developments in Nutrition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475299124023862
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author Anna Vanderkooy
Elaine L Ferguson
Nisha Sharma
Ndèye Yaga Sy
Rosenette Kane
Alissa M Pries
author_facet Anna Vanderkooy
Elaine L Ferguson
Nisha Sharma
Ndèye Yaga Sy
Rosenette Kane
Alissa M Pries
author_sort Anna Vanderkooy
collection DOAJ
description Background: Recall bias or memory error is a known limitation of recall-based dietary assessment methods and can lead to substantial misrepresentation of diets. Pictorial recall aids have been used by various studies to mitigate recall bias, but their effect on quantitative, 4-pass 24-h dietary recall (24HR) results has not yet been measured. Objectives: This article examines uptake of pictorial recall aids among caregivers of young children in Kathmandu Valley, Nepal, and Guédiawaye Department, Senegal; describes what foods/beverages are subject to recall bias in these contexts; and assesses the effect of these recall aids on estimated dietary outcomes. Methods: We used cross-sectional data from 24HR surveys that provided a recall aid to reduce caregiver recall bias. Young children’s dietary outcomes were calculated from the 24HR data. Logistic regressions were used to compare characteristics and estimated dietary outcomes of children by recall aid uptake. McNemar’s test and paired t-tests were used to compare estimated dietary outcomes in initial 24HR data with revised 24HR data that incorporated omitted items identified by the recall aid. Results: Pictorial recall aids had relatively high uptake by caregivers in both contexts. Beverages, unhealthy snacks, and fruit were most subject to recall bias. Adding omitted items identified by recall aids resulted in statistically significant changes in most dietary outcomes assessed. Children of caregivers who chose to use the recall aid had significantly different estimated dietary outcomes than children of caregivers who did not use the recall aid. Conclusions: The use of pictorial recall aids modifies 24HR results in these 2 contexts. Rigorous research is needed to fully understand the impact of recall aids on 24HR methodology and results, with an aim to improve the accuracy of dietary assessment and ultimately inform evidence-based nutrition programming, policy, and recommendations.
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spelling doaj-art-caff458a08dd4582ba35f3de69b156cc2025-08-20T02:30:13ZengElsevierCurrent Developments in Nutrition2475-29912025-02-01910445210.1016/j.cdnut.2024.104452The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and SenegalAnna Vanderkooy0Elaine L Ferguson1Nisha Sharma2Ndèye Yaga Sy3Rosenette Kane4Alissa M Pries5Helen Keller International, Dakar, Senegal; Corresponding author.Department of Population Health, London School of Hygiene and Tropical Medicine, London, United KingdomHelen Keller International, Kathmandu, NepalHelen Keller International, Dakar, SenegalHelen Keller International, Dakar, SenegalHelen Keller International, NY, United StatesBackground: Recall bias or memory error is a known limitation of recall-based dietary assessment methods and can lead to substantial misrepresentation of diets. Pictorial recall aids have been used by various studies to mitigate recall bias, but their effect on quantitative, 4-pass 24-h dietary recall (24HR) results has not yet been measured. Objectives: This article examines uptake of pictorial recall aids among caregivers of young children in Kathmandu Valley, Nepal, and Guédiawaye Department, Senegal; describes what foods/beverages are subject to recall bias in these contexts; and assesses the effect of these recall aids on estimated dietary outcomes. Methods: We used cross-sectional data from 24HR surveys that provided a recall aid to reduce caregiver recall bias. Young children’s dietary outcomes were calculated from the 24HR data. Logistic regressions were used to compare characteristics and estimated dietary outcomes of children by recall aid uptake. McNemar’s test and paired t-tests were used to compare estimated dietary outcomes in initial 24HR data with revised 24HR data that incorporated omitted items identified by the recall aid. Results: Pictorial recall aids had relatively high uptake by caregivers in both contexts. Beverages, unhealthy snacks, and fruit were most subject to recall bias. Adding omitted items identified by recall aids resulted in statistically significant changes in most dietary outcomes assessed. Children of caregivers who chose to use the recall aid had significantly different estimated dietary outcomes than children of caregivers who did not use the recall aid. Conclusions: The use of pictorial recall aids modifies 24HR results in these 2 contexts. Rigorous research is needed to fully understand the impact of recall aids on 24HR methodology and results, with an aim to improve the accuracy of dietary assessment and ultimately inform evidence-based nutrition programming, policy, and recommendations.http://www.sciencedirect.com/science/article/pii/S2475299124023862recall aidmemory aidrecall biasmemory errordietary assessment24-h recall
spellingShingle Anna Vanderkooy
Elaine L Ferguson
Nisha Sharma
Ndèye Yaga Sy
Rosenette Kane
Alissa M Pries
The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
Current Developments in Nutrition
recall aid
memory aid
recall bias
memory error
dietary assessment
24-h recall
title The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
title_full The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
title_fullStr The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
title_full_unstemmed The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
title_short The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal
title_sort use of pictorial recall aids modifies dietary assessment results experiences from quantitative 24 hour dietary recalls of young children in nepal and senegal
topic recall aid
memory aid
recall bias
memory error
dietary assessment
24-h recall
url http://www.sciencedirect.com/science/article/pii/S2475299124023862
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