Comparison of 24-h Diet Records, 24-h Urine, and Duplicate Diets for Estimating Dietary Intakes of Potassium, Sodium, and Iodine in Children

Accurately estimating nutrient intake can be challenging, yet it is important for informing policy. This cross-sectional validation study compared the use of three methods for estimating the intake of sodium, potassium, and iodine in children aged 9-11 years in New Zealand. Over the same 24 hour period, participants collected duplicate diets (n = 37), weighed food records (n = 84), and 24 hour urine samples (n = 82). Important differences were found between dietary estimates of sodium, potassium, and iodine using the three methods of dietary assessment, suggesting that different methods of assessment have specific limitations for the measurement of these nutrients in children. Bland Altman plots show relatively wide limits of agreement for all measures and nutrients. These results support the World Health Organization's (WHOs) recommendations to use urinary assessment to measure population sodium and iodine intake, while dietary assessment appears to be more accurate for estimating potassium intake. Compared to reference values, our results suggest that the children in this study consume inadequate iodine, inadequate potassium, and excess dietary sodium. Public health measures to reduce sodium intake, increase intake of fruit and vegetables, and iodine-rich foods are warranted in New Zealand.