Accuracy of dietary recall using the USDA five-step multiple-pass method in men: An observational validation study

Objective This observational validation study was conducted under controlled conditions to test the accuracy of dietary recall in normal weight, overweight, and obese men using the USDA five-step multiple-pass method for dietary recall. Design Cross-sectional analysis of actual and recalled intake of food during 1 day. Subjects/setting Forty-two men ranging in age from 21 to 65 years and in body mass index from 21 to 39 kg/m(2) who lived in the metropolitan Washington DC area were studied. Intervention The subjects selected and consumed all meals and snacks, for 1 day, from a wide variety of foods provided at a human study facility. Main outcome measures Actual and recalled energy, protein, carbohydrate, and fat intakes were determined by direct observation and by a 24-hour dietary recall, respectively. Dietary recall was determined via telephone administration of the USDA five-step multiple-pass method the following day. Statistical analyses performed Analysis of variance and covariance tested the overall accuracy of recall and the effect of body mass index on dietary recall. Bland-Altman plots were used to assess bias in recall of food intake. Results In this population of men, there were no significant differences between actual and recalled intakes of energy (3,294 +/- 111 and 3,541 +/- 124 kcal/day), protein (117 +/- 5 and 126 +/- 5 g/day), carbohydrate (414 +/- 16 and 449 +/- 16 g/day), or fat (136 +/- 7 and 146 +/- 8 g/day), respectively. Accuracy of recall was not related to body mass index in that the obese men recalled food intake as accurately as the nonobese men. The energy intake of these men was significantly correlated (r=0.57, P<.05) with their estimated energy requirements. Significant interindividual variation in accuracy of recall was found. Conclusions Under controlled conditions, the USDA five-step multiple-pass method can accurately assess intakes of energy, protein, carbohydrate, and fat in a population of men regardless of their body mass index. Researchers and clinical dietitians need to continue to examine factors that influence underreporting and overreporting of food intake by the multiple-pass 24-hour recall method.