Validation of a pre-coded food record for infants and young children

Background/Objectives: To assess the validity of a 7-day pre-coded food record (PFR) method in 9-month-old infants against metabolizable energy intake (ME(DLW)) measured by doubly labeled water (DLW); additionally to compare PFR with a 7-day weighed food record (WFR) in 9-month-old infants and 36-month-old children. Subjects/Methods: The study population consisted of 36 infants (age: 9.03 +/- 0.2 months) and 36 young children (age: 36.1 +/- 0.3 months) enrolled in a cross-over design of 7 consecutive days PFR vs 7 consecutive days WFR. Children were randomly assigned to one method during week 1, crossing over to the alternative method in week 2. Total energy expenditure (TEE) and ME(DLW) were obtained in the 9-month-old infants using the DLW technique for 7 days while recording with PFR. Results: For the 9-month-old group, PFR showed a mean bias of + 726 kJ/day, equivalent to 24%, (P<0.0001) compared with ME(DLW) (n = 29). Using WFR as the reference in this group no between-method differences were found for energy, fat and carbohydrate. Energy intake in the 36-month-old children was 12% higher in the PFR vs WFR (P<0.0001), and protein plus total fat intake were overestimated with the PFR (P = 0.008, P<0.0001, respectively). Conclusions: The study indicates that the PFR may be a valuable tool for measuring energy, energy-yielding nutrients and foods in groups of 9-month-olds infants and 36-month-olds young children. European Journal of Clinical Nutrition (2012) 66, 91-96; doi:10.1038/ejcn.2011.133; published online 10 August 2011