Validation of dietary applications of Household Consumption and Expenditures Surveys (HCES) against a 24-hour recall method in Uganda

Background. The benefits of food fortification depend on the proportion of the population that uses the fortified food (coverage), the amount of the food being consumed, and the additional content of micronutrients in the food. Coverage and amounts consumed can be determined by 24-hour recall or Food Frequency Questionnaires (FFQs). However, these methods are rarely applied. Secondary analysis of data from Household Consumption and Expenditures Surveys (HCES) can be used for these purposes; however, such data analysis has not been validated. Objective. To compare the results of HCES and 24-hour recall for estimating the consumption profile of potential fortification vehicles in Uganda. Methods. Food intake estimates for 24- to 59-month-old children and 15- to 49-year-old women derived from a one-day 24-hour recall carried out in Uganda (Kampala, North, and Southwest) were compared with data from two HCES (2006, nationwide, and 2008, coupled with the 24-hour recall). The analyzed foods were vegetable oil, sugar, wheat flour, maize flour, and rice. Results. Food consumptio 'n estimates calculated from HCES may be less accurate than estimates derived by 24-hour recall. Nevertheless, the HCES results are sensitive enough to differentiate consumption patterns among population strata. In Uganda, HCES predicted proportion of the population that consumes the foods, and approximated intakes of main food vehicles by the observed consumers (those who reported using the foods), although estimates for the latter were lower for wheat flour and rice. Conclusions. HCES data offer the basic information needed to provide a rationale for, and help design, food fortification programs. Individual intake surveys are still needed, however, to assess intrahousehold use of foods.