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A methodological report from the Malmö Diet and Cancer study: development and evaluation of altered routines in dietary data processing

Elisabet Wirfält1*, Irene Mattisson1, Ulla Johansson1, Bo Gullberg2, Peter Wallström1 and Göran Berglund1

Author Affiliations

1 Department of medicine, surgery and orthopaedics, Lund University, University hospital in Malmö, SE-205 02 Malmö, Sweden

2 Department of community medicine, Lund University, University hospital in Malmö, SE-205 02 Malmö, Sweden

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Nutrition Journal 2002, 1:3  doi:10.1186/1475-2891-1-3

Published: 19 November 2002

Abstract

Background

In the Malmö Diet and Cancer study, information on dietary habits was obtained through a modified diet history method, combining a 7-day menu book for cooked meals and a diet questionnaire for foods with low day-to-day variation. Half way through the baseline data collection, a change of interview routines was implemented in order to reduce interview time.

Methods

Changes concentrated on portion-size estimation and recipe coding of mixed dishes reported in the menu book. All method development and tests were carefully monitored, based on experiential knowledge, and supplemented with empirical data. A post hoc evaluation study using "real world" data compared observed means of selected dietary variables before and after the alteration of routines handling dietary data, controlling for potential confounders.

Results

These tests suggested that simplified coding rules and standard portion-sizes could be used on a limited number of foods, without distortions of the group mean nutrient intakes, or the participants' ranking. The post hoc evaluation suggested that mean intakes of energy-adjusted fat were higher after the change in routines. The impact appeared greater in women than in men.

Conclusions

Future descriptive studies should consider selecting subsets assessed with either method version to avoid distortion of observed mean intakes. The impact in analytical studies may be small, because method version and diet assistant explained less than 1 percent of total variation. The distribution of cases and non-cases across method versions should be monitored.