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Nutrition-related health problems such as obesity are frequent among children and adolescents of Turkish descent living in Germany, yet data on their dietary habits are scarce. One reason might be the lack of validated assessment tools for this target group. We therefore aimed to validate protein and K intakes from one 24 h recall against levels estimated from one 24 h urine sample in children and adolescents of Turkish descent living in Germany.
Cross-sectional analyses comprised estimation of mean differences, Pearson correlation coefficients, cross-classifications and Bland–Altman plots to assess the agreement between the nutritional intake estimated from a single 24 h recall and a single 24 h urine sample collected on the previous day.
Data from forty-three study participants (aged 5–18 years; 26 % overweight) with a traditional Turkish background were included.
The 24 h recall significantly overestimated mean protein and K intake by 10·7 g/d (95 % CI of mean difference: 0·6, 20·7 g/d) and 344 mg/d (95 % CI 8, 680 mg/d), respectively. Correlations between intake estimates were r = 0·25 (P = 0·1) and 0·31 (P = 0·05). Both methods classified 70 % and 69 % of the participants into the same/adjacent quartile of protein and K intake and misclassified 7 % and 7 %, respectively, into the opposite quartile. Bland–Altman plots indicated a wide scattering of differences in both protein and K intake.
Among children and adolescents of traditional Turkish descent living in Germany, one 24 h recall may only be valid for categorizing subjects into high, medium or low consumers.
To date, only a few nutritional assessment methods have been validated against the biomarker of urinary-N excretion for use in children and adolescents. The aim of the present study was to validate protein intake from one day of a weighed dietary record against protein intake estimated from a simultaneously collected 24 h urine sample.
Cross-sectional analyses including 439 participants of the Dortmund Nutritional and Longitudinally Designed (DONALD) Study from four age groups (3–4, 7–8, 11–13 and 18–23 years). Mean differences, Pearson correlation coefficients (r), cross-classifications and Bland–Altman plots were used to assess agreement between methods.
Weighed dietary records significantly underestimated mean protein intake by −6·4 (95 % CI −8·2, −4·7) g/d or –11 %, with the difference increasing across the age groups from −0·6 (95 % CI −2·7, 1·5) g/d at age 3–4 years to –13·5 (95 % CI –18·7, –8·3) g/d at age 18–23 years. Correlation coefficients were r = 0·7 for the total study sample and ranged from r = 0·5 to 0·6 in the different age groups. Both methods classified 85 % into the same/adjacent quartile for the whole study group (83–86 % for the different age groups) and 2·5 % into the opposite quartile (1·9–3·1 % for the different age groups). Bland–Altman plots for the total sample indicated that differences in protein intake increased across the range of protein intake, while this bias was not obvious within the age groups.
Protein intake in children and adolescents can be estimated with acceptable validity by weighed dietary records. In this age-heterogeneous sample, validity was lower among adolescents and young adults.
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