Effectiveness of the US Department of Agriculture 5-step multiple-pass method in assessing food intake in obese and nonobese women.

BACKGROUND National surveys of food intake rely on the 24-h dietary recall method for assessing the nutrient intakes of Americans. OBJECTIVES This observational validation study was conducted under controlled conditions to test the effectiveness of the US Department of Agriculture (USDA) 5-step multiple-pass method for dietary recall; to test the ability of normal weight, overweight, and obese women to recall food intake; and to test the accuracy of macronutrient recall. DESIGN Women (n = 49) aged 21-65 y with a body mass index (in kg/m(2)) of 20-45 selected all meals and snacks for 1 d from a wide variety of foods. A 24-h dietary recall with the use of the USDA 5-step multiple-pass method was administered by telephone the following day. Analysis of variance and covariance tested the overall accuracy of recall and the effect of BMI on dietary recall. RESULTS As a population, the women overestimated their energy and carbohydrate intakes by 8-10%. No significant differences between mean actual and recalled intakes of energy and the macronutrients were observed in the obese women. Normal-weight and overweight women significantly (P < 0.01) overestimated their energy, protein, and carbohydrate intakes. Recalled fat intake was not significantly different from actual intake in women across the BMI range studied. CONCLUSIONS The USDA 5-step multiple-pass method effectively assessed mean energy intake within 10% of mean actual intake on the previous day. Obese women more accurately recalled food intake than did overweight and normal-weight women despite undereating on the day of the study.