Validation of Visual Estimation of Portion Size Consumed As a Method for Estimating Food Intake by Young Indian Children (Short Report) (Report‪)‬

INTRODUCTION Methods currently used for assessing the dietary practices of children are maternal 24-hour recall, food diaries, dietary histories, food-frequency recalls, semi-quantitative food-frequency recalls, and the techniques of estimating portion sizes of food intakes by weighing, visual estimation, or by applying standard portion sizes (1). All these methods have significant shortcomings (2,3). Multiple studies have shown that parental recall of child's food intake excludes a large part of non-mealtime intake (4). The direct observation of food intake among young children is often considered only an appropriate method in natural or cafeteria settings (6-8), overcomes the potential limitations of maternal recall and influence of literacy levels of respondents, and is less likely to alter feeding behaviour of young children (9). The commonly-used and accepted method of pre- and post-weighing of foods during observation is cumbersome and, in many cultures, unacceptable; in addition, it may actually modify the intake by drawing attention of caretaker (10). Direct observation using visual estimation is a non-intrusive method of estimating dietary intake and may provide a better alternative (11-14). In direct observation, trained personnel observe food-consumption behaviour and visually estimate food intake, and the accuracy of estimation varies by type and quantity of food (6). Observation can be labour-intensive; it is, therefore, usually done either for only one meal or for one day's meal (14,15). The validity of direct observation using visual estimates for measuring food intake has been evaluated in few studies in developed-country settings (7,8,16). Data on validation of these techniques in developing-country field-settings are lacking. In a study, where food intake from a test meal was estimated by pre- and post-weighing of all foods the child consumed, we evaluated the direct visual estimation of portion size consumed as a method for estimating food intake.